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How research informs care in sexual assault and domestic violence

May 15, 2017

By Lindsay Jolivet

Sheila Macdonald
Sheila Macdonald, the clinical manager of the Women’s College Hospital Sexual Assault and Domestic Violence Care Centre

Evidence is key for the work of Sheila Macdonald, the clinical manager of the Women’s College Hospital Sexual Assault and Domestic Violence Care Centre (SA/DVCC) and the provincial coordinator of the Ontario Network of Sexual Assault/Domestic Violence Care and Treatment Centres (SADVTC).

In this interview, Sheila shared how a partnership with Women’s College Research Institute (WCRI) has informed the care offered at centres across Ontario.

How does research inform the work you do across Ontario and at the Women’s College Hospital (WCH) Sexual Assault and Domestic Violence Care Centre (SA/DVCC)?

In my role as provincial coordinator, I collaborate with the 35 hospital-based sexual assault treatment centres across the province. We partnered with the WCRI many years ago because we wanted to make sure that the work we were doing was evidence-based.

Dr. Janice Du Mont, a senior scientist at Women’s College Research Institute has provided the leadership in our research initiatives, which has ensured data quality and integrity. In 2003, we carried out a HIV Post-exposure Prophylaxis (PEP) project because patients had started to ask about access to HIV PEP medications after an assault. A research team led by Dr. Mona Loutfy, an HIV expert here at WCH, and Dr. Du Mont, developed, implemented and evaluated an HIV PEP program of care in collaboration with 24 SADVTC programs in Ontario. That resulted in the development of a program of care for HIV PEP with funding from the Ontario Ministry of Health and Long-Term Care for the medication.

As a Network, we also worked with Dr. Du Mont to carry out a client evaluation study from 2009 to 2011 to evaluate our services and identify any gaps in our care. Although the clients that do see us express a high degree of satisfaction with services, we wanted to identify any improvements that could be made to services.

Currently, the Network and Dr. Du Mont have several initiatives underway to strengthen the training/education for SADVTC clinicians across the province. One initiative is the first step toward enhancing training for service provision for victims/survivors who identify as transgender. We have an Advisory Committee of experts that is providing leadership and guidance on this project. A second initiative is a collaborative project led by the Ontario Federation of Indigenous Friendship Centres to strengthen service delivery for Indigenous persons.

On a population level, why is it important for us to be studying sexual assault and domestic violence?

Violence against women occurs at alarming rates with significant negative impacts on the victims/survivors, their families and the community. We need a better understanding of the impact of violence, and the supports needed to aid in recovery. We also need to work on prevention strategies to reduce violence from happening in the first place. Finally, we need to identify the strengths and weaknesses of the current system in place that respond to issues of violence including criminal justice system processes, and work collaboratively to improve these systems.

What research are you collaborating on now that could help address these issues?

The ongoing development of evidence-based training for health professionals is really important. Robin Mason, PhD, a scientist at WCRI, and Dr. Du Mont and myself have collaborated on educational initiatives to strengthen clinical expertise by developing curricula at DVEducation.ca. One of the curricula we are working on right now is focused on service provider understanding of the less well-understood responses to sexual assault; for example, why a victim/survivor would contact the perpetrator subsequent to a sexual assault.  In addition to gaining an understanding of such issues, the curriculum will aid service providers in providing appropriate responses to women who have been sexually assaulted.

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