Introduction

Background

In 2024, the Victorian Government announced its Strengthening Women’s Safety Package – a suite of reforms aimed at strengthening Victoria’s family violence system, and approaches to preventing and responding to family and gendered violence. The package included a $9.8 million investment for Respect Victoria to co-design and deliver a multi-year, place-based prevention initiative in Ballarat (a project now known as Respect Ballarat).

Respect Ballarat, a community model to prevent gendered violence (footnote 1), is the first initiative of its kind in Australia, providing an opportunity to:

• deliver violence prevention activities at scale
• design and implement comprehensive, integrated prevention approaches that combine primary and secondary prevention interventions
• build evidence on what works to prevent gendered violence at a community and population level.  

Purpose and scope of this review

The purpose of this review was to identify and synthesise evidence on early intervention in gendered violence prevention (footnote 2) to inform the design, development and implementation of integrated prevention activities for the Respect Ballarat initiative. The objectives of the review were to:  

1. determine how early intervention is defined and conceptualised in gendered violence prevention policy, practice and research
2. understand how early intervention is applied in practice to prevent gendered violence, including the types of programs and interventions used, and their key components, strategies, principles and practices.

We sought to identify policy and practice documents that specifically mentioned early intervention (secondary prevention) in gendered violence and/or violence against women, as well as evidence on early intervention programs and interventions aimed at preventing or reducing gendered violence.  

An assessment of the quality and/or effectiveness of these interventions and program was out of scope for this review. General theoretical and practice evidence on public health, health promotion and prevention approaches were also out of scope, as was evidence on tertiary prevention or response interventions for gendered violence.  

Public health approach to preventing gendered violence

The World Health Assembly formally recognised violence as a public health priority in 1996 (1), which established a clear global mandate for a public health approach to gendered violence and provided a strong impetus for the development of prevention theory and evidence to inform gendered violence policy, practice and programming (2, 3).  

The public health approach draws on feminist, human rights and criminal justice theories and frameworks. Feminist approaches emphasise addressing patriarchy, gendered power relations and structural gender inequality; human rights approaches emphasise the obligations of governments to prevent and eradicate violence against women under international law; and criminal justice approaches focus on enforcing domestic laws through deterrence and punishment (2, 4-6).  

The public health approach seeks to benefit the whole population by addressing the underlying societal conditions and causes of violence, as well as community, family and individual circumstances, risks and protective factors. It is also underpinned by fundamental health promotion and public health models and concepts, such as the socio-ecological model of health, settings-based approach, life course approach and prevention classification schema (4). The socio-ecological model is used to map the various determinants, risk factors and protective factors that influence gendered violence across individual, family, community and societal domains. It is also used to inform policy and programming by highlighting points of prevention and intervention across its four domains and guiding the selection of appropriate interventions and strategies (3-4, 6-7).  

The prevention classification schema is used to categorise gendered violence interventions and activities according to three levels of prevention: primary, secondary and tertiary prevention. Early conceptualisations of gendered violence described the three levels of prevention as (4, 8):  

1. primary prevention, which aims to prevent violence before it occurs
2. secondary prevention (early intervention), which focuses on the more immediate responses to violence
3. tertiary prevention, which focuses on long-term care following violence.  

This schema has been widely adopted in international and national frameworks, plans and strategies, and provides the basis for prevention policy and programming globally. Gendered violence prevention theory, evidence and practice has continuously evolved, including the way the prevention classification schema is conceptualised and described. One of the earliest global frameworks on gendered violence prevention, the UN framework to underpin action to prevent violence against women describes the three levels of prevention as (5):  

1. preventing violence before it occurs (i.e. new cases of violence)
2. preventing the recurrence of violence
3. preventing or limiting the impacts of violence.

In some public health models and frameworks, prevention activities are further categorised into intervention type, based on their intended target groups (9). In these models, ‘universal’ interventions target the whole population regardless of risk, ‘selective’ interventions target those most at risk of perpetration or victimisation, and ‘indicated’ interventions target those already using violence. Other frameworks promote a more integrated prevention approach in which ‘selective’ interventions that address specific risk factors (or people at risk) are incorporated as a core component of primary prevention approaches and interventions (3, 10, 11).

As prevention work primarily seeks to influence structural and population-level change, gendered violence prevention frameworks and approaches have tended to emphasise and prioritise primary prevention activities and interventions (5, 6). In contrast, while evidence on early intervention practices and approaches is emerging, there is currently a lack of evidence-based frameworks and guidelines to inform early intervention policy and programming, including integrated prevention initiatives that incorporate primary prevention and early intervention components.

Risk and protective factors for gendered violence  

There are a range of known risk and protective factors for gendered violence, as outlined in several prominent global prevention frameworks and guides (4, 5, 11, 12). Risk factors increase the likelihood of someone experiencing or using violence, while protective factors buffer against risk factors and/or reduce the likelihood of experiencing or using violence. Risk and protective factors can exist at the individual, relationship/family, community and societal level. They include social, economic and political conditions and circumstances, as well as community and neighbourhood contexts and characteristics.  

It is important to note that risk factors are not deterministic, and the presence of one or more risk factors does not mean an individual will experience or use violence. Rather, the presence of several risks and/or specific patterns of risk shape the overall risk profile for an individual, family or neighbourhood/community and therefore increase the likelihood of someone experiencing and using violence. Similarly, understanding protective factors and how to leverage these, alongside efforts to neutralise or reduce risk factors, can decrease the likelihood of individuals using or experiencing gendered violence.  

Understanding the risk and protective factors for gendered violence is critical for designing and delivering effective prevention programs and mutually reinforcing primary and secondary interventions and activities. In place-based prevention initiatives targeting whole communities (i.e. with defined geographic boundaries), developing a comprehensive community risk profile is useful for informing universal prevention activities that attend to community-wide risk and protective factors, as well as more targeted interventions that address setting-specific and cohort-specific risk and protective factors.  

Gendered violence prevention policy in Australia

Ending gendered violence is a commitment and a priority of all governments in Australia. The National Plan to End Violence against Women and Children 2022-2032 (13) provides the overarching policy framework guiding violence prevention policy priorities of all governments across Australia, and their collective commitment to end violence against women within a generation. The plan outlines priorities, objectives and actions across four domains:

1. prevention
2. early intervention
3. response
4. recovery and healing.  

These domains are generally referred to as ‘the continuum’ and broadly describe key points or opportunities for intervention in gendered violence. Each state and territory government also has its own family violence plan, strategy or framework, and these align with the national plan priorities and articulate their specific actions across the four domains of the continuum. (footnote 3)  

Prevention work in Australia is also guided by Change the story (6), developed by Our Watch, the national primary prevention agency. This framework focuses specifically on primary prevention, and sets out a universal, population approach to preventing violence against women. It also describes a ‘continuum’ made up of the four domains of the National Plan to End Violence against Women and Children, but it overlays this with the prevention classification system used in public health models of prevention. As such, primary prevention is described as ‘whole of population’ initiatives that address the underlying drivers of violence against women; while early intervention is described as activity that aims to change the trajectory for people at higher-than-average risk of perpetrating violence. Tertiary prevention is used interchangeably with response, and is described as preventing the recurrence of violence; and recovery focuses on the ongoing safety, health and wellbeing of people who have experienced violence.  

As these overarching gendered violence policies serve separate but complementary purposes, the continuum of violence is framed in slightly different ways. As a result, prevention and early intervention in particular are currently understood and applied differently across governments portfolios and departments, and the family violence system and service sectors more broadly.  

The early intervention gap

There are some existing government strategies and plans that outline a commitment to early intervention, but the interventions and actions specified within them are narrow in scope, largely focusing on improving identification of and response to family and domestic violence through better risk assessment and management (13-15). There has also been some investment in and commitment to early intervention through men’s referral services and therapeutic work with children and young people, including those who have experienced or been exposed to domestic and family violence, and those who are showing early signs of using violence or who are using violence (14-16).  

The limited focus on early intervention in government policy, the narrow scope of early intervention actions and commitments, and the apparent lack of funded early intervention programs in Australia has hampered the development and implementation of integrated prevention approaches to gendered violence. In addition, as very few early intervention programs have been funded and evaluated in Australia, there is currently limited evidence available to guide the design and implementation of early intervention programs and activities in the Australian context.

There is a growing recognition of the need to better define and prioritise early intervention in government policy in Australia, to adequately fund early intervention programs and interventions, and to develop evidence on effective early intervention practice and programs (17-19). (footnote 4) This review outlines the evidence on early intervention definitions, concepts and approaches that will be useful for informing government policy and programming, as well as for the design and implementation of early intervention programs and activities.  

Footnotes