501
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Yount KM, Krause KH, Miedema SS. Preventing gender-based violence victimization in adolescent girls in lower-income countries: Systematic review of reviews. Soc Sci Med 2017; 192:1-13. [PMID: 28941786 DOI: 10.1016/j.socscimed.2017.08.038] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 08/17/2017] [Accepted: 08/28/2017] [Indexed: 01/08/2023]
Abstract
This systematic review of reviews synthesizes evidence on the impact of interventions to prevent violence against adolescent girls and young women 10-24 years (VAWG) in low- and middle-income countries (LMICs). Theories of women's empowerment and the social ecology of multifaceted violence frame the review. Child abuse, female genital mutilation/cutting (FGMC), child marriage, intimate partner violence (IPV), and sexual violence were focal outcomes. Our review followed the Assessment of Multiple Systematic Reviews (AMSTAR) for the systematic review of reviews, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for a systematic review of recent intervention studies. Of 35 reviews identified between June 7 and July 20, 2016, 18 were non-duplicate systematic reviews of medium-to-high quality. Half of these 18 reviews focused on interventions to prevent IPV. Only four focused on adolescents, of which three focused on child marriage and one compared findings across early and late adolescence. None focused on interventions to prevent child abuse or sexual violence in adolescent/young women. From these 18 reviews and the supplemental systematic review of intervention studies, data were extracted on 34 experimental or quasi-experimental intervention studies describing 28 interventions. Almost all intervention studies measured impacts on one form of VAWG. Most studies assessed impacts on child marriage (n = 13), then IPV (n = 8), sexual violence (n = 4), child abuse (n = 3), and FGMC (n = 3). Interventions included 1-6 components, involving skills to enhance voice/agency (n = 17), social networks (n = 14), human resources like schooling (n = 10), economic incentives (n = 9), community engagement (n = 11) and community infrastructure development (n = 6). Bundled individual-level interventions and multilevel interventions had more favorable impacts on VAWG. Interventions involving community engagement, skill-building to enhance voice/agency, and social-network expansion show promise to reduce VAWG. Future interventions should target poly-victimization, compare impacts across adolescence, and include urban, out-of-school, married, and displaced/conflict-affected populations in LMICs, where VAWG may be heightened.
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Affiliation(s)
- Kathryn M Yount
- Hubert Department of Global Health, Emory University, 1518 Clifton Rd, NE, Atlanta, GA 30322, USA; Department of Sociology, Emory University, 1555 Dickey Dr., Atlanta, GA 30322, USA.
| | - Kathleen H Krause
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd, NE, Atlanta, GA 30322, USA
| | - Stephanie S Miedema
- Department of Sociology, Emory University, 1555 Dickey Dr., Atlanta, GA 30322, USA
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502
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Vlahovicova K, Melendez-Torres GJ, Leijten P, Knerr W, Gardner F. Parenting Programs for the Prevention of Child Physical Abuse Recurrence: A Systematic Review and Meta-Analysis. Clin Child Fam Psychol Rev 2017; 20:351-365. [PMID: 28378136 PMCID: PMC5527061 DOI: 10.1007/s10567-017-0232-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Child physical abuse is an issue of global concern. Conservative estimates set global prevalence of this type of maltreatment at 25%, its consequences and cost to society escalating with increasing frequency and severity of episodes. Syntheses of the evidence on parenting programs for reducing rates of physical abuse recidivism have, to date, not been able to establish effectiveness. Paucity of data and inconsistent inclusion criteria in past reviews made meta-analysis often impossible or uninformative. The current systematic review updates prior reviews and overcomes some of the methodological issues they encountered by pooling trial-level data from a well-defined scope of trials of parenting interventions aimed at preventing the re-abuse of children by parents with substantiated or suspected physical abuse history. Randomized controlled trials and rigorous non-randomized designs were sought via nine online databases, two trial registries, several clearinghouses and contact with experts. A total of fourteen studies of variable quality were included in this review, four of which had outcomes that enabled meta-analysis. Overall, this review presents evidence supporting the effectiveness of parenting behavioral programs based on social learning theory for reducing hard markers of child physical abuse recidivism. Meta-analysis found that the absolute risk reduction in risk of recidivism was 11 percentage points less for maltreating parents who undergo parenting programs (RD = -0.11, 95% CI [-0.22, -0.004], p = 0.043, I 2 = 28.9%). However, the pooled effect size was not statistically significant when calculated as a risk ratio (0.76, 95% CI [0.54, 1.07], I 2 = 38.4%). Policy makers and practitioners should be made aware that this intervention method is backed by promising evidence featuring modest yet significant reductions in hard markers of child physical abuse, even though the methodological robustness of these findings should be further explored in future research.
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Affiliation(s)
| | | | - Patty Leijten
- University of Oxford, Oxford, UK
- UvA University of Amsterdam, Amsterdam, Netherlands
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503
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Peterman A, Neijhoft A(N, Cook S, Palermo TM. Understanding the linkages between social safety nets and childhood violence: a review of the evidence from low- and middle-income countries. Health Policy Plan 2017; 32:1049-1071. [PMID: 28444197 PMCID: PMC5886196 DOI: 10.1093/heapol/czx033] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2017] [Indexed: 01/20/2023] Open
Abstract
As many as one billion children experience violence every year, and household- and community-level poverty are among the risk factors for child protection violations. Social safety nets (SSNs) are a main policy tool to address poverty and vulnerability, and there is substantial evidence demonstrating positive effects on children's health and human capital. This paper reviews evidence and develops a framework to understand linkages between non-contributory SSNs and the experience of childhood emotional, physical and sexual violence in low- and middle-income countries. We catalogue 14 rigorous impact evaluations, 11 of which are completed, analysing 57 unique impacts on diverse violence indicators. Among these impacts, approximately one in five represent statistically significant protective effects on childhood violence. Promising evidence relates to sexual violence among female adolescents in Africa, while there is less clear evidence of significant impacts in other parts of the developing world, and on young child measures, including violent discipline. Further, few studies are set up to meaningfully unpack mechanisms between SSNs and childhood violence; however, those most commonly hypothesized operate at the household level (through increases in economic security and reductions in poverty-related stress), the interpersonal level (improved parental behaviours, caregiving practices, improved psychosocial well-being) and at the child-level (protective education and decreases in problem or risky behaviours). It is important to emphasize that traditional SSNs are never designed with violence prevention as primary objectives, and thus should not be considered as standalone interventions to reduce risks for childhood violence. However, SSNs, particularly within integrated protection systems, appear to have potential to reduce violence risk. Linkages between SSNs and childhood violence are understudied, and investments should be made to close this evidence gap.
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Affiliation(s)
- Amber Peterman
- UNICEF Office of Research—Innocenti, Piazza SS, Annunziata 12, Florence 50122, Italy
| | | | - Sarah Cook
- UNICEF Office of Research—Innocenti, Piazza SS, Annunziata 12, Florence 50122, Italy
| | - Tia M Palermo
- UNICEF Office of Research—Innocenti, Piazza SS, Annunziata 12, Florence 50122, Italy
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504
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Kayiwa J, Clarke K, Knight L, Allen E, Walakira E, Namy S, Merrill KG, Naker D, Devries K. Effect of the good school toolkit on school staff mental health, sense of job satisfaction and perceptions of school climate: Secondary analysis of a cluster randomised trial. Prev Med 2017; 101:84-90. [PMID: 28579503 DOI: 10.1016/j.ypmed.2017.05.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 05/20/2017] [Accepted: 05/27/2017] [Indexed: 10/19/2022]
Abstract
The Good School Toolkit, a complex behavioural intervention delivered in Ugandan primary schools, has been shown to reduce school staff-perpetrated physical violence against students. We aimed to assess the effect of this intervention on staff members' mental health, sense of job satisfaction and perception of school climate. We analysed data from a cluster-randomised trial administered in 42 primary schools in Luwero district, Uganda. The trial was comprised of cross-sectional baseline (June/July 2012) and endline (June/July 2014) surveys among staff and students. Twenty-one schools were randomly selected to receive the Toolkit, whilst 21 schools constituted a wait-listed control group. We generated composite measures to assess staff members' perceptions of the school climate and job satisfaction. The trial is registered at clinicaltrials.gov (NCT01678846). No schools dropped out of the study and all 591 staff members who completed the endline survey were included in the analysis. Staff in schools receiving the Toolkit had more positive perspectives of their school climate compared to staff in control schools (difference in mean scores 2.19, 95% Confidence Interval 0.92, 3.39). We did not find any significant differences for job satisfaction and mental health. In conclusion, interventions like the Good School Toolkit that reduce physical violence by school staff against students can improve staff perceptions of the school climate, and could help to build more positive working and learning environments in Ugandan schools.
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Affiliation(s)
- Joshua Kayiwa
- Ministry of Health, Public Health Emergency Operations Centre, Kampala, Uganda.
| | - Kelly Clarke
- Institute for Global Health, University College of London, UK
| | - Louise Knight
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | | | | | - Karen Devries
- London School of Hygiene and Tropical Medicine, London, UK
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505
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Hughes K, Bellis MA, Hardcastle KA, Sethi D, Butchart A, Mikton C, Jones L, Dunne MP. The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. LANCET PUBLIC HEALTH 2017; 2:e356-e366. [PMID: 29253477 DOI: 10.1016/s2468-2667(17)30118-4] [Citation(s) in RCA: 2205] [Impact Index Per Article: 315.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 05/31/2017] [Accepted: 06/05/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND A growing body of research identifies the harmful effects that adverse childhood experiences (ACEs; occurring during childhood or adolescence; eg, child maltreatment or exposure to domestic violence) have on health throughout life. Studies have quantified such effects for individual ACEs. However, ACEs frequently co-occur and no synthesis of findings from studies measuring the effect of multiple ACE types has been done. METHODS In this systematic review and meta-analysis, we searched five electronic databases for cross-sectional, case-control, or cohort studies published up to May 6, 2016, reporting risks of health outcomes, consisting of substance use, sexual health, mental health, weight and physical exercise, violence, and physical health status and conditions, associated with multiple ACEs. We selected articles that presented risk estimates for individuals with at least four ACEs compared with those with none for outcomes with sufficient data for meta-analysis (at least four populations). Included studies also focused on adults aged at least 18 years with a sample size of at least 100. We excluded studies based on high-risk or clinical populations. We extracted data from published reports. We calculated pooled odds ratios (ORs) using a random-effects model. FINDINGS Of 11 621 references identified by the search, 37 included studies provided risk estimates for 23 outcomes, with a total of 253 719 participants. Individuals with at least four ACEs were at increased risk of all health outcomes compared with individuals with no ACEs. Associations were weak or modest for physical inactivity, overweight or obesity, and diabetes (ORs of less than two); moderate for smoking, heavy alcohol use, poor self-rated health, cancer, heart disease, and respiratory disease (ORs of two to three), strong for sexual risk taking, mental ill health, and problematic alcohol use (ORs of more than three to six), and strongest for problematic drug use and interpersonal and self-directed violence (ORs of more than seven). We identified considerable heterogeneity (I2 of >75%) between estimates for almost half of the outcomes. INTERPRETATION To have multiple ACEs is a major risk factor for many health conditions. The outcomes most strongly associated with multiple ACEs represent ACE risks for the next generation (eg, violence, mental illness, and substance use). To sustain improvements in public health requires a shift in focus to include prevention of ACEs, resilience building, and ACE-informed service provision. The Sustainable Development Goals provide a global platform to reduce ACEs and their life-course effect on health. FUNDING Public Health Wales.
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Affiliation(s)
- Karen Hughes
- College of Health and Behavioural Sciences, Bangor University, Bangor, UK; Directorate of Policy, Research and International Development, Public Health Wales, Clwydian House, Wrexham, UK
| | - Mark A Bellis
- College of Health and Behavioural Sciences, Bangor University, Bangor, UK; Directorate of Policy, Research and International Development, Public Health Wales, Clwydian House, Wrexham, UK.
| | - Katherine A Hardcastle
- Directorate of Policy, Research and International Development, Public Health Wales, Clwydian House, Wrexham, UK
| | - Dinesh Sethi
- World Health Organization Regional Office for Europe, Division of NonCommunicable Diseases and Promoting Health through the Life-Course, Copenhagen, Denmark
| | - Alexander Butchart
- World Health Organization, Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, Geneva, Switzerland
| | - Christopher Mikton
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Lisa Jones
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Michael P Dunne
- School of Public Health and Social Work, Queensland University of Technology, Queensland, Australia
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506
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Berens AE, Jensen SKG, Nelson CA. Biological embedding of childhood adversity: from physiological mechanisms to clinical implications. BMC Med 2017; 15:135. [PMID: 28724431 PMCID: PMC5518144 DOI: 10.1186/s12916-017-0895-4] [Citation(s) in RCA: 295] [Impact Index Per Article: 42.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/20/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Adverse psychosocial exposures in early life, namely experiences such as child maltreatment, caregiver stress or depression, and domestic or community violence, have been associated in epidemiological studies with increased lifetime risk of adverse outcomes, including diabetes, heart disease, cancers, and psychiatric illnesses. Additional work has shed light on the potential molecular mechanisms by which early adversity becomes "biologically embedded" in altered physiology across body systems. This review surveys evidence on such mechanisms and calls on researchers, clinicians, policymakers, and other practitioners to act upon evidence. OBSERVATIONS Childhood psychosocial adversity has wide-ranging effects on neural, endocrine, immune, and metabolic physiology. Molecular mechanisms broadly implicate disruption of central neural networks, neuroendocrine stress dysregulation, and chronic inflammation, among other changes. Physiological disruption predisposes individuals to common diseases across the life course. CONCLUSIONS Reviewed evidence has important implications for clinical practice, biomedical research, and work across other sectors relevant to public health and child wellbeing. Warranted changes include increased clinical screening for exposures among children and adults, scale-up of effective interventions, policy advocacy, and ongoing research to develop new evidence-based response strategies.
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Affiliation(s)
- Anne E Berens
- Boston Children's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA.,Laboratories of Cognitive Neuroscience, Boston Children's Hospital/Harvard Medical School, 1 Autumn Street, Boston, 02215, Massachusetts, USA
| | - Sarah K G Jensen
- Boston Children's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA.,Laboratories of Cognitive Neuroscience, Boston Children's Hospital/Harvard Medical School, 1 Autumn Street, Boston, 02215, Massachusetts, USA
| | - Charles A Nelson
- Boston Children's Hospital, Boston, Massachusetts, USA. .,Harvard Medical School, Boston, Massachusetts, USA. .,Laboratories of Cognitive Neuroscience, Boston Children's Hospital/Harvard Medical School, 1 Autumn Street, Boston, 02215, Massachusetts, USA. .,Graduate School of Education, Harvard University, Cambridge, Massachusetts, USA.
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507
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Namy S, Carlson C, O'Hara K, Nakuti J, Bukuluki P, Lwanyaaga J, Namakula S, Nanyunja B, Wainberg ML, Naker D, Michau L. Towards a feminist understanding of intersecting violence against women and children in the family. Soc Sci Med 2017; 184:40-48. [PMID: 28501019 PMCID: PMC5737762 DOI: 10.1016/j.socscimed.2017.04.042] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 04/24/2017] [Accepted: 04/25/2017] [Indexed: 12/19/2022]
Abstract
While intimate partner violence (IPV) against women and violence against children (VAC) have emerged as distinct fields of research and programming, a growing number of studies demonstrate the extent to which these forms of violence overlap in the same households. However, existing knowledge of how and why such co-occurrence takes place is limited, particularly in the Global South. The current study aims to advance empirical and conceptual understanding of intersecting IPV and VAC within families in order to inform potential programming. We explore shared perceptions and experiences of IPV and VAC using qualitative data collected in December 2015 from adults and children in Kampala, Uganda (n = 106). We find that the patriarchal family structure creates an environment that normalizes many forms of violence, simultaneously infantilizing women and reinforcing their subordination (alongside children). Based on participant experiences, we identify four potential patterns that suggest how IPV and VAC not only co-occur, but more profoundly intersect within the family, triggering cycles of emotional and physical abuse: bystander trauma, negative role modeling, protection and further victimization, and displaced aggression. The discussion is situated within a feminist analysis, including careful consideration of maternal violence and an emphasis on the ways in which gender and power dynamics can coalesce and contribute to intra-family violence.
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508
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Abstract
More than 1 billion children - half the children in the world - are victims of violence every year. As part of the Post-2015 sustainable development agenda, the UN has issued a global call-to-action: to eliminate violence against children. Essential to preventing violence against children is guidance to countries on using the best available evidence to address this problem. THRIVES provides this evidence. It represents a framework of complementary strategies that, taken together, have potential to achieve and sustain efforts to prevent violence against children. These strategies, which span health, social services, education, and justice sectors, include Training in parenting, Household economic strengthening, Reduced violence through legislative protection, Improved services, Values and norms that protect children, Education and life skills, and Surveillance and evaluation. For each THRIVES area, we review evidence for effectiveness and identify programmatic or policy examples. This framework will facilitate commitments to effective, sustainable, and scalable action.
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509
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Smith DE. Homophobic and transphobic violence against youth: The Jamaican context. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2017. [DOI: 10.1080/02673843.2017.1336106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Delores E. Smith
- Department of Child and Family Studies, College of Education, Health, and Human Sciences, University of Tennessee, Knoxville, TN, USA
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510
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Wandera SO, Clarke K, Knight L, Allen E, Walakira E, Namy S, Naker D, Devries K. Violence against children perpetrated by peers: A cross-sectional school-based survey in Uganda. CHILD ABUSE & NEGLECT 2017; 68:65-73. [PMID: 28414938 PMCID: PMC5458732 DOI: 10.1016/j.chiabu.2017.04.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 03/29/2017] [Accepted: 04/04/2017] [Indexed: 06/07/2023]
Abstract
Violence against children by peers is a global public health problem. We aimed to assess factors associated with peer violence victimization among primary school children in Uganda. We conducted multilevel multivariable logistic regression analyses of cross-sectional data from 3706 primary students in 42 Ugandan primary schools. Among primary school students, 29% and 34% had ever experienced physical and emotional violence perpetrated by their peers, respectively. Factors strongly associated with both physical and emotional violence were similar and overlapping, and included exposure to interparental violence, having an attitude supportive of violence against children from school staff, not living with biological parents, working for payment, and higher SDQ score. However, we found that younger age, sharing sleeping area with an adult and achieving a higher educational performance score, were specifically associated with physical violence. On the other hand, being female, walking to school, reporting disability and eating one meal on the previous day, were particularly associated with emotional violence. Interventions to reduce peer violence should focus on family contexts, school environments and those with poor socio-economic status may need extra support.
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Affiliation(s)
- Stephen Ojiambo Wandera
- Department of Population Studies, School of Statistics and Planning, Makerere University, Kampala, Uganda; Postdoctoral Research Fellow, Demography and Population Studies, University of the Witwatersrand, Johannesburg, South Africa.
| | - Kelly Clarke
- Institute for Global Health, University College London, United Kingdom.
| | - Louise Knight
- Department of Global Health, London School of Hygiene and Tropical Medicine (LSHTM), London, UK.
| | | | - Eddy Walakira
- Department of Social Work and Social Administration, Makerere University, Kampala, Uganda.
| | | | | | - Karen Devries
- Department of Global Health, London School of Hygiene and Tropical Medicine (LSHTM), London, UK.
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511
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Violence Victimization in Korean Adolescents: Risk Factors and Psychological Problems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14050541. [PMID: 28534822 PMCID: PMC5451991 DOI: 10.3390/ijerph14050541] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 05/08/2017] [Accepted: 05/18/2017] [Indexed: 11/16/2022]
Abstract
We examined the risk factors for and psychological problems associated with violence victimization in a nationwide representative sample of Korean adolescents. Data from the 2016 Korean Youth Risk Behavior Web-based Survey was used. Participants were asked about their experience of being a victim of violence that required medical treatment during the past 12 months, as well as their perceived health, happiness, sleep satisfaction, stress, depressed mood, and suicidality. The 12-month prevalence of violence victimization requiring medical treatment was 2.4%. The results indicated that adolescents were at an increased risk for violence victimization if they were male, older, had parents of a foreign nationality, did not reside with their family, worked part time, resided in small cities or rural areas, were high or low in socioeconomic status (SES), exhibited high or low levels of academic performance, used alcohol or tobacco, and were sexually active. In addition, while violence victimization was negatively associated with perceived health and happiness, it was positively associated with perceived stress, depressed mood, and suicidality. The results indicate that a social disadvantage, involvement in risky behavior, and psychological problems are associated with violence victimization. Effective violence prevention efforts should thus target high-risk groups, and clinical attention is needed to address the psychological costs associated with violence victimization.
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512
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Ameli V, Meinck F, Munthali A, Ushie B, Langhaug L. Associations between adolescent experiences of violence in Malawi and gender-based attitudes, internalizing, and externalizing behaviors. CHILD ABUSE & NEGLECT 2017; 67:305-314. [PMID: 28327416 DOI: 10.1016/j.chiabu.2017.02.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 02/15/2017] [Accepted: 02/17/2017] [Indexed: 06/06/2023]
Abstract
Little is known about adolescent exposure to and factors associated with violence in Malawi. The aim of this research was to describe the prevalence of exposure to violence among adolescents in Malawi, and test the hypotheses that such exposures are associated with gender-based violent attitudes, and with internalizing and externalizing problems. In 2014, 561 primary school pupils were interviewed (50% girls), and logistic regression analysis was performed on gender-stratified data, adjusting for sociodemographic differences. Both girls and boys had witnessed domestic violence (28.5% & 29.6%), experienced emotional abuse at home (23.1% & 22.9%), physical abuse at home (28.1% & 30.4%), physical abuse at school (42.4% & 36.4%), and been bullied (33.8% & 39.6%). Among girls, internalized violent attitudes towards women were associated with emotional abuse at home (OR 2.1) and physical abuse at school (OR 1.7). Condoning rape was associated with physical abuse at school (OR 1.9). Bullying perpetration was associated with emotional abuse at home (OR 4.5). Depression was associated with emotional abuse at home (OR 3.8) and physical abuse at school (OR 2.4). Among boys, violent attitudes towards women and condoning rape were not associated with violence exposure. Bullying perpetration was associated with having been a victim of bullying (OR 2.9) and physical abuse at school (OR 2.7). Depression was associated with emotional abuse at home (OR 2.9), domestic violence (OR 2.4) and physical abuse at school (OR 2.5). These findings can inform programs designed to reduce violence victimization among Malawian girls, both in homes and schools.
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Affiliation(s)
- Vira Ameli
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK.
| | - Franziska Meinck
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK; OPTENTIA, School of Behavioural Sciences, North-West University, Vanderbeijlpark, South Africa
| | | | - Boniface Ushie
- Regional Psychosocial Support Initiative (REPSSI), Johannesburg, South Africa
| | - Lisa Langhaug
- Regional Psychosocial Support Initiative (REPSSI), Johannesburg, South Africa
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513
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Bhutta ZA, Guerrant RL, Nelson CA. Neurodevelopment, Nutrition, and Inflammation: The Evolving Global Child Health Landscape. Pediatrics 2017; 139:S12-S22. [PMID: 28562245 DOI: 10.1542/peds.2016-2828d] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/21/2016] [Indexed: 11/24/2022] Open
Abstract
The last decade has witnessed major reductions in child mortality and a focus on saving lives with key interventions targeting major causes of child deaths, such as neonatal deaths and those due to childhood diarrhea and pneumonia. With the transition to Sustainable Development Goals, the global health community is expanding child health initiatives to address not only the ongoing need for reduced mortality, but also to decrease morbidity and adverse exposures toward improving health and developmental outcomes. The relationship between adverse environmental exposures frequently associated with factors operating in the prepregnancy period and during fetal development is well established. Also well appreciated are the developmental impacts (both short- and long-term) associated with postnatal factors, such as immunostimulation and environmental enteropathy, and the additional risks posed by the confluence of factors related to malnutrition, poor living conditions, and the high burden of infections. This article provides our current thinking on the pathogenesis and risk factors for adverse developmental outcomes among young children, setting the scene for potential interventions that can ameliorate these adversities among families and children at risk.
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Affiliation(s)
- Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada; .,Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Richard L Guerrant
- Center for Global Health, Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Charles A Nelson
- Laboratories of Cognitive Neuroscience, Boston Children's Hospital, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; and.,Human Development Program, Harvard Graduate School of Education, Cambridge, Massachusetts
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514
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Shiva Kumar AK, Stern V, Subrahmanian R, Sherr L, Burton P, Guerra N, Muggah R, Samms-Vaughan M, Watts C, Mehta SK. Ending violence in childhood: a global imperative. PSYCHOL HEALTH MED 2017; 22:1-16. [DOI: 10.1080/13548506.2017.1287409] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
| | | | | | - Lorraine Sherr
- Research Department of Infection and Population Health, University College London, London, UK
| | - Patrick Burton
- Centre for Justice and Crime Prevention, Cape Town, South Africa
| | - Nancy Guerra
- Department of Psychology and Social Behavior, University of California at Irvine, Irvine, CA, USA
| | | | - Maureen Samms-Vaughan
- Department of Child and Adolescent Health, University of West Indies, Kingston, Jamaica
| | - Charlotte Watts
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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515
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Lin PZ, Bai HY, Sun JW, Guo W, Zhang HH, Cao FL. Association between child maltreatment and prospective and retrospective memory in adolescents: The mediatory effect of neuroticism. CHILD ABUSE & NEGLECT 2017; 65:58-67. [PMID: 28113085 DOI: 10.1016/j.chiabu.2017.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 12/30/2016] [Accepted: 01/11/2017] [Indexed: 06/06/2023]
Abstract
The purpose of this study was to examine the relationship between child maltreatment and prospective and retrospective memory in children/adolescents by investigating the mediating role of neuroticism. In total, 662 children/adolescents aged 10-16 years were recruited from a middle school in China, and they completed questionnaires comprising the Childhood Trauma Questionnaire, Prospective and Retrospective Memory Questionnaire, and the Neuroticism subscale of the NEO Five-Factor Inventory. The severity of maltreatment was positively associated with the severity of impairment of memory (prospective and retrospective considered together) in children/adolescents. Children/adolescents exposed to maltreatment tended to display higher levels of neuroticism. Neuroticism partially mediated the association between child maltreatment and memory in all the subjects. The results of multigroup analyses showed neuroticism fully mediated the relationship between child maltreatment and memory for boys, in which the effect size of indirect effect was 0.52, and partially mediated the association for girls with 0.44 effect size of indirect effect. Early intervention aimed to reduce neuroticism might contribute to a better prognosis in children/adolescences with poor memory function.
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Affiliation(s)
- Ping-Zhen Lin
- School of Nursing, Shandong University, Jinan, Shandong 250012, PR China.
| | - Hua-Yu Bai
- School of Nursing, Shandong University, Jinan, Shandong 250012, PR China.
| | - Ji-Wei Sun
- School of Nursing, Shandong University, Jinan, Shandong 250012, PR China.
| | - Wei Guo
- Shandong Women's University, Jinan, Shandong 250300, PR China.
| | - Hui-Hui Zhang
- School of Nursing, Shandong University, Jinan, Shandong 250012, PR China.
| | - Feng-Lin Cao
- School of Nursing, Shandong University, Jinan, Shandong 250012, PR China.
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516
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Rumble L, Ramly AA, Nuryana M, Dunne MP. The Importance of Contextual Factors in Carrying Out Childhood Violence Surveys: a Case Study from Indonesia. CHILD INDICATORS RESEARCH 2017; 11:405-421. [PMID: 29527242 PMCID: PMC5838122 DOI: 10.1007/s12187-017-9457-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/13/2017] [Indexed: 05/28/2023]
Abstract
Nationally representative research into violence against children is necessary to understand the scale and complexity of such violence and to evaluate prevention efforts. To date, however, most countries do not have adequate data. In 2013, the government of Indonesia conducted a national Violence Against Children Survey (VACS). This was a cross-sectional household survey of male and female 13-to-24- year-olds designed to estimate physical, emotional, and sexual violence prevalence. The target was to interview at least 2580 individuals; but response rates were much lower than anticipated (females = 66.6%; males = 56.1%). Insufficient data was available across several variables and there were unexpected anomalies in obtained data. We conducted a retrospective analysis of the survey to understand impediments and to advise future national efforts in Indonesia and other low-to-middle-income contexts. Survey managers and implementers (n = 22) were interviewed online and in person. We also carried out secondary analysis of the child survey data to identify factors possibly associated with (non-)response and assessed field notes from interviewers. Culturally inappropriate timing of data-collection (during Ramadan) may have had a negative impact on household responsiveness and the availability of children at home. Face-toface interviews in households were considered to impede participation and disclosure. Survey field staff and managers expressed the need for deeper training and a more comprehensive pilot. Recommendations to improve privacy and anonymity include the use of self-administered questionnaires and school-based rather than at-home surveys. These and other findings from this case study may be useful in planning future surveys in Indonesia and similar social and cultural contexts.
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Affiliation(s)
- Lauren Rumble
- UNICEF Indonesia, World Trade Center 6, 10th Floor, Jl. Jenderal Surdirman Kav.31, Jakarta, 12920 Indonesia
| | - Ali Aulia Ramly
- UNICEF Indonesia, World Trade Center 6, 10th Floor, Jl. Jenderal Surdirman Kav.31, Jakarta, 12920 Indonesia
| | - Mu’man Nuryana
- Ministry of Social Affairs of the Republic of Indonesia, Jalan Salemba Ryan, No.28, Jakarta, Pusat 10430 Indonesia
| | - Michael P. Dunne
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, QLD 4059 Australia
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517
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Lilleston PS, Goldmann L, Verma RK, McCleary-Sills J. Understanding social norms and violence in childhood: theoretical underpinnings and strategies for intervention. PSYCHOL HEALTH MED 2017; 22:122-134. [DOI: 10.1080/13548506.2016.1271954] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- P. S. Lilleston
- International Center for Research on Women, Washington, DC, USA
| | | | - R. K. Verma
- International Center for Research on Women, New Delhi, India
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518
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Latent class analysis of violence against adolescents and psychosocial outcomes in refugee settings in Uganda and Rwanda. Glob Ment Health (Camb) 2017; 4:e19. [PMID: 29230315 PMCID: PMC5719474 DOI: 10.1017/gmh.2017.17] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 07/18/2017] [Accepted: 08/04/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Little is known about violence against children in refugee camps and settlements, and the evidence-base concerning mental health outcomes of youth in refugee settings in low and middle-income countries is similarly small. Evidence is needed to understand patterns of violence against children in refugee camps, and associations with adverse mental health outcomes. METHODS Surveys were conducted with adolescent refugees (aged 13-17) in two refugee contexts - Kiziba Camp, Rwanda (n = 129) (refugees from Democratic Republic of Congo) and Adjumani and Kiryandongo refugee settlements, Uganda (n = 471) (refugees from South Sudan). Latent Class Analysis was utilized to identify classes of violence exposure (including exposure to witnessing household violence, verbal abuse, physical violence and sexual violence). Logistic regressions explored the association between latent class of violence exposure and symptoms of depression and anxiety. RESULTS In Rwanda, a two-class solution was identified, with Class 1 (n = 33) representing high levels of exposure to violence and Class 2 (n = 96) representing low levels of exposure. In Uganda, a three-class solution was identified: Class 1 (high violence; n = 53), Class 2 (low violence, n = 100) and Class 3 (no violence, n = 317). Logistic regression analyses indicated that latent violence class was associated with increased odds of high anxiety symptoms in Rwanda (AOR 3.56, 95% CI 1.16-0.95), and high v. no violence class was associated with depression (AOR 3.97, 95% CI 1.07-7.61) and anxiety symptoms (AOR 2.04, 95% CI 1.05-3.96) in Uganda. CONCLUSIONS The present results support the existing evidence-base concerning the association between violence and adverse mental health outcomes, while identifying differences in patterns and associations between refugee youth in two different contexts.
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519
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Testing the effectiveness of a transdiagnostic treatment approach in reducing violence and alcohol abuse among families in Zambia: study protocol of the Violence and Alcohol Treatment (VATU) trial. Glob Ment Health (Camb) 2017; 4:e18. [PMID: 29230314 PMCID: PMC5719477 DOI: 10.1017/gmh.2017.10] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 06/06/2017] [Accepted: 06/12/2017] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Violence against women and girls (VAWG) is an urgent global health problem. Root causes for VAWG include the individual- and family-level factors of alcohol abuse, mental health problems, violence exposure, and related adverse experiences. Few studies in low- and middle-income countries (LMIC) have assessed the effectiveness of psychological interventions for reducing VAWG. This randomized controlled trial, part of the What Works to Prevent Violence Against Women and Girls consortium, examines the effectiveness of a common elements treatment approach (CETA) for reducing VAWG and comorbid alcohol abuse among families in Zambia. METHODS/DESIGN Study participants are families consisting of three persons: an adult woman, her male husband or partner, and one of her children aged 8-17 (if available). Eligibility criteria include experience of moderate-to-severe intimate partner violence by the woman and hazardous alcohol use by her male partner. Family units are randomized to receive CETA or treatment as usual. The primary outcome is VAWG as measured by the Severity of Violence Against Women Scale, assessed along with secondary outcomes at 24 months post-baseline. Interim assessments are also conducted at 4-5 months (following CETA completion) and 12 months post-baseline. CONCLUSIONS This ongoing trial is one of the first in sub-Saharan Africa to evaluate the use of an evidence-based common elements approach for reducing VAWG by targeting a range of individual- and family-level factors, including alcohol abuse. Results of this trial will inform policy on what interventions work to prevent VAWG in LMIC with local perspectives on scale up and wider implementation.
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520
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Fry D, Blight S. How prevention of violence in childhood builds healthier economies and smarter children in the Asia and Pacific region. BMJ Glob Health 2016; 1:i3-i11. [PMID: 28588988 PMCID: PMC5418648 DOI: 10.1136/bmjgh-2016-000188] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 10/14/2016] [Indexed: 11/14/2022] Open
Abstract
Investments in preventing violence against children in the Asia and Pacific region will bring important social and economic returns that contribute to building the region's 'cognitive capital'. An analysis of burden of violence research in the region is presented to identify the impacts of violence and to demonstrate these returns. Violence is an everyday experience in the lives of many children in the Asia-Pacific, and the toxic stress associated with such routine forms of violence may permanently impact the architecture and chemistry of the developing brain. This can undermine learning and affect behavioural, social and emotional functioning as children grow into adulthood. Given the hundreds of millions of children affected by violence in the region each year, its cumulative impact translates into the annual loss of hundreds of billions of dollars-or about 2% of gross domestic product of the Asia and Pacific region. Violence prevention can affect positively on health and productivity, reduce expenditure on crisis response, improve children's developmental and educational outcomes, and prevent crime. The sustainable development goals and the emerging global consensus on effective prevention strategies constitute a powerful new agenda to end violence against children, and there are critical steps that governments can take to accelerate action.
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Affiliation(s)
- Deborah Fry
- Moray House School of Education, University of Edinburgh, Edinburgh, UK
| | - Stephen Blight
- UNICEF East Asia and Pacific Regional Office, Bangkok, Thailand
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521
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Wirtz AL, Alvarez C, Guedes AC, Brumana L, Modvar C, Glass N. Violence against children in Latin America and Caribbean countries: a comprehensive review of national health sector efforts in prevention and response. BMC Public Health 2016; 16:1006. [PMID: 27659869 PMCID: PMC5034460 DOI: 10.1186/s12889-016-3562-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 08/19/2016] [Indexed: 12/02/2022] Open
Abstract
Background Violence against children (VAC) remains a global problem. The health sector has an opportunity and responsibility to be part of the multi-sector collaboration to prevent and respond to VAC. This review aimed to assess the health sector’s response to VAC among Latin American & Caribbean (LAC) countries, particularly as it relates to physical violence, sexual violence, and neglect. Method National protocols for the identification and provision of health care to child survivors of violence, abuse and neglect were solicited in partnership with UNICEF and PAHO/WHO country offices within the LAC region. A parallel systematic review was undertaken in January 2015 to review studies published in the last 10 years that describe the regional health sector response to VAC. Results We obtained health sectors guidelines/protocols related to VAC from 22 of 43 (51 %) countries and reviewed 97 published articles/reports that met the review inclusion criteria. Country protocols were presented in Spanish (n = 12), Portuguese (n = 1), and English (n = 9). Thematic areas of country protocols included: 1) identifying signs and symptoms of VAC, 2) providing patient-centered care to the victim, and 3) immediate treatment of injuries related to VAC. The systematic review revealed that health professionals are often unaware of national protocols and lack training, resources, and support to respond to cases of VAC. Further, there is limited coordination between health and social protection services. Conclusions VAC remains an international, public health priority. Health professionals are well-positioned to identify, treat and refer cases of VAC to appropriate institutions and community-based partners. However, poor protocol dissemination and training, limited infrastructure, and inadequate human resources challenge adherence to VAC guidelines. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3562-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrea L Wirtz
- Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
| | - Carmen Alvarez
- Community Public Health Nursing, Johns Hopkins School of Nursing, Baltimore, USA
| | - Alessandra C Guedes
- Family, Gender and Life Course Department, Pan American Health Organization/World Health Organization, Regional Office for the Americas, Washington, DC, USA
| | - Luisa Brumana
- UNICEF Latin America and Caribbean Regional Office, Panama, Panama
| | - Cecilie Modvar
- UNICEF Latin America and Caribbean Regional Office, Panama, Panama
| | - Nancy Glass
- Community Public Health Nursing, Johns Hopkins School of Nursing, Baltimore, USA
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522
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Benedini KM, Fagan AA, Gibson CL. The cycle of victimization: The relationship between childhood maltreatment and adolescent peer victimization. CHILD ABUSE & NEGLECT 2016; 59:111-121. [PMID: 27568065 DOI: 10.1016/j.chiabu.2016.08.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 08/11/2016] [Accepted: 08/15/2016] [Indexed: 06/06/2023]
Abstract
Child maltreatment has been demonstrated to have many short- and long-term harmful consequences for victims, but whether or not child abuse is associated with an increased risk of peer victimization during adolescence is unclear. This study analyzed prospective data from 831 children and parents participating in the Longitudinal Studies on Child Abuse and Neglect (LONGSCAN) to investigate the relationships between child physical and sexual abuse and adolescent victimization by peers, as well as the potential for gender to moderate these relationships. Results from ordinal logit regression models indicated that children who were physically abused prior to age 12, based on official reports, parent reports, and child reports, had a greater risk of experiencing more intimidation and physical assault by peers at age 16. Having a history of sexual abuse predicted more physical assault but not intimidation. There was no evidence that gender moderated these relationships; in all cases, the relationship between abuse and revictimization was similar for boys and girls. The findings emphasize the need to provide victims of abuse with assistance to help prevent a cycle of victimization.
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Affiliation(s)
- Kristen M Benedini
- Department of Sociology and Criminology & Law, University of Florida, 3219 Turlington Hall, P. O. Box 117330, Gainesville, FL 32611-7330, United States, United States.
| | - Abigail A Fagan
- Department of Sociology and Criminology & Law, University of Florida, 3219 Turlington Hall, P. O. Box 117330, Gainesville, FL 32611-7330, United States, United States.
| | - Chris L Gibson
- Department of Sociology and Criminology & Law, University of Florida, 3219 Turlington Hall, P. O. Box 117330, Gainesville, FL 32611-7330, United States, United States.
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523
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Cluver L, Meinck F, Shenderovich Y, Ward CL, Romero RH, Redfern A, Lombard C, Doubt J, Steinert J, Catanho R, Wittesaele C, De Stone S, Salah N, Mpimpilashe P, Lachman J, Loening H, Gardner F, Blanc D, Nocuza M, Lechowicz M. A parenting programme to prevent abuse of adolescents in South Africa: study protocol for a randomised controlled trial. Trials 2016; 17:328. [PMID: 27435171 PMCID: PMC4950110 DOI: 10.1186/s13063-016-1452-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 06/28/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND An estimated one billion children experience child abuse each year, with the highest rates in low- and middle-income countries. The Sinovuyo Teen programme is part of Parenting for Lifelong Health, a WHO/UNICEF initiative to develop and test violence-prevention programmes for implementation in low-resource contexts. The objectives of this parenting support programme are to prevent the abuse of adolescents, improve parenting and reduce adolescent behavioural problems. This trial aims to evaluate the effectiveness of Sinovuyo Teen compared to an attention-control group of a water hygiene programme. METHODS/DESIGN This is a pragmatic cluster randomised controlled trial, with stratified randomisation of 37 settlements (rural and peri-urban) with 40 study clusters in the Eastern Cape of South Africa. Settlements receive either a 14-session parenting support programme or a 1-day water hygiene programme. The primary outcomes are child abuse and parenting practices, and secondary outcomes include adolescent behavioural problems, mental health and social support. Concurrent process evaluation and qualitative research are conducted. Outcomes are reported by both primary caregivers and adolescents. Brief follow-up measures are collected immediately after the intervention, and full follow-up measures collected at 3-8 months post-intervention. A 15-24-month follow-up is planned, but this will depend on the financial and practical feasibility given delays related to high levels of ongoing civil and political violence in the research sites. DISCUSSION This is the first known trial of a parenting programme to prevent abuse of adolescents in a low- or middle-income country. The study will also examine potential mediating pathways and moderating factors. TRIAL REGISTRATION Pan-African Clinical Trials Registry PACTR201507001119966. Registered on 27 April 2015. It can be found by searching for the key word 'Sinovuyo' on their website or via the following link: http://www.pactr.org/ATMWeb/appmanager/atm/atmregistry?_nfpb=true&_windowLabel=BasicSearchUpdateController_1&BasicSearchUpdateController_1_actionOverride=%2Fpageflows%2Ftrial%2FbasicSearchUpdate%2FviewTrail&BasicSearchUpdateController_1id=1119.
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Affiliation(s)
- Lucie Cluver
- />Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER UK
- />Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Franziska Meinck
- />Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER UK
| | | | - Catherine L. Ward
- />Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Rocio Herrero Romero
- />Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER UK
| | - Alice Redfern
- />Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER UK
| | - Carl Lombard
- />Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
| | - Jenny Doubt
- />Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER UK
| | - Janina Steinert
- />Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER UK
| | - Ricardo Catanho
- />Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER UK
| | - Camille Wittesaele
- />Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER UK
| | - Sachin De Stone
- />Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER UK
| | - Nasteha Salah
- />Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER UK
| | - Phelisa Mpimpilashe
- />Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER UK
| | - Jamie Lachman
- />Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER UK
- />Clowns Without Borders South Africa, PO Box 18670, Durban, 4014 South Africa
| | - Heidi Loening
- />UNICEF, Offices of Research – Innocenti, Florence, Italy
| | - Frances Gardner
- />Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER UK
| | - Daphnee Blanc
- />Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER UK
| | - Mzuvekile Nocuza
- />Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER UK
| | - Meryn Lechowicz
- />Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER UK
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524
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Kornilova MS, Batluk JV, Yorick RV, Baughman AL, Hillis SD, Vitek CR. Decline in HIV seroprevalence in street youth 2006-2012, St. Petersburg, Russia: moving toward an AIDS-free generation. Int J STD AIDS 2016; 28:345-356. [PMID: 27147268 DOI: 10.1177/0956462416649275] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 2006 survey of street youth at pre-mapped street youth locations in St. Petersburg, Russia, found extremely high HIV seroprevalence (37.4%) among 313 street youth aged 15-19 years of age, strongly associated with injection drug use, which was reported by 50.6% of participants. In response, multi-sectoral social support and prevention measures were instituted. In 2012, we conducted a follow-up survey of 15- to 19-year-old street youth using the same study procedures as in 2006. Of 311 participants, 45 (14.5%) reported injection drug use; 31 participants (10.0%, 95% confidence interval, 6.0%-16.2%) were HIV-seropositive . Predictors independently associated with HIV seropositivity included injection drug use (adjusted prevalence ratio 53.1) and transactional sex (adjusted prevalence ratio 1.3). None of the 178 participants aged 15-17 years were HIV-positive. Thirty of 31 (96.8%) HIV-seropositive individuals reported injection drug use. Street youth in St Petersburg had a 73% decrease in HIV seroprevalence from 2006 to 2012, primarily due to decreased initiation of injection drug use. This marked reduction in the HIV epidemic among street youth occurred after implementation of extensive support programs and socio-economic improvements.
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Affiliation(s)
- Marina S Kornilova
- 1 U.S. Centers for Disease Control and Prevention, Moscow, Russian Federation
| | - Julia V Batluk
- 2 Doctors to Children, St Petersburg, Russia.,3 Saint-Petersburg State University, St. Petersburg, Russia
| | | | - Andrew L Baughman
- 4 U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Susan D Hillis
- 4 U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Charles R Vitek
- 1 U.S. Centers for Disease Control and Prevention, Moscow, Russian Federation
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525
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Guedes A, Bott S, Garcia-Moreno C, Colombini M. Bridging the gaps: a global review of intersections of violence against women and violence against children. Glob Health Action 2016; 9:31516. [PMID: 27329936 PMCID: PMC4916258 DOI: 10.3402/gha.v9.31516] [Citation(s) in RCA: 135] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 05/17/2016] [Accepted: 05/18/2016] [Indexed: 01/04/2023] Open
Abstract
Background The international community recognises violence against women (VAW) and violence against children (VAC) as global human rights and public health problems. Historically, research, programmes, and policies on these forms of violence followed parallel but distinct trajectories. Some have called for efforts to bridge these gaps, based in part on evidence that individuals and families often experience multiple forms of violence that may be difficult to address in isolation, and that violence in childhood elevates the risk of violence against women. Methods This article presents a narrative review of evidence on intersections between VAC and VAW – including sexual violence by non-partners, with an emphasis on low- and middle-income countries. Results We identify and review evidence for six intersections: 1) VAC and VAW have many shared risk factors. 2) Social norms often support VAW and VAC and discourage help-seeking. 3) Child maltreatment and partner violence often co-occur within the same household. 4) Both VAC and VAW can produce intergenerational effects. 5) Many forms of VAC and VAW have common and compounding consequences across the lifespan. 6) VAC and VAW intersect during adolescence, a time of heightened vulnerability to certain kinds of violence. Conclusions Evidence of common correlates suggests that consolidating efforts to address shared risk factors may help prevent both forms of violence. Common consequences and intergenerational effects suggest a need for more integrated early intervention. Adolescence falls between and within traditional domains of both fields and deserves greater attention. Opportunities for greater collaboration include preparing service providers to address multiple forms of violence, better coordination between services for women and for children, school-based strategies, parenting programmes, and programming for adolescent health and development. There is also a need for more coordination among researchers working on VAC and VAW as countries prepare to measure progress towards 2030 Sustainable Development Goals.
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Affiliation(s)
- Alessandra Guedes
- Family, Gender and Life Course Department, Pan American Health Organization/World Health Organization, Regional Office for the Americas, Washington, DC, USA;
| | - Sarah Bott
- Family, Gender and Life Course Department, Pan American Health Organization/World Health Organization, Regional Office for the Americas, Washington, DC, USA
| | - Claudia Garcia-Moreno
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Manuela Colombini
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
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526
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Mutavi T, Mathai M, Kumar M, Nganga P, Obondo A. Psychosocial Outcomes Among Children Following Defilement And The Caregivers Responses To The Children's Trauma: A Qualitative Study From Nairobi Suburbs, Kenya. AFRICAN JOURNAL OF TRAUMATIC STRESS 2016; 5:38-47. [PMID: 29333533 PMCID: PMC5762133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Defilement is traumatic and often associated with psychosocial problems in children, parental distress and significant social strain on family relationships and well-being. This study aimed at examining psychosocial outcomes in defiled children and their caregivers' perceptions of the children's trauma after defilement. The study was carried out between June 2015 and July 2016 at Kenyatta National Hospital and Nairobi Women's Hospital. It adopted a qualitative descriptive design using interviews to obtain information from six purposely selected caregivers comprising of four mothers, one father and one grandmother. All the perpetrators were adult males and two of the defiled children were male and 5 were female. Two of the children were siblings; a brother and his sister. Five of the perpetrators were known to the children and one of these was the child's biological father. The defiled children had negative outcomes in terms of poor academic performance, low self esteem, depression and poor social relationships. In addition one of the children contracted HIV/AIDS, two became pregnant, one was used to traffic drugs, and another had mental retardation. The caregivers felt significant psychosocial distress. There is therefore, need to routinely screen for psychological, social and physical outcomes of children exposed to defilement trauma and to always consider caregiver distress when treating these children.
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Affiliation(s)
- Teresia Mutavi
- Department of Psychiatry, School of Medicine, College of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Muthoni Mathai
- Department of Psychiatry, School of Medicine, College of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Manasi Kumar
- Department of Psychiatry, School of Medicine, College of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Pauline Nganga
- Department of Psychiatry, School of Medicine, College of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Anne Obondo
- Department of Psychiatry, School of Medicine, College of Health Sciences, University of Nairobi, Nairobi, Kenya
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Clarke K, Patalay P, Allen E, Knight L, Naker D, Devries K. Patterns and predictors of violence against children in Uganda: a latent class analysis. BMJ Open 2016; 6:e010443. [PMID: 27221125 PMCID: PMC4885281 DOI: 10.1136/bmjopen-2015-010443] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To explore patterns of physical, emotional and sexual violence against Ugandan children. DESIGN Latent class and multinomial logistic regression analysis of cross-sectional data. SETTING Luwero District, Uganda. PARTICIPANTS In all, 3706 primary 5, 6 and 7 students attending 42 primary schools. MAIN OUTCOME AND MEASURE To measure violence, we used the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool-Child Institutional. We used the Strengths and Difficulties Questionnaire to assess mental health and administered reading, spelling and maths tests. RESULTS We identified three violence classes. Class 1 (N=696 18.8%) was characterised by emotional and physical violence by parents and relatives, and sexual and emotional abuse by boyfriends, girlfriends and unrelated adults outside school. Class 2 (N=975 26.3%) was characterised by physical, emotional and sexual violence by peers (male and female students). Children in Classes 1 and 2 also had a high probability of exposure to emotional and physical violence by school staff. Class 3 (N=2035 54.9%) was characterised by physical violence by school staff and a lower probability of all other forms of violence compared to Classes 1 and 2. Children in Classes 1 and 2 were more likely to have worked for money (Class 1 Relative Risk Ratio 1.97, 95% CI 1.54 to 2.51; Class 2 1.55, 1.29 to 1.86), been absent from school in the previous week (Class 1 1.31, 1.02 to 1.67; Class 2 1.34, 1.10 to 1.63) and to have more mental health difficulties (Class 1 1.09, 1.07 to 1.11; Class 2 1.11, 1.09 to 1.13) compared to children in Class 3. Female sex (3.44, 2.48 to 4.78) and number of children sharing a sleeping area predicted being in Class 1. CONCLUSIONS Childhood violence in Uganda forms distinct patterns, clustered by perpetrator and setting. Research is needed to understand experiences of victimised children, and to develop mental health interventions for those with severe violence exposures. TRIAL REGISTRATION NUMBER NCT01678846; Results.
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Affiliation(s)
- Kelly Clarke
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Louise Knight
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Karen Devries
- London School of Hygiene and Tropical Medicine, London, UK
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van der Kolk B. Commentary: The devastating effects of ignoring child maltreatment in psychiatry--a commentary on Teicher and Samson 2016. J Child Psychol Psychiatry 2016; 57:267-70. [PMID: 26889892 DOI: 10.1111/jcpp.12540] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2016] [Indexed: 11/30/2022]
Abstract
Despite the numerous studies over the past 30 years that have clarified the devastating effects of child maltreatment on mental and physical health, the role of trauma within the caregiving system remains unrecognized both in our diagnostic systems and in our dominant treatment paradigms. Research of people with histories of caregiver abuse and neglect consistently demonstrates problems with concentration, anger, panic, depression, food intake, drugs, and sleep, as well as decreased Heart RateVariability, higher levels of stress hormones, and reduced or impaired immune response. Their relationship between documented brain changes and psychopathology is complex. Traumatic life experiences during childhood and adolescence are far more common than expected. The Centers for Disease Control and Prevention estimates that child maltreatment may be the most costly public health issue in the United States, Eradicating child abuse in America would reduce the overall rate of depression by more than half, alcoholism by two-thirds, and suicide, serious drug abuse, and domestic violence by three quarters. It would also have a significantly positive effect on workplace performance, and vastly decrease the need for incarceration. The current practice of applying multiple distinct comorbid diagnoses to traumatized children prevents a comprehensive treatment approach. Approaching their problems from a framework of memories of discreet traumatic ignores the fact that the damage affects the brain's neural circuitry and goes well beyond dealing with discrete painful events. Our great challenge is to learn to utilize the brain's neuroplasticity to reorganize defective brain circuits.
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