Components of Family-Focused Interventions that Have Common Impacts Across Parental Domestic Violence and Abuse, Mental Ill-Health, and Substance Misuse: An Intervention Components Analysis.

Support for families experiencing domestic violence and abuse (DVA), mental ill-health (MH) and substance misuse (SU) is often delivered in siloes, despite the frequent co-occurrence of these public health issues. Little evidence-based guidance exists on which interventions best support families experiencing a combination of these problems. Identifying intervention components with common impacts across parental DVA, MH and SU could inform policy and practice. We conducted an Intervention Components Analysis (ICA) to identify intervention components that have common impacts across parental DVA, MH and SU. We searched ten databases for randomised controlled trials of family-focused interventions targeting, and measuring an impact on, one or more of these issues. We developed an initial coding framework using open coding to guide the coding of subsequent studies. Descriptive analyses identified common components across target outcomes (DVA/MH/SU) and robust variance meta-regressions explored the relationship between intervention components and treatment effects. A Lived Experience Advisory Group informed our presentation and interpretation of the results. We identified 164 interventions: 40 focused on a combination of DVA, MH and SU and 124 addressed one issue alone. None of the 20 components identified were unique to any specific outcome and no single component was associated with meaningful improvement in outcomes. Interventions aiming to provide integrated support across outcomes were less successful at improving MH and SU outcomes than those targeting single issues. We found no evidence of commonly effective intervention components. Better alignment between components and underlying processes driving DVA/MH/SU, and alternative intervention designs, are needed.