What moves health providers to incorporate intimate partner violence management within their daily practice?

Despite recognition of intimate partner violence (IPV) as a public health problem, the actual integration of the prevention and management of IPV within health services remains a challenge. Laws, plans, and protocols exist, but many providers remain unsympathetic or feel unprepared to deal with IPV. Where integration has been carried out impact evaluations are ongoing; however, realistic evaluations exploring the mechanisms behind the success or failure of such interventions are lacking. This research project aims to explore why and how certain providers choose to get involved in the fight against IPV in their daily practices in primary level health facilities in Spain, where policies have been passed and strong efforts have been done to implement them within the national health system. For doing this, a realistic evaluation methodology has been chosen in order to elucidate which are the mechanisms that move certain health facilities and providers to assume this challenge. In coordination with national researchers and decisions makers, selected primary level health facilities that have successfully integrated the detection and management of IPV will be in-depth explored using observation and interviews. These first-hand qualitative data will be combined with the review of existing information to ascertain the contextual factors and inner mechanisms behind the success of existing intervention in the selected facilities. It is expected that results will illuminate efforts to integrate the detection and management of IPV within health facilities. The research process will also become an opportunity to further develop the methodology of realistic evaluation by critically assessing it from a gender perspective.