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. 2021 May 31;2021(5):CD012423. doi: 10.1002/14651858.CD012423.pub2

Cutshall 2019.

Study characteristics
Methods Design: RCT
Unit of randomisation: not reported
Participants Healthcare provider: newly‐licensed mental health professionals, such as licensed clinical social workers; licensed professional counsellors; licensed marriage and family therapists; licensed clinical psychologists
Other: N/A
Location/Setting: online delivery to healthcare providers at home or the office in the USA
Sample size: n = 53 (intervention group n = 26, control group n = 27)
Number of withdrawals/dropouts: nil
Sex: 20 men, 31 women, 2 non‐binary
Mean age: 7 = 20 ‐ 29 years; 29 = 30 ‐ 39 years; 11 = 40 ‐ 49 years; 5 = 50 ‐ 59 years; 1 = 60 ‐ 69 years
Inclusion criteria: less than 5 years clinical experience, have treated at least 1 victim of IPV
Exclusion criteria: if healthcare provider had any additional/specialised coursework in trauma practice of IPV or sexual violence outside of the graduate programme, licensed longer than 5 years
Interventions Intervention (n = 26): online only, interactive web‐based IPV and sexual violence training; total of 15 hours (3 x 5‐hour sessions offered over 3 consecutive weeks); 3 modules (module 1: introduction to IPV and rape culture ‐ definitions, prevalence, myths; module 2: marginalised populations (e.g. children, military); and module 3: knowledge of IPV and sexual violence reporting, rape culture, consent, advocacy skills, confidence levels in providing therapeutic intervention and follow‐up care)
Control (n = 27): wait‐list
Outcomes Primary outcomes
  • Knowledge (actual and perceived) of IPV and Perceived self‐efficacy. This was assessed using a modified PREMIS scale. It asked 15 questions to assess IPV knowledge, perceived IPV advocacy knowledge, perceived IPV systems knowledge, perceived IPV efficacy/confidence in providing counselling. Items were rated on a 5‐point Likert scale (nothing ‐ very much)

  • Knowledge of sexual violence, and rape culture. This was assessed using used a modified version of the Personal Assessment for Advocates Working with Victims of Sexual Violence measure. 4 separate scales were developed from this measure to assess sexual violence knowledge, perceived sexual violence advocacy knowledge, perceived sexual violence systems knowledge, perceived sexual violence confidence in providing counselling. Each item on a 5‐point Likert scale (not true ‐ true)

  • Other: Treatment Acceptability Questionnaire; Client Satisfaction Questionnaire; feasibility survey questions ‐ intervention reach, survey completion, acceptability, recruitment, attrition/barriers to retention, etc.


Secondary outcomes: not reported
Timing of outcome assessment: 1 follow‐up at 4 weeks after baseline
Notes Study start date: not reported
Study end date: not reported
Funding source: not reported
Conflicts of interest: not reported
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Quote: "A waitlist‐controlled design was used, and participants were randomized into either the educational intervention group (15‐hour training) or the waitlist control group”. (p 49)
Allocation concealment (selection bias) Unclear risk Comment: no information provided on allocation.
Blinding of participants and personnel (performance bias)
All outcomes High risk Comment: High risk of performance bias as outcomes were self‐reported and participants were aware of allocation status
Quote: "Participants who met inclusion criteria were informed that they would be randomly assigned to either one of two treatment groups”. (p 61)
Blinding of outcome assessment (detection bias)
All outcomes Low risk Comment: self‐reported outcomes used
Quote: “I administered a pre‐test using the following outcome measures: the personal assessment for advocates working with victims of sexual violence and the PREMIS previously noted.” (p 62)
Incomplete outcome data (attrition bias)
All outcomes Low risk Quote: "Adherence to the waitlist control, educational training intervention, post‐test, and questionnaires was at 100% adherence and retention in both the initial intervention group and the waitlist intervention group.” (p 68)
Selective reporting (reporting bias) Low risk Comment: all relevant outcomes from the Methods section were reported in the Results section of the study
Other bias Low risk Comment: no other risks identified