Additional information

CRediT contribution statement

Caroline Bradbury-Jones (https://orcid.org/0000-0002-5237-6777): Conceptualisation (equal), Formal analysis (lead), Funding acquisition (equal), Investigation (lead), Methodology (lead), Project administration (lead), Visualisation (equal), Writing – original draft (lead), Writing – editing and reviewing (lead).

Sarah Damery (https://orcid.org/0000-0003-3681-8608): Conceptualisation (equal), Data curation (lead), Formal analysis (lead), Funding acquisition (equal), Investigation (lead), Methodology (lead), Software (lead), Visualisation (equal), Writing – original draft (lead), Writing – editing and reviewing (lead).

Kirsten Fruin (https://orcid.org/0000-0002-5018-1052): Methodology (supporting), Writing – editing and reviewing (supporting).

Clare Gunby (https://orcid.org/0000-0001-8428-6621): Data curation (lead), Formal analysis (lead), Investigation (lead), Methodology (lead), Project administration (supporting), Visualisation (equal), Writing – original draft (lead), Writing – editing and reviewing (lead).

Jenny Harlock (https://orcid.org/0000-0002-2300-750X): Conceptualisation (equal), Data curation (lead), Formal analysis (lead), Funding acquisition (equal), Investigation (supporting), Methodology (supporting), Visualisation (equal), Writing – original draft (supporting), Writing – editing and reviewing (supporting).

Lucy Hebberts (https://orcid.org/0000-0002-8568-2973): Formal analysis (supporting), Methodology (supporting), Writing – editing and reviewing (supporting).

Louise Isham (https://orcid.org/0000-0002-3660-1073): Data curation (lead), Formal analysis (lead), Investigation (supporting), Methodology (supporting), Visualisation (equal), Writing – original draft (lead), Writing – editing and reviewing (lead).

Anne-Marie Jones (https://orcid.org/0000-0001-7348-8068): Formal analysis (supporting), Methodology (supporting), Visualisation (equal), Writing – original draft (lead).

Fay Maxted (https://orcid.org/0000-0002-1599-1412): Conceptualisation (equal), Funding acquisition (equal), Methodology (supporting), Writing – editing and reviewing (supporting).

Amelia Mighty: Formal analysis (supporting), Methodology (supporting), Writing – editing and reviewing (supporting).

Priti Parmar (https://orcid.org/0000-0003-4344-144X): Conceptualisation (equal), Funding acquisition (equal), Methodology (supporting), Writing – editing and reviewing (supporting).

Laura Patterson (https://orcid.org/0000-0001-7586-8080): Formal analysis (supporting), Methodology (supporting), Visualisation (equal), Writing – original draft (lead), Writing – editing and reviewing (supporting).

Jason Schaub (https://orcid.org/0000-0002-6878-2366): Conceptualisation (equal), Data curation (lead), Formal analysis (supporting), Funding acquisition (equal), Investigation (supporting), Methodology (supporting), Writing – editing and reviewing (supporting).

Fee Scott (https://orcid.org/0000-0003-0019-7571): Formal analysis (supporting), Methodology (supporting), Writing – editing and reviewing (supporting).

Harriet Smailes (https://orcid.org/0000-0003-0430-7053): Data curation (lead), Formal analysis (lead), Investigation (supporting), Methodology (lead), Software (lead), Visualisation (equal), Writing – original draft (lead), Writing – editing and reviewing (supporting).

Debs Smith (https://orcid.org/0000-0002-5020-1228): Conceptualisation (equal), Formal analysis (supporting), Funding acquisition (equal), Methodology (supporting), Writing – original draft (supporting), Writing – editing and reviewing (supporting).

Julie Taylor (https://orcid.org/0000-0002-7259-0906): Conceptualisation (equal), Funding acquisition (equal), Methodology (supporting), Project administration (supporting), Supervision (lead), Writing – original draft (supporting), Writing – editing and reviewing (supporting).

Acknowledgements

Thanks to Dr Gill Coombes who led the submission of the grant and was successful in the award. Gill left at the beginning of the grant and her input and leadership are acknowledged and appreciated. Thank you to Dr Sam Warner, University of Warwick, for her role as chair of the PROSPER Steering Committee and to all members of the Steering Committee for their sage advice and guidance along the way. We acknowledge the contribution of all the participants and partner organisations who have given time to PROSPER – your time given to the process has been invaluable. Thanks are extended to Lisa Ward for ‘shepherding’ the additional, creative work with the co-researchers. It literally would not have happened without you. Thank you to Rachel Norton for your support with editing and preparing this report. Finally, sincerest thanks to Pam Nayyar who has been a solid rock in the project management of PROSPER. Your ceaseless patience and kindness have glued the team together and that has been appreciated by everyone.

Patient data statement

This work uses data provided by patients and collected by the NHS as part of their care and support. Using patient data is vital to improve health and care for everyone. There is huge potential to make better use of information from people’s patient records, to understand more about disease, develop new treatments, monitor safety, and plan NHS services. Patient data should be kept safe and secure, to protect everyone’s privacy, and it’s important that there are safeguards to make sure that it is stored and used responsibly. Everyone should be able to find out about how patient data are used. #datasaveslives You can find out more about the background to this citation here: https://understandingpatientdata.org.uk/data-citation.

Data-sharing statement

All available, anonymised data can be obtained from the corresponding author on reasonable request.

Ethics statement

The PROSPER study was subject to the following ethical approvals:

The University of Birmingham Science, Technology, Engineering and Mathematics ethics committee. February 2020 (ERN_19-1152A) and October 2020 (ERN_19-1152B).

Ethical approval from the University of Birmingham and research governance approval from the Health Research Authority (HRA) and Health and Care Research Wales (HCRW) January 2021 (REC reference: 20/HRA/6042). The Association of Directors of Children’s Services (ADCS) (Ref: RGE201005), and Association of Directors of Adult Social Services approved sharing the survey weblink(s) amongst their members. Data that underlie the findings will be available immediately following publication with no end date from the Principal Investigator, on reasonable request and following deidentification.

Key ethical issues identified and mitigated

The principal ethical considerations involved in carrying out qualitative work with victim-survivors in the PROSPER study were: to protect participants’ confidentiality and the safe storage of their data; to protect and promote their welfare, ensuring that participation does not cause unnecessary distress or retraumatisation; to ensure that participants meaningfully consent to taking part and that their consent is understood as dynamic and conditional. Broadly, the following ethical issues were anticipated with associated mitigating actions:

1. Exiting the researcher–participant relationship Previous experience suggests that researchers and co-researchers may find it difficult to exit the research relationship with a participant, particularly when discussing sensitive topics such as SV. Participants may inadvertently develop an attachment to the interviewer, particularly if good rapport is developed during an interview. This can be challenging for the researchers to handle, particularly with participants to whom they may feel a duty of care. This was a potential ethical problem for WP 1 and 3 interviews. Mitigating actions: Researchers’ and co-researchers’ contact details were not shared with participants, who were provided with the study office number only.
2. Overinvolvement of the researchers/co-researchers Operating somewhat in reverse to point 1, researchers may likewise feel drawn into participants’ lives, particularly co-researchers, who, as victim-survivors of SV themselves, are likely to identify with, and feel empathy for the victim-survivors they interview. Researchers may find it upsetting to hear about participants’ experiences and may not always feel they know how to react. Mitigating actions: A distress protocol for the study set out how this risk would be minimised and covered in detail in initial training for co-researchers and any members of the academic team who required such training. As per the Participant Information Sheet, it was made clear that researchers would not take on any ongoing role with a research participant, but rather, would signpost participants to sources of support and advice, where relevant. It is noteworthy that most of the research team had significant experience of practice and research in the field of SV and were brought onto the project for these skills. This was an important mitigating factor.
3. Confidentiality There was a risk, albeit a low risk, that one of the research team might live or work in one of the areas selected as a case study site, raising important issues of confidentiality (WP3). Mitigating action: Researchers/co-researchers did not undertake victim-survivor interviews in an area where they lived or worked and/or were likely to have a connection to one of the victim-survivor participants or an associated VSS service.
4. Consent Some participants may have found it challenging to decline the opportunity to participate and we needed to draw on our extensive experience to design materials that enabled victim-survivors and those with special educational needs to participate safely. Mitigating actions: We developed pictorial materials to explain the research in accessible terms and ensured that sufficient time was given to explaining the research. Consent was treated as a dynamic process and researchers remained alert to signs that a participant may have wished to stop the interview or move to a new topic. Written informed consent was taken for all participants in WPs 1 and 3. Researchers explained with every participant, what taking part involved, their right to withdraw, how data are stored and how confidentiality and anonymity were to be maintained. All interviews were followed by a short debriefing discussion, ensuring the participant could reflect on the interview and any further questions. Audio-recorded or written consent was collected from all participants in line with the ethical permissions. We briefed VSS organisations regarding our eligibility criteria for recruitment (which had been designed to minimise distress/risk of retraumatisation) and the need for the organisations to exercise sensitivity and reassurance when approaching potential participants. We requested that they reassure all potential participants that if they did not wish to take part, it would not affect any future care/support they may need from that service.
5. Disclosure of SV experiences In any study such as PROSPER, there is the risk of disclosure of non-recent or ongoing SV, for participants and researchers, plus a risk that team members may experience vicarious trauma. Mitigating actions: A clear and comprehensive safeguarding policy ensured that potential issues were dealt with swiftly and effectively. The team were fully briefed on the policy and the importance of adhering to it, although fortunately, no significant safeguarding or disclosure matters arose.
6. Well-being and safety of the co-researchers The co-research component of PROSPER was strong in terms of effort, time, contribution and potential impacts. It carried with it several ethical issues, most of which have been alluded to in Chapter 6. We adopted the following practices to ensure the ethical conduct of this integral part of the study:
   1. We worked in line with the NIHR guidance for involving the public in research106 and specifically to help us deal with some potentially thorny ethical issues such as payments.107
   2. We advertised the opportunity for the co-researcher roles widely, via national networks such as People in Research, The Survivors Trust, Rape Crisis England and Wales and Male Survivors Partnership. This was in an attempt to recruit people from as diverse backgrounds and experiences as possible.
   3. We ensured that co-researchers had a full and informed understanding about the research and what it involved as part of the recruitment process.
   4. Training and mentorship were provided to equip co-researchers with the required support and skills to undertake the role.
   5. Reflective sessions (online) were held regularly as a forum for ongoing support and mentoring of the co-researchers and a sharing of experiences and learning across the team.
7. Well-being and safety of the whole team During the WPs that involved interviewees (victim-survivors and staff), we were aware of the potential for participants to become distressed as a result of taking part. We followed the principles of the McCosker et al.108 distress protocol and that of Drauker et al.109 to guide decisions about appropriate action in the event of such distress. Information about local sources of support was included in the written documentation about the study and interviews were halted if the interviewee became upset. Support for research team members followed recommendations developed by two of the team’s co-applicants as regards managing risks for vicarious trauma.110 For example, we embedded regular supervision for researchers, PPIE co-applicants and the co-researchers in which we addressed the potential for vicarious distress. We endeavoured to create an environment in which the difficulties of listening to and engaging with people’s experiences of SV could be acknowledged as upsetting. This, we hope, helped to build resilience and compassion across the whole team.

Information governance statement

Risks to confidentiality of information in WP3

Documents provided by organisations in case study sites did not include any service user identifiable information. VSS organisations sharing performance/outcome data with the research team did so in aggregated form only. Data were shared and transported on encrypted secure data sticks. Contact information for participants was stored securely at the University of Birmingham and destroyed on completion of the project.

Data protection

With prior consent, all interviews (WP1 and 3) and focus groups (WP1) were digitally recorded on encrypted devices. The recordings were transferred directly to the secure study folder and then deleted from the recording device. Recordings were transcribed using a professional transcription firm which is registered with The Information Commissioner. The transcripts were anonymised and uploaded to NVivo (a qualitative data analysis software). All personal and signifying data were kept confidential. Participants were assigned identifying numbers and these numbers were used to ensure transcripts, field notes and communication records were appropriately stored and categorised. The index for these identifying numbers was stored on the study secure folder.

Data were stored electronically on a secure folder using the University of Birmingham’s Research Drive which provides secure, backed-up storage of research data. The secure study folder can only be accessed by named members of the team and was password protected. The folder is protected by the University’s high level of security that protects against spam and virus scanners. The data will be stored for 10 years. Using the BEAR Datashare ‘sync and share’ tool ensures central replication and back-up to a central data store. The system provides the mechanism for securely sharing data with collaborators. The University of Birmingham has established systems for data storage and back-up (every 24 hours) which safeguard data. The study data will be held for 10 years.

The BEAR Archive provides a secure and resilient service, available to researchers from all disciplines for the long-term storage of valuable data from completed research projects or data where access is not required in the short or medium term. On request, a default allocation of working data storage is provided to each principal investigator for the duration of ‘live’ projects. Long-term storage for other valuable data which are not currently in use, including from completed research, is provided in the BEAR Archive.

The appointed research fellows had day-to-day responsibility for the management and curation of the data sets, and preparation of the data and the technical report for archiving. Strategic and managerial responsibility for the data sets was with the principal investigator who in turn is responsible to the University. The anonymised data set will be stored in strict accordance with the revised General Data Protection Regulations (2018)96 and the Data Protection Act (2018).97

Disclosure of interests

Full disclosure of interests: Completed ICMJE forms for all authors, including all related interests, are available in the toolkit on the NIHR Journals Library report publication page at https://doi.org/10.3310/WWKT3077.

Primary conflicts of interest: None declared.

Publication

Bradbury-Jones C, Damery S, Fruin K, Gunby C, Harlock J, Hebberts L, et al. The scope, range and use of voluntary sector specialist sexual violence services in England: findings and recommendations from a national study. Health Social Care Community 2025:9368961. https://doi.org/10.1155/hsc/9368961

Disclaimers

This article presents independent research funded by the National Institute for Health and Care Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, the HSDR programme or the Department of Health and Social Care. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, the HSDR programme or the Department of Health and Social Care.