The role of public health in the primary prevention of interpersonal violence: A systematic review of international frameworks

Abstract

In recent years, there has been a surge of interest in violence as a public health issue. Preventing violence before it occurs and developing effective response strategies are key to achieving the United Nations Sustainable Development Goals and improving health and well-being. This systematic scoping review explores the role of public health frameworks in the primary prevention of interpersonal violence. A systematic literature search was undertaken to identify frameworks from both academic and grey literature. Extracted records (n = 17) were thematically analyzed to explore themes, divergences, and theoretical underpinnings. Most frameworks were published in the last decade by national and international public health bodies. The majority were from high-income countries and explored a range of interpersonal violence types. Nine themes were identified, which provide opportunities for violence prevention across the socio-ecological model, including: families, caregivers, and early years; early identification and support; schools, education, and skill development; safe community environments; safe activities and trusted adults; social norms and values; empowerment and equality; policy and legislation; and poverty reduction. These frameworks evidence the leadership role played by public health in the development and implementation of the primary prevention of violence. However, to effectively embed a public health approach, the review identified several areas which warrant further attention. These included redressing disparities in evidence, particularly from low income countries; building the evidence base for addressing community and structural determinants of violence such as gender, poverty, and inequality; and investing in research which explores the implementation of primary prevention approaches.

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REVIEW
The role of public health in the primary
prevention of interpersonal violence: A
systematic review of international frameworks
Lara Snowdon*
,†, Zara Quigg*, Conan Leavey*
ABSTRACT
In recent years, there has been a surge of interest in violence as a public health issue. Preventing violence before it occurs
and developing effective response strategies are key to achieving the United Nations Sustainable Development Goals and
improving health and well-being. This systematic scoping review explores the role of public health frameworks in the
primary prevention of interpersonal violence. A systematic literature search was undertaken to identify frameworks from
both academic and grey literature. Extracted records (n = 17) were thematically analyzed to explore themes, divergences,
and theoretical underpinnings. Most frameworks were published in the last decade by national and international public
health bodies. The majority were from high-income countries and explored a range of interpersonal violence types. Nine
themes were identied, which provide opportunities for violence prevention across the socio-ecological model, includ-
ing: families, caregivers, and early years; early identication and support; schools, education, and skill development; safe
community environments; safe activities and trusted adults; social norms and values; empowerment and equality; policy
and legislation; and poverty reduction. These frameworks evidence the leadership role played by public health in the
development and implementation of the primary prevention of violence. However, to effectively embed a public health
approach, the review identied several areas which warrant further attention. These included redressing disparities in
evidence, particularly from low-income countries; building the evidence base for addressing community and structural
determinants of violence such as gender, poverty, and inequality; and investing in research which explores the imple-
mentation of primary prevention approaches.
Key Words Primary prevention; public health approach; evidence-based practice; violence prevention.
INTRODUCTION
Interpersonal violence contributes to the global burden of
premature death and injury, as well as having serious, life-
long consequences for health and well-being (Krug etal.,
2002). Interpersonal violence involves the intentional use of
physical force or power against other persons by an indi-
vidual or small group of individuals and may be physical,
sexual, or psychological, or involve deprivation and neglect.
Interpersonal violence can be further divided into family,
partner, and commun ity violence (Mercy etal., 2017). Prevent-
ing interpersonal violence before it occurs and developing
effective response strategies are key to achieving the United
Nations (UN) Sustainable Development Goals (Quigg etal.,
2020), improving the health and well-being of individuals
and communities, and benetting the economy and society
(WHO, 2 0 21).
Following the 1996 World Health Assembly resolution
(WHA49.25) which declared violence a major and growing
public health problem across the world and the 2002 World
Health Organization (WHO) World Report on Violence and
Health (Krug etal., 2002), there has been a surge of interest in
violence as a public health issue. The public health approach
premises that violence can be predicted and prevented from
occurr ing through understandi ng and modifying risk factors,
prevention programmi ng, policy interventions, and advocacy
(Krug etal., 2002). Public health bodies from across the globe
have increasingly published frameworks designed to support
the implementation of a public health approach to violence
prevention (i.e., Our Watch (2015), David-Ferdon etal. (2016),
Correspondence to: Lara Snowdon, School of Public and Allied Health, Public Health Institute, World Health Organization Collaborating Centre for Violence Preven-
tion, Faculty of Health, Liverpool John Moores University, 3rd Floor, Exchange Station, Tithebarn Street, Liverpool, L2 2QP, UK. E-mail: l.c.snowdon@2021.ljmu.ac.uk
To cite: Snowdon, L., Quigg, Z., and Leavey, C. (2024). The role of public health in the primar y prevention of interpersonal violence: A systematic review of international
frameworks. Journal of Community Safety and Well-Being, 9(4), 176–183. https://doi.org/10.35502/jcswb.406

177Journal of Community Safety and Well-Being, Vol 9(4), December 2024 | journalcswb.ca | @JournalCSWB
VIOLENCE PREVENTION AND PUBLIC HEALTH, Snowdon etal.
WHO (2016), and WHO (2019)). Typically, these frameworks
provide an epidemiological analysis of violence as a public
health issue, outline the process of developing a public health
approach, and provide guidance on evidence-based practice
for prevention.
The range of regional, national, and international frame-
works seek to realize a collective ambition to apply public
health concepts to the management of a problem historically
regarded as a criminal justice concern (Krug etal., 2002).
However, there is large variation in the approach, content,
and structure of these frameworks. At a time when the
public health approach to violence prevention is becoming
increasingly prominent (WHO, 2022), an exploration of the
public health role, including an analysis of the messaging
on primary prevention, is an important contribution. Par-
ticularly, in supporting the adoption, implementation, and
embedding of a public health approach to violence prevention
across countries, that builds on the international evidence.
METHOD
A systematic literature search was undertaken to identify
violence prevention frameworks from academic and grey
literature. The search included two phases. Phase one
(December 2022) included a search of academic databases
(CINAHL, Medline, and Web of Science) using a defined
search strategy (Table I) and eligibility criteria (Table II). Phase
two (January 2023) identied grey literature through hand
searching relevant organizational websites, international
evidence repositories, and Google, in addition to contacting
international experts to request relevant records. Backward
searches were completed for all records that met the inclu-
sion criteria.
The rst author screened records for eligibility, extracted
data, and removed duplicates. All records were assessed
against the inclusion/exclusion criteria and for accuracy
and consistency by the second author. Where there were
multiple papers describing one framework, these were clus-
tered together for the purpose of analysis. The systematic
review was guided by the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) checklist
(PRISMA, 2015), outlined in the ow diagram (Figure 1).
Following full-text review, 17 frameworks were included.
The extracted data were analyzed using thematic analysis
(Braun & Clarke, 2006).
RESULTS
Framework Characteristics
Most records were published by national public health
agencies (53%) and international organizations (24%). The
remaining records were regional (6%) (i.e., a group of coun-
tries) or sub-national (18%) (state or region). Analysis of
publication dates demonstrates that there has been a rapid
increase in the number of frameworks published in the past
10 years (82%).
Aside from international frameworks (24%), geographic1
distribut ion was uneven, with over half f rom the Region of the
Americas (53%), two from the Western Pacic Region (12%),
and one each from the African (6%) and European Regions
(6%). No frameworks were identied from the Eastern Med-
iterranean or Southeast Asian Regions. Most frameworks
were from high-income countries (59%), and 18% were from
middle-income countries.2 No frameworks were identied
from low-income countries. However, one international
framework (Mercy etal., 2008) is a framework for preventing
violence in developing countries.
Violence Type and Target Group
Most frequently, frameworks (35%) focused on violence
against women (VAW). Within this category, one framework
from Australia focused specifically on violence against
Aboriginal and Torres Strait Islander women and their chil-
dren (Our Watch, 2018). Other violence types included inter-
personal violence (18%), youth violence (12%), violence against
TAB LE I Search terms
Framework OR “technical package”
“Public health” OR “whole system” OR “population health” OR prevent* OR “primary prevent*”
Violence OR maltreatment OR abuse
TAB LE I I Eligibility criteria
Inclusion Criteria Exclusion Criteria
Available in English language. Not available in English language.
Framework must provide information on evidence -based strategies
for the primary prevention of interpersonal violence as part of a
public health approach.
Not part of a wider public health approach to violence prevention.
Focused on primary prevention of interpersonal violence. Not focused on primary prevention.
Not focused on interpersonal violence prevention.
Frameworks should provide a methodology or discussion of how
they have been developed through an evidence -based approach.
Not evidence based.
1World Health Organization regions.
2World Bank country classification by income.

178Journal of Community Safety and Well-Being, Vol 9(4), December 2024 | journalcswb.ca | @JournalCSWB
VIOLENCE PREVENTION AND PUBLIC HEALTH, Snowdon etal.
children (12%), sexual violence (6%), intimate partner violence
(IPV) (6%), family violence (6%), and gun violence (6%).
Primary Prevention Strategies
All frameworks promoted the implementation of multi-com-
ponent violence prevention programming as part of a
whole-system approach. According to public health science,
to generate population scale impact, an integrated, systemic
model should be utilized in which there are multiple the-
ory and evidence-based interventions implemented across
the socio-ecological model (Krug etal., 2002). This model
aims to address the range of factors that can contribute to
violence across the life course at an individual, relationship,
community, and societal level. Given the range of modiable,
interrelated risk and protective factors for violence, there is
growing evidence that multi-component approaches which
address multiple factors across the socio-ecological model
are more effective in preventing violence than those with
a single component (Degue etal., 2014; Nation etal., 2003).
Thus, through a whole-system approach, interventions func-
tion together to reinforce the conditions for interpersonal
violence prevention in a comprehensive and sustainable way
(David-Ferdon etal., 2016).
To promote this multi-component programming, all
frameworks provided a range of strategies for the primary
prevention of violence, as part of a public health approach.
Through thematic analysis, nine themes were identied that
describe the range of violence prevention strategies included
in the frameworks across all forms of interpersonal violence
represented. The themes are organized across the socio-eco-
logical model (Figure 2).
Families, caregivers, and early years
This theme was represented commonly within the frame-
works (David-Ferdon etal., 2016; Matzopoulos & Myers,
2014; Mercy etal., 2008; Our Watch, 2021; Wells & Ferguson,
2012; WHO, 2016). It describes how investing in a child’s
early years can benet health and well-being across the life
course, as a protective factor for violence prevention (Darling
etal., 2020; WHO, 2016). Examples of interventions identied
included antenatal and postnatal care, childhood home vis-
itation, parenting skills and family relationship programs,
affordable and accessible childcare, pre-school enrichment,
quality education in the early years, domestic abuse preven-
tion programs, and enhanced services to support families/
children with parents in prison.
Records identified
though database
search
(n = 57)
Additional records
identified through other
sources
(n = 20)
Records identified for
title screening after
deduplication
(n = 60)
Abstracts screened
(checked against
criteria by second
author)
(n = 36)
Records excluded
(n = 13)
Full text articles
screened
(n = 23)
Full text articles
included (n = 17)
Records excluded
(n = 6)
Records excluded
(n = 24)
FIGURE 1 PRISMA flow diagram of search and inclusion process.

179Journal of Community Safety and Well-Being, Vol 9(4), December 2024 | journalcswb.ca | @JournalCSWB
VIOLENCE PREVENTION AND PUBLIC HEALTH, Snowdon etal.
Early identification and support
Many frameworks (Basile etal., 2016; David-Ferdon etal.,
2016; Matzopoulos & Myers, 2014; Niolon etal., 2017; UNDP,
2014; Wells & Ferguson, 2012; WHO, 2016, 2019) stressed the
importance of early identication and support to ensure that
individuals are identied and receive appropriate support
when they are at-risk of and/or have experienced violence.
While this is classied as secondary prevention, it plays a
critical role in complementing primary prevention services
which are often delivered universally, as many people may
have experienced violence or trauma during childhood or
adulthood. Interventions included helplines, trauma-in-
formed training, specialist services, identication and referral
in healthcare and custody settings, and safeguarding.
Schools, education, and skill development
Education settings play a crucial role in violence prevention.
These are places where children and young people socialize,
learn about relationships, develop a sense of belonging, and
acquire knowledge, skills, and experiences (WHO, 2016). The
majority of frameworks identied education as a key setting
for prevention (Basile etal., 2016; David-Ferdon etal., 2016;
Fortson etal., 2016; Mercy etal., 2008; Niolon etal., 2017; Our
Watch, 2021; Rajan etal., 2022; Tek kas Kerman & Betrus, 2020;
UN Women, 2015; WHO, 2016, 2019). Strategies for violence
prevention included increasing children’s access to effec-
tive, gender-equitable education, socio-emotional learning
and life-skills training, whole school approaches, schemes
to prevent exclusion, trauma-informed schools, bystander
programs, relationship and dating violence prevention pro-
grams, and ensuring that education environments are safe,
enabling, and free from violent punishment.
Safe activities and trusted adults
Children and young people’s risk of becoming involved in
violence can be reduced through strong connections with
caring adults and undertaking activities that encourage skill
development (including development of healthy relation-
ships), creativity, learning, and growth (David-Ferdon etal.,
2016; Mercy etal., 2008; Niolon etal., 2017; WHO, 2016). These
relationships can have a positive inuence on children and
young people’s choices and prevent them from experiencing
violence and engaging in health risk behaviours (e.g., using
alcohol and drugs/harmfu l sexual behaviour) (David-Ferdon
etal., 2016). Activities included play, sports, arts, and cultural
activities; grassroots community-led schemes (particularly
in marginalized communities); after-school programs; and
youth work. These activities are used universally and/or
targeted toward those who have experienced or are at-risk
of violence to prevent further violence/risks.
Safe community environments
Many frameworks included a focus on the provision of safe
community environments to ensure that people feel safe
where they live, work, and play (Abt, 2017; Basile etal., 2016;
David-Ferdon etal., 2016; Niolon etal., 2017; Oregon Depart-
ment of Human Services, 2005; Rajan etal., 2022; Tekkas
Kerman & Betrus, 2020; WHO, 2016, 2019). Communities can
include places with any dened population with shared char-
acteristics and environments. Characteristics of a commu-
nity’s environment can inuence how a person/group acts,
creating a context that can have a positive or negative effect
on their behaviour. Approaches that modify the characteris-
tics of these places are considered community-level ways of
working (WHO, 2016). Examples included improving the built
environment to create appealing, safe, and accessible com-
munity spaces or identif ying violence hotspots to inform the
development and targeting of prevention activity, including
alcohol-licensing decisions, transport planning, or policing.
Social norms and values
Group and individual behaviours are inuenced by social
norms and values. For example, social norms and values
guide attitudes a nd behaviours arou nd child-rearing, gender
roles, sexuality, inclusion, and the acceptability of violence
within a group or society. Violence prevention efforts in
this area seek to strengthen social norms and values that
support non-violent, respectful, nurturing, positive, and
gender-equitable relationships. This type of violence pre-
vention strategy was prominent in frameworks which seek
to prevent gender-based violence (Basile etal., 2016; Fortson
etal., 2016; Mercy etal., 2008; Oregon Department of Human
Services, 2005; Our Watch, 2018, 2021; Wells & Fotheringham,
2022; WHO, 2019), but also featured in other frameworks to
prevent violence against children (WHO, 2016). Examples of
interventions included group work to challenge adherence
to restrictive and harmful social and gender norms; inter-
ventions to challenge social norms relating to child mar-
riage; community mobilization programs; active (positive)
bystander interventions; as well as social norms marketing
campaigns.
Empowerment and equality
Cross-national evidence indicates that rates of violence are
lower in countries where there is less inequality between
groups, as social inequalities relating to gender, race, eth-
nicity, sexuality, disability, and migrant status increase the
likeli hood of violence taking place (David-Ferdon etal., 2016).
In turn, violence further ingrains and perpetuates those
inequalities, leaving margi nalized populations more vulner-
able to violence, exploitation, harm, neglect, maltreat ment,
trauma, and its consequences. As such, many frameworks
promoted the use of prim ary prevention strategies which seek
to promote the empowerment of women and marginalized
Society
Social norms
and values
Empowerment
and equality
Policy and
legislation
Poverty
reduction
Community
Schools,
education, and
skill development
Safe
community
environments
Safe activities
and trusted
adults
Individual
Families,
caregivers, and
early years
Early
identification and
support
FIGURE 2 Violence primary prevention themes mapped against the so-
cio-ecological model.

180Journal of Community Safety and Well-Being, Vol 9(4), December 2024 | journalcswb.ca | @JournalCSWB
VIOLENCE PREVENTION AND PUBLIC HEALTH, Snowdon etal.
groups (Basile etal., 2016; Matzopoulos & Myers, 2014; Our
Watch, 2018, 2021; UN Women, 2015; WHO, 2019). Examples
of interventions included gender mainstreaming3 and gender
budgeting;4 minimum basic income schemes; strengthening
economic programs to promote full and equal labour force
participation; and strengthening leadership opportunities,
including political participation for people from marginal-
ized groups.
Policy and legislation
A robust legislative and policy framework lays the ground-
work to prevent violence, address risk factors (and promote
protective factors), and legislate for employing a human rights
and gender equality approach. It can also provide a struct ure
for protecting, responding to, and supporting victims, wit-
nesses, and children. While laws alone cannot reduce vio-
lence, implementing and enforcing them strengthen s violence
prevention efforts (WHO, 2016). This strategy for primary
prevention was more frequent in international frameworks
or those from middle-income countries, where rule of law
to safeguard children and young people and marginalized
groups may not be as well established (Matzopoulos &
Myers, 2014; Mercy etal., 2008; Tekkas Kerman & Betrus,
2020; UN Women, 2015; WHO, 2016). Examples of policy and
legislation included prohibiting violent punishment of chil-
dren by parents, teachers, or other caregivers; criminalizing
sexual abuse and exploitation of children; preventing alcohol
misuse through minimum age purchase limits; preventing
child mariage; limiting access to rearms and weapons; and
increasing statutory funding for prevention programs.
Poverty reduction
The adverse impacts of violence are most severe in communi-
ties with high levels of socioeconomic deprivation. Reducing
poverty and income inequality is a fundamental building
block in preventing violence and improving community
safety (Bourguignon, 2000). A range of frameworks included
strategies to tackle poverty and socio-economic inequality as
a key focus for the primary prevention of violence (Niolon
etal., 2017; UNDP, 2014; WHO, 2016). Examples of interven-
tions included minimum basic income schemes; strength-
ening economic programs to promote full and equal labour
force participation; strengthening leadership opportunities
for people from margi nalized groups; and gender budgeting.
DISCUSSION
Public Health Role in Violence Prevention
In 2002, the “World Report on Violence and Health” (Krug etal.,
2002) set out for the rst time a global, public health approach
to violence prevention. Since then, international bodies (e.g.,
WHO/UN) have invested signicantly in this approach, most
recently, through the development of the INSPIRE framework
and technical package to prevent violence against children
(WHO, 2016), and the RESPECT framework to prevent VAW
(WHO, 2019). Despite the WHA recognizing violence as a
major public health issue over two decades ago, our study
demonstrates that while there has been a proliferation of
this approach internationally, this has predominantly been
in recent years, with 82% of the frameworks identied pub-
lished in the past decade.
For many, the involvement of public health in the violence
prevention agenda is a welcome one, particularly regard ing its
focus on prim ary prevention (Nation etal., 2021). However, for
some, it represents public health “empire building” (Keithley
& Robinson, 2000) or even part of a post-colonial agenda that
embeds structural global inequal ity (Richa rdson, 2020). While
these opinions may be uncomfortable for public health prac-
titioners to consider, Orchowski (2019) argues that, criticisms
notwithst anding, preventing violence is of such importance to
promoting human health and well-being, it warrants critical
attention to improve evidence, theory, and practice.
How Robust is the Evidence?
As a science-based approach which focuses on improving
population health, public health is inherently interdisciplin-
ary. Interdisciplinary research and practice can bring new
insights and understanding across disciplinary boundaries
to address sophisticated or so-called “wicked” problems (van
Teijlingen etal., 2019), such as violence (Krug etal., 2002). This
systematic review demonstrates the breadth of interdisci-
plinary theory and evidence that has now been collated to
produce a range of strategies for primary prevention which
seek to modify risk pathways for violence across the social
ecology (Figure 2). However, signicant gaps in the research
remain which warrant attent ion if public health wants to truly
“walk the talk” of preventing violence. Nation etal. (2021)
argue that while public health has had success in tackling
youth violence, by focusing on individual and interpersonal
factors such as healthy relationships, developing problem
solving, and diffusing interpersonal conict (Farrell & Flan-
nery, 2006), it has had less success in demonstrating popula-
tion-level effects or diminishing race and class inequities in
violence-related outcomes (Golden & Earp, 2012).
Similarly, this systematic review provides clear evidence
of a global inequit y in the development of public health frame -
works and violence prevention research. Most frameworks
identied in this study were from high-income countries,
with only a small representation from middle-income coun-
tries (n = 3), and none from low-income countries. However,
>90% of violence-related deaths worldwide occur in low- to
middle-income countries, where the mortality rate due to
violence is almost 2.5 times greater than that in high-income
countries (Matzopoulos etal., 2008). Overall, there is a lack
of literature exploring violence prevention interventions in
low-income countries. Lester etal. (2017) suggest that despite
the prevalence of sexual assault rates in Africa, Eastern Med-
iterranean, and Southeast Asia, most programs are imple-
mented and evaluated in the United State of America. This
global inequity should be a priority for international bodies
as the implementation of violence prevention interventions is
likely to differ between high and low resource settings, and
in different political, cultural, and social contexts.
One of the striking messages laid out for the rst time
in the World Report on Violence and Health (Krug etal., 2002)
is the extent to which all forms of violence are interlinked.
3Gender transformative approaches are concerned with redressing
gender inequalities, removing structural barriers, such as unequal
roles and rights, and empowering disadvantaged populations.
4Gender budgeting involves conducting a gender-based assessment
of budgetary decisions.

181Journal of Community Safety and Well-Being, Vol 9(4), December 2024 | journalcswb.ca | @JournalCSWB
VIOLENCE PREVENTION AND PUBLIC HEALTH, Snowdon etal.
The report presents a typology which proposes how di fferent
types of violence are fundamentally diverse expressions of
the same human behaviour (Krug etal., 2002). This idea has
since been developed by public health researchers, based
on evidence of risk and protective factors which are shared
across multiple forms of violence, and has been used to
advocate for the use of approaches which address multiple,
“overlapping” risk factors to prevent siloed working and
improve impact (Wilkins etal., 2018).
Indeed, our study demonstrates that there is consider-
able homogeneity between primary prevention strategies
proposed across different forms of interpersonal violence,
such as investment in early years or whole school approaches.
However, a notable difference was evident when examining
frameworks to prevent VAW, which invoked feminist theory
and placed a gender transformative approach at the heart of
solutions, despite global evidence that men are more likely
to perpetrate nearly all types of interpersonal violence than
women (Fleming etal., 2015).
The WHO recommends that a “gender transformative”
paradigm is used for the prevention of VAW (Brush & Miller,
2019). However, no similar recommendation is made for the
prevention of other forms of violence, despite evidence that
adherence to “traditional masculinity ideologies” is associ-
ated with poor health outcomes and violence perpetration for
men, and increased violence victimization and poor health
outcomes for women (Barker etal., 2007; Jewkes etal., 2011).
Furthermore, interventions designed to increase gender-eq-
uitable attitudes and behaviours have evidenced impact on
other health risk behaviours such as alcohol use, substance
use, transactional sex, as well as the prevention of VAW
and other forms of interpersonal violence perpetration and
victimization (Coker etal., 2017; Jewkes etal., 2008). As such,
this potential bias in the implementation of evidence-based
primary prevention requires further scrutiny.
Challenges for Implementation
Another area which warrants attention are more pragmatic
concerns regarding the implementation of a public health
approach, particularly on a global scale. Vincenten etal.
(2019) write how improving public health outcomes through
successful uptake of evidence-based interventions is not a
simple or quick task. Instead, it involves the co-ordinated
efforts of public health experts to inuence commissioning,
decision-making, and policy. Several authors have reported
barriers to achieving uptake of evidence-based practice
within complex public health systems (Cairney, 2012; Dam-
schroder etal., 2009; Oliver etal., 2014). However, there is
little global research into the implementation of violence
prevention programming specically.
In one multi-agency study in Sweden, Jakobsson etal.
(2012) report on a range of barriers to the implementation of
IPV prevention among multi-agency professionals, including
lack of knowledge and commitment, professional disillusion,
and deferment of responsibility. Similarly, Matzopoulos &
Myers (2014) explore successes and challenges to the imple-
mentation of the Western Cape Government’s Integrated
Provincial Violence Prevention Policy Framework. They high light
intra-departmental priorities and the impact of competing
policies and directives as early barriers to implementation.
However, these critical reections on the implementation
of primary prevention approaches represent a small, but
growing, area of research.
Limitations
While this research comprehensively reviewed global public
health frameworks for violence prevention, a key limitation
is that the search was conducted in the English language.
As such, there may be a range of frameworks not identied
in the review.
CONCLUSION
This study explored the extent and content of international
public health frameworks for violence prevention, assessing
the guida nce and messaging that public health bod ies provide
regarding the primary prevention of interpersonal violence
through a public health approach. Nine primary prevention
themes were identied, providing opport unities for violence
prevention across the socio-ecological model. However,
we identied several areas for further attention including
addressing evidence gaps and tensions, and investing in
research which explores the implementation of prevention
approaches. Consideration of both; the common approaches
across frameworks and gaps identied is critical for trans-
forming and embedding a public health approach to violence
prevention at a global and community level.
ACKNOWLEDGEMENTS
The authors thank Dr. Jo Hopkins, Dr. Alex Walker, Bryony Parry,
Emma Barton, and Muqaddasa Abdul Wahid from Public Health
Wales and Dr. Hannah Timpson from Liverpool John Moores Uni-
versity for their support in developing this research.
CONFLICT OF INTEREST DISCLOSURES
The authors have no conicts of interest to declare.
AUTHOR AFFILIATIONS
*School of Public and Allied Health, Public Health Institute, World
Health Organization Collaborating Centre for Violence Prevention,
Liverpool John Moores University, Liverpool, UK; †World Health
Organization Collaborating Centre on Investment for Health and
Wellbeing, Policy and International Health, Public Health Wales,
Cardiff, UK.
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