000			03049nab a22002657a 4500
999			_c6027 _d6027
005			20250625151458.0
008			181024t2018 -nz||||| |||| 00| 0 eng d
040			_aAFVC
100			_91206 _aGear, Claire
245			_aExploring the complex pathway of the primary health care response to intimate partner violence in New Zealand _cClaire Gear, Elizabeth Eppel and Jane Koziol-McLain
260			_bBMC, _c2018
500			_aHealth Research Policy and Systems, 2018, 16:99
520			_aBackground: Integrating sustainable responses to intimate partner violence in health care is a persistent and complex problem internationally. New Zealand holds a leading role, having established national health system infrastructure for responding to intimate partner violence within hospital and selected community settings. However, resources for, and engagement with, the primary health care sector has been limited. The present study focuses on what affects a sustainable response to intimate partner violence within New Zealand primary health care settings. Methods: Utilising complexity theory, we reconceptualised a sustainable primary health care response to intimate partner violence as a complex adaptive system. To explore interactions between agents, we analysed the function(s) of key policy, strategy, guideline and evaluation documents informing intimate partner violence responsiveness in health care. We chronologically threaded these documents together by their function(s) to show how discourse influencing intimate partner violence responsiveness emerges from agent interactions. Results: This paper presents a complexity informed implementation narrative of the New Zealand health system response to intimate partner violence across the last two decades, focused on the participation of the primary health care sector. We demonstrate how competing discourses have contributed to system gaps and unintended consequences over time. Our findings consider implications for a sustainable response to intimate partner violence in primary health care and call attention to system interactions that challenge a whole health system approach in New Zealand. Conclusions: Use of complexity theory facilitates an innovative perspective of a persistent and complex problem. Given the complexity of the problem and New Zealand’s leadership, sharing the lessons learnt is critical for the international community involved in developing health care system approaches to intimate partner violence. (Authors' abstract). Record #6027
650			_aDOMESTIC VIOLENCE _9203
650			_aHEALTH SERVICES _9290
650			_aINTERVENTION _9326
650			_aINTIMATE PARTNER VIOLENCE _9431
651		4	_aNEW ZEALAND _92588
700			_aEppel, Elizabeth _96867
700			_aKoziol-McLain, Jane _91511
773	0		_tHealth Research Policy and Systems, 2018, 16:99
830			_aHealth Research Policy and Systems _97928
856			_uhttps://doi.org/10.1186/s12961-018-0373-2 _zDOI: 10.1186/s12961-018-0373-2 (Open access)
942			_2ddc _cARTICLE