Developing Core Outcome Sets for psycho-social interventions to improve outcomes for children with experience, or at risk, of maltreatment or domestic abuse

Widespread recognition that child maltreatment (CM) and children’s exposure to domestic violence and abuse (DVA) are common and have serious and long-term adverse health consequences, have resulted in policies to ensure that services safeguard children and respond to DVA. However, evidence about how services can effectively respond is more limited. Evidence of the effectiveness and cost-effectiveness of intervening on outcomes for children and family members is limited, partly because of the variety of outcome measures used in trials and other types of evaluative studies. Inconsistent measures make it difficult to synthesise findings across studies to provide a clear evidence base for policy.

Core outcome measures are required for primary data collection in trials and surveys, but are also needed for choosing administrative data to evaluate the range of programmes that potentially impact on vulnerable families. Core outcome measures would also focus economic analyses on relevant outcomes. Our study aims to develop two discrete core outcome sets for use in future evaluation of psycho-social interventions aimed at improving outcomes for children experiencing or having experienced either (or both): i) maltreatment; or ii) DVA. We recognise that children’s experiences of maltreatment and DVA frequently overlap, however currently the response to these two types of trauma are quite different, at least in the UK. This warrants separate outcome sets, although we will explore where they overlap.

We will use a two phase mixed methods study design to develop a list of candidate outcome indicators, domains and areas, and to assess and develop consensus amongst stakeholders regarding the most important outcomes to include in each COS.


Emma Howarth School of Psychology, UEL, University Way, London, UK E16 2RD

Claire Powell, Institute of Child Health, UCL, 30 Guilford St, London, UK WC1N 1EH

Jenny Woodman, Institute of Education, UCL, 27/8 Woburn Square, London, UK WC1H 0AA

Erin Walker, UCL Partners, 170 Tottenham Court Road, London, UK W1T 7HA

Ruth Gilbert, Institute of Child Health, UCL, 30 Guilford St, London, UK WC1N 1EH
United Kingdom

Gene Feder, School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Bristol BS8 2PS
United Kingdom

Further Study Information

Current Stage: Ongoing
Date: April 2019 - September 2021
Funding source(s): This study is funded by the National Institute for Health Research (NIHR) Policy Research Programme. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Health Area

Disease Category: Child health

Disease Name: Child maltreatment, Domestic violence and abuse

Target Population

Age Range: 0 - 18

Sex: Either

Nature of Intervention: Other, Psychological & behavioural

Stakeholders Involved

- Charities
- Clinical experts
- Families
- Patient/ support group representatives
- Policy makers
- Researchers
- Service commissioners
- Service providers
- Service users

Study Type

- COS for clinical trials or clinical research
- COS for practice


- Consensus meeting
- Delphi process
- Interview
- Literature review
- Semi structured discussion
- Systematic review

Mixed methods, two phase study. Phase 1: Multiple methods will be used to identify items for the candidate list including several rapid reviews of different evidence types, consultation with key stakeholders and qualitative interviews to capture the voices of marginalised groups. Data will be synthesised to produce a taxonomy of outcomes, from which the candidate list will be produced. Phase 2: A three panel, two round adapted eDelphi.

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