Women's awareness of the help services increased significantly from 76% in a 2000 survey to 84% in 2003 ...... sp o n se s. No. awareness raising initiatives conducted by RDVC's ..... Perth: IRC, University of Western Australia; 2005. 6. FDVU.
TABLE OF CONTENTS EXECUTIVE SUMMARY............................................................................................................................. I CAMPAIGN POSITIONING AND FOCUS .............................................................................................. III TARGET GROUPS.................................................................................................................................... III EARLY YEARS PREVENTION ...................................................................................................................IV EVALUATION AND RESEARCH ...............................................................................................................V REFERRAL AND SERVICES.......................................................................................................................V COLLABORATION AND COORDINATION............................................................................................VI 1
BACKGROUND TO THE REVIEW .................................................................................................... 1
1.1
The continuing magnitude of family and domestic violence ............................................ 1
1.2
Freedom From Fear – WA’s response to violence against women .................................... 2
2
AIMS OF THE REVIEW ..................................................................................................................... 5
3
METHODOLOGY ............................................................................................................................ 6
3.1
Background research.............................................................................................................. 7
3.2
Interview and discussion guide.............................................................................................. 7
3.3
Stakeholder interviews ............................................................................................................ 8
3.4
Data analysis and appraisal ................................................................................................... 9
4
TERMINOLOGY............................................................................................................................... 9
5
FINDINGS OF THE REVIEW ........................................................................................................... 10
5.1
Key achievements to date ................................................................................................... 11
5.2
How has Freedom From Fear fared against its objectives? .............................................. 11
6 6.1
RELEVANCE OF A SOCIAL MARKETING APPROACH TO FAMILY & DOMESTIC VIOLENCE .... 24 Social marketing applied to domestic violence................................................................ 26
7
COST EFFECTIVENESS OF PREVENTING DOMESTIC VIOLENCE................................................. 28
8
FUTURE DIRECTIONS..................................................................................................................... 30
8.1 Target group ........................................................................................................................... 31 8.1.1 Inclusion of some current ‘other audiences’ as secondary target group ...................31 8.1.2 Subgroups not as effectively reached or impacted by current strategies .................32 8.2
Overarching campaign directions ...................................................................................... 36
8.3 Media Strategies .................................................................................................................... 37 8.3.1 Media messages/concepts ..................................................................................................38 8.3.2 Media executions/imagery ...................................................................................................39 8.3.3 Media channels.......................................................................................................................39 8.3.4 Media scheduling....................................................................................................................40 8.4
Other contemporary social marketing methods and new technologies ....................... 41
8.5
Other Support Strategies ....................................................................................................... 42
8.6 Research & Evaluation........................................................................................................... 43 8.6.1 Formative evaluation..............................................................................................................43 8.6.2 Strategy and campaign evaluation....................................................................................45 9
CONCLUSIONS AND RECOMMENDATIONS .............................................................................. 47
Target groups ............................................................................................................... 48 Evaluation and research .................................................................................................................... 50 Referral and services .......................................................................................................................... 51 Collaboration and coordination ....................................................................................................... 51 REFERENCES .......................................................................................................................................... 53 APPENDICES ......................................................................................................................................... 56
ACKNOWLEDGEMENTS We wish to thank all those who gave up their time to assist this review, and for the valuable and reflective views expressed by those interviewed.
TABLES Table 5-1
Freedom From Fear – key achievements, strengths and weaknesses ................11
Table 5-2
Evaluating effectiveness of behaviour and social change campaigns.............12
Table 6-1
Current and potential campaign themes identified in literature .........................27
FIGURES Figure 1-1
Freedom From Fear target groups................................................................................4
Figure 1-2
Mass Media as an umbrella for other strategies ........................................................4
Figure 1-3
Key campaign waves since inception ........................................................................5
Figure 3-1
Methodology for the Review of Freedom From Fear................................................6
Figure 5-1
Acceptability of certain behaviours – ok to yell; ok to hit......................................16
Figure 5-2
Perpetration of DV over the campaign life .............................................................16
Figure 5-3
Helpline callers by type/reason (1/1/1998 – 5/2/2005) ...........................................20
Figure 5-4
Men’s awareness of help and helpline......................................................................21
Figure 5-5
MDVH Caller profile by age (1/1/1998 – 5/2/2005)..................................................22
Figure 5-6
Helpline calls, referrals and program participation .................................................23
Figure 5-7
Women’s awareness of MDVH ....................................................................................24
Figure 6-1
Benefits and Limitations of mass media.....................................................................25
Figure 6-2
Tiers of prevention ..........................................................................................................26
Figure 7-1
The Domestic Violence Financial Pyramid...............................................................29
Figure 8-1
Freedom from Fear and domestic violence prevention .......................................30
Figure 8-2
Context for addressing Indigenous family violence ................................................34
Figure 8-3
5 P’s of marketing applied to Freedom From Fear ..................................................36
Figure 8-4
Matrix of evaluation measures ....................................................................................45
EXECUTIVE SUMMARY Freedom From Fear was launched in 1998 and pioneered the application of public health and social marketing strategies to address domestic violence prevention and early intervention, targeting men who use violence against women.
The campaign was
underpinned by extensive sector and stakeholder consultation, formative research with target groups and ad-testing. While comprehensive evaluation of media waves and some individual strategies and adjunct services have been undertaken for the Family and Domestic Violence Unit (FDVU) at various times, this review represents the first synthesised review of the achievements, scope, and directions of Freedom From Fear. The overall aim of this review was to consider the achievements of the campaign to date and to inform the development of future strategies to raise awareness of domestic violence and impact on community and target group attitudes and behaviours in the future. The review also considered the ongoing relevance of the campaign, the appropriateness of existing strategies in the current environment, and emergent issues that may need to be addressed in its next iteration. The methodology for the review included stakeholder consultations, analysis of relevant literature, examination of relevant evaluation reports and consideration of relevant contextual issues, both within WA and nationally. A range of published literature and reports and unpublished data sources were reviewed. A total of 27 detailed stakeholder interviews were conducted as part of the review.
These included people within the FDVU and
Department for Community Development (DCD) and a range of external stakeholders. The review methodology ensured that stakeholders represented the perspectives of victims, Indigenous people, service providers and policy and program managers and those in direct contact with the target group. The review was undertaken between October 2005 and April 2006. Key stakeholders were consulted regarding the effectiveness of Freedom From Fear to date and to ascertain their views on the form, positioning, and role of future iterations. The review drew upon the stakeholder consultations and available data and evidence to gauge how Freedom From Fear has progressed against its initial long term objectives, and to assess the currency of these objectives, and any potential refinements for future phases of the campaign. In the report that follows, the bulk of findings from the review are discussed in the context of these objectives and as considerations for future directions. The review process and findings confirmed the complexities of preventing and deterring behaviour as psychologically, socially, behaviourally and ecologically complex as violence. Notwithstanding these challenges, the majority of stakeholders concurred that Freedom From
i
Fear, and in particular its media component, has contributed to increased awareness and shifting norms and attitudes surrounding the acceptability of violence as a means of resolving problems. The portrayal of the impact on children in the media executions is felt to have contributed strongly to this.
In targeting perpetrators and those at risk of perpetrating
domestic violence, Freedom From Fear is recognised as having addressed an important prevention void and integral component of a comprehensive approach to reducing family and domestic violence in WA. Overall, Freedom From Fear has achieved or progressed towards many of the objectives set forth at its inception. In retrospect however, some of the initial objectives were too broad or difficult to measure, or required intervention in areas outside of the remit of the Freedom From Fear campaign. The review thus provides some direction for refinement and repositioning of objectives for the program’s next iteration. Limitations in data collection and availability also hinder evaluation of the effectiveness of many strategies and services in the domestic violence sector and this is reflected in some of the review recommendations.
Key findings and recommendations The conclusions and key recommendations described below reflect major themes and considerations that emerged from the review process and readers are encouraged to refer to the complete report for the context and rationale that underpins these recommendations. There are also other findings and considerations identified throughout the report that are not framed as formal recommendations, but are nonetheless relevant to the future prevention of family and domestic violence and to Freedom From Fear. The future directions of Freedom From Fear are intertwined within a broader context that includes the Western Australian Family and Domestic Violence State Strategic Plan 2004 2008; the activities, directions and funding of counseling services and programs in WA; trends and issues within the sector and community more broadly and national violence prevention initiatives.
Taking these contextual issues into account, the review supported further
consolidating the strategies and achievements of Freedom From Fear to date, but also identified potential opportunities to expand or shift focus. Role within the FDVU Freedom From Fear was conceived and developed as a comprehensive domestic violence prevention campaign that included the establishment of the MDVH, referral programs, regional networks and a range of other strategies. Many of these services and strategies have subsequently become part of the core business of the FDVU. While the review acknowledges that the Freedom From Fear branding now most appropriately applies to the media and social marketing campaign and strategies, it is important that the links and synergies between these and the other services and activities
ii
of the FDVU remain recognised and fostered. Reshaping community understandings and norms abut domestic violence and precipitating those at risk to seek help is a vital element in the mix of FDVU activity and addresses a number of the focus areas of the current WA Family and Domestic Violence Strategic Plan 2004-2008. Campaign positioning and focus The review found strong support for the continued focus on prevention and promotion of early help-seeking behaviour among men, along with the retention of messages that highlight the impact on children. It is timely to more explicitly capitalise on recent changes to pertinent legislation and police powers as a leveraging opportunity to provide the campaign with a new but complementary angle. The WA Family and Domestic Violence Strategic Plan 2004-2008 and the Violence Restraining Amendments (VRO) Amendments are still relatively recent, providing a window of opportunity to strengthen the ‘position’ of domestic violence as a crime or a criminal offence in future Freedom From Fear strategies. There is a need to further broaden community notions of family and domestic violence beyond physical manifestations, to include emotional and more subtle albeit less physical forms of violence and abuse. Target groups Targeting perpetrators and potential perpetrators of violence against women remains an essential and evidence-based focus for Freedom From Fear. However, the review supported refined target group segmentation and greater focus on some priority groups and intermediaries, including: Exploration of alternative strategies and terminology to engage men who do not perceive themselves as ‘perpetrators’ or who are unlikely and/or reluctant to recognise that they need help or to seek help prior to crisis-point. More overt delineation as a target group of friends, family, colleagues witnessing or aware of family and domestic violence. This could include the dissemination of relevant resources or advice for those wanting to help either a perpetrator or victim within a domestic violence situation, as well as greater emphasis on prompting and mobilizing the general community, and those who know those directly affected by family and domestic violence, to ‘do something’ . Inclusion of people from Indigenous, CALD and rural and remote communities as high priority target groups. This entails both targeted initiatives and consideration and inclusion of these groups within ‘mainstream’ strategies, resources and programs.
iii
Clarification of the role of Freedom From Fear and the FDVU in relation to family and domestic violence among Indigenous people. With the Gordon Inquiry implementation drawing to an end in 2007, it is vital that the longer term role for DCD (including FDVU and Freedom From Fear) be clarified and that more appropriate strategies for Indigenous men who need or seek help are developed collaboratively. Acknowledgement of other relational contexts in which violence occurs, including exploration of appropriate ways to address violence perpetrated within same sex relationships or by women against men. The need to specifically target priority population groups is balanced with the evidence for maintaining the momentum for behavioural and environmental change at the population level. This balance needs to be struck in planning and resourcing decisions to ensure that the impetus for change provided by Freedom From Fear to date is not lost. Strategy mix and resources This review supported the continuation of a strong media component as part of the social marketing and overall Freedom From Fear program mix. Social marketing campaigns have the potential to shape both community and target group norms and behaviours in relation to domestic violence, but momentum and impact are diminished if not sustained. This is of noted concern given that Freedom From Fear has not had an overt media presence, other than sporadic press media for three years. The current strategy mix of television and radio media, press, printed materials and public relations strategies remains sound and evidence-based. There is scope to use radio further (given its cost effectiveness and reach) but the efficacy of press strategies used to date is unknown and evaluation of these is recommended. Promotion of the MDVH and ‘cues to action’ in settings frequented by the target group (e.g. workplaces, websites frequented by target group) are an under utilised communications avenue. New media executions may be needed to further progress the desired shifts in attitudes (e.g. issues of responsibility, justification) and behaviours among the target group and to precipitate men to seek help before things get out of hand. Early years prevention Preventing the ‘first act’ of violence is a key primary prevention aim but requires a long term outlook and comprehensive strategy across sectors. Such prevention needs to ideally begin in childhood, addressed through parenting, bullying, relationship and school-based strategies.
These strategies fall outside of the
rubric of Freedom From Fear but are reinforced by the role that Freedom From Fear plays
iv
in raising awareness and challenging and shaping community norms and attitudes in relation to violence. Evaluation and research Evaluation strengths of Freedom From Fear to date include the rigorous media evaluations that provided baseline data and subsequent tracking of impact measures along the five media waves to date.
However, the ability of this review to accurately assess the
effectiveness of Freedom From Fear against its objectives was hindered by a number of systemic limitations in data collection and availability. The review of perpetrator programs undertaken in WA in 2002 found significant gaps in data that precluded the evaluation of perpetrator program effectiveness. Some 4 years later, our review draws the same conclusion and concurs with the recommendations for improved systemic data collection contained in that earlier review. Prioritised evaluation needs include appropriate measures and methodologies for evaluating the short-term and long term effectiveness of perpetrator services and programs by tracking perpetrator behaviour following use of the helpline, program referral and program participation. Current data collection relates primarily to group participation and helpline calls and referrals, but needs to be expanded to reflect the counseling role played directly by the MDVH as well as counseling and support services that may be subsequently be provided to individuals (which are not reflected in group participation statistics). The comprehensive formative research that underpinned the development of Freedom From Fear was conducted nearly a decade ago and new or additional formative research is recommended. This could include formative research with perpetrators and potential perpetrators, those in or at risk of violent relationship, follow up of program participants and MDVH callers, people of Indigenous or CALD background or stakeholders in intermediary settings and agencies. Referral and services It is essential that media and other strategies that direct men or those concerned or affected by domestic violence to seek help, be backed up by appropriate counseling and treatment services. The MDVH and perpetrator programs play a pivotal role in this regard, but there is scope to address issues relating to the adequacy of pertinent services for specific population groups, particularly Indigenous and CALD males (and women) and those residing in some regional areas.
v
The appropriateness of ‘one size fits all’ program models for perpetrators was frequently raised by stakeholders, reinforcing the pressing need for more comprehensive evaluation of the efficacy of current programs and services. Related to this is the need to better understand barriers to seeking help, reasons for program attrition and triggers for behavioural relapse. Family and Domestic violence is often intertwined with other risk factors, including alcohol and drug misuse, mental health problems and psychosocial issues. For men with multiple risk factors or issues, more integrated case management approaches across service providers are warranted. Options for providing help, counseling or referral for men who are unlikely to ‘make a call’ warrant further exploration and could include web-based counseling or smaller and more discrete take-home information and self-help materials. Collaboration and coordination As domestic violence falls within the remit of many sectors and agencies, coordination and collaboration is difficult, but vital.
The review observed fragmentation in
communications and awareness and understanding of others activities between key sectors, between service agencies delivering similar programs, between researchers and practitioners and between different project areas within DCD. Given the emphasis on coordination, cooperation and collaboration in the WA Family and Domestic Violence Strategic Plan (2004-2008) these issues warrant attention.
Final conclusions Freedom From Fear has received national and international recognition for its unique and comprehensive approach to the prevention of domestic violence against women, both within the domestic violence sector, and more broadly, as an effective example of social marketing strategies applied to a complex psychological and social and public health issue. While the campaign has been effective in many regards, the need for a long term and comprehensive outlook that underpinned the original planning for Freedom From Fear remains strong. Just as the precursors and precipitants of domestic violence are multifaceted and entrenched, so too are the strategies and interventions required to prevent the onset and consequences of violent behaviour. As a social marketing and communications program, Freedom From Fear not only communicates with the target group to prompt preventive action, but more broadly, contributes to the reshaping of community and perpetrator attitudes and norms around violence. As such, it supports, complements and is reinforced by the many services and programs within the Department for Community Development and
vi
other sectors that work towards family and domestic violence protection and prevention and provision. The contextual and legislative landscape that underlies domestic violence has changed in many ways since the inception of Freedom From Fear, hence some refinement and refocusing of the campaign is appropriate. Yet many of objectives and strategic elements remain just as relevant and it is efficacious to continue to build upon the campaign’s strengths. Freedom From Fear represents a radical departure from conventional victim focused and tertiary interventions within a public health framework; as a landmark application of health promotion and social marketing principles, it has gained considerable achievement. The evidence to date would suggest that future success will hinge on innovation, evidence based decision making and courage to recognise domestic violence for what it is, a problem that can be potentially prevented with an appropriate mix of state of the art social marketing and health promotion tenets.
vii
ABBREVIATIONS
ABS
Australian Bureau of Statistics
CALD
Culturally and Linguistically Diverse
DCD
Department for Community Development
FDVU
Family and Domestic Violence Unit
FFF
Freedom From Fear campaign
MDVH
Men’s Domestic Violence Helpline
RDVC
Regional Domestic Violence Committee
SES
Socio-economic status
UNIFEM
United Nations Development Fund For Women
VRO
Violence Restraining Order
WDVH
Women’s Domestic Violence Helpline
WHO
World Health Organisation
viii
1 BACKGROUND TO THE REVIEW 1.1
The continuing magnitude of family and domestic violence
Primarily although not exclusively, family and domestic violence is enacted by men, against women. The true prevalence and extent of domestic violence consequences is difficult to ascertain as it often goes unreported by victims or unadmitted by perpetrators [1, 2]. In the International Violence Against Women Survey (IVAWS), over one third of Australian women who had ever had an intimate partner had experienced some form of violence by a partner in their lifetime
[3],
while in the ABS Women’s Safety
Survey (1996), 23% of women who had ever been married or defacto reported that they had experienced violence by a partner at some stage during their relationship
[4].
A 2006 replication of this survey is currently being undertaken by the ABS. As under-reporting of family and domestic violence is widely recognised, Western Australian statistics are a conservative snapshot at best.
However, the Acts
Amendment (Family and Domestic Violence) Act 2004 has significantly strengthened the powers and obligations of the police to deal with family and domestic violence. The police are now required to investigate acts of family and domestic violence and are able to take out 24 and 72 hour orders to remove a perpetrator of violence from the home.
Since the Act came into effect on 1 December 2004, police have
responded to 22,334 incidents of family and domestic violence, of which 11,708 (or 52.4 per cent) were recorded as offences which resulted in 8,800 arrests. More than 5,200 police orders were issued in the first 12 months of operation of the legislation. Women are significantly more likely to be victims of family and domestic violence
[5],
comprising
more than two thirds of the applicants for Violence Restraining Orders and nearly three quarters of the victims in domestic violence call-outs [6]. Limitations in the way in which data on domestic violence is collected and reported have been noted in other recent reviews
[5, 7]
and preclude an accurate assessment of
the full health, social and community impact. The incidence of injury from domestic violence per 100, 000 adult women in WA varies according to the source but ranges from
1.6
(police
recorded
248.1(restraining order data)
[8].
homicides),
129.2
(hospital
admissions
data)
to
Hospitalisation due to violence (among those 15 years
and older) inflicted by an intimate partner is 5.9 times higher among females compared with males
[5].
Victimisation is often repeated, with 24% of intimate partner violence
victims presenting more than once to Royal Perth Hospital between July 2002 and December 2003 [5].
1
Estimating the cost of domestic violence to the community is complex, not only because of limitations in the way in which criminal and hospital data is collected and reported, but also because of the difficulties of measuring the substantial burden of indirect costs relating to lost quality of life, pain, fear and suffering
[9].
In a recent study
of the health costs of violence against women using the World Health Organisation’s ‘burden of disease’ methodology, violence was responsible for more ill-health and premature death among Victorian women under the age of 45 than other well-known health risk factors such as smoking, high blood pressure and obesity
[10].
Domestic
violence was estimated to cost the Australian community $8.1 billion in 2002-2003, taking into account the costs of pain and suffering, health costs and long-term productivity costs [11]. Although family and domestic violence can and does occur across the socioeconomic, demographic, cultural and geographic spectrum, it is a more significant problem for some groups within the community. In particular, violence in a family or domestic context is far more prevalent in Indigenous communities and households
[12],
with hospitalisation due to violence (among those 15 years and older) inflicted by an intimate partner 83 more times likely among Indigenous people compared with the non-Indigenous population remote areas
[13]
[5].
Domestic violence is also more prevalent in rural and
and is often exacerbated by the circumstances and issues faced by
people in lower socio-economic areas. While the prevalence of family and domestic violence among people from CALD backgrounds is difficult to quantify, it variably exists within different cultural communities and presents additional complexities for both victims and perpetrators, as well as for domestic violence campaigns and services
[2, 14].
Female violence towards men is a
cloudy area that is presently under researched but foremost in the minds of those working in the field. Similarly, increasing attention is being directed towards same-sex couple violence however this area also has additional challenges which differentiate it from family and domestic violence.
1.2
Freedom From Fear – WA’s response to violence against women
In 1995, the Western Australian government formed a taskforce to address the issue of family and domestic violence.
Preliminary research was commissioned in 1996 to
identify appropriate communication strategies for a program that would contribute to changing the attitudes and in the longer term, behaviours of violent men. The findings of that preliminary research underpinned the campaign thereafter known as the Freedom From Fear campaign against domestic violence that was launched in August 1998.
2
Freedom From Fear pioneered the application of public health and social marketing strategies to address domestic violence prevention and early intervention and was underpinned by extensive sector and stakeholder consultation, formative research with target groups and ad-testing. Given the complex nature of violence and behaviour change, Freedom From Fear was designed to be a long-term multi-phased program, to be evaluated by performance targets regarding knowledge, attitude, belief and behaviour change over time. The overall goal of Freedom From Fear is to contribute to the reduction of domestic violence in Western Australia. This long term goal is girded by six long term objectives, which are to: promote and reinforce understanding and acceptance in the community that many forms of domestic violence are a crime increase awareness in the general community that violence is not an acceptable method of resolving problems and difficulties promote
understanding
and
acceptance
in the
community that the
perpetrator is responsible for the violence prevent the first act of violence committed by ‘at risk’ men end acts of violence committed by perpetrators encourage and assist appropriate responses from service providers to perpetrators, potential perpetrators and victims. Complementing these long term objectives are three specific objectives that have underpinned phase one (i.e. the campaign to date) of Freedom From Fear: To increase knowledge within the community, and specifically amongst the primary target group, about state-wide and local resources available and the methods of accessing assistance; To promote understanding and acceptance in the community, and amongst men in particular, that: -
The perpetrator is responsible for the violence, not the victim; and
-
There are no circumstances in which domestic violence is justified;
To increase the number of perpetrators and men ‘at risk’ who are seeking assistance and advice from appropriate services. The primary target groups for the campaign to date are depicted in Figure 1-1. It is pertinent to note that as Freedom From Fear was unique in its focus on men and perpetrators, considerable effort was made to gain the support of women’s
3
organisations and female victims for the overall program and the specific media and materials subsequently produced. Figure 1-1
Freedom From Fear target groups
Primary Target Group Reachable male perpetrators of domestic violence who are currently not in treatment. Non-perpetrators (men) who are at risk of perpetrating violence.
Other Audiences Women of all ages. Direct and indirect victims of domestic violence, including children. Male and female aboriginal people. Males and females from nonEnglish speaking backgrounds. Families and friends of people in violent relationships
Secondary Target Group All other men who are at risk of becoming, or are currently reachable perpetrators of domestic violence. Tertiary Target Group Non-perpetrators (men) not at risk – i.e. the general population of males.
The campaign has been supported by a combination of strategies as depicted in Figure 1-2. Figure 1-2
Mass Media as an umbrella for other strategies
Source: D Patterson, 2001
As depicted in Figure 1-3 below, Freedom From Fear ran as a comprehensive and relatively intense campaign between 1998 and 2003. Only minor media activity has
4
occurred since 2003, but in conjunction with continued provision of the Men’s Domestic Violence Helpline (MDVH) and referral programs; Regional Domestic Violence Committee (RDVC) activities; and some new initiatives including the Preventing Family Disintegration in Culturally and Linguistically Diverse Communities Partnership Approach (2003); General Practitioners Project; the Schools Project and the Workplace project [15]. Figure 1-3
Key campaign waves since inception
Formative Benchmark Wave 1 Wave 2 Wave 3 Wave 4 Wave 5 Periodic Research
August
October
April
October
April
May
Media
1996
1998
1998
1999
1999
2001
2003
2003-05
The impact and effectiveness of Freedom From Fear has been tracked by a series of campaign reports and statistics collected by the MDVH and referral agencies. Nearly a decade since Freedom From Fear was originally conceived, it is however, timely to assess the ongoing relevance of the campaign, the appropriateness of existing strategies in the current environment, and emergent issues that may need to be addressed in its next iteration. These considerations underpin this review which was tendered and contracted by the Family and Domestic Violence Unit (FDVU) of the Department for Community Development (DCD) in late 2005.
2 AIMS OF THE REVIEW The overall aim of the review is to: report on the achievements of the campaign to date and to establish effective ways to raise awareness of domestic violence and impact on community attitudes and behaviours in the future. The specific objectives of the review were to: review past evaluations to establish the success or otherwise of campaign strategies review past evaluations to determine the impact on the target group’s knowledge, attitudes, beliefs, behaviours and behavioural intentions review qualitative research commissioned by the FDVU and other agencies to determine likely attitudes and beliefs among the broader community
5
review the campaign within the context of other current initiatives in Western Australian to address family and domestic violence examine contemporary social marketing methods and new technologies to determine the appropriateness of existing campaign strategies identify any overseas social marketing attempts to reach perpetrators or potential perpetrators of domestic violence and any lessons or implications they may have for the campaign determine key stakeholders’ perceptions of the campaign assess the ongoing relevance of the campaign and make recommendations regarding the future direction of the campaign.
3 METHODOLOGY The methodology for the review is depicted in Figure 3-1 below. Figure 3-1
Methodology for the Review of Freedom From Fear
Stage 1
Review set-up & past research
Meet DCD FDVU past research & key contact list exchanged, review process finalized. Background review, Lit review & research commenced. Develop interview instrument(s), and gain approval from DCD FDVU. Schedule interviews with Campaign developers & key stakeholders.
Stage 2
Data collection & interviews
Stakeholder & campaign development group member interviews; face-to-face, phone, group interview, & electronic replies.
Attendance at other presentations, seminars specific to F&DV. Collection, collation and analysis of previous evaluation data.
6
Stage 3
Data analysis & final reporting Analysis of interview data. Analysis of additional evaluation data requested from FDVU & MDVH. Finalise literature review. Prepare draft report. Present draft report including methodology, results and recommendations. Refine report following input from DCD DFVU. Final report submission.
The final methodology employed corresponds to that proposed in the original tender, with the addition of attendance at a number of timely Family and Domestic Violence forums and seminars held in Perth during the period of the review. The processes entailed in the background research (stage 1), development of interview questions (stage 1), conduct of stakeholder consultations (stage 2) and data appraisal and analysis appraisal (stage 2 and 3) are described in more detail below.
3.1
Background research
While depicted in stage 1, the identification and review of data, evidence and literature continued concurrently through subsequent stages of the review.
The
information sourced included: Past Freedom From Fear campaign evaluation reports and qualitative research. Men’s Domestic Violence HelpLine data (22/10/2004 – 30/10/2005 inclusive). Published literature and reports relating to domestic violence campaigns and strategies undertaken elsewhere, both nationally and internationally. Literature on contemporary social marketing methods. Information and papers available through the Australian Domestic and Family Violence Clearinghouse database. Reports and data relating to incidence and impact of domestic violence in WA. Telephone and e-mail enquires with relevant researchers and practitioners. Information provided in the process of stakeholder consultations.
3.2
Interview and discussion guide
The discussion guide for the stakeholder interviews (see Appendix 2) was developed based on the review objectives, preliminary background research and input from the FDVU. The discussion guide ensured comprehensive and consistent coverage of issues, but it was designed and used so as to allow for considerable flexibility in the sequence and scope of discussion topics, with capacity to accommodate the specific expertise or perspectives of individual stakeholders. While Freedom From Fear is most frequently referred to as a ‘campaign’,
it was explained to all stakeholders that the term
campaign in this context and within the discussion questions, encompassed much more than the mass media component, and extended to the other publicity, education, counselling and referral elements of Freedom From Fear. A shortened version of questions based on the discussion guide was sent by electronic mail to a number of stakeholders who were not able to be interviewed face-to face or
7
by telephone. These stakeholders were either regionally based and/or away from their office during the consultation period.
3.3
Stakeholder interviews
The original list of stakeholders to be consulted was provided by the FDVU, along with relevant contact details (see Appendix 3). The stakeholders encompassed: Campaign Development and Advisory Group members (7) Regional Domestic Violence Committees (7) Other key stakeholders (19) consisting of representatives from; Community Based Organisations, Department of Justice and the Family Protection Unit, DCD, the Men’s Domestic Violence Helpline Counsellors and The Gordon Implementation Unit within the Department of the Premier and Cabinet. A number of additional relevant stakeholders were identified during the course of the review or suggested by other stakeholders. It was beyond the scope, budget and timeframe of this review to pursue the majority of those suggested, but their names and contact details are provided in Appendix 3 should FDVU wish to progress consultations further. All nominated stakeholders were sent an introductory letter by the FDVU outlining the nature of the review, requesting their involvement and identifying the consultants (Lisa Wood and Justine Leavy) that would be contacting them to arrange an interview either face to face or by teleconference. An interview outline was emailed to any stakeholders who indicated that they would like an overview of the questions for the purposes of interview preparation. Face to face interviews were scheduled with metropolitan stakeholders and telephone interviews scheduled with regional stakeholders. A number of key stakeholders were interviewed in a paired or group format process and this is indicated on the stakeholder schedule (Appendix 3). The face-to-face interviews lasted between 60-90 minutes for each interview. The telephone interviews lasted 45-60 minutes for each interview. A total of 27 stakeholders participated in the review. Unfortunately some (seven) of the key stakeholders originally identified by FDVU did not participate. Reasons for nonparticipation included: requests that we contact an alternative or more appropriate person/group; declines because of commitments and repeated non-reply (deemed not contactable after 5 unreturned phone calls). The stakeholders that were not available face-to-face or by telephone were sent a hard copy of the interview questions and asked to fax/email responses back to us. Nine people completed that interview format.
8
3.4
Data analysis and appraisal
This review has not sought to duplicate the wealth of valuable data and information already collected through the post campaign evaluation waves (conducted by TNS Social Research, previously NFO Donovan Research); helpline and service provider reports; and several specifically commissioned reviews relating to: barriers that prevent country men from accessing domestic violence services programs for mandated and voluntary participants domestic violence project
[17].
[16];
[30];
evaluation of perpetrator
and an exploratory workplace
Instead, the review has focused on providing a synthesis
of stakeholder feedback, existing data sources, pertinent literature and our own observations as consultants conversant with public health and social marketing campaigns. In addition, where we identified gaps in the existing data or information relevant to the review objectives, additional or new information was sought and where necessary computed and analysed. This included the most recent MDVH and service agency statistics that have not been collated elsewhere. Unfortunately some of the information sought (e.g. reported violence statistics corresponding to campaign waves) was not able to be accessed.
4 Terminology Prior to presenting the review findings, it is pertinent to raise the issue of appropriate terminology. Since the inception of Freedom From Fear almost ten years ago, there have been changes and debate surrounding the language and terminology associated with family and domestic violence. In the context of this report, the word perpetrator is used for consistency with the original terminology used within the program objectives and strategies, although the trend towards usage of the term men who use violence against women
[18]
is
acknowledged and as discussed later in our review, supported. Similarly, a more contemporary description for victim is women (and children) who are or have experienced or are experiencing male violence
[18].
However, as the term victim was
used in the Freedom From Fear long term objectives, and was still in usage by some stakeholders, it is used in this report, but is not intended to imply a sense of helplessness or any other negative connotation [18]. The term family and domestic violence is a more encompassing descriptor and tends to be used in contemporary research and publications and is reflected in current DCD terminology also. In this report, we use the term family and domestic violence where possible, but retain use of the term domestic violence where it occurs in the context of previous Freedom From Fear research. Family and domestic violence in the context of
9
the literature and the Freedom From Fear campaign has been defined as ‘behaviour which results in physical, sexual or psychological damage, forced isolation, economic deprivation, or behaviour which causes the victim to live in fear. It includes partners who are married defacto or otherwise emotionally connected, ex-partners and any family members’
[19].
This definition is consistent with that used in the WA Family and
Domestic Violence Strategic Plan (2004-2008) and in the Best Practice Model for the Provision of Programs for Victims of Domestic Violence in Western Australia [6]. Another key definitional issue that arose during the consultations pertains to the scope of persons that are included within the rubric of family and/or domestic violence. Historically the field has evolved in response to violence between spouses, de facto partners, former spouses or former de factor partners
[20].
Increasingly, there has been
acknowledgment in the field that family and domestic violence includes a range of family members, particularly when considering violence in Indigenous communities. Moreover, while domestic violence typically conveys violence enacted by men against women, the realities of same-sex couple violence and in some instances, female instigated violence were frequently raised by stakeholders during the course of the review. The term ‘Indigenous’ is used to refer to the first peoples or original inhabitants of an area and is increasingly used in an international context. It is used throughout this report to describe the Aboriginal peoples and Torres Strait Islanders.
5 Findings of the review As reflected in the objectives set forth by the FDVU for the review, its scope was broad and entailed considerable ‘reflecting back’ on Freedom From Fear activity and effectiveness to date, with a view to ‘moving forward’. We have sought to synthesise as much as possible, the findings derived from the various methods of review, information collection and analysis, as this seems the most helpful approach if the report is to be useful for reflection and planning. We have also sought to align relevant findings to both the long and shorter term objectives set forth for Freedom From Fear when it was first established, as this provides an appropriate lens through which to view the campaign’s progress and effectiveness. The findings of the review are presented in the subsections that follow: Key achievements to date How has Freedom From Fear fared against its objectives Relevance of a social marketing approach to family and domestic violence Future Directions
10
5.1
Key achievements to date
Complementing the review of available data and reports, the review sought to ascertain stakeholder views on the achievements of Freedom From Fear to date (see Table 5-1). This was done with a view to appraising its effectiveness and informing future directions for Freedom From Fear, rather than as a post mortem exercise. With any ‘first time’ campaign or program, there are inevitable lessons learnt in hindsight, issues that arise in translating planned strategies into practice, and evaluative complexities that emerge.
As such, stakeholders were asked to describe both key
strengths and weaknesses of the campaign. These are summarized along with key achievements in Table 5-1. Table 5-1
Freedom From Fear – key achievements, strengths and weaknesses
Key Achievements •
Increased community
Key Strengths •
awareness of family &
Built on both
groups (both campaign
Awareness and
professional knowledge,
and counseling options)
provision of help for
and field research
•
Has ‘run its race’
Cutting edge social
•
One size fits all model
•
•
•
Awareness there is help for victims
•
•
Setting Best Practice
for services/counseling
Effectively using
does not work
children as a lever •
Well resourced
Brought the tragedy of
•
Establishment and
•
Only deals with physical violence
•
Inadequate tracking of
domestic violence into
maintenance of Men’s
men to determine
‘living rooms’ and
Domestic Violence
longer term
contextualised it as a
Helpline
effectiveness
•
private family matter Reinforced that children
•
& young people are deeply affected by domestic & family violence
5.2
marketing approach
Standards
community issue not a
•
Culturally inappropriate for Indigenous & CALD
men •
•
formative research
domestic violence •
Comprehensive
Weaknesses
•
Powerful television
•
Unequal distribution of
media
funding amongst
Good use of radio
strategies e.g. media vs
advertisements
service provision
Consistency and links
•
Scope for better links
between elements,
between all the
rather than ad hoc
relevant agencies
How has Freedom From Fear fared against its objectives?
When established, Freedom From Fear was underpinned by six overarching long term objectives; with the first phase framed around three more specific shorter term phase 1
11
objectives (see section 1.2). As is appropriate, the five successive waves of campaign evaluation have considered the impact of the campaign against these phase 1 objectives. For the purposes of this review however, we have sought to also gauge how Freedom From Fear has progressed against the broader long term objectives, and additionally, to assess the currency of these objectives, and any potential refinements for future iterations of the campaign. Prior to discussing the progress and effectiveness of Freedom From Fear against its objectives however, it is pertinent to consider a number of important caveats (see Table 5-2). Identified from the literature and our own experience, these apply to the complexities of behaviour and social change and the way in which public health and social marketing campaigns operate generally, but are magnified in their application to a unique and unprecedented campaign targeting behaviour as psychologically, socially, behaviourally and ecologically complex as violence. Table 5-2
Evaluating effectiveness of behaviour and social change campaigns Complexities of evaluating the effectiveness of behaviour and social change campaigns
It can be difficult to isolate the impact of the campaign from the impact of other activity impinging on the health behaviour in question. It is often inappropriate to try and isolate the impact of the campaign from that of other activity, as conceptually campaigns are seen as working synergistically with these other measures. Campaigns occur in the ‘real world’ not in scientific laboratories, and so it is difficult to conduct scientifically rigorous evaluative research and, to control for intervening variables. Health related behaviours are complex and difficult to change and it is not always possible to see a direct effect in the short-term.
Notwithstanding
these
caveats,
there
is
considerable
evidence
that
public
communication campaigns do play an important role in communicating information to the public, placing health on the public’s agenda, and contributing to changing lifestyle behaviours
[21-23].
Of relevance to Freedom From Fear, the potential for
effectiveness is enhanced through the application of formative research, attention to problem definition, clearly linked aims and
strategies, detailed audience analysis,
realistic goal setting, supplementation with local-level activity, and sound use of theory and previous research
[24].
These factors are considered amongst the stakeholder
feedback, data analysis and review observations synthesized in the following discussion of how Freedom From Fear has fared against its objectives: 12
Long term objective 1: Promote and reinforce understanding and acceptance in the community that many forms of domestic violence are a crime. The criminal nature of domestic violence as articulated in this objective has not been explicitly promoted or addressed by Freedom From Fear to date, although it is seen by some as having been implicit. The absence of an overt ‘criminality focus’ in the early years of Freedom From Fear is not necessarily a failure or weakness however, with stakeholder support generally expressed for the greater initial emphasis given to the social and community unacceptability of domestic violence; the prevention/early intervention focus for those at risk of perpetrating; and the provision of avenues for help. Ideologically, the contextualisation of the criminal nature of domestic violence within the broader context of behavioural and community values, norms and fundamental human rights is seen as appropriate for Freedom From Fear, both in the past, and in future iterations. While stakeholders concur that the criminal nature and consequences of domestic violence are critically important and should not be downplayed, there are clearly social, environmental and normative factors that also need to be tackled if the problem is to be addressed in an effective and comprehensive manner. Nonetheless, there is also considerable scope and need to raise both community and target group awareness of the perceived severity of the ‘criminal’ nature of domestic violence. Feedback from counselling agencies and police indicate that there is still often low comprehension and/or denial of the criminal nature of domestic violence among elements of the primary target group. This includes men from lower SES and some CALD and Indigenous backgrounds, which contend with issues of cultural tolerance and silence around domestic and other forms of violence.
While deterrence theory
[25]
recognises that criminal threats and sanctions alone are limited in eliciting significant behavioural change, legal and social sanctions against family and domestic violence are intertwined and can act as a powerful and pragmatic lever for some men who are less responsive to emotional or rational appeals and/or who wish to remain outside of the court or prison system. The criminal dimension of domestic violence now has greater currency than it had when Freedom From Fear commenced because of the recent changes in the Violence Restraining Order (VRO) Amendments Bill (2004) and the recommendations following The Gordon Enquiry (2002). The WA Family and Domestic Violence Strategic Plan 20042008 and the VRO Amendments are still relatively recent, providing a window of opportunity to strengthen the ‘position’ of domestic violence as a crime or a criminal
13
offence in future Freedom From Fear strategies. It is now exceedingly timely for this objective to be more explicitly addressed, capitalising on recent changes to pertinent legislation and police powers as a leveraging opportunity to provide the campaign with a new but complementary angle.
Long term objective 2: Increase awareness in the general community that violence is not an acceptable method of resolving problems and difficulties.
This objective has been addressed through various Freedom From Fear strategies to date, both explicitly (through the information disseminated through publications, the helpline and intervention programs) and more implicitly (through the consequences and ‘ugliness’ of domestic violence as portrayed in the media advertising). The focus of Freedom From Fear has however been primarily on the unacceptability of violence within a home and partner-partner context, whilst the objective potentially embraces a wider interpretation of violence and the contexts, settings and population groups to which it might apply. Quite a number of stakeholders in fact supported the broadening of Freedom From Fear to address the wider interpretation of this objective. As such, this recognises that domestic violence does not breed or occur in a vacuum from other forms of violence, and that there are societal norms, behaviours, environmental cues and triggers that may be common across various forms of violence. Many stakeholders (including those working with victims) also noted the need to acknowledge that not all violence is perpetrated by men against women, and that this objective is equally applicable to same-gender relationships, and in some instances to female instigated violence against men. As campaign evaluation surveys have primarily sampled men who are perpetrators or at risk of perpetrating violence (although with a subset of non-perpetrator males), the findings cannot be readily extrapolated to provide a measure of overall shifts in community attitudes regarding the acceptability of violence. An exception to this is the campaign evaluation surveys of women undertaken in 1999 and 2003. The 2003 Women’s Awareness and Attitudes survey found high levels of support for the Freedom From Fear campaign among women (and men), with very little negative ‘take-out’ (e.g. most disagreed that the ads conveyed that women who suffer domestic violence deserve it in some way). The majority of stakeholders concurred that Freedom From Fear, and in particular its media component, has contributed to increased awareness and shifting norms and
14
attitudes surrounding the acceptability of violence as a means of resolving problems. The portrayal of the impact on children in the media executions is felt to have contributed strongly to this. Other more external factors that have complemented and contributed to these shifts include legislative changes, the national ‘Australia says no’ campaign, increasing attention to the prevention of bullying and violence in schools and other mainstream media attention drawn to negative incidents and/or consequences of domestic violence and other forms of violence. Related to acceptability, although not explicated in the Freedom From Fear objectives, the campaign has also been seen to have been effective in highlighting that choosing to use violence against a partner is a choice, and importantly, a choice that doesn’t have to be made or for which help is at hand. Understandably, those working at the coalface with perpetrators or victims of domestic violence were most likely to have a more conservative view of the extent to which such norms have shifted. The five evaluation waves have tracked some positive shifts in beliefs about the unacceptability or justifiability of various forms of violence (e.g. hitting in self-defense, yelling loudly in response to nagging) among the target group since 1998. As noted in the most recent evaluation however, some beliefs (e.g. women never provoke occasional slapping) have tracked in a negative direction.
Long term objective 3: Promote understanding and acceptance in the community that the perpetrator is responsible for the violence. Links with Phase 1 objective 2: Promote understanding and acceptance in the community, and amongst men in particular, that the perpetrator is responsible for violence, not the victim; and that there are no circumstances in which domestic violence is justified. Although issues of responsibility and acceptability were not overtly addressed in the phase 1 media advertising executions.
[26]
it was nonetheless implicit in most of the media
The notion of perpetrator responsibility has also been a key message
delivered through written materials and through the counseling and help services provided for perpetrators. It is reinforced by the efforts of victim support programs to counter notions of self-responsibility and self-blame often experienced by those against whom violence has been perpetrated within a relationship.
15
Evaluation data indicates that the campaign has been effective in this regard. In the campaign evaluation of the mirror ads for example, 66% of men surveyed felt that the ad clearly communicated that such violence is the man’s responsibility. Compared to base-line data collected in 1998, the acceptability of several forms of emotional and physical violence among the target group has decreased (see Figure 5-1, Figure 5-2). Figure 5-1
Acceptability of certain behaviours – ok to yell; ok to hit 37%
40
32%
31%
35
25%
30 25
32%
28% 23%
22%
22%
22% Ok to yell when nagging
20
Ok to hit in self defence
15 10 5
ay
'0 3
n= 40 1
n= 39 9 5, M W
W
W
4, A p
r' 01
t9 9
n=
n= 38 5
r' 99 2, A p
3, O c
35 9 n= k W
Be nc hm ar
Figure 5-2
40 0
0
Perpetration of DV over the campaign life Yelled loudly at them
80 70 60 50 40 30 20 10 0
W
1
ct ,O
Put down/belittled Threatened to hit Thrown something
'98
40 N=
0
W
2,
Ap
99 r'
5 38 n= W
3
c ,O
99 t'
0 40 n= W
4
r Ap
'01
9 39 n=
W
M 5,
ay
3 '0
1 40 n=
Tried to hit Hit in self-defence
Source: 'Freedom From Fear' Post Campaign Evaluation Wave 5[26]
Notwithstanding these gains, the most recent campaign evaluation
[26]
concluded that
the current suite of media advertisements may have reached an impasse in further moving perpetrator attitudes towards acknowledgement that domestic violence is never justified, and that executions more explicitly focusing on issues of responsibility and acceptability may be required to further attain this objective. Consultations with stakeholders in direct contact with both perpetrators and victims of domestic violence
16
substantiated this view, with defensive or justified explanations for occurrences of violence still common among perpetrators.
Such denial or diminishment of self-
responsibility is well recognised in the literature
[25]
and remains one of the key
impediments to effective behavioural reform. As Freedom From Fear has encountered, issues of responsibility and causality in relation to domestic violence are fraught with sensitivities, with some men’s groups in particular, critical of approaches that infer that violence is never provoked or the result of an escalated and complex chain of events. Interestingly, while no stakeholder group advocates buying into the argument that family and domestic violence is ever justifiably provoked, or worse, ‘asked for’, there is cautious recognition of the fact that the circumstances and factors that precipitate domestic violence may not be clear-cut or entirely one-way, and of the need to acknowledge the complexity underpinning the causes and triggers of violence within relationships. Related to this were calls from a range of stakeholders, to broaden the predominant emphasis of Freedom From Fear beyond physical manifestations of violence, to include emotional and more subtle albeit less physical forms of violence and abuse. Thus while the relevance of this objective was supported overall, stakeholder comments reflected a number of nuances that suggested that the wording and focus of the objective could be slightly repositioned for future iterations.
This included issues of
terminology described in Section 4 of this report.
Long term objective 4: Prevent the first act of violence committed by ‘at risk’ men.
While there was support for this objective ideologically, it was seen by many stakeholders to be somewhat ambitious as worded and difficult to evaluate. As underscored by the consultations, the ‘first act’ of violence usually occurs or is precipitated along a fluid life-course trajectory, preceded by a variety of factors or incidents indicative of a ‘slippery slope’ or negative spiral. As an act of violence may be physical or emotional, overt or covert, the identification of the ‘first act’ is difficult, albeit less so for explicit physical violence.
Stakeholders
working with perpetrators and victims also described the environments in which many perpetrators grow up and/or live in, as being diffused with violence in some form or another, hence the capacity to anticipate or recognise or ‘own’ an act of violence can be limited.
17
As noted by the Helpline counsellors, calls are most frequently precipitated by regretted acts of violence or partner demands for cessation of violence.
This attests to the
difficulties of primary prevention among ‘at risk’ men. Similar conclusions can be drawn from the published literature
[27-29],
although studies to date have been most often
conducted with identified perpetrators, rather than those at risk who have not yet committed a first act of violence. Preventing the ‘first act’ of violence has a strong primary prevention emphasis and requires a long term outlook, far beyond the duration of Freedom From Fear to date. As argued by a number of stakeholders, such prevention needs to ideally begin in childhood, addressed through parenting, bullying, relationship and school-based strategies.
The FDVU’s Schools Project and the Workplace project are examples of
settings based collaborative approaches congruent with a primary prevention emphasis. Long term objective 5: End acts of violence committed by perpetrators. As with the preceding objective, the desirable intent of this objective was not disputed by stakeholders, but the wording, measurability and achievability of ‘ending acts of violence’ was seen by some stakeholders to be problematic.
Foremost, there is
uncertainty as to whether the objective reflects an overarching aim or vision for Freedom From Fear or pertains to the cessation of violence by individual perpetrators. While Freedom From Fear campaign evaluations provide some evidence of attitudinal, perceptual, and behavioural shifts pertinent to this objective, some long term tracking of perpetrator behaviour following use of the helpline and subsequent program referral and participation is needed. Our review was unable to identify any routine tracking of such behavioural outcomes (as reported by perpetrator or validated by victim), with the bulk of program evaluation currently relating to process indicators (i.e. referral and program participation rates). While data is routinely collected on helpline calls, referrals to programs and program participant numbers and attendance, these are process or at best impact measures only, and the relative dearth of outcome evaluation of the MDVH and programs was one of the more prominent and frequently noted weaknesses of Freedom From Fear observed by stakeholders, including those working in service/program delivery. Resource limitations, the absence of systems for routine collection of such data and the complexities of longer term follow up with men in the target group because of
18
itinerancy and confidentiality issues, were the most frequently provided explanations. Similar issues are identified in the literature [28].
Long term objective 6: Encourage and assist appropriate responses from service providers to perpetrators, potential perpetrators and victims. Social marketing campaigns vary considerably in the extent to which ‘calls to action’ for individual behaviour change need to be and are supported by relevant services, supports and policies. Violence is a complex and often entrenched behaviour with many psycho-social facets and both perpetrators and victims usually require proactive help, guidance and support. When the campaign was established, there was thus a clear ethical and ‘needs’ imperative to ensure that there were both avenues for the target group to turn to immediately when moved to contemplate behaviour change (i.e. the helpline) and in turn, to be referred to and to receive requisite counseling, therapy, skills and support. The men’s helpline and the subsequent referral to programs comprised the primary forms of assistance for perpetrators and potential perpetrators, complemented by brief self-help materials. Promotion of such assistance has been channeled through the media, publicity and resource (i.e. pamphlets, posters) strategies, health professionals and using in some instances, settings likely to be frequented by the target group. Overall, stakeholders concur that the promotion and provision of services for perpetrators and those at risk of perpetrating violence has been an integral and essential component of Freedom From Fear since its inception and that this has filled a prominent void. Even stakeholders admitting to initial concerns about the diversion of resources from victim support programs to perpetrator assistance services conceded that such concerns had subsequently been alleviated, and that the perpetrator counseling, referral and treatment programs are now generally well recognized as integral component of a comprehensive response to domestic violence in WA. There was general support therefore for the appropriateness and relative attainment of this objective, although views varied as to the: adequate availability of services relative to demand; appropriateness of what was sometimes referred to as a ‘one size fits all’ program model (and related issues of attrition); difficulties of reaching those within the target group who are unlikely and/or reluctant to recognize that they need help or to take that first help-seeking step;
19
inadequacy of pertinent services for specific population groups, particularly Indigenous and CALD males (and women) and those in some regional areas; appropriate measures and methodologies for evaluating the short-term and long term effectiveness of perpetrator services and programs; and need to ensure that the short and long term safety of women and children remains a paramount consideration.
Phase 1 campaign objective 1 To increase knowledge within the community, and specifically amongst the primary target group, about state-wide and local resources available and the methods of accessing assistance. The MDVH was established as the primary conduit for achieving this objective, along with some targeted promotion by service agencies of programs, self help materials and services available.
Comprehensive data collected by the MDVH between January
1998 and February 2005 provides an informative profile of the types and volume of calls received by the helpline over this period (see Figure 5-3 ). Figure 5-3
Helpline callers by type/reason (1/1/1998 – 5/2/2005) Adult with issues related to DV, 182 Other, 7868
Child at DV risk, 59
Person expressing interest not identifying, 888
Perpetrator at risk, 8909
Person reporting suspected DV, 1262
Adult with issues related to DV Child at DV risk Perpetrator at risk Victim at risk
Victim at risk, 4529
Person reporting suspected DV Person expressing interest not identifying Other
Over the 7 year period depicted in Figure 5-3, a total of 23 697 calls were received by the MDVH.
Men who self-identified as perpetrators or at risk of perpetrating
represented 37.5% (8909) of calls over this period.
20
From total calls received, 17.7%
(4184) referrals were made by the MDVH to service agencies and programs, with the bulk of these referrals relating to self-identifying perpetrators. Campaign evaluation data collected since the inception of Freedom From Fear indicates that there has been a significant increase in awareness of the availability of help for those who are violent or who may become violent, as well as a corresponding increase in awareness of the availability of a telephone helpline (Figure 5-4). However, as the MDVH is the main conduit and first point of contact for assistance, the low levels of awareness of the helpline have been identified as a concern in several of the evaluation reports. While we concur in part with these concerns, it is pertinent to note that even well entrenched campaigns such as QUIT often achieve telephone line awareness levels of between 60% and 70%, and smoking is a salient issue for a greater proportion of the population than domestic violence, with around one fifth of the adult population smoking. In our view, the difficulties of maintaining awareness of the availability of help and demand for helpline services during non-media periods (as experienced by Freedom From Fear and other public health campaigns with counselling and information services) is of greater concern, as this raises ethical issues about the need for more regular media to keep such awareness of helpline services ‘top of mind’. Figure 5-4
Men’s awareness of help and helpline
80 70
69
65
60
52
50
57
52
42
31
30
27
21
20
19
10
25
Aware of help serv ices in general Aware of MDVH/telephone counselling Able to name MDVH
4
0
k ar m h nc Be
53
43
40
g Au
74
73
'98 W
ct O , 1
8 '9 W
2,
v No
8 '9
3 99 01 '0 r' r' p p ay A A M 3, 4, 5, W W W
Source: FFF Post Campaign Evaluation Wave 5, 2003
Barriers to seeking help correspond to those documented in the literature [30] and in the most recent evaluation (wave 5) included not believing they need help (41%), able to get help elsewhere (43%), privacy and it not being anyone else’s business (34%); and concerns about confidentiality (24%). Caller data collected by the MDVH suggests that propensity to call the helpline varies markedly by age, with self-identifying perpetrators most likely to be aged between 20 and 40 years (see Figure 5-5). Further investigation is
21
required to ascertain whether age variations in help-seeking behaviour are in part explained by the incidence rates of domestic violence perpetration among men of different ages. Figure 5-5
MDVH Caller profile by age (1/1/1998 – 5/2/2005)
10000 9000
Unknown
8000
54+ years
7000
40-54 years
6000
20-40 years
5000
0-20 years
4000 3000 2000 1000 0 Adult w ith issues related to DV
Child in DV/At risk
Perpetrator/At Person express Person Risk self interest - not reporting identifying identifying suspected DV
Despite the low levels of men able to specifically name where they can turn for help, not knowing where to turn for help does not appear to be a significant barrier cited per se. Additional barriers exist for men in regional areas and men from CALD or Indigenous backgrounds; these are discussed at Section 8.1.2 and extensively in the TNS report on barriers preventing country men from accessing domestic violence services [30]. Attitudinal barriers to seeking help were mirrored in the low rates of help-seeking behaviour among those surveyed, with only 2% having called the Helpline and 14% having sought professional advice, despite the fact that 58% of the sample selfidentified as perpetrators of emotional violence and 15% of physical violence. Such a chasm between recognition of a problem and taking action should not be construed as a failure of Freedom From Fear however, as it is consistent with numerous behaviour change theories and studies. Applications of the stages of change model to perpetrated violence for example, posit that even once men move from the precontemplative or emotive cluster, they are often not yet prepared or sufficiently motivated to take action [27]. Moreover, as observed by helpline counsellors and agencies working with perpetrators in the course of our review, perpetrators of violence do not necessarily progress naturally through all of these stages, and often need to reach a crisis point before they
22
will seek external help. Prompting men to seek help prior to crisis point is clearly challenging, but as discussed later in this report, warrants further exploration. Even if men do call the helpline, there is an inevitable ‘drop off’ at each stage of the subsequent process, with only 16% of men referred to a program in 2004 completing it (see Figure 5-6), corresponding to 18.3% completing in 2003 and 13.6% in 20021.
While
attrition rates are also high in the literature, issues of ‘poor fit’ between perpetrators of violence and the forms of counseling and help available are also documented in published studies and were alluded to in relation to the WA context by a number of stakeholders during our consultations. Figure 5-6
600
Helpline calls, referrals and program participation
546 MDVH Referrals
460
500
423
Agreed to make Appt
400
Presented 1st Appt Group program
300
Cont. group program
200 84
74
100
71
Completed* (attend final session)
0 2002
2003
2004
From a victim’s perspective the 2003 Women’s Survey reported that victims of physical violence were supportive of the fact that help is specifically for men (11% of victims of physical violence say this compared to 2% non-victims), which is an important positive move forward in the thinking process away from the belief that money spent on perpetrators could have been better spent on victims and their children. Women’s awareness of the help services increased significantly from 76% in a 2000 survey to 84% in 2003 (see Figure 5-7).
1
Data not available for 2005
23
Figure 5-7
Women’s awareness of MDVH
84
84%
82 80 78 76
74%
76%
74 72 70 68
Womens Wave 1 ' 99
Womens Wave 2 ' 03
Mens Wave 5 Apr ' 03
Source: Donovan Research, campaign evaluation [26]
There has also been a significant increase in the proportion of women who have talked about the campaign with a female friend who has a violent partner (2%-6%). Accordingly it highlights the importance of strategies that include family and friends and also that family and friends can help develop a safety plan if required. This is corroborated by MDVH data which indicates that nearly 1 in 4 calls (5328) received in 1998-2005 were from people seeking information about domestic violence and another 5% (1262) wanting to report or talk about suspected domestic violence.
6 Relevance of a social marketing approach to family and domestic violence As with many health related behaviours, violence is complex and its causes and triggers multi-faceted, hence a long term outlook for effective prevention and early intervention is essential.
Regardless of the behavioural change theory or model
applied, there is generally a progression of stages or range of factors (internal and external) to be influenced, before actual behavioural change occurs
[31-33].
In
marketing and social marketing models, there is substantial emphasis placed on knowing and understanding the target group, and designing all elements of a campaign to maximise impact with the target group [34]. Social marketing is often narrowly equated with mass media, often because this is the most visual element of the campaign, and sometimes because the campaign is itself inadequately underpinned or supported by other strategies. In the commercial sector however, campaign and marketing strategies are complemented by attention to a range of other issues including product quality and availability, competitors, market
24
climate and trends, internal efficiency etc. It should be no different in the community services
or
public
health
sectors,
whereby
campaigns
and
marketing
are
complemented and supported by relevant policy, economic, service delivery and structural measures that all have the potential to contribute to a common outcome goal. The use of the mass media is often the most intensely debated aspect of health promotion campaigns. From a review of relevant literature, the key benefits of using the mass media to promote health are summarised below (Figure 6-1): Figure 6-1
Benefits and Limitations of mass media
Key Benefits
Limitations
•
identified by the general public as a major source of health information [35];
•
taps into existing communications channels and can reach a large proportion of the population, including population subgroups who are difficult to reach through other means [36];
•
relatively cost-effective, low cost per capita & less labour intensive than many other strategies for modifying health behaviour [37];
•
Can reach a large proportion of the population simultaneously [36] which is advantageous for creating a groundswell of public support;
•
commercial products can offer instant gratification; health risk behaviours are often more physiologically and psychologically entrenched; the marketing environment is sometimes hostile to messages about changing health related behaviour; the gains are too long term to be perceived as outweighing the costs of behaviour change; and it is more difficult to offer incentives or guarantees of satisfaction. Potential to be undermined by commercial media messages promoting the very behaviour seeking to change (as occurs in the areas of alcohol, nutrition).
• can be used to shape or set public agendas and to foster a climate conducive to structural, environmental or legislative interventions [35];
•
The ‘ selling’ of health behaviour change through the media is more complex than the marketing of commercial products [39]. Reasons include:
Less likely to be effective if they are not complemented and reinforced by consistent messages at the community, social and political level.
provides an umbrella of awareness and support for interventions that take place at the community or individual level [38].
The complexity of health behaviours renders it sometimes difficult to define simple prescriptive actions [40].
Social marketing when applied to public health or community issues typically includes mass media strategies (e.g. television, radio or press) complemented and reinforced by ‘on the ground’ communications strategies such as the provision of self-help materials, health
professional
counseling,
referral
and
advice,
educational
activities
in
appropriate settings and local publicity. There is however an ever increasing array of marketing and social change tools available to design and implement programs that
25
promote socially beneficial behaviour change
[23].
Interpersonal (guerrilla) marketing,
web-based and new IT strategies, partnership with the retail sector, use of alternative settings are among strategies being used to reach distinct target audiences
[23].
Specific forms of social marketing are discussed further at Section 7.3.
6.1
Social marketing applied to domestic violence
Social marketing approaches to health and social issues are premised on an understanding that the behaviour of focus is preventable, at least in part. Using a public health model, violence prevention and early intervention initiatives can be broadly grouped as depicted in Figure 6-2 Figure 6-2
[10, 41].
Tiers of prevention Early Interventions Targeted at individuals/ groups who exhibit early signs of perpetrating violent behaviour. Intervention Strategies Aim to deal with violence that has occurred. Prevents consequences & re-occurrence.
Primary Preventions Seek to prevent violence before it occurs.
Source: Vichealth, 2004 [10]
Overlaying these tiers of prevention, interventions can be defined by the target group of interest. That is, universal interventions encompass approaches aimed at groups or the general population without regard to individual risk, whilst approaches aimed at those considered at heightened risk for violence are termed selected interventions and finally approaches aimed at those who have already demonstrated violent behaviour, such as perpetrators are known as indicated interventions
[42].
The majority of
interventions both in Australia and world-wide, have focused most on secondary and tertiary responses to violence, with victims (namely women and children) the priority target group
[41].
Yet a comprehensive response to family and domestic violence
should not only protect and support those directly affected, but also promote nonviolence, reduce the perpetration of violence, and aim to change the circumstances and the conditions that give rise to violence in the first place. Such an approach is congruent with the priority areas of prevention, protection and promotion that underpin the current WA Family and Domestic Violence State Strategic Plan. The Freedom From Fear Campaign was the first of its type in Australia
[22],
being a
government funded mass media-based campaign focusing primarily on perpetrators
26
and men at risk of perpetrating domestic violence and asking them to voluntarily seek help to change their violent ways
[22].
Within the family and domestic violence sector,
this represented a radical departure from victim focused and tertiary Interventions and services while within public health, it represented a landmark application of health promotion and social marketing principles, models and strategies to a complex psychosocial and community issue. As such, Freedom From Fear has been acclaimed nationally and overseas [43]. There is an ever increasing emphasis on the importance of evidence based decision making and program planning in both the public and private sectors. Compared to when Freedom From Fear was conceived, there is now a sizeable scattering around the globe of campaigns and social marketing initiatives targeting violence against women. Accordingly, we now have a plethora of resources that can be accessed, including Australian and international based electronic resources, national and state based databases and reports from internationally recognized organisations such as WHO and UNIFEM. Reviewing all of this literature as it relates to family and domestic violence in Western Australia is a mammoth task and beyond the scope of this review. We have thus drawn heavily from the timely and recently completed review of international and Australian social marketing/public education campaigns focusing on violence against women that was commissioned by Vichealth
[18].
Its authors, Donovan and Vlais
[18]
identify
eight key themes that have been defined to date in campaigns targeting the issue of violence against women, both within Australia and internationally (Table 6-1). Table 6-1
Current and potential campaign themes identified in literature Themes used in campaigns to date
Deterrence
appeals
(criminal
offence
Women’s rights and empowerment
focus) Breaking the silence
Changing social norms
Negative impact on children
Appeals
to
family/friends/witnesses
to
intervene Negative impact on women Potential themes that could be tried Threat of loss of partner, children
Violence is morally wrong
Justice system ‘voice’/response efficacy
Positive relationship incentives/appeals
The themes depicted in Table 6-1 correspond closely to the themes identified in our own review of literature and with the communication approach options raised by
27
stakeholders. Donovan and Vlais provide an expansive and insightful discussion of the rationale, application and efficacy of each of these approaches, and refer often to the Freedom From Fear formative and evaluation research as part of this discussion. Their review also identifies a number of potential communications angles that have not yet been identified as having been applied to family and domestic violence.
These
potential themes are also included in Table 6-1 and are described in Donovan and Vlais’ report [18]. Above the individual state or country level, violence has been recognised as a major preventable health and social problem by transnational organisations such as the World Health Organisation (WHO)
[44]
and UNIFEM
[45].
WHO’s global campaign for
violence prevention is holistic and has a strong primary prevention focus, with strategies including training new parents, helping children learn social skills; assisting communities to control the availability of alcohol; enhancing services for victims and strengthening policies that promote gender, social and economic equality [44].
7 Cost effectiveness of preventing domestic violence In community service and health sectors with limited resources, the value of social marketing and other prevention strategies is sometimes questioned, particularly if the benefits require a longer time period to be realised. However, there is increasing evidence in Australia and overseas documenting the economic benefits of investing in the prevention of public health and social problems, paralleled by growing recognition of the unsustainability of systems that focus primarily on treatment. For example, an epidemiological and economic analysis of public health programs to reduce tobacco consumption, coronary heart disease, HIV/AIDS, measles and road trauma computed substantial net savings and reduced government expenditure on hospitalization and treatment in all five program areas [46]. Cost-benefit analyses relating to domestic violence pose many challenges and difficulties and have rarely been undertaken
[9],
although there is general concurrence
that the benefits of prevention and early intervention far outweigh the many health, criminal and social costs associated with family and domestic violence.
Several
Australian studies in the late 80’s and early 90’s sought to compute the average cost of services or treatment per victim; while the computations and methods vary considerably, the direct costs alone per victim/case ranged between $9458 to $51 000 and would be considerably higher in today’s dollar terms [9] . It was beyond the scope of this review and the data available to accurately contextualise the costs of the Freedom From Fear program within the broader rubric of
28
the costs of domestic violence to the WA community. computations provide some pertinent insights.
Nonetheless, even crude
For example, the total media
expenditure over a 7 year period for Freedom for Fear equated to approximately $75 per call responded to by the MDVH and $428 per referral made to programs.2 These costs are significantly less than even the most conservative costs incurred in relation to victims of violence, and go nowhere near the policing and justice costs associated with perpetrators see (Figure 7-1). In the 2005/06 financial year, the monies allocated to Freedom From Fear media ($170 000) was modest relative to other public health and community issue campaign budgets and was less than the funds allocated to the MDVH ($191 000) and funded programs conducted for DCD by Relationships Australia and Centrecare ($226 228). Figure 7-1
The Domestic Violence Financial Pyramid
$ FFF FFF MDVH MDVH Programs Programs––Funded Funded Services Services Treatment Treatment&&hospitalization hospitalization ofofvictims victims Criminal/Prison Criminal/Prisoncosts costs(including (including mandated programs) mandated programs) Indirect Indirectcostscosts-psychological, psychological,loss lossofof productivity, productivity, reduced reducedquality qualityofoflife life
2
$$$$
based on figures in Appendix 5, with total media expenditure) of $1 793 730 (1998/99-2004/05, with 23 697 calls received over the comparable period (1/1998 – 2/2005).
29
8 Future Directions As articulated earlier, Freedom From Fear is founded upon a mix of primary prevention, early intervention and intervention strategies, with deliberate linkages between the awareness raising and social marketing components (primary prevention and early intervention), the MDVH and referral processes (early intervention) and treatment programs (intervention/treatment). This is depicted in Figure 8-1. Figure 8-1 Relationship between Freedom from Fear and domestic violence prevention
Reduce Family & Domestic Violence
Prevention-Protection-Provision Prevention-Protection-Provision Freedom Freedom From From Fear Fear
Self Help & Promotional materials
Workplace
Schools
CALD Indigenous Rural & remote
MDV MDVHelpline Helpline
Settings & Intermediaries GP Practice
Youth Same sex
Target Groups
People with Disabilities
Perpetrator Programs
Projects Projects
Police
Men’s groups
As such, implications for the future directions of Freedom From Fear are intertwined with the broader context of domestic violence strategies including the Western Australian Family and Domestic Violence State Strategic Plan and the activities, directions and funding of counseling services and programs in WA. Future directions and strategies for Freedom From Fear are also contextualised and affected by trends and issues within the sector and community more broadly. This includes changes arising from the VRO Acts Amendments Bill (2004), the continuing implementation of recommendations from the Gordon Inquiry and the advent of the federal ‘Australia says No’ campaign, all of which are recent and post-date the inception of Freedom From Fear.
30
The discussion of considerations for future directions of Freedom From Fear is couched around the themes of: target groups; overarching campaign directions; media strategies; other contemporary social marketing approaches; other support strategies; and research and evaluation.
8.1
Target group
The phase one Freedom From Fear strategies focused on reaching the primary target group (male perpetrators and potential perpetrators), while minimizing any unforeseen negative
impact
and outcomes on
the
‘other
audiences’. The
stakeholder
consultations and review of literature and programs elsewhere supports the retention of male perpetrators and potential perpetrators as the primary target group, along with a number of population subgroups warranting inclusion or greater attention in the next iteration of Freedom From Fear, in particular: ‘other audiences’ who have in fact been positively rather than just neutrally impacted by the campaign to date, or who would be appropriate to target in future; and subgroups of the primary target group not as effectively reached or impacted by current strategies, among whom domestic violence is a prevalent issue.
8.1.1
Inclusion of some current ‘other audiences’ as secondary target group
Feedback from stakeholders, data on the gender and nature of calls to the helpline and the review of literature
[18]
support the more overt delineation of friends, family,
colleagues witnessing or aware of violence as a Freedom From Fear target group. Previously, these were grouped with ‘other audiences’. As Freedom From Fear has experienced
to date,
media
messages
targeting
perpetrators and
potential
perpetrators also impact on the awareness, attitudes and cues to action of this secondary target group. While the helpline has accommodated calls and requests for advice from these, there is scope to further legitimate this role and to consider the development and dissemination of relevant resources or advice for those wanting to help either a perpetrator or victim within a domestic violence situation. In the same vein, Freedom From Fear has precipitated cues to action from victims, be it on behalf of their partners in terms of directing them to help, or by empowering them to seek help themselves. MDVH counsellors and data indicates that a sizeable number of calls have been received from victims (representing 19% of calls (4529 calls) in the 1998-
31
2005 period).
Indeed, this in part precipitated the establishment of the Women’s
Domestic Violence Helpline in August 2003. The fact that calls are still received directly from women by MDVH however, suggests that there is some blurring of the distinction or overlap between the two phone services in the public’s eye. For example, women sometimes contact the MDVH concerned about a violent partner or male they are aware is violent, and seeking clarification about what he can do about it3 (personal communication MDVH, 2006). Clearly there are ideological, gender and confidentiality reasons for maintaining and promoting the men’s and women’s services as two separate helplines. Nonetheless, as noted earlier, specific awareness of the MDVH (as opposed to a helpline generally) remains low among the target group. Agencies working with men also acknowledge that there is a grey and overlapping line between strategies targeting perpetrators and victims, and as identified by Ellen Pence in her recent Western Australian Domestic Violence Audit, the alignment between interventions and services targeting men and women is a critical determinant of effective outcomes for both parties, as well as for the ‘family and domestic violence system’.
8.1.2
Subgroups of the primary target group not as effectively reached or impacted by current strategies
As already recognized by FDVU, people of Indigenous background, from CALD communities, or living in rural or remote areas are more difficult to reach through conventional broad-based public strategies, and are enmeshed in a host of other life circumstances and factors that can exacerbate the likelihood of domestic violence perpetration or victimisation. Indigenous and CALD communities While the issues and needs of each of Indigenous and CALD communities are unique, there are some overlapping strands that have led to an intertwined discussion in this section of our review. It was appropriately recognised as beyond the scope of the first phase of a broadbased Freedom From Fear campaign to specifically target Indigenous or CALD background men who are, or are potentially violent against women. It was addressed in the phase one planning document however the advertising messages were tested with these specific groups to ensure they did not offend or cause unintended negative attitudes. In addition it was recognized that key campaign resources and publications would be required in a variety of languages to meet the needs of CALD groups (DVPU 3
In this instance a safety check would be conducted, i.e. is the caller safe?, and counselling and information would be provided.
32
1998). As with all social marketing and mass media campaigns however, even with targeted media buying (as occurred throughout Freedom From Fear media waves) ‘exposure’ to advertisements cannot be confined to the target group, hence the impact on other viewers needs to be considered. Consultations undertaken with Indigenous representatives prior to the first phase indicated that Freedom From Fear ad concepts and executions may not directly engage or connect with Indigenous men in the same way as Caucasian men, but did not envision negative impacts as such. It was anticipated that the program would reach some Indigenous and CALD men depending on their degree of acculturation within mainstream society [30]. The original ten-year plan proposed additional funding to address issues specific to Aboriginal and CALD communities. The report prepared for the FDVU in which barriers preventing country men were examined states that: It remains our strong conviction that for any campaign or program to effectively address family or domestic violence within these groups, it must be developed specifically for each defined target audience [30, p46].
There has been no specific sampling of Indigenous or CALD men in the Freedom From Fear media evaluations to date, but anecdotal feedback from stakeholders working with Indigenous people and CALD communities generally felt that the ads may have contributed to some raised awareness, but have diminished salience because of the type of males, homes and scenarios portrayed, although it was conceded that they are not overtly “white” by virtue of the grainy executions. Qualitative research on the flow-on effects to CALD and Indigenous men carried out by Donovan’s Research in 2001 found that Indigenous men tend to deny the ads are directed at them because the images portrayed depict white (mainstream) men with white (mainstream) families living in white (mainstream) homes. Importantly however, they do not reject the ads on this basis, ‘appreciating’ the fact that the ads convey that family and domestic violence is not solely an Indigenous problem. Since Freedom From Fear was established, the profile and public concern around issues of Indigenous family violence has risen considerably, precipitated by the findings and implementation
of recommendations of the
Gordon
Inquiry. Discussions with
stakeholders highlighted the complex combination of factors that need to be addressed in order to prevent or even reduce Indigenous family violence. These include loss of cultural identity, role and alienation together with unemployment, boredom and drug and alcohol abuse. The approach recommended by the Donovan research group (see Figure 8-2) is still applicable in this regard.
33
Figure 8-2 Context for addressing Indigenous family violence
Alienation Loss of role
Unemployment Violence
Alcohol Boredom
Reduction will improve situation
Reduction will reduce incidence
Primary Target Source: Barriers that Prevent Country Men from Accessing Domestic Violence Services p46, TNS 2002
A recurring and strong theme throughout the stakeholder consultations related to the need to more overtly consider this target group in future iterations of the campaign. Of note, is the fact that stakeholders working with Indigenous people stressed that this requires more than separate Indigenous specific programs and initiatives, and that there is a need for the ‘mainstream’ Freedom From Fear campaign to work more actively in this area, as well as collaboratively with others such as the Gordon Inquiry, the WA Police, RDVCs and those involved in referral and counseling for Indigenous people. With the Gordon Inquiry implementation drawing to an end in 2007, it is vital that the longer term role for DCD, including FDVU and Freedom From Fear be clarified and set forth as a matter of continuing, if not increased priority. Calls to the helpline, or participation on programs (other than mandated attendance) by men from CALD or Indigenous backgrounds has been rare. While beyond the scope of Freedom From Fear per se, the absence of culturally appropriate counseling options, voluntary and mandated programs for both perpetrators and victims from diverse backgrounds was frequently noted. People from CALD groups for example, are often reticent to discuss the possibility that family and domestic violence may exist within their community, or is an issue for them, as they are unwilling to attract any unfavourable attention from mainstream communities who already may regard them with some negativity [30].
34
Research conducted in 1995 by the Office of Multicultural Interests
[47]
identified factors
that may pre-dispose CALD people to domestic violence, or increase their vulnerability, these include: The extent of language proficiency; The extent of membership of religious or linguistic groups/communities; Education and socio-economic level; and The extent and experience of racial prejudice. In our discussion with stakeholders these themes remain predisposing factors associated with the CALD communities living in both city and rural Western Australia. Other reasons articulated for disadvantaged access to services and support by people from CALD backgrounds included lack of knowledge about available services, language barriers, fear of police and people in positions of authority, different religious and cultural beliefs and social isolation. Of pertinence to the appropriateness of campaign messages and materials for CALD communities, TNS research found that some CALD men felt the Freedom From Fear ads undermined their position of authority within the family unit, by informing other family members that their behaviour is not deemed acceptable within the Australian community context [30]. As reiterated by stakeholders working with CALD communities and by the literature in this area, program planners need to acknowledge that all CALD individuals are unique and will not belong to a homogenous group. Accordingly the broad Freedom From Fear program strategies do not necessarily fit the needs of individual CALD communities, and as raised by stakeholders, there needs to be culturally appropriate services, increased awareness of relevant services, establishment of trust and a more ‘whole of community’ approach. Recent funding provided by DCD, FDVU and the Federal government has led to research and initiatives that more specifically consider and address issues relating to issues such as family disintegration in CALD communities[17] and the translation and dissemination of pertinent information into multiple languages. Men from regional and remote areas Freedom From Fear has been proactive and innovative in its efforts to not be a metrocentric campaign, as exemplified in the network of Regional Domestic Violence Committees that have been engaged in the campaign since its inception. Unfortunately, stakeholder interviews with the RDVC’s proved the most difficult to arrange, and despite repeated efforts, we were not able to gather as many regional perspectives as had been hoped.
However, a report prepared by TNS in 2002
eloquently summarises many of the pertinent issues and makes recommendations for this regional demographic that remain applicable in 2006.
35
Our own consultations detected a perceived gap between country and city men in terms of access and use of domestic violence services, and this is substantiated in TNS’s delineation of barriers that deter men in regional areas from calling the helpline or seeking help
[30].
Identified barriers included pride, lack of confidentiality because of
the ‘small town’ phenomenon, preference for face to face or local service, reluctance to admit to needing help and not wanting to use the phone.
8.2
Overarching campaign directions
The Western Australian Family and Domestic Violence State Strategic Plan has ten focus areas based on a comprehensive and targeted approach, however a number of the focus areas specified in the strategic plan are pertinent to Freedom From Fear, both as currently positioned, and in terms of its continuation and future directions. Focus Area Two of the strategic plan relates to facilitating community education to raise public awareness and recognises as a priority area, the development of a number of resources to encourage community support for victims of family and domestic violence together with implementation of a comprehensive media and radio campaign
[6].
Given that perpetrators and potential perpetrators remain a high priority target group for Freedom From Fear, an overall mix of strategies based on the five P’s as applied to social marketing remains appropriate, as illustrated in Figure 8-3. Figure 8-3
5 P’s of marketing applied to Freedom From Fear The 5 P’s
The Strategies
Product
MDVH Counselling Programs Self help booklets. posters
Price
Programs, booklets, helpline all provided free
Promotion
TV Radio Posters
Place
Metro area, 6 regional areas
People
Telephone counsellors
Beyond the 5 P’s, social marketing encapsulates a set of tools and skills that can be applied to bring about social change through strategies tailored to influence those among whom the behaviour change is desired. Used effectively in the planning and development of phase one, these tools include formative research, pre-testing of messages, audience segmentation, use of settings and negotiation with stakeholders. In marketing parlance, the original core ‘product’ which ‘offered’ men the opportunity to keep the family relationships intact by stopping or not using violence towards their
36
partner, remains relevant to the target group and the community and is congruent with the literature and general stakeholder sentiment.
There was no feedback from
stakeholders or evidence from the data or literature reviewed that warranted a radical abandonment or departure from the focus on preventing male violence against women that has underpinned Freedom From Fear to date. Rather, there was generally support for further consolidating the strategies and achievements to date, but with some potential opportunities to expand or shift focus. The most recurring suggestions for new or expanded angles included: Extension of messages and strategies to more explicitly encompass non-physical forms of violence; Greater emphasis on prompting and mobilizing the general community, and those who know those directly affected by family and domestic violence, to ‘do something’; Leveraging the opportunity presented by legislative changes to provide the campaign with a new but complementary slant; Greater attention to priority segments within the target group, in particular people from Indigenous and CALD communities, along with men in regional environments; and Exploration of appropriate ways to incorporate violence perpetrated within same sex relationships or by women against men.
8.3
Media Strategies
As noted elsewhere in this review, the media component of Freedom From Fear has provided an impetus and umbrella for many of the campaigns activities and outcomes to date. The ads used in each media wave are depicted in Appendix 4. This review supports the continuation of a strong media component as part of the social marketing and overall campaign/program mix. While the review yields some suggestions and implications for specific media strategies and directions, these need ultimately to be determined by the goals, objectives and overarching theme formulated for Freedom From Fear in its next iteration. Moreover, detailed media and strategy recommendations were beyond the scope of this review, and as reflected in the extensive review undertaken by Donovan and Vlais, is a major undertaking in its own right. DCD is referred to this report [18] and to recommendations in the more recent evaluations undertaken by TNS
[26];
Evaluation of Perpetrator Programs
for Mandated and Voluntary Participants in Western Australia; and barriers that prevent
37
country men from accessing domestic violence services as a valuable adjunct to the present review. Nonetheless, the review identified a number of issues and considerations pertinent to the media component of Freedom From Fear, relating to concepts and messages; executions/imagery; media channels; and scheduling:
8.3.1
Media messages/concepts Analysis of campaign evaluation data indicates that the more recent ads resonated more with perpetrators of physical rather than emotional violence. This is pertinent to consider if Freedom From Fear elects to broaden its focus to more overtly tackle emotional and other non physical forms of violence in future iterations. The efficacy of the ‘effect on kids’ theme recurred throughout all evaluation waves and is reiterated in the literature stakeholders interviewed.
[18]
and across the spectrum of
Moreover, stakeholders working with CALD and
Indigenous males concurred that children are an extremely powerful angle to use with these harder to reach target groups. Given the significant gap between the percentage of men surveyed who self identify as perpetrators and the proportion that have done something about this or sort help, there is scope to explore the potential for alternative media messages that might precipitate men to seek help before things get out of hand. Feedback from counsellors relating to the reluctance of men to label themselves as perpetrators is also relevant here. Evaluation data relating to the lower believability of the call to action ads (modeling picking up the phone to call MDVH) among the target group is also pertinent to consider. The evaluation wave reports provide a wealth of data on the efficacy of particular ads in relation to particular attitudinal or behavioural shifts. For example, the first series of ads were more effective in communicating that help is available, and effects on others and prompted a greater number calls to MDVH during on air time. By contrast, the second series of ads (mirror) were more effective in communicating responsibility. This was reiterated by numerous anecdotes from stakeholders referring to the mirror as powerful prompt for selfreflection and realization. These data highlight the powerful potential for media executions to ‘work on’ particular campaign objectives and should be revisited in any future media strategy planning.
38
8.3.2
Media executions/imagery While the Wave 4 and 5 campaign evaluation reports and stakeholder feedback indicates that the current suite of ads have not reached total wear out point (particularly given several years have lapsed since last shown), some stakeholders expressed concern about the diluted cut-through or impact were the same ads to be featured yet again.
As noted by TNS in the Wave 5
evaluation, new executions may be needed to further progress the desired shifts in attitudes and behaviours among the target group [26]. As encountered by other social marketing and public health campaigns, including those run in WA, new advertisements are sometimes needed to reinvigorate a campaign and re-catch the attention of the target group. Depending on the direction taken with phase 2, previously effective ads can be interspersed with the scheduling of new ads, as has been done effectively by Smarter than Smoking and the Quit campaign. At present, the grainy somber coloured imagery of the television ads is mirrored in the Freedom From Fear booklets and written resources.
Stakeholders
interfacing with the target group often indicated that the visual imagery of these resources is dated; the old style telephone depicted on the cover of the self-help booklet a pertinent example of this. Quite a number of stakeholders also felt that the somber colours used in the campaign materials conveyed oppressive or ‘secrecy’ overtones and did not encourage men to think that positive change was possible. However others felt that this ‘masculine’ colour scheme (dark blue/brown hues) resonated with the primary target group.
8.3.3
Media channels Radio advertisements appear to have performed strongly across the campaign waves to date. Given the cost effectiveness of radio and the potential to target it to men who listen to the radio during work hours (e.g. building sites, transportation drivers and men in the rural sector), there is scope to further utilize radio in phase 2. There are also radio stations and/or programs that target Indigenous or CALD communities. Television advertisements have the greatest capacity for dramatic, graphic images evoking powerful emotions within a short time frame. Television programming today allows for programs to include low levels of violence, sexual themes and other adult themes. Therefore the importance and construction of the visuals and the graphics that complement phase 2 television advertisements
39
must not be diluted by programs readily accessible and viewed by the target population that condone certain levels of violence as socially acceptable. Community newspaper advertisements have continued to be part of the Freedom From Fear media strategy until as recently as December 2005. The distribution mechanisms for Community Newspapers that exist throughout the state and relatively low cost, makes press an appealing strategy.
However
there has been no evaluation to date of the awareness or efficacy of Freedom From Fear press strategies. Similarly, there is no data on the impact of recent advertisements featuring local personalities (e.g. Peter Bell, Dixie Marshall) on the target group. Anecdotally there is varied opinion about the appropriateness of using high profile sporting figures and other personalities in print (and television) media. The rationale is presumably to generate publicity, attract attention and better engage the target audience to accept the proposed socially desirable behaviours. However, unless these sporting figures and personalities are also known for their indisputable involvement in the issue, it is unlikely that they will have the desired substantial impact
[18].
Furthermore, recent examples of various media reports of
sportsmen’s sexual and other aggression towards women, suggests that further pre-testing of using sporting figures and other personalities is required to avoid skepticism and ‘broken credibility’.
8.3.4
Media scheduling As with other public health campaigns such as QUIT, the volume of calls to the MDVH, and in turn the number of referrals, are clearly linked to the periods and durations of time in which Freedom From Fear has been on air. There have been high rates of phone calls during intensive TV/radio campaign periods
[48].
Furthermore it was pointed out that active periods of the advertising campaign had significant impact on the workload of the Helpline. This presents an ethical issue for government funded campaigns, if discontinuation of a campaign or diminished air-time in effect results in fewer people seeking or receiving help. This is a pertinent issue for Freedom From Fear which has not had an overt media presence, other than sporadic press media, since April 2003. The national Australia says No campaign has provided a media presence and reinforcement in WA relating to family and domestic violence. However, it has a different target group, a different focus and directs callers to a national helpline service. There appears to have been only marginal increases in MDVH calls during scheduled media bursts of Australia says No advertising. The existence of
40
differing national and state helpline numbers is a potential source of confusion for the public. The possibility of tagging advertisements shown in WA with the MDVH number or diverting calls received nationally from WA back to the MDVH merit exploration. The QUITline is a pertinent example of a single number that is promoted nationally and in each state but that operates as a directed service at the individual state and territory level. During the course of our interviews some service providers, MDVH counsellors and the police acknowledged that family and domestic violence has seasonal peaks and troughs through out the calendar year. The explanations for these vary and are not underpinned by any theory, however they could be mapped and used in effective media scheduling and maximizing reach to the target group by timed media scheduling.
8.4
Other contemporary social marketing methods and new technologies
A plethora of new marketing methods and approaches abounds in the commercial world and have to a lesser extent, been applied to social marketing and public health[22,
49].
It was beyond the scope of this review to explore these in detail, but
consideration has been given to some of the relevant literature, along with consultations with Professor Rob Donovan and past Freedom From Fear campaign managers. It should be noted however, that the emergence and use of new marketing ideas, particularly of a technology nature, races miles ahead of the literature, and there is very little published evidence regarding the effectiveness or relative efficacy of many of the strategies and tactics being promulgated. Campaigns targeting young people on health or social issues have been particularly quick to trial new ways of reaching and engaging this target group. Smarter than Smoking SMS competitions, drug aware sponsored band concerts, web-based ‘are you at risk’ alcohol quizzes and the infamous ‘condom trees’ of the north-west are just some innovative examples. It is pertinent to note however, that agencies such as Healthway and the National Heart Foundation recognize that the impact of health messages delivered through more ambient or less mainstream channels is strengthened when those messages are underpinned by a broader and high profile mass media campaign. Hence new technologies and novel marketing approaches are unlikely to eclipse television and radio advertising as key planks of public health social marketing. In view of the primary target group and the nature of the ‘product’ as it pertains to family and domestic violence, the current strategy mix of television and radio media, press, printed materials and public relations strategies are still highly relevant. There is after all, less scope with an issue like violence, to engage the target group in
41
competitions, incentives or text messaging.
Relatively unexplored avenues that do
warrant further exploration (through more extensive review of literature and programs elsewhere and through formative research with the target group) include: Web-based options: may be less confronting for some men than making a phone-call e.g. web-based avenues for seeking information, making initial contact with the ‘helpline’, and even modules of interactive self-help materials; Settings based cues to reflect on behaviour or seek help; although there is some sensitivity and unpalatability around the issue of family and domestic violence (not all stakeholders thought it an appropriate drink coaster message!) settings frequented by men such as workplaces, TABs and sporting clubs can be used to provide visual cues. Toilet door advertising, posters in workplaces are examples. Discrete ‘take home’ information. A number of stakeholders interfacing with the target group noted that the size of the men’s booklet (and even of the women’s resource) is off-putting as it is difficult to pick up and carry discretely. Wallet cards (e.g. with the MDVH and some key tips or other support/help options) have been used effectively by other public health campaigns. Notwithstanding the preceding suggestions, specific communication strategies or technologies for phase 2 cannot be judiciously informed by this review, but require a deeper, updated understanding of the target group’s needs, access and self efficacy towards new technologies and other social influences.
Regardless of the social
marketing strategies adopted in future iterations of Freedom From Fear, an integrated marketing mix is essential
[23],
as effectiveness is undermined when campaigns become
‘bitsy’ or fragmented.
8.5
Other Support Strategies
Considerations for future social marketing endeavours under the Freedom From Fear banner are consistent with the 2004-2008 Western Australian Family and Domestic Violence Strategic Plan Focus Area Eight – ‘Build Community Capacity to Respond to Family and Domestic Violence’ and include: call to action resources and activities; localised opportunities and settings for social norms marketing; partnerships with on the ground services and networks as a vital source of support. In addition, Focus Areas Three, Five and Seven of the Western Australian Family and Domestic Violence State Strategic Plan, are aimed at: Implementation of standards, competencies and best practice guidelines; Improving Inter-agency coordination, cooperation and collaboration; and Improving service capacity to respond effectively to diversity. The State Government has recently provided increased funding to implement
42
a new model of Regional Coordination for Family and Domestic Violence in 14 regions across WA
[50].
The role of the RDVC is to achieve a more coordinated and effective
agency response to people experiencing family and domestic violence, with the new model fostering greater consistency and cooperation between government and nongovernment agencies and service providers in regional areas. Coordinated services and responses across agencies are particularly imperative for the many men whose violence is intertwined with other risk factors such as alcohol and drug use, mental health and psycho-social issues. Furthermore, alternative settings to reach men (e.g. the workplace) have been trialed in research projects in Western Australia
[51]
and it would be judicious to introduce some
of the strategies recommended by that recent research in the next iteration of Freedom From Fear.
8.6
Research & Evaluation
At both the individual strategy and overall campaign level, research and evaluation is a critical determinant of effectiveness, as well as the means by which effectiveness is determined. Formative research at the strategy and program development stage is important for ensuring that programs are evidence based, relevant to target groups, and likely to work. Program evaluation is essential for assessing the implementation and outcomes of a campaign and its strategies, improving a program’s efficiency or effectiveness and for demonstrating accountability
[52].
Population monitoring of
attitudinal and behavioural trends, and of policy and environmental changes, provides insights into the bigger picture and the type of ‘first order’ evaluation required for determining the impact of a strategic framework overall
[53].
Our findings in relation to
each of these aspects of research and evaluation are discussed below.
8.6.1
Formative evaluation
The extensive formative research (unparalled in many social marketing campaigns) that underpinned the development of the original strategies and media executions is recognised by many stakeholders as a key strength of Freedom From Fear. As confirmed by Donovan and Vlais’s review of social marketing campaigns targeting violence against women
[18],
many of the insights and campaign implications derived
from this original formative research remain valid and have been substantiated by subsequent literature and campaigns elsewhere, as well as by Freedom From Fear evaluations. However, it is now 10 years since the Freedom From Fear formative research was undertaken and there have been considerable changes in the legislative, community services sector and broader societal context in which family and domestic
43
violence occurs. Moreover, there is a ‘new’ cohort of male perpetrators or potential perpetrators that have moved into adulthood since Freedom From Fear began. While this review has explored some of the potential future directions for Freedom From Fear,
it
is
premature
and
inappropriate
to
recommend
specific
strategies,
communication themes or executions without new or additional formative research being undertaken.
Insights elicited from our discussions with stakeholders working
directly with both perpetrators and victims strongly highlighted the value of further qualitative research with these groups in particular. Moreover, the need for the next phase of Freedom From Fear to be underpinned by new formative research and ad testing was clearly articulated during our stakeholder interviews. The Smarter than Smoking campaign in WA has replicated its qualitative research with adolescent smokers and non-smokers every five years, using such research both to assess the currency of existing communication objectives and strategies and to provide directions for future communication strategies and media planning and selection [54]. Suggested avenues for useful formative research include: Focus groups with male perpetrators and potential perpetrators – issues to explore include changes in attitudes, beliefs and behaviours that have been detected in campaign evaluations, as well as areas where anticipated changes have not occurred;
feedback on current suite of media, resource, referral and support
strategies; responsiveness to changes in laws, community attitudes; avenues for further prompting help seeking behaviour and the feasibility of invoking action prior to crisis; Focus groups with men and women in, or at risk of a violent relationship – as recommended in the most recent campaign evaluation
[26],
there is a need to
explore how people distinguish between couple conflict and violence, triggers for violence (given that many of those being monitored have very low baseline rates as reasons for violence), receptivity to seeking help, attitudes towards partner seeking help, situations in which females may also instigate violence; Follow up of recent or discontinued program participants – factors influencing attendance post-referral, relapse, program completion;
appropriateness of
current counseling approaches, self-reported changes in attitudes and behaviours in relation to violence, partner; feedback on MDVH contact and receptivity to possible call-back or follow up contact used by some other telephone counseling services to deter relapse; Qualitative research with Indigenous men and women – explore attitudes and beliefs around family and domestic violence; assess pertinence and message
44
take-out of existing Freedom From Fear executions and strategies, possible strategy ideas, pertinent help seeking cues, prompts and services; In-depth interviews or group discussions with CALD men and women (separate) in target group, along with key opinion leaders in respective communities – similar issues to those suggested for Indigenous research; Explore other avenues for targeted promotion of helpline e.g. posters in pub toilets, workplaces, discrete wallet cards so not having to pick up big pamphlet. Requires discussion with target group as well as tertiary target groups/settings that might disseminate such strategies/resources.
8.6.2
Strategy and campaign evaluation
Freedom From Fear has some significant research and evaluation strengths but also has some gaps and limitations that hinder a complete analysis of its effectiveness to date and limit some of the inferences or suggestions that can be elicited for future directions. Figure 8-4 depicts some of the core process, impact and outcome measures that we believe comprise a sound evaluation framework for Freedom From Fear.
MEDIA Time Process Media air time/TARPS Amount of unpaid publicity/media coverage
Help seeking responses
Impact
TIME
Process
Impact
No. calls to helpline
% callers who receive counseling or participate in programs % program participants completing No. repeat contacts E.g. if offend again after ringing or attending course No. actions taken by victims or on behalf of victims E.g. call police
No. referrals to agencies No. resources distributed to target group or those who can disseminate to target group No. awareness raising initiatives conducted by RDVC’s
Change in beliefs, attitudes among target group re acceptability, responsibility Changes awareness of campaign, avail of help
Outcome
Prevalence of domestic violence incidents - WA
Trend in proportion of women victimised by DV % men no longer perpetrating after contact with helpline or course… (self report and as reported by partner) Morbidity and mortality statistics relating to DV in WA
45
Shared Outcomes
As conveyed by Figure 8-4, all family and domestic violence interventions ultimately share a common overarching goal, succinctly captured in the themes prevention, protection and provision that underpin the Western Australian Family and Domestic Violence State Strategic Plan and hence hopefully which contribute to the same long term outcome measures. The process and impact measures however differ, although may contribute to each other (e.g. raised awareness of helpline through media contributing to increased calls and hence greater referrals).
Such inter-relationship
between strategies, and between the impacts of various strategies, is one of the major evaluation challenges for public health and community programs generally, as well as for social marketing campaigns. As noted in Section 6, the very nature of social marketing and the way it operates, renders it difficult to isolate the impact of individual strategies at the outcome level. While there is some interactive effect also at the impact level, the types of process and impact measures identified in Figure 8-4 are widely used in program and campaign evaluation across a diversity of disciplines and issues and are indicative of the relative effectiveness of the strategies to which they relate. Evaluation strengths of Freedom From Fear to date include the rigorous media evaluations that provided baseline data and subsequent tracking of impact measures along the five media waves to date. Although some statistics are collected by the MDVH and agencies providing programs and counseling, this is primarily of a process or small impact nature. The review of perpetrator programs undertaken in WA in 2002 found significant gaps in data that precluded the evaluation of perpetrator program effectiveness. Some 4 years later, our review draws the same conclusion and did not find systemic evidence of the type of improved data collection recommended by that review. Recommendations include a collaborative approach to evaluating perpetrator programs between funding bodies, service providers and other key stakeholders; specifically designed tools and collection measures that allow for the collection of reliable data that can be compared intra-agency and inter-agency; and best practice in data collection and evaluation including storing core data electronically and working to develop suitable data collection software and ongoing data input. Importantly, agencies funding agreements should include a follow-up of men and partners after six months and the Justice Department has data available on men referred to perpetrator programs including number referred, attendance, completion or breach and re-arrest. Data collection and evaluation also needs to be extended to reflect the role of counseling provided directly by the MDVH (ie it can be of value in its own right even if client does not take up program referral option), as well as individual
46
counseling or support provided by service agencies that does not fall within the data collected on group programs. At a population level, it is timely to design a survey to establish a baseline of broader community attitudes and sentiments on which to inform future planning and activities. Data is needed on contemporary attitudes towards family and domestic violence, along with an examination of the factors that contribute to community attitudes and precipitates shifts in these.
9 Conclusions and Recommendations As the substance of this review and report has been to appraise the achievements of Freedom From Fear to date and inform its future directions, it is difficult to succinctly distil the feedback and implications in only a few recommendations. The conclusions and key recommendations described below reflect major themes and considerations that emerged from the review process and readers are encouraged to refer to the complete report for the context and rationale that underpins these recommendations. There are also other findings and considerations identified throughout the report that are not framed as formal recommendations, but are nonetheless relevant to the future prevention of family and domestic violence and to Freedom From Fear. As articulated in the report, the future directions of Freedom From Fear are intertwined within a broader context that includes the Western Australian Family and Domestic Violence State Strategic Plan 2004 - 2008; the activities, directions and funding of counseling services and programs in WA; and by trends and issues within the sector and community more broadly. Taking these contextual issues into account, the review supported further consolidating the strategies and achievements of Freedom From Fear to date, but with some potential opportunities to expand or shift focus.
Role within the FDVU Freedom From Fear was conceived and developed as a comprehensive violence prevention campaign that included the establishment of the MDVH, referral programs, regional networks and a range of other strategies.
Many of these services and
strategies have subsequently become part of the core business of the FDVU. While the review acknowledges that the Freedom From Fear branding now most appropriately applies to the media and social marketing campaign and strategies, it is important that the links and synergies between these and the other services and activities of the FDVU remain recognised and fostered. Reshaping community
47
understandings and norms abut domestic violence and precipitating those at risk to seek help is a vital element in the mix of FDVU activity and addresses a number of the focus areas of the current WA Family and Domestic Violence Strategic Plan (2004-2008).
Campaign positioning and focus The review found strong support for the continued focus on prevention and promotion of early help-seeking behaviour among men, along with the retention of messages that highlight the impact on children. It is timely to more explicitly capitalise on recent changes to pertinent legislation and police powers as a leveraging opportunity to provide the campaign with a new but complementary angle. The WA Family and Domestic Violence Strategic Plan 2004-2008 and the VRO Amendments are still relatively recent, providing a window of opportunity to strengthen the ‘position’ of domestic violence as a crime or a criminal offence in future Freedom From Fear strategies. There is a need to further broaden community notions of violence beyond physical manifestations, to include emotional and more subtle albeit less physical forms of violence and abuse.
Target groups Targeting perpetrators and potential perpetrators of violence against women remains an essential and evidence-based focus for Freedom From Fear. However, the review supported refined target group segmentation and greater focus on some priority groups and intermediaries, including: Exploration of alternative strategies and terminology to engage men who do not perceive themselves as ‘perpetrators’ or who are unlikely and/or reluctant to recognise that they need help or to seek help prior to crisis-point. More overt delineation as a target group of friends, family, colleagues witnessing or aware of violence. This could include the dissemination of relevant resources or advice for those wanting to help either a perpetrator or victim within a domestic violence situation, as well as greater emphasis on prompting and mobilizing the general community, and those who know those directly affected by family and domestic violence, to ‘do something’. Inclusion of people from Indigenous, CALD and rural and remote communities as high priority target groups. This entails both targeted initiatives and consideration
48
and inclusion of these groups within ‘mainstream’ strategies, resources and programs. Clarification of the role of Freedom From Fear and the FDVU in relation to family and domestic
violence
among
Indigenous
people.
With
the
Gordon
Inquiry
implementation drawing to an end in 2007, it is vital that the longer term role for DCD (including FDVU and Freedom From Fear) be clarified and that more appropriate strategies for Indigenous men who need or seek help are developed collaboratively. Acknowledgement of other relational contexts in which violence occurs, including exploration of appropriate ways to address violence perpetrated within same sex relationships or by women against men. The need to specifically target priority population groups is balanced with the evidence for maintaining the momentum for behavioural and environmental change at the population level. This balance needs to be struck in planning and resourcing decisions to ensure that the impetus for change provided by Freedom From Fear to date is not lost.
Strategy mix and resources This review supported the continuation of a strong media component as part of the social marketing and overall Freedom From Fear program mix. Social marketing campaigns have the potential to shape both community and target group norms and behaviours in relation to domestic violence, but momentum and impact are diminished if not sustained. This is of noted concern given that Freedom From Fear has not had an overt media presence, other than sporadic press media for three years. The current strategy mix of television and radio media, press, printed materials and public relations strategies remains sound and evidence-based. There is scope to use radio further (given its cost effectiveness and reach) but the efficacy of press strategies used to date is unknown and evaluation of these is recommended. Promotion of the MDVH and ‘cues to action’ in settings frequented by the target group (e.g. workplaces, websites frequented by target group) are an under utilised communications avenue. New media executions may be needed to further progress the desired shifts in attitudes (e.g. issues of responsibility, justification) and behaviours among the target group and to precipitate men to seek help before things get out of hand.
49
Early years prevention Preventing the ‘first act’ of violence is a key primary prevention aim but requires a long term outlook and comprehensive strategy across sectors. Such prevention needs to ideally begin in childhood, addressed through parenting, bullying, relationship and school-based strategies. These strategies fall outside of the rubric of Freedom From Fear but are reinforced by the role that Freedom From Fear plays in raising awareness and challenging and shaping community norms and attitudes in relation to violence.
Evaluation and research Evaluation strengths of Freedom From Fear to date include the rigorous media evaluations that provided baseline data and subsequent tracking of impact measures along the five media waves to date. However, the ability of this review to accurately asses the effectiveness of Freedom From Fear against its objectives was hindered by a number of systemic limitations in data collection and availability. The review of perpetrator programs undertaken in WA in 2002 found significant gaps in data that precluded the evaluation of perpetrator program effectiveness. Some four years later, our review draws the same conclusion and concurs with the recommendations for improved systemic data collection contained in that earlier review. Prioritised evaluation needs include appropriate measures and methodologies for evaluating the short-term and long term effectiveness of perpetrator services and programs by tracking perpetrator behaviour following use of the helpline, program referral and program participation. Current data collection relates primarily to group participation and helpline calls and referrals, but needs to be expanded to reflect the counseling role played directly by the MDVH as well as counseling and support services that may be subsequently be provided to individuals (which are not reflected in group participation statistics). The comprehensive formative research that underpinned the development of Freedom From Fear was conducted nearly a decade ago and new or additional formative research is recommended. This could include formative research with perpetrators and potential perpetrators, those in or at risk of violent relationship, follow up of program participants and MDVH callers, people of Indigenous or CALD background or stakeholders in intermediary settings and agencies.
50
Referral and services It is essential that media and other strategies that direct men or those concerned or affected by domestic violence to seek help, be backed up by appropriate counseling and treatment services. The MDVH and perpetrator programs play a pivotal role in this regard, but there is scope to address issues relating to the adequacy of pertinent services for specific population groups, particularly Indigenous and CALD males (and women) and those residing in some regional areas. The appropriateness of ‘one size fits all’ program models for perpetrators was frequently raised by stakeholders, reinforcing the pressing need for more comprehensive evaluation of the efficacy of current programs and services. Related to this is the need to better understand barriers to seeking help, reasons for program attrition and triggers for behavioural relapse. Family and Domestic violence is often intertwined with other risk factors, including alcohol and drug misuse, mental health problems and psychosocial issues. For men with multiple risk factors or issues, more integrated case management approaches across service providers are warranted. Options for providing help, counseling or referral for men who are unlikely to ‘make a call’ warrant further exploration and could include web-based counseling or smaller and more discrete take-home information and self-help materials.
Collaboration and coordination As domestic violence falls within the remit of many sectors and agencies, coordination and collaboration is difficult, but vital.
The review observed
fragmentation in communications and awareness and understanding of others activities between key sectors, between service agencies delivering similar programs, between researchers and practitioners and between different project areas within DCD.
Given the emphasis on coordination, cooperation and
collaboration in the WA Family and Domestic Violence Strategic Plan 2004-2008 these issues warrant attention.
Final conclusions Freedom From Fear has received national and international recognition for its unique and comprehensive approach to the prevention of domestic violence against women, both within the domestic violence sector, and more broadly, as an effective example of social marketing strategies applied to a complex psychological and social and
51
public health issue. While the campaign has been effective in many regards, the need for a long term and comprehensive outlook that underpinned the original planning for Freedom From Fear remains strong. Just as the precursors and precipitants of domestic violence are multifaceted and entrenched, so too are the strategies and interventions required to prevent the onset and consequences of violent behaviour. As a social marketing and communications program, Freedom From Fear not only communicates with the target group to prompt preventive action, but more broadly, contributes to the reshaping of community and perpetrator attitudes and norms around violence. As such, it supports, complements and is reinforced by the many services and programs within the Department for Community Development and other sectors that work towards family and domestic violence protection and prevention and provision. The contextual and legislative landscape that underlies domestic violence has changed in many ways since the inception of Freedom From Fear, hence some refinement and refocusing of the campaign is appropriate. Yet many of objectives and strategic elements remain just as relevant and it is efficacious to continue to build upon the campaign’s strengths. Freedom From Fear represents a radical departure from conventional victim focused and tertiary interventions within a public health framework; as a landmark application of health promotion and social marketing principles, it has gained considerable achievement. The evidence to date would suggest that future success will hinge on innovation, evidence based decision making and courage to recognise domestic violence for what it is, a problem that can be potentially prevented with an appropriate mix of state of the art social marketing and health promotion tenets.
52
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Donovan R, Vlais R. VicHealth Review of Communication Components of Social Marketing/Public Education Campaigns focusing on violence against women. Melbourne: Victorian Health Promotion Foundation; 2005.
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Donovan Research. ' Freedom From Fear'Post Campaign Evaluation Wave 5; 2003.
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Donovan R, Paterson D, Francas M. Targeting Male Perpetrators of Intimate Partner Violence: Western Australia' s "Freedom From Fear" Campaign. SMQ 1999;3:127-144.
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UNIFEM. Picturing a Life Free of Violence: Media and communication Strategies to End Violence Against Women. 2001.
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Bagshaw D, Chung D, Couch M, Lilburn S, Wadham B. Reshaping Responses to Domestic Violence: Commonwealth of Australia; 2000.
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Dixon J. Interim Review of the Men' s Domestic Violence Helpline. 1999.
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Nuehaser L, Kreps G. Rethinking Communication in the E-health Era. Journal of Health Psychology 2003;8(1):7-23.
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Family and Domestic Violence Unit. Newsletter (May): Department for Community Development; 2006.
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Hopkins L, Plamer M, Boyd ER, Gibbons L. Responding in the Workplace to Domestic Violence: Edith Cowan University, Family and Domestic Violence Unit; 2005.
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Appendix One Other commissioned reports: Barriers that prevent Country Men from Accessing Domestic Violence Services Domestic Violence Prevention Unit. Contract G00102/DV170. Commonwealth Contract WA# 7. June 2002 (marked not final version) Freedom From Fear. Campaign against Domestic Violence. Media Resource and Information Kit 101 Ways Great & Small to Prevent Family Violence. A Victorian Resource Kit. A Project of the Domestic Violence and Incest Resource Centre. Finucane MCG., & Finucane S., September 2004 Evaluation Reports 1. Research Report: Development of Strategies for a Mass Media campaign to Facilitate the Reduction of Domestic Violence. 96103 October 1996 2. Report: Testing of Advertising Concepts for Community Education Campaign. 98074 July 1998 3. Report: Domestic Violence ADTEST® 98140 September 1998 4. Report: ‘Freedom From Fear’ ADTEST® 01017 March 2001 5. Report: ‘Freedom From Fear’ ADTEST® II 00132 August 2000 6. Report: ‘Freedom From Fear’ Campaign Evaluation 98176 November 1998 7. Report: ‘Freedom From Fear’ Post Campaign Evaluation II 99040 April 1999 x 2 copies 8. Interim Review of the Men’s Domestic Violence Helpline November 1999. J Dixon 9. Report: ‘Freedom From Fear’ Post Campaign Evaluation III 99184 January 2000 x 2 copies 10. Report: ‘Freedom From Fear’ Women’s Awareness and Attitudes to the Campaign (Phase 1) 99167 February 2000 11. Final Report: ‘Freedom From Fear’ Women’s Awareness and Attitudes to the Campaign (Phase 2) 03063 September 2003 12. Final Report: ‘Freedom From Fear’ Post Campaign Evaluation Wave 4 01062 October 2001 13. Final Report: ‘Freedom From Fear’ Post Campaign Evaluation Wave 5 03062 May 2003 14. Men’s Domestic Violence Help Line Evaluation Summary Report: 2 99046 March 2000 x 2 copies 15. Report: ‘Freedom From Fear’ Perpetrator Research 00003 September 2000
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16. Report: Domestic Violence Attitude Benchmark 98166 October 1998 17. Appendix D – Freedom From Fear Program Implications. Prepared by Donovan Research. No date. 18. DVPU -Campaign Evaluation Benchmark. Topline results. Women. ‘Freedom From Fear’ Post Evaluation Campaign III (Women) Dec. 1999 Master File 19. Domestic Violence Community Education Campaign 3 Year Plan 1998-2000 & Phase One 1998 Planning Document. DVPU Feb 1998 20. Freedom From Fear Creative Brief Supplement Domestic Violence Community Education Campaign Phase One 1998 21. Freedom From Fear Creative Brief Supplement Domestic Violence Community Education Campaign Phase One October 2000 22. Freedom From Fear Creative Brief Supplement Domestic Violence Community Education Campaign Phase One October 2001 23. Perpetrator Research Summary Report: to Domestic Violence Prevention Unit. Feb 2001 Francas M., & Donovan R. 24. Good Practice In Social Marketing – Key Findings from the 2003 Women’s Awareness and Attitude survey Post Campaign Evaluation five (Men’s Survey)
57
Appendix Two Discussion guide –Freedom From Fear Name: Organisation: Date interviewed:
Background 1.
What is your organisation's role in domestic violence prevention or services in WA?
2.
Has your organisation been involved (directly or indirectly, past or present) in the Freedom From Fear campaign or community strategies affiliated with it? If so, can you describe this involvement? In what ways has Freedom From Fear directly impacted on your organisation’s activities?
Discussion Part 1: looking back 3.
Generally, how effective would you say the Freedom From Fear campaign has been in achieving its objectives to date? Probe specifically re views of effectiveness in relation to awareness raising, attitudinal change, influences on behavioural intentions and behaviour long term objectives
promote and reinforce understanding and acceptance in the community that many forms of domestic violence are a crime increase awareness in the general community that violence is not an acceptable method of resolving problems and difficulties promote understanding and acceptance in the community that the perpetrator is responsible for the violence prevent the first act of violence committed by ‘at risk’ men end acts of perpetrators
violence
committed
by
encourage and assist appropriate responses from service providers to perpetrators, potential perpetrators and victims.
58
specific objectives of the Freedom From Fear campaign phase one:
To increase knowledge within the community, and specifically amongst the primary target group, about state-wide and local resources available and the methods of accessing assistance; To promote understanding and acceptance in the community, and amongst men in particular, that: The perpetrator is responsible for the violence, not the victim; There are no circumstances in which domestic violence is justified; To increase the number of perpetrators and men ‘at risk’ who are seeking assistance and advice from appropriate services.
4.
What stands out to you as the two or three biggest impacts that it has had since its inception?
5.
What stands out to you as the two or three things that maybe haven’t happened or been achieved to optimal level under the Freedom From Fear campaign banner?
6.
To what extent has Freedom From Fear influenced attitudes regarding domestic violence prevention amongst people in your organisation and/or client groups that you work with (if applicable)
7.
What would you regard to be the main strengths and main weaknesses of the Freedom From Fear campaign to date? (probe here specifically re media elements, referral and helpline, resources and currency of these etc)
8.
Are there particular objectives or strategies that have proven difficult to: i. Progress, or ii. Evaluate
9.
Domestic Violence prevention requires a comprehensive approach working with a broad spectrum of agencies, partnerships and organisations. In your view: a. How ‘successful’ has Freedom From Fear been in collaborating with other relevant groups and engaging other organisations and sectors in achieving its objectives? b.
How well do the requisite links between campaign, referral/helpline, service providers and community level components exist and work in practice? probe what are seen to be stronger or weaker links in this chain.
59
10.
Freedom From Fear has been heralded as a brave and progressive direction for a state government to take in relation to domestic violence, both in terms of its prevention and perpetrator focus, and because of the collaboration it has required from government agencies, service providers etc. Do you have any overall perceptions, comments or observations relating to this?
Discussion Part 2:
11.
Looking ahead
Thinking about the next 5 years, do you see that Freedom From change or evolve or try something new in any of the following areas:
Fear needs to
Objectives Public profile and awareness among target group Type/Balance/mix of strategies Referral processes/links to support/counselling services Resources Target group and avenues used to reach target group Links with other relevant agencies Evaluation
12.
Are there new or emerging issues pertinent to domestic violence prevention that need to be taken into account in any future planning for Freedom From Fear?
13.
Do you have any views on the federal government Australia says No campaign and how it fits with Freedom From Fear and other domestic violence prevention and early intervention strategies in WA?
14.
Do you have any other suggestions for the directions of next 5 or so years?
15.
Are there other organisations or programs in WA that you think should collaborate or consult with?
16.
Is there scope for your organisation to be more effectively linked or engaged with Freedom From Fear in relation to domestic violence prevention and early intervention?
Other issues raised …. 60
Freedom From Fear over the
Freedom From Fear
Appendix Three
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