Author s response to reviews Title: Developing a response to family violence in primary health care: The New Zealand experience Authors: Claire Gear (gearjc@gmail.com) Jane Koziol-McLain (jkoziolm@aut.ac.nz) Denise Wilson (dlwilson@aut.ac.nz) Faye Clark (faye@aztec.co.nz) Version: 2 Date: 14 Jul 2016 Author s response to reviews: BMC Family Practice Editorial Board 15 July 2016 Dear Editors, Thank you for the opportunity to provide a response to the comments resulting from the peer review process for the paper Developing a response to family violence in primary health care: The New Zealand experience (FAMP-D-16-00161R1). Please find below our point-by-point response. Regards, Claire Gear
Corresponding Author Centre for Interdisciplinary Trauma Research Auckland University of Technology, Auckland, New Zealand cgear@aut.ac.nz Reviewer 1: Muhammad Alotaibi ABSTRACT 1. The significance of the study needs to be made clearer. Authors Response: We have edited the Background section to make the significance clearer (p.2). BACKGROUND 2. Some key references were missing namely New Zealand healthcare system and information about the domestic violence in New Zealand. Authors Response: We have inserted the following references: Inserted following reference which provides readers with information on New Zealand Primary Health Care Services Funding and Contracting (p.3): Ministry of Health Primary Care Team: Primary health care services funding and contracting. http://www.health.govt.nz/system/files/documents/pages/primary-care-funding-flows- 3sept2015v2.pdf; 2015. Inserted following reference regarding the lack of strategy informing family violence responsiveness within New Zealand primary health care settings (p.3): Gear C, Koziol-McLain J, Wilson D, Rae N, Samuel H, Clark F, McNeill E: Primary healthcare response to family violence: A Delphi evaluation tool. Quality in Primary Care 2012, 20(1):15-30.
Inserted following reference which points the reader to further information about Doctors for Sexual Abuse Care (p.4): DSAC: Doctors for sexual abuse care, [http://www.dsac.org.nz/] 3. References were very old or missing. Authors Response: We have made the following changes: Updated following reference regarding primary health care responses. Colombini, Mayhew & Watts (2008) is still cited elsewhere as this is a key text regarding health sector integration: Colombini M, Mayhew S, Watts C: Health-sector responses to intimate partner violence in lowand middle-income settings: A review of current models, challenges and opportunities. Bulletin of the World Health Organization 2008, 86(8):635-642. To: Black MC: Intimate Partner Violence and Adverse Health Consequences: Implications for Clinicians. American Journal of Lifestyle Medicine 2011, 5(5):428-439. Deleted following as other references sufficient: McCaw B, Berman WH, Syme SL, Hunkeler EF: Beyond screening for domestic violence. A systems model approach in a managed care setting. American Journal of Preventive Medicine 2001, 21:170-176. Following are primary health care guidelines that have not been updated which highlights the lack of work in responding to family violence in primary health care: Ministry of Health: Recognising and responding to partner abuse: A resource for general practice. Wellington, New Zealand; 2003. Ministry of Health: Recommended referral process for general practitioners: Suspected child abuse and neglect. Wellington, New Zealand; 2000. This is the key reference for the qualitative thematic analysis methods used:
Braun V, Clarke V: Using thematic analysis in psychology. Qualitative Research in Psychology 2006, 3(2):77-101. Refers to the guidelines that were published at the time the VIP programme started: Fanslow J: Family violence intervention guidelines: Child and partner abuse. Wellington, New Zealand: Ministry of Health; 2002. The guidelines were updated in 2016, this reference has been added: Fanslow JL, Kelly P, Ministry of Health: Family violence assessment and intervention guideline: Child abuse and intimate partner violence. 2 edn. Wellington, New Zealand: Ministry of Health; 2016. Updated: McDaniel RR, Driebe DJ: Complexity science and health care management. In: Advances in Health Care Management. Volume 2, edn. Published online: 09 Mar 2015: Elsevier Science Ltd; 2001: 11-36 To: McDaniel RR, Jr., Driebe DJ, Lanham HJ: Health care organizations as complex systems: new perspectives on design and management. Advances in health care management 2013, 15:3-26. Deleted following as other references sufficient: Miller WL, McDaniel Jr RR, Crabtree BF, Stange KC: Practice Jazz: Understanding Variation in Family Practices Using Complexity Science. Journal of Family Practice 2001, 50(10):872-878. METHOD 4. When was the study conducted? Authors Response: Information on the time data was collected for both methods is provided in the first sentence of the Follow-up evaluation focus group section (we have removed parentheses from around the dates to make this clearer) (p.4) and in the first sentence of the Primary health care family violence network group activity section (p.5).
5. What were the criteria for inclusion and exclusion? Authors Response: Inclusion criteria is noted in the first sentence of the Follow-up evaluation focus group section. We have added a short sentence Participation was on a voluntary basis and sites were excluded if they felt unable to participate to make the exclusion criteria clearer (p.4 last line). The inclusion criteria for participating in the network group activity is outlined in the second sentence and last sentence of the Primary health care family violence network group activity section. We have made minor edits to make this clearer (p.5). 6. What were the characteristics of the sample, particularly with respect to other variables that might influence study findings? Authors Response: The sample characteristics are provided within the first paragraph of the Results section (p.6). It is highlighted in the Discussion section (p.13, second paragraph) that the study uses a sample of volunteer sites and primary health care advocates dedicated to addressing family violence and suggests that without this strong commitment, organizations would find developing a response to family violence unfeasible. DISCUSSION 7. Limitations of the study were not sufficiently addressed. Authors Response: The authors have provided further discussion of study limitations (p.13). REFERENCES LIST 8. One third of the references, seven were old - please see if there are more recent references to cite. Authors Response: See point 3 above. Reviewer 2. Hüseyin ELB Introduction:
1. The aim of the study should be expressed clearly and unambiguously. Authors Response: We have edited sentences to make the aim of the study clearer (p.4, paragraph 2). Methods Participants and Features 2. Features of the participants should be described in more detail. Authors Response: Participant characteristics are provided in the Results section (p.6, paragraph 1). 3. It should be explained more clearly how to determine the participants. The grounds should be specified. Authors Response: As in response to Reviewer 1, point 5: Inclusion criteria is noted in the first sentence of the Follow-up evaluation focus group section. We have added a short sentence Participation was on a voluntary basis and sites were excluded if they felt unable to participate to make the exclusion criteria clearer (p.4 paragraph 4). The inclusion criteria for participating in the network group activity is outlined in the second sentence and last sentence of the Primary health care family violence network group activity section. We have made minor edits to make this clearer (p.5). 4. Is the purpose/ how to perform of the research explained to the participants before the trial? Authors Response: We have made minor edits (p.5, paragraph 1 and 3) to make this clearer. Environment 5. It should be specified that where / when focus group interview made step by step (time period, (e.g. reached a total person, whether the acceptance or not)
Authors Response: We find this comment unclear. Focus group locations and time are provided on p.5 paragraph 2. Number of focus group participants are provided in the Results section (p.6 paragraph 1). Data Collection Techniques Used 6. The competence of the person who obtained the datas (focus group interview, network group activity) should be more clearly expressed. Authors Response: We have made edits to provide this information (p.5 paragraph 2; p.6 paragraph 1) 7. If the data collected person / persons should be trained, the cultivation process to be described in detail. Authors Response: We have added a sentence to provide this information (p.5 paragraph 2).