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Realist evaluation of violence prevention education in health care

In brief

  • Health care workers are at risk for physical and verbal violence from those they provide care for, with higher rates of violence-related injuries compared to workers in other occupations.
  • In BC, a provincial educational program (Provincial Violence Prevention Curriculum) has been rolled out to staff within most high and medium risk health care settings.
  • Evaluating the success of the program using traditional methods and measures has been difficult due to the variety and complex nature of the different places where individuals work, and the fact that in many places most violence is not reported.
  • This project uses a realist evaluation approach to focus on practical explanations of how, why, for whom, and in what circumstances the violence prevention education is effective in preventing violence and related injuries.

Frequently asked questions

Who is doing and funding the research?

The evaluation is being conducted by researchers at the Partnership for Work, Health & Safety at the University of BC and is funded by WorkSafeBC.

Why is it being done?

Everyone involved in providing health care in BC is concerned about violence against health care workers and wants to take action to prevent the violence and protect the safety of staff. Understanding how the education is or is not effective, for whom, and in what circumstances, helps leaders to make wise decisions about programs and policies to address the violence.

Where is it being done?

The evaluation of violence prevention education is focused on violence from patients in emergency departments and will be conducted at one rural, one community and one urban tertiary site in each of three health authorities:

  • Fraser Health: Fraser Canyon Hospital, Langley Memorial Hospital, and Surrey Memorial Hospital
  • Vancouver Coastal Health: Squamish General Hospital or Sechelt Hospital, Lion’s Gate Hospital and Vancouver General Hospital
  • Island Health: Research sites are currently being determined

Who can participate and what is involved?

Individual confidential interviews of about 1 hour will be held with frontline emergency staff who: have worked in the emergency department for at least one year, attended the BC violence prevention education within the past five years, and interact with patients related to care. Focus groups of about 1 hour will be held with violence prevention educators, acute care leaders, and Joint Occupational Health and Safety (JOSH) Committee members. Individuals in both interviews and focus groups will be asked to provide feedback on ideas and explanations about how and why the education is or is not effective in preventing violence and injuries.

How are people invited to participate?

Posters will be placed in emergency departments at the research sites and individuals wishing to participate in an interview will voluntarily contact the research team at the number/email given. Potential focus group participants will receive an email and they can voluntarily contact the research team if they wish to participate.

What are the benefits for participants?

Participation is an opportunity for concerned health care workers to contribute to solutions to prevent violence from patients. To preserve confidentiality of who participates, interviews will be held outside of scheduled work hours. At the end of the interview individuals will receive a $75 gift card in appreciation. Where possible focus groups will be held within existing meetings during work time and at the end of the session participants will receive a $20 gift card in appreciation.

When is it happening?

Interviews and focus groups will be held between January and July 2019.

What is the Realist approach?

A realist approach to understanding how education is effective is based on the belief that as humans we have both a shared understanding of our experiences in the world and an individual interpretation of those experiences. Not all programs work for all people in all situations and the realist approach to evaluation looks for patterns of where education is and is not effective, in what circumstances, how and why. This information helps in the developing and revising programs and policies. A realist approach to evaluation was developed and is widely used in the United Kingdom. For more information please visit www.ramesesproject.org.


Learn more about our other work on violence prevention in health care: Violence prevention programs in health care

Contact: sharon.provost@ubc.ca

a place of mind, The University of British Columbia

School of Population and Public Health
2206 East Mall,
Vancouver, BC, V6T 1Z3, Canada
Tel: 604-822-2772
Partnership for Work, Health and Safety
2206 East Mall,
Vancouver, BC, V6T 1Z3, Canada
Tel: 604-822-8544

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