Study Protocol: Understanding context of violence against healthcare through citizen science and evaluating the effectiveness of a code of conduct and of a de‑escalation of violence training

Violence against healthcare workers (HCWs) is a global issue, and it can be particularly severe in humanitarian contexts. However, there is limited evidence on effective and affordable approaches to address this problem. Understanding the context of community distrust and motivation for violence against HCWs will be critical for developing effective, tailored, and culturally appropriate responses, including a training on violence de-escalation and a community behavioral change approach to increase public trust in HCWs. This study aims therefore to compare the effectiveness and cost-effectiveness of different interventions to reduce violence against HCWs in two post-crisis settings, providing valuable evidence for future efforts to address this issue.

Qualitative and citizen science methods will explore motivations, causes, and contributing factors that lead to violence against HCWs. Preliminary findings will inform participatory meetings aimed at co-developing local rules of conduct, followed by a validation and legitimisation process. The effectiveness of the two interventions will be evaluated through a stepped-wedge randomised-cluster trial. It will measure the frequency and severity of violence, as well as secondary outcomes such as post-traumatic stress disorder (PTSD), job burnout, empathy, or HCWs’ quality of life at various points in time. A cost-effectiveness study will also compare the two strategies.

Find out more in this study protocol.