Alignment and political will: upscaling an Australian respectful relationships program.

Many small scale efficacious programs and interventions need to be 'scaled-up' in order to reach a larger population. Although it has been argued that interventions deemed suitable for upscaling need to have demonstrated effectiveness, be able to be implemented cost-effectively and be accepted by intended recipients, these factors alone are insufficient in explaining which programs are adopted more broadly. Upscaling research often identifies political will as a key factor in explaining whether programs are supported and up-scaled, but this research lacks any depth into how political will is formed and has not applied policy theories to understanding the upscaling process. This article uses a political science lens to examine the key factors in the upscaling process of a Respectful Relationships in Schools Program. Focus groups and interviews were conducted with project staff, managers and community organizations involved in the program. The results reveal how a key focusing event related to a highly profiled personal tragedy propelled family violence into the national spotlight. At the same time, the organization leading the respectful relationships program leveraged their networks to position the program within the education department which enabled the government to quickly respond to the issue. The study highlights that political will is not a stand-alone factor as depicted by up-scaling models, but rather is the end point of a complex process that involves many elements including the establishment of networks and aligned programs that can capitalize when opportunities arise.

The influence of contextual factors on implementation fidelity in a whole school approach to prevention of violence against women.

ISSUE ADDRESSED: Implementation fidelity relates to the degree of adherence to implementation protocols and content and helps to guide replication of evidence-based programs. In settings-based research, notions of fidelity have been applied more often to delivery of education content rather than whole of setting change. The aims of this paper were firstly, to analyse how contextual factors influenced implementation of a whole school program on respectful relationships education, and secondly given the findings, discuss whether a more flexible approach to implementation fidelity may have yielded increased school engagement. METHODS: The project was conducted in 19 secondary schools in Victoria in 2015. This paper reports on focus groups and interviews which were conducted with 81 school staff and 28 staff from the lead agency, community agency partners, and departmental staff to understand the contextual factors influencing implementation. RESULTS: The program followed a traditional implementation fidelity approach of considering core elements and some minor scope for adaption which engaged some regions and schools but not others. CONCLUSION: An alternative notion of implementation fidelity, "fidelity to function," may have permitted increased flexibility to tailor the intervention components to suit different school and community contexts and potentially, increasing both the reach and impact of the program. SO WHAT?: Understanding how to apply notions of fidelity to guide whole of setting change are important considerations if programs are to be replicated to have wider reach and greater impact and effectiveness.

Applying systems theory to the evaluation of a whole school approach to violence prevention.

Issue addressed Our Watch led a complex 12-month evaluation of a whole school approach to Respectful Relationships Education (RRE) implemented in 19 schools. RRE is an emerging field aimed at preventing gender-based violence. This paper will illustrate how from an implementation science perspective, the evaluation was a critical element in the change process at both a school and policy level. Methods Using several conceptual approaches from systems science, the evaluation sought to examine how the multiple systems layers - student, teacher, school, community and government - interacted and influenced each other. A distinguishing feature of the evaluation included 'feedback loops'; that is, evaluation data was provided to participants as it became available. Evaluation tools included a combination of standardised surveys (with pre- and post-intervention data provided to schools via individualised reports), reflection tools, regular reflection interviews and summative focus groups. Results Data was shared during implementation with project staff, department staff and schools to support continuous improvement at these multiple systems levels. In complex settings, implementation can vary according to context; and the impact of evaluation processes, tools and findings differed across the schools. Interviews and focus groups conducted at the end of the project illustrated which of these methods were instrumental in motivating change and engaging stakeholders at both a school and departmental level and why. Conclusion The evaluation methods were a critical component of the pilot's approach, helping to shape implementation through data feedback loops and reflective practice for ongoing, responsive and continuous improvement. Future health promotion research on complex interventions needs to examine how the evaluation itself is influencing implementation. So what? The pilot has demonstrated that the evaluation, including feedback loops to inform project activity, were an asset to implementation. This has implications for other health promotion activities, where evaluation tools could be utilised to enhance, rather than simply measure, an intervention. The findings are relevant to a range of health promotion research activities because they demonstrate the importance of meta-evaluation techniques that seek to understand how the evaluation itself was influencing implementation and outcomes.

Prevalence and Factors Associated With Men's Perpetration of Intimate Partner Violence in South Tarawa, Kiribati.

In the Republic of Kiribati, two-thirds of women report experiencing intimate partner violence (IPV) during their lifetime. Less is known about men's perpetration of IPV, or associated risk factors, in this high-prevalence setting. We conducted a cross-sectional study with 429 currently partnered men aged 15 to 49 in South Tarawa, Kiribati, to estimate the prevalence of, and risk factors associated with, currently married men's perpetration of physical and sexual IPV against female partners. Two-thirds (63%) of currently partnered men reported past year physical and/or sexual IPV. Modifiable risk factors associated with men's perpetration of physical and/or sexual IPV included child physical abuse (adjusted odds ratio [aOR]: 2.31), gender inequitable attitudes (aOR: 1.12), and antisocial behaviors, including gang involvement (aOR: 3.36) and involvement in fights with weapons (aOR: 3.54). Intimate partner violence prevention approaches in Kiribati should prioritize efforts to prevent child maltreatment, promote gender equitable norms and practices, and reduce community violence.