Violence Against Health Care Workers in Fragile Settings (VIA-H)

Swiss Tropical and Public Health (TPH) Institute

Status: Completed

Conditions: Workplace Violence

Treatments: Behavioral: Code of conduct delivered via a warning board; Behavioral: Training in de-escalating violence

Study type: Interventional

Funder types: Other

Identifiers

NCT05419687

70198

Details and patient eligibility

About

The general objective of the project is to assess whether a violence de-escalating training for health professionals and of a publicly displayed Code of Conduct (a set of rules developed through a citizen science and co-design approach) for both health professionals and clients at the level of the health facility, can reduce the incidence and severity of episodes of violence, and to identify the most cost-effective way to implement these interventions in rural Democratic Republic of Congo (DRC) and in the mega city of Baghdad, Iraq.

Full description

The study will adopt a stepped-wedge cluster-randomized intervention trial (SW-CRT) design to assess the two intervention components, a violence de-escalating training and the implementation of the code of conduct co-developed during the formative qualitative phase. The study will adopt a closed cohort with repeated measurements on the same participants (nurses in DRC and junior doctors in Baghdad) and will involve the unidirectional transition of each enrolled cluster (health facilities in DRC and secondary hospitals in Baghdad) from the control (no intervention) to the intervention sequence in a randomized sequential manner according to a predefined roll out process.

Enrollment: 798 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• HCWs from selected participating health facilities in DRC, junior doctors during their first year resident and permanent health care staff from participating secondary hospitals in Iraq
• HCWs and junior medical doctors and permanent health care staff must have been employed/ or worked as HCW/ medical doctors or as permanent health care staff for at least 6 months
• All above participants must have completed the written informed consent

Exclusion criteria

• Age <18 years; cognitive impairment

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Double Blind

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798 participants in 11 patient groups

Arm 1 De-escalating violence training

Experimental group

Description:

The de-escalating violence training intervention will be introduced after a pre-interventional period of 3 months. A refreshment training will be introduced at month 11.

Treatment:

Behavioral: Training in de-escalating violence

Arm 2 De-escalating violence training

Experimental group

Description:

The de-escalating violence training intervention will be introduced before the second observation period at month 11. A refreshment training will be introduced at month 18.

Treatment:

Behavioral: Training in de-escalating violence

Arm 3 De-escalating violence training

Experimental group

Description:

The de-escalating violence training intervention will be introduced before the third observation period at month 18.

Treatment:

Behavioral: Training in de-escalating violence

Arm 4 De-escalating violence training + Code of conduct

Experimental group

Description:

The de-escalating violence training intervention will be introduced after a pre-interventional period of 3 months. The code of conduct via a warning board will be introduced at month 11. A refreshment training will be introduced at month 18.

Treatment:

Behavioral: Training in de-escalating violence

Behavioral: Code of conduct delivered via a warning board

Arm 5 De-escalating violence training + Code of conduct

Experimental group

Description:

The de-escalating violence training intervention and the code of conduct via a warning board will be simultaneously introduced at month 11. A refreshment training will be introduced at month 18.

Treatment:

Behavioral: Training in de-escalating violence

Behavioral: Code of conduct delivered via a warning board

Arm 6 Code of conduct + De-escalating violence training

Experimental group

Description:

The code of conduct via a warning board will be introduced at month 11. The de-escalating violence training intervention will be introduced at month 18.

Treatment:

Behavioral: Training in de-escalating violence

Behavioral: Code of conduct delivered via a warning board

Arm 7 De-escalating violence training + Code of conduct

Experimental group

Description:

The de-escalating violence training intervention is introduced after a pre-interventional period of 3 months. The code of conduct via a warning board and a refreshment training will be simultaneously introduced at month 18.

Treatment:

Behavioral: Training in de-escalating violence

Behavioral: Code of conduct delivered via a warning board

Arm 8 De-escalating violence training + Code of conduct

Experimental group

Description:

The de-escalating violence training intervention will be introduced before the second observation period at month 11. The code of conduct via a warning board and a refreshment training will be simultaneously introduced at month 18.

Treatment:

Behavioral: Training in de-escalating violence

Behavioral: Code of conduct delivered via a warning board

Arm 9 De-escalating violence training + Code of conduct

Experimental group

Description:

The code of conduct via a warning board and the violence de-escalating training will be simultaneously introduced at month 18.

Treatment:

Behavioral: Training in de-escalating violence

Behavioral: Code of conduct delivered via a warning board

Arm 10 Code of conduct

Experimental group

Description:

The code of conduct via a warning board will be introduced at month 11.

Treatment:

Behavioral: Code of conduct delivered via a warning board

Arm 11 Code of conduct

Experimental group

Description:

The code of conduct via a warning board will be introduced at month 18.

Treatment:

Behavioral: Code of conduct delivered via a warning board