Introduction
The research conducted by Hegarty et al. (2010) is titled “women’s evaluation of abuse and violence care in general practice: a cluster randomized controlled trial (weave).” The researchers begin the article by providing detailed background information on the problem under investigation. They provide an extensive definition of intimate partner abuse, its components, and the common perpetrators and victims. The researchers also discuss the prevalence rate of intimate partner abuse, the health consequences on the victims particularly women and unborn babies, as well as the nature of healthcare issues surrounding the vice. Hegarty et al. (2010) further point out that the inadequate disclosure of partner abuse incidences has led to a focus on research into the prevalence, outcomes, and interactions between the patients and health care providers. This research has further found encouraging results in screening and intervention as approaches to addressing the problem. Based on this extensive background information provided by Hegarty et al. (2010), readers of the article gain a deeper insight into the problem of intimate partner abuse. Most importantly, readers can understand why the study has been undertaken and its significance in addressing the problem under investigation.
Purpose of the Study
The purpose of the study has been made explicit by the researchers. The purpose immediately follows the background information section. Hegarty et al. (2010) argue that the major purpose of the study is to determine a comprehensive intervention that would enhance the overall quality of life of the victims by improving their mental wellbeing and implementing safety behaviors. Although this is the fundamental purpose, the researchers also outline the secondary objectives that will be addressed by the study. The researchers also state the hypothesis that will be tested by the study. The statement of the purpose of the study is indeed clear and straightforward and this helps the readers to anticipate what would follow next. The placement of this section immediately after the background information section also serves to increase the readability and comprehension of the study.
Research Design
The research design is a cluster randomized controlled trial that adheres to the guidelines set forth by the CONSORT statement. In the study, the cluster level will consist of the general practitioners while the individual level will consist of the women. It is important to note that the researchers made explicit the ethical principle of the study which is important because it involves human subjects. They argue that the study is approved by the Human Research Ethics Committee of the University of Melbourne (Hegarty et al., 2010, p. 4).
Participants: Inclusion and Exclusion Criteria
The eligibility of the general practitioners is based on their active practice during the past year, the number of sessions they have each week, the nature of their practice, and the native language of their patients. The GPs who were included in the study are those with 3 or more sessions each week; a computerized practice; an active practice in the last year; and 70% or more English-speaking patients.
The eligibility of the women participants is based on the frequency of their interaction with the participating GP and age. Women who were included are those who had active consultation with the practicing GP during the last year and those between 16 and 50 years of age. Women were not included in the study if the GP felt that they were not in a position to offer informed consent or if they could not grasp the content of the questionnaires or were incapable of taking part in the study due to mental, physical, intellectual, cognitive, or English language challenges. Additionally, women were also included if during the telephone conversations they disclosed a fear of their intimate partner in the last year. Although this section offers useful information about the participants of the study, the information seems to be a bit complex for the readers. This is especially the case for the inclusion and exclusion criteria used in selecting the women participants. Furthermore, the researchers do not make explicit the reasons behind the inclusion/exclusion criterion and how it influences the study. Such information would be significant to any reader and for replication of the study in the future.
Sample Size
The researchers state that the final sample had 89 women in both the comparison and intervention groups. The researchers used 80% power to enable the clustering effect as well as identify clinically significant disparities between the two groups after 12 months. Hegarty et al. (2010) further state that 40 GPs were selected (20 in each group) to permit the screening of about 500 women for each practice (a total of 20000 women). The response rate of the women was 40% (8000) out of which 10% (800) had experienced some sort of intimate partner abuse in the past 12 months. From this, 60% showed an interest in learning more about the project, a further 70% agreed to take part in the study, and a further 80% completed and returned their questionnaires. Based on randomization, the final sample size was 89 women in each group (Hegarty et al., 2010, p. 4). It is important to note that the procedure used to arrive at the sample size has been clearly described by the researchers using the inclusion and exclusion criteria discussed earlier. In addition, the researchers used a flow chart to show each of the stages followed in arriving at the sample size. This enables the readers to have an understanding of the choice of the sample size.
Recruitment of the General Practitioners
The GPs taking part in the study were also selected using several strategies. Random sampling was used to select GPs who practiced “within 150 km radius of Melbourne: 750 in urban and 250 in rural Melbourne. In addition, the GPs had to be registered with the Australasian Medical Publishing Company and some practiced in shared maternity care,” (Hegarty et al., 2010, p. 6). Letters of invitation as well as information about the study were sent to the eligible GPs. Besides following this procedure to select the GPs, the researchers also asked for assistance (in the form of advertising) from a general practice research network based in Victoria. A contract was signed by the selected practitioners for the study after which they were required to sign a consent form and fill in a questionnaire. A reimbursement of $500 was offered to the participating GPs. This served as a motivation for the GPs to take part in the study. Like in the selection of the women, the selection procedure for the GPs has been clearly described by the researchers thus making it easier for the readers to understand.
Data Collection
The major data collection instrument used in the screening phase of the study was a mailed questionnaire. At this stage, the major purpose of the questionnaire was to identify the eligible participants for the study. At the trial stage, a questionnaire was used together with the WHOQoL-Bref instrument. Unfortunately, the researchers fail to describe further this latter instrument. Readers therefore cannot tell what the instrument measures and its significance to this particular study. Other instruments have also been mentioned albeit briefly thus making it difficult for readers to know why they were used in the first place or the items they measure. In addition, scales used in the study have been briefly mentioned but not discussed. For instance, Hegarty et al. (2010) mention that a 5-point Likert scale was used to measure “comfort to discuss the abuse with GP,” (p. 8) but they do not outline the components of the scale. These limitations are apparent throughout the data collection section. Despite these shortcomings, the researchers have made the effort of including tables that show some of the variables measured at different stages of the project.
Data Analysis and Reporting
Several data analysis techniques were used to serve different purposes. For instance, descriptive data analysis techniques such as frequencies, means, percentages, and standard deviations were used to summarize the characteristics of the participants. A comparison of these characteristics was then done to ensure that randomization was successful. On the other hand, statistical tests such as inter-cluster correlations were undertaken for the major variables. In addition, “Generalized Estimating Equations and mixed-effects linear regression were used for the binary outcomes and to make comparisons of the mental health and quality of life between the two groups,” (Hegarty et al., 2010, p. 9). The researchers used an independent data monitoring committee that met at four different stages of the study. Although the study made use of several data analysis tools, each was meant to serve its purpose to ensure the effectiveness of the hypothesis testing. Most importantly, the use of an independent data monitoring committee helped to ensure the credibility of the study’s findings by eliminating researcher-induced bias.
Discussion
The discussion of this article focuses on the significance of creating and testing the interventions for screening and counseling programs for female victims of intimate partner abuse. The researchers also outline the importance of using primary care facilities to access information about partner abuse and the victims. The discussion also focuses on the benefits of conducting a randomized controlled trial to test hypotheses dealing with intimate partner abuse. Hegarty et al. (2010) further argue that such studies should factor in close follow-up and the safety and health consequences of the victims. Recommendations have also been made on the necessity of building proof about the effective response to the vice under investigation. Other recommendations include the importance of respecting the dignity of women and appreciating the diverse experiences of women as far as intimate partner abuse is concerned.
Conclusion
It is important to note that this article does not describe the weave study. Instead, it describes the design of the study, that is, what will be done during the execution of the study. As a result, the article neither shows the results of the study nor discusses the findings. In short, the article is more of a research proposal for the weave study.
Reference
Hegarty, K. L., Gunn, J. M., O’Doherty, L. J., Taft, A., Chondros, P., Feder, G., et al. (2010). Women’s evaluation of abuse and violence care in general practice: a cluster randomized controlled trial (weave). BMC Public Health, 10(2), 1-12.