Evidence map›Paper›PMID 41864964›Full record

Trial reportBMC medicine2026

A culturally-safe primary care intervention for migrant/refugee women suffering domestic violence and abuse: HARMONY-a pragmatic cluster randomised controlled trial.

Angela J Taft, Felicity Young, Kelsey L Hegarty, Jane Yelland, Danielle Mazza, Douglas Boyle, Richard Norman, Claudia García-Moreno, Cattram Nguyen, Xia Li and 3 more

Abstract readRandomized Controlled TrialPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

13 authors.

Angela J TaftJudith Lumley Centre, La Trobe University, Bundoora, Vic, 3086, Australia. a.taft@latrobe.edu.au.ORCID 0000-0002-6350-843X
Felicity YoungJudith Lumley Centre, La Trobe University, Melbourne, Australia.
Kelsey L HegartyDepartment of General Practice and Primary Care, University of Melbourne, Melbourne, Australia.
Jane YellandMurdoch Children's Research Institute, Melbourne, Australia.
Danielle MazzaDepartment of General Practice, Monash University, Melbourne, Australia.
Douglas BoyleDepartment of General Practice and Primary Care, University of Melbourne, Melbourne, Australia.
Richard NormanCurtin University, Perth, WA, Australia.
Claudia García-MorenoDepartment of Sexual and Reproductive Health and Research, WHO, Geneva, Switzerland.
Cattram NguyenMurdoch Children's Research Institute, Melbourne, Australia.
Xia LiStatistics Department, La Trobe University, Melbourne, Australia.
Bijaya PokharelJudith Lumley Centre, La Trobe University, Melbourne, Australia.
Molly Allen-LeapJudith Lumley Centre, La Trobe University, Melbourne, Australia.
Gene FederCentre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImmigrant women can experience high rates of domestic violence and abuse (DVA) and migration trauma. Family or general practitioners (GPs) have limited DVA training or support to manage culturally competent DVA practice and associated trauma. The HARMONY study aimed to increase culturally competent DVA identification and referral among all, but especially migrant/refugee women from South-Asia, attending Australian GP clinics.

methodsTwenty-four GP clinics were recruited among two South-Asian communities in Northwest and Southeast Melbourne for a pragmatic cluster randomised controlled trial. Eligible clinics (i) employed ≥ 1 South-Asian GPs, (ii) used 1 of 2 electronic software programs, and (iii) agreed to anonymised, aggregated data extraction from computerised records. The intervention comprised (a) GP DVA educator and bilingual South-Asian DVA advocate co-delivering 4 h of online accredited culturally competent DVA training, and (b) 12 months follow-up support by the DVA advocate to intervention clinics. Comparison clinics offered routine care and were offered DVA training following the intervention's completion. Investigators and statistician were blinded to allocation, but clinics and frontline staff were not. Aggregated, anonymised routine data were extracted for primary outcomes of DVA identification and referral at 12 and 15 months. Per-protocol adjusted, intention-to-treat analysis using Poisson regression.

resultsFive of 24 GP recruited clinics withdrew before the trial began due to COVID-19. At baseline, GPs recorded DVA in 0.6% of 45,438 women, (but 0.4% among South-Asian women) and none recorded DVA referrals. Identification trended up in both arms, but we found no evidence of difference in DVA identification at 12 months in Intervention (0.98%, 252/25816) vs Comparison (0.88%, 199/22546), IRR 1.17 (95% CI 0.60 to 2.28) or at 15 months Intervention 1.01% (287/26218) vs Comparison 0.96% (217/22643), IRR 1.17 (95% CI 0.60-2.67). Referrals were rare (Int 14/252 vs Comp 6/199). 6/14 Intervention referrals were South-Asian women. No adverse events were reported.

conclusionsWhile we found no evidence of HARMONY effectiveness, COVID-19 may have undermined its implementation. The model is promising for future research and refinement for clinics motivated to improve DVA management with diaspora minority ethnic communities.

trial registrationACTRN12618001845224p registered:13/11/2018.

Indexed as

Culturally Competent CareDomestic ViolenceEmigrants and ImmigrantsPrimary Health CareTransients and MigrantsAdultAsia, SouthernAustraliaFemaleHumansMiddle AgedReferral and ConsultationSouth Asian PeopleCultural competencyDomestic violence and abuseEthnic minorityGeneral practicePrimary careRandomised trialSouth Asian

Identifiers

PMID41864964
PMCPMC13130777

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.