Process Evaluation of Supporting Family Doctors to Address Elder Abuse Intervention in Malaysia: A Mixed-Method Evaluation

PurposeThis study aims to conduct a process evaluation of Supporting Family Doctors to Address Elder Abuse (SAFE) intervention, a training program, and clinical guidelines developed to assist the family doctor in intervening in elder abuse (EA).Method160 family doctors answered pre-and post-training questionnaires on knowledge of EA, attitude, subjective norms, and the perceived behavioral control to intervene in EA, followed by semi-structured interviews post-intervention with a purposive sample of family doctors who participated in the SAFE intervention (N = 39).ResultsThere is a significant increase in mean scores of the knowledge, attitude, and subjective norms six months post-intervention (p < 0.001). The mean scores of perceived behavioral control of family doctors to intervene in EA decreased but were statistically insignificant (p > 0.05). Qualitative data explained the observed effect and process underlying the knowledge transfer and implementation of the SAFE intervention. Knowledge improvements due to awareness enhancement led to empowerment and confidence as the training program was effectual and comprehensive. Family doctors' self-reflection and empathy toward older adults contribute to attitude changes. Family doctors are better coordinated and receive support in intervening in EA. However, various roadblocks affect their perceived ability to intervene in EA and enhancement strategies necessary to assist family doctors to intervene in EA efficiently.ConclusionThe SAFE intervention was feasible and effective in improving family doctors' competency to intervene in EA. However, findings showed that doctors' capacities must go hand in hand with empowering older adults, creating awareness among community members, and pushing for law and policy reforms.