Making the Case for Domestic Violence Prevention Through the Lens of Cost-Benefit
A Manual for Domestic Violence Prevention Practitioners
(and the State and Local Policy-Makers They Present to)
Valuing Outcome Is A Challenge
The cost tools in this Manual help place value on a prevention program, yet prevention of violence against intimate partners is a long-term process that deals with multiple factors at every point in the process. We always want to keep in mind and make clear: the results of a prevention program are difficult to measure, as the outcomes are complex and they occur in both the near- and the long-terms.
It is predicted that domestic violence could be reduced by as much as 75% if identification and intervention were offered routinely in medical settings.
McFarlane J, Soeken K. Campbell J, Parker B, Reel S,, Silva C. Severity of Abuse to Pregnant Women and Associated Gun Access of the Perpetrator. Public Health Nursing. 1998; 15:201-206. Cited in: Help Network: Mobilizing the Health Community to Prevent Gun Death and Injury.
Guns and Domestic Violence Fact Sheet, 2006.
“If I’m getting consistent answers on surveys or in interviews that show me that the people who have attended the training either see the red flags earlier, get out earlier, are not tolerant of violent relationships or don’t get involved at all in violent relationships, I’m able to show that participants have the knowledge and skills to know what to do in their own relationships and act as role models in the community. On a very concrete level, the police recently added a checkbox to track incidences of same-sex IPV and that was really exciting because of the specific target populations. These data will give us an opportunity to check back to see if there was any change in incidents of same-sex IPV reported to the police. Still, it’s difficult to measure the impact that we’re having on an overall societal level since there are so many factors involved.”
Delena Couchman, Prevention Program Coordinator
Los Angeles Gay & Lesbian Center, Los Angeles, California. September 23, 2005.
This makes it all the more important for us to have baseline measures of the knowledge, behaviors or policies we are attempting to change, and to use unchanging mechanisms (such as surveys) to track changes. To emphasize this, we have charted a comparison between simple and complex outcomes in both the short-term and long-term:
|
Prevention Outcomein County “A”
|
Short-term Outcome
|
Long-term Outcome
|
|---|---|---|
| Measurability Simple | Annual Incidence (in # per capita in the area where the program is operating) of injury resulting from domestic violence drops. For example:In 2002, there were 4,783 incidences of domestic violence injury reported at the three county hospitals. With a population of 100,000, this represents 4.8% of the population.In 2003, there were 1310 incidences, representing 1.3% of the population.This is a decrease of 3.5% | Decade Long Incidence (in # per capita in the area where the program has operated) of injury resulting from domestic violence drops. For example:From 1993 to 2003, domestic injury incidences resulting from domestic violence decreased from 5.9% to 1.3% |
| Measurability Complex | In the year following the start of a prevention program, people’s(in the area where the program is operating) understandings of Domestic Violence improve. For example:A community survey conducted in 2002 in County A showed that 36% of respondents could identify domestic violence characteristics.The same survey in 2003 showed that 52% of respondents could identify domestic violence characteristics. | In the decade following a prevention program, people’s(in the area where the program operated) understandings of Domestic Violence improve. For example:A community survey conducted in 1993 in County A showed that only 12% of respondents could identify domestic violence characteristics.The same survey in 2003 showed that 52% of respondents could identify domestic violence characteristics, representing an increase of 40%. |
In the end, we must acknowledge that most outcome and benefit measures, no matter how refined, only estimate the whole picture. This is where understanding the theory which drives your prevention program is quite important – a subject we will explore in the next chapter.