1
|
Trivedi M, Dumkrieger G, Chong CD, Leibovit-Reiben Z, Schwedt TJ. A history of abuse is associated with more severe migraine- and pain-related disability: Results from the American Registry for Migraine Research. Headache 2024; 64:1109-1123. [PMID: 39051483 DOI: 10.1111/head.14787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 06/06/2024] [Accepted: 06/15/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Prior studies have established an association between a history of abuse and more severe migraine presentation. OBJECTIVES This cross-sectional, observational study of a clinic-based migraine population used validated measures to elucidate migraine-specific and migraine-related burdens among patients with a history of abuse. METHODS Patients with migraine (n = 866) from the American Registry for Migraine Research self-reported if they had a history of emotional, physical, and/or sexual abuse and completed questionnaires assessing migraine-related burden: Migraine Disability Assessment, Subjective Cognitive Impairment Scale for Migraine Attacks, Work Productivity and Activity Impairment, Patient-Reported Outcomes Measurement Information System Pain Interference, Patient Health Questionnaire-2, and Generalized Anxiety Disorder-7. Migraine-related burden in patients with versus without a history of abuse was compared. Subsequently, a mediation analysis evaluated the impact of depression and anxiety symptoms in the relationship between abuse history and migraine burden. RESULTS A history of abuse was reported by 36.5% (n = 316/866) of participants. After controlling for patient age, sex, years lived with headache, and headache frequency, a history of abuse was significantly associated with more severe migraine-related disability. The combined burden of depression and anxiety symptoms mediated the relationship. CONCLUSION A history of abuse is associated with greater migraine-related disability. Future studies should determine if identification and management of the psychological and physical sequelae of abuse reduce migraine burden.
Collapse
Affiliation(s)
- Meesha Trivedi
- Department of Neurology, Mayo Clinic, Phoenix, Arizona, USA
- Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, Texas, USA
| | | | | | - Zachary Leibovit-Reiben
- Department of Neurology, Mayo Clinic, Phoenix, Arizona, USA
- College of Medicine - Tucson, University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Todd J Schwedt
- Department of Neurology, Mayo Clinic, Phoenix, Arizona, USA
| |
Collapse
|
2
|
Prakash J, Fay K, Gujrathi R, Rosner B, Nour N, Khurana B. Antepartum Intimate Partner Violence: Development of a Risk Prediction Model. J Womens Health (Larchmt) 2024; 33:1259-1266. [PMID: 38770781 DOI: 10.1089/jwh.2024.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024] Open
Abstract
Objectives: To explore socio-behavioral, clinical, and imaging findings associated with antepartum intimate partner violence (IPV) and aid in risk stratification of at-risk individuals. Methods: We analyzed electronic medical records during indexed pregnancies for 108 pregnant patients who self-reported antepartum IPV (cases) and 106 age-matched pregnant patients who did not self-report antepartum IPV (controls). Sociodemographic, clinical, and radiology data were analyzed via chi-squared and Fisher's exact tests with p < 0.05 as the threshold for significance. Stepwise logistic regression was applied to derive a risk prediction model. Results: The proportion of cases reporting emotional IPV (76% vs. 52%) and/or physical IPV (45% vs. 31%) during pregnancy significantly increased from prior to pregnancy. Cases were significantly more likely to report prepregnancy substance use (odds ratio [OR] = 2.60; 95% confidence interval [CI]: 1.13-5.98), sexually transmitted infections (OR = 3.48; 95%CI: 1.64-7.37), abortion (OR = 3.17; 95%CI: 1.79, 5.59), and preterm birth (OR = 5.97; 95%CI: 1.69-21.15). During pregnancy, cases were more likely to report unstable housing (OR = 5.26; 95%CI: 2.67-10.36), multigravidity (OR = 2.83; 95%CI: 1.44-5.58), multiparity (OR = 3.75; 95%CI: 1.72-8.20), anxiety (OR = 3.35; 95%CI: 1.85-6.08), depression (OR = 5.58; 95%CI: 3.07-10.16), substance use (OR = 2.92; 95%CI: 1.28-6.65), urinary tract infection (UTI) (OR = 3.26; 95%CI: 1.14-9.32), intrauterine growth restriction (OR = 10.71; 95%CI: 1.35-85.25), and cesarean delivery (OR = 2.25; 95%CI: 1.26-4.02). Cases had significantly more OBGYN abnormalities on imaging and canceled more radiological studies (OR = 5.31). Logistic regression found housing status, sexually transmitted infection history, preterm delivery history, abortion history, depression, and antepartum UTI predictive of antepartum IPV. The risk prediction model achieved good calibration with an area under the curve of 0.79. Conclusions: This study identifies significant disparities among patients experiencing antepartum IPV, and our proposed risk prediction model can inform risk assessment in this setting.
Collapse
Affiliation(s)
- Jaya Prakash
- Trauma Imaging Research and Innovation Center, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Kathryn Fay
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Rahul Gujrathi
- Trauma Imaging Research and Innovation Center, Department of Radiology, Boston Medical Center, Boston, Massachusetts, USA
| | | | - Nawal Nour
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Bharti Khurana
- Trauma Imaging Research and Innovation Center, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
3
|
Zhao X, Liu J, Brown MJ, Alston K. Intimate Partner Violence and Antenatal Depression Among Underserved Pregnant Women. J Womens Health (Larchmt) 2024; 33:1102-1110. [PMID: 38629622 DOI: 10.1089/jwh.2023.1189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2024] Open
Abstract
Introduction: Few studies have examined the associations of intimate partner violence (IPV) exposure during pregnancy and types of IPV with antenatal depression among underserved pregnant women. Methods: Data came from participants from a Healthy Start program in South Carolina between 2015 and 2019 (n = 1,629). The first two questions in the Woman Abuse Screening Tool (WAST) were used to measure IPV exposure, that is, having a problematic relationship with their partner. Those who had IPV exposure were assessed with six additional questions of the WAST. Principal component analysis was conducted on the 8-item WAST data to identify underlying types of IPV exposure. Antenatal depression was defined as the Center for Epidemiologic Studies Depression scores ≥16. Results: Participants were racially diverse (71% black, 21% white) with 85% Medicaid recipients. Nearly 12% of participants reported IPV exposure and 30% reported antenatal depression. The odds of having IPV exposure were higher among unmarried women, those with less than a high school education, and those who lacked family support. The odds of having antenatal depression were 2.5 times higher (95% CI: 1.9-3.5) among women with IPV exposure. After controlling for covariates, a one-point increase in the scores for psychological IPV (Factor 1) or a problematic relationship (Factor 3) was associated with increased odds of antenatal depression. Conclusion: This is one of the first studies to estimate the prevalence of IPV exposure using a proxy measure (a problematic relationship) among underserved U.S. pregnant women. Its positive association with antenatal depression suggests the utility of screening for a problematic relationship using a two-item WAST and providing assistance to those with IPV exposure.
Collapse
Affiliation(s)
- Xingpei Zhao
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA
| | - Monique J Brown
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA
| | - Kimberly Alston
- Prisma Health, Midlands Healthy Start, Columbia, South Carolina, USA
| |
Collapse
|
4
|
Tesema GA, Gbagbo FY, Okeke SR, Ameyaw EK, Yaya S. Is sexual autonomy a protective factor against intimate partner violence? Evidence from 27 sub-Saharan African countries. PLoS One 2024; 19:e0308108. [PMID: 39074128 DOI: 10.1371/journal.pone.0308108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 07/15/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND Though women in sub-Saharan Africa have increased risk of intimate sexual violence, research on the association between sexual autonomy and intimate partner violence among this population has not received the requisite attention. Consequently, we investigated if sexual autonomy is a protective factor against intimate partner violence among women in sub-Saharan Africa. METHODS Secondary data analysis was conducted based on the Demographic and Health Surveys (DHSs) of 27 sub-Saharan African countries from 2008 to 2021. A total of 104,523 married or cohabitating women were included in the study. We applied a multilevel Poisson regression model with robust variance to identify associated factors. Variables with a p-value<0.2 in the bi-variable multilevel Poisson regression analysis were considered for the multivariable analysis. The Adjusted Prevalence Ratio (APR) with its 95% confidence interval (CI) was reported, and variables with a p-value <0.05 were included in the multivariable analysis. RESULTS The prevalence of intimate partner violence and sexual autonomy among women in SSA were 32.96% [95% CI: 32.68%, 33.25%] and 88.79% [95% CI: 88.59%, 88.97%], respectively. Women in Sierra Leone had the highest prevalence of IPV (52.71%) while Comoros had the lowest prevalence of IPV (8.09%). The prevalence of sexual autonomy was highest in Namibia (99.22%) and lowest in Mali (61.83%). The MOR value in the null model was 1.26. We found that women who had sexual autonomy are 1.28 times [APR = 1.28, 95% CI: 1.17, 1.40] more likely to experience IPV than women who had no sexual autonomy. CONCLUSION This study has demonstrated that sexual autonomy is significantly associated with intimate partner violence, however, it does not necessarily act as a protective factor. The study suggests the need for more education on intimate partner violence targeting women's partners. This can help secure the commitment of the perpetrators to rather become proponents of anti-intimate partner violence and further offer women the necessary support for them to attain their full fundamental rights in all spheres of life.
Collapse
Affiliation(s)
- Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fred Yao Gbagbo
- Department of Health Administration and Education University of Education Winneba, Kumasi, Ghana
| | - Sylvester R Okeke
- Centre for Social Research in Health, UNSW Sydney, Kensington, Australia
| | - Edward Kwabena Ameyaw
- Institute of Policy Studies and School of Graduate Studies, Lingnan University, Tuen Mun, Hong Kong
- L & E Research Consult Ltd, Wa, Upper West Region, Ghana
| | - Sanni Yaya
- The George Institute for Global Health, Imperial College London, London, United Kingdom
| |
Collapse
|
5
|
Han YY, Celedón JC. The effects of violence and related stress on asthma. Ann Allergy Asthma Immunol 2024:S1081-1206(24)00479-4. [PMID: 39069155 DOI: 10.1016/j.anai.2024.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 07/10/2024] [Accepted: 07/19/2024] [Indexed: 07/30/2024]
Abstract
In the United States, people living in deprived urban areas and persons in certain minoritized groups are often exposed to violence and affected with asthma, and epidemiologic studies have shown a link between exposure to violence (ETV) and asthma throughout the lifespan. Indeed, ETV at the individual, intrafamilial and community levels has been linked to asthma in children and adults. In this review, we discuss the evidence for a causal relation between ETV and asthma, emphasizing findings published in the last five years. Interpretation of the available evidence is limited by variable quality of the assessment of ETV or asthma, potential recall and selection bias, inability to estimate the relative contribution of various types of violence to the observed associations, lack of objective biomarkers of asthma or asthma endotypes, and inconsistent consideration of potential confounders or modifiers of the ETV-asthma link. Despite such limitations, the aggregate evidence from studies conducted in different locations and populations suggests that ETV affects asthma and asthma outcomes, and that this is explained by direct physiologic effects of violence-related distress and indirect effects (e.g., through risky health behaviors or co-morbidities). Thus, large prospective studies with careful assessment of specific types of ETV, key covariates and comorbidities (including mental illness), and asthma are needed to advance this field. Such research efforts should not preclude screening for maltreatment in children with asthma and ETV-related depression and anxiety in adolescents and adults with asthma. Further, vigorous policies are needed to curtail violence, as such policies could benefit patients with asthma while saving lives.
Collapse
Affiliation(s)
- Yueh-Ying Han
- Division of Pulmonary Medicine, Department of Pediatrics, University of Pittsburgh Medical Center (UPMC) Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Juan C Celedón
- Division of Pulmonary Medicine, Department of Pediatrics, University of Pittsburgh Medical Center (UPMC) Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania.
| |
Collapse
|
6
|
Chan JP, Harris KA, Berkowitz A, Ferber A, Greenwald BD, Valera EM. Experiences of Domestic Violence in Adult Patients with Brain Injury: A Select Overview of Screening, Reporting, and Next Steps. Brain Sci 2024; 14:716. [PMID: 39061456 PMCID: PMC11274718 DOI: 10.3390/brainsci14070716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 07/11/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
This select overview examines the important intersection of adult domestic violence, including intimate partner violence and elder abuse, with brain injury. Despite the high prevalence of domestic violence amongst brain injury patients, there is a notable gap in screening and management training for providers. To provide optimal patient care, brain injury medicine clinicians must screen, recognize, and treat patients who have experienced domestic violence. This select overview highlights barriers to screening, validated screening tools from other medical disciplines, and management considerations for the brain injury clinician. A suggested protocol for domestic violence screening and management, as well as recommended resources for providers and patients, is summarized.
Collapse
Affiliation(s)
- Jessie P. Chan
- JFK Johnson Rehabilitation Institute, Edison, NJ 08820, USA; (J.P.C.); (K.A.H.); (A.B.); (A.F.)
- Department of Physical Medicine and Rehabilitation, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA
- Department of Physical Medicine and Rehabilitation, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
| | - Kristen A. Harris
- JFK Johnson Rehabilitation Institute, Edison, NJ 08820, USA; (J.P.C.); (K.A.H.); (A.B.); (A.F.)
- Department of Physical Medicine and Rehabilitation, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA
- Department of Physical Medicine and Rehabilitation, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
| | - Arielle Berkowitz
- JFK Johnson Rehabilitation Institute, Edison, NJ 08820, USA; (J.P.C.); (K.A.H.); (A.B.); (A.F.)
- Department of Physical Medicine and Rehabilitation, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA
- Department of Physical Medicine and Rehabilitation, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
| | - Ally Ferber
- JFK Johnson Rehabilitation Institute, Edison, NJ 08820, USA; (J.P.C.); (K.A.H.); (A.B.); (A.F.)
- Department of Physical Medicine and Rehabilitation, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA
- Department of Physical Medicine and Rehabilitation, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
| | - Brian D. Greenwald
- JFK Johnson Rehabilitation Institute, Edison, NJ 08820, USA; (J.P.C.); (K.A.H.); (A.B.); (A.F.)
- Department of Physical Medicine and Rehabilitation, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA
- Department of Physical Medicine and Rehabilitation, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
| | - Eve M. Valera
- Massachusetts General Hospital, Charlestown, MA 02129, USA;
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| |
Collapse
|
7
|
Bahati C, Nyiranteziryayo A, Izabayo J, Atete P, Sezibera V, Mutesa L. Mental health outcomes of offspring exposed to parental intimate partner violence in Rwanda. BMC Pediatr 2024; 24:419. [PMID: 38956491 PMCID: PMC11218358 DOI: 10.1186/s12887-024-04884-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 06/12/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Children who witness parental intimate partner violence (IPV) are more likely to develop mental health issues compared to those who do not witness such violence. OBJECTIVE The main objective of this study is to assess the association between parental intimate partner violence and child mental health outcomes. METHODOLOGY This cross-sectional study involved 548 participants divided into two groups: parents (N = 304) and offspring (N = 244). The participants were recruited from Mageragere Sector in the City of Kigali (urban), as well as Mbazi and Ruhashya sectors in Huye District (rural). To assess the difference about mental difficulties reported by the offspring, a Mann-Whitney U test was employed to compare the responses of parents and their children on mental health outcomes. Additionally, multiple linear regression analysis was conducted to explore the association between parental intimate partner violence (IPV) and the mental health outcomes of their offspring. RESULTS The results highlighted significant levels of mental and emotional challenges in children, as reported by both parents and the children themselves. Depression and youth conduct problems were more prevalent among the children compared to their parents, whereas anxiety and irritability were more commonly reported by parents than by their children. Intimate partner violence showed to be a predictor of irritability and anxiety symptoms in offspring. In terms of irritability, depression, and youth conduct problems they were identified as predictors of anxiety symptoms. Particularly, anxiety and irritability were revealed to predict youth conduct problems. CONCLUSION The study indicates that parental intimate partner violence (IPV) has an impact on the mental well-being of their offspring. Furthermore, it was observed that there is not only a correlation between IPV and poor mental health outcomes, but also a connection between different mental conditions, implying that children exposed to IPV are more prone to experiencing a range of mental issues. As a result, intervention programs should place emphasis on addressing the mental disorders of both parents and children.
Collapse
Affiliation(s)
- Claire Bahati
- Department of Clinical Psychology, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
| | - Amina Nyiranteziryayo
- Department of Clinical Psychology, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Josias Izabayo
- Centre for Mental Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Pauline Atete
- Centre for Mental Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Vincent Sezibera
- Centre for Mental Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Leon Mutesa
- Centre for Human Genetics, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| |
Collapse
|
8
|
Camarda A, Bradford JY, Dixon C, Horigan AE, DeGroot D, Kaiser J, MacPherson-Dias R, Perry A, Slifko A, Slivinski A, Bishop-Royse J, Delao AM. ENA Clinical Practice Guideline Synopsis: Intimate Partner Violence Screening. J Emerg Nurs 2024; 50:573-577. [PMID: 38960549 DOI: 10.1016/j.jen.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 09/07/2023] [Indexed: 07/05/2024]
|
9
|
Bante A, Ayele G, Alamirew B, Ahmed M. Regulatory problems and associated factors among infants in Arba Minch health and demographic surveillance system sites, southern Ethiopia. PLoS One 2024; 19:e0305722. [PMID: 38889163 PMCID: PMC11185483 DOI: 10.1371/journal.pone.0305722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/03/2024] [Indexed: 06/20/2024] Open
Abstract
INTRODUCTION Infant regulatory problems are a common source of concern for parents, and they increase the risk of impaired infant-caregiver bonding. Despite their impact, they are often overlooked in Ethiopia. Hence, this study aimed to determine the prevalence and associated factors of infant regulatory problems in Arba Minch Health and Demographic Surveillance System sites in southern Ethiopia. METHODS A community-based cross-sectional study was conducted among 451 mother-infant pairs from February 15 to March 15, 2022. Regulatory problems were assessed using diagnostic interviews for regulatory problems. The data was collected using an open data kit Android application and analyzed with Stata version 17.0. Bivariable and multivariable logistic regression analyses were computed to identify factors associated with each infant regulatory problem. Statistical significance was declared at a p-value < 0.05. RESULTS In this study, four hundred forty-nine mother-infant pairs were involved, with a response rate of 99.5%. The prevalence of excessive crying, feeding problems, and sleeping difficulties was 14.03% [95% CI: 10.95, 17.59], 20.04% [95% CI: 16.44, 24.05], and 13.59% [95% CI: 10.55, 17.11], respectively. Attending primary education (AOR: 2.54, 95% CI: 1.22, 5.32), high perceived social support (AOR: 0.32, 95% CI: 0.12, 0.89), feeding problems (AOR: 5.0, 95% CI: 2.65, 9.45), and depression, anxiety, and stress (DAS) symptoms (AOR: 2.67, 95% CI: 1.19, 5.98) were associated with excessive crying. In addition, a family size of above five (AOR: 1.82, 95% CI: 1.03, 3.22), excessive crying (AOR: 3.76, 95% CI: 1.85, 7.65), sleeping problems (AOR: 2.29, 95% CI: 1.13, 4.65), comorbid DAS symptoms (AOR: 3.42, 95% CI: 1.64, 7.11), alcohol abuse (AOR: 1.89, 95% CI: 1.04, 3.42), and late initiation of complementary feeding (AOR: 2.67, 95% CI: 1.22, 5.88) were associated with feeding problems. Furthermore, attending primary education (AOR: 2.35, 95% CI: 1.16, 4.77), feeding problems (AOR: 3.47, 95% CI: 1.86, 6.48), and comorbid DAS symptoms (AOR: 3.23, 95% CI: 1.53, 6.84) were associated with sleeping problems. CONCLUSIONS Approximately one-third of infants encountered at least one regulatory problem. Level of education, perceived social support, feeding problems, and DAS symptoms were associated with excessive crying. Large family sizes, excessive crying, sleeping problems, comorbid DAS symptoms, alcohol abuse and, late initiation of complementary feeding increase the likelihood of feeding problems. Moreover, attending primary education, feeding problems, and comorbid DAS symptoms increase the odds of sleeping problems. Continuous guidance and support on infant soothing techniques, cognitive and behavioral therapy, and counselling on appropriate coping strategies for postpartum women are imperative to reduce the burden of infant regulatory problems.
Collapse
Affiliation(s)
- Agegnehu Bante
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Gistane Ayele
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Birhanu Alamirew
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Muluken Ahmed
- School of Medicine, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| |
Collapse
|
10
|
Schellhammer SK, Starnes JR, Mudhune S, Goore L, Marlar L, Oyugi S, Wamae J, Shumba CS, Rogers A, Mbeya J, Vill B, Otieno AS, Wamai RG, Were LPO. Interpersonal violence against women and maternity care in Migori County, Kenya: evidence from a cross-sectional survey. Front Glob Womens Health 2024; 5:1345153. [PMID: 38784942 PMCID: PMC11111867 DOI: 10.3389/fgwh.2024.1345153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/17/2024] [Indexed: 05/25/2024] Open
Abstract
Background Interpersonal violence (IPV) is an issue of major public health concern, with 24% of Kenyan women reporting physical violence perpetrated by a current husband or partner. IPV has profound impacts on physical and mental health outcomes, particularly for pregnant women; it has been found to increase the risk of perinatal mortality, low birth weight, and preterm birth. This study aims to identify variables associated with IPV and assess the effects of IPV experience on prenatal and peripartum maternal healthcare in Migori County, Kenya. Findings build on a previous study that investigated a smaller region of Migori County. Methods Responses to cross-sectional household surveys conducted in six wards of Migori County, Kenya in 2021 from female respondents aged 18 and older were analyzed. The survey contained validated screening tools for interpersonal violence. Group-wise comparisons, and bivariate and multivariate logistic regression analyses were performed to describe community prevalence, factors associated with IPV against women, and the effect of IPV exposure on prenatal and peripartum health care. Results This study finds that 2,306 (36.7%) of the 6,290 respondents had experienced lifetime IPV. IPV experience was associated with the age group 25-49 (adjusted odds ratio (aOR) 1.208; 95%CI: [1.045-1.397]; p = 0.011), monogamous marriage [aOR 2.152; 95%CI: (1.426-3.248); p < 0.001], polygamous marriage [aOR 2.924; 95%CI: (1.826-4.683); p < 0.001], being widowed/divorced/separated [aOR 1.745; 95%CI: (1.094-2.786); p < 0.001], feeling an attitude of "sometimes okay" toward wife beating [aOR 2.002 95%CI: (1.651, 2.428); p < 0.001], having been exposed to IPV in girlhood [aOR 2.525; 95%CI: (2.202-2.896); p < 0.001] and feeling safe in the current relationship [aOR 0.722; 95%CI: (0.609, 0.855); p < 0.001]. A depression score of mild [aOR 1.482; 95%CI: (1.269, 1.73); p < 0.001] and severe [aOR 2.403; 95%CI: (1.429, 4.039); p = 0.001] was also associated with IPV experience, and women who experienced emotional abuse were much more likely to have experienced IPV [aOR 10.462; 95% CI: (9.037, 12.112); p < 0.001]. Adjusted analyses showed that having experienced IPV was negatively associated with attending at least four antenatal care visits during the most recent pregnancy (OR 0.849, p = 0.044) and with having a skilled birth attendant (OR 0.638, p = 0.007). Conclusions IPV is prevalent in Migori County, Kenya, with increased prevalence among women aged 25-49, those residing in West Kanyamkago, those in a monogamous or polygamous marriage, those who have been widowed/divorced/separated, and those with severe depressive symptoms. Further, IPV exposure is associated with lower use of maternal care services and may lead to worse maternal health outcomes. There is need for enhanced effort in addressing social and gender norms that perpetuate IPV, and this study can contribute to guiding policy interventions and community responses towards IPV.
Collapse
Affiliation(s)
| | - Joseph R. Starnes
- Department of Pediatrics, Division of Pediatric Cardiology, Vanderbilt University School of Medicine, Nashville, TN, United States
- Lwala Community Alliance, Rongo, Kenya
| | | | - Lou Goore
- Lwala Community Alliance, Rongo, Kenya
| | | | | | | | - Constance S. Shumba
- Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, United States
| | | | | | - Beffy Vill
- Department of Health Services, Migori County, Kenya
| | | | - Richard G. Wamai
- Department of Cultures, Societies, and Global Studies, Northeastern University, Boston, MA, United States
| | - Lawrence P. O. Were
- Department of Health Sciences & Department of Global Health, Boston University, Boston, MA, United States
| |
Collapse
|
11
|
Deaterly C, Richards V, Weaver M, Villalba K, Varma D, Payton I, Cook R. Associations of Intimate Partner Violence and Drug Use on Viral Suppression Among Women Living With HIV in South Florida: A Secondary Analysis. J Assoc Nurses AIDS Care 2024; 35:245-251. [PMID: 38417080 PMCID: PMC11216898 DOI: 10.1097/jnc.0000000000000439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
ABSTRACT Suboptimal viral suppression is associated with worse outcomes and increased HIV transmission among women with HIV (WWH). Based on syndemic theory, we hypothesized that women exposed to recent intimate partner violence (IPV) and current drug use would be most likely to have suboptimal HIV viral suppression. We analyzed baseline data from a longitudinal clinical trial (WHAT-IF? Will Having Alcohol Treatment Improve My Functioning?) that enrolled WWH from Miami, FL, who reported heavy drinking. Bivariate logistic regression was done, mean age was 48 years ( n = 194; SD : 8.7), 40% had current drug use (other than alcohol), and 14% reported recent IPV. WWH who reported both IPV and drug use had the highest rate of suboptimal viral suppression (45%), but these differences were not statistically significant. The high rates of suboptimal viral suppression, drug use, and IPV suggest a need to include screening for IPV in clinical guidelines related to HIV care in women.
Collapse
Affiliation(s)
- Caroline Deaterly
- University of Florida College of Nursing and a pre-doctoral student with the Southern HIV and Alcohol Research Consortium, Gainesville, FL, USA
| | | | - Michael Weaver
- University of Florida College of Nursing, Gainesville, FL, USA
| | - Karina Villalba
- University of Central Florida College of Medicine, Orlando, FL, USA
| | - Deepthi Varma
- University of Florida Department of Epidemiology, Gainesville, FL, USA
| | - Isaac Payton
- University of Florida College of Nursing and a pre-doctoral student with the Southern HIV and Alcohol Research Consortium, Gainesville, FL, USA
| | - Robert Cook
- University of Florida Department of Epidemiology, Gainesville, FL, USA
| |
Collapse
|
12
|
Winter AK, Due C, Ziersch A. Wellbeing Outcomes and Risk and Protective Factors for Parents with Migrant and Refugee Backgrounds from the Middle East in the First 1000 Days: A Systematic Review. J Immigr Minor Health 2024; 26:395-408. [PMID: 37410193 PMCID: PMC10937786 DOI: 10.1007/s10903-023-01510-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 07/07/2023]
Abstract
The First 1000 Days (the period from conception to a child's second birthday) is an important developmental period. However, little is known about experiences of parents with refugee and migrant backgrounds during this period. A systematic review was conducted according to PRISMA guidelines. Publications were identified through searches of the Embase, PsycINFO, PubMed, and Scopus databases, critically appraised, and synthesised using thematic analysis. A total of 35 papers met inclusion criteria. Depressive symptomatology was consistently higher than global averages, however maternal depression conceptualisations differed across studies. Several papers reported changes in relationship dynamics as a result of having a baby post-migration. Consistent relationships were found between social and health support and wellbeing. Conceptualisations of wellbeing may differ among migrant families. Limited understanding of health services and relationships with health providers may impede help-seeking. Several research gaps were identified, particularly in relation to the wellbeing of fathers, and of parents of children over 12 months old.
Collapse
Affiliation(s)
- Amelia Kate Winter
- School of Psychology, The University of Adelaide North Terrace, Adelaide, 5005, Australia.
| | - Clemence Due
- School of Psychology, The University of Adelaide North Terrace, Adelaide, 5005, Australia
| | - Anna Ziersch
- College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, 5001, Australia
| |
Collapse
|
13
|
Wei X, Wang W, Law YW, Zhang H. The Impacts of Intimate Partner Violence on Postpartum Depression: An Updated Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:1531-1550. [PMID: 37480328 DOI: 10.1177/15248380231188068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Abstract
The associations between intimate partner violence (IPV) and postpartum depression (PPD) have been well established in previous reviews. However, none has explored potential differences between IPV subtypes or exposure times, which could help healthcare providers recognize the adverse impacts of various IPV subtypes and conduct comprehensive IPV screening. This study aimed to estimate the impacts of overall IPV and its subtypes (physical, psychological, and sexual) on PPD using an updated meta-analysis and to examine the potential role of IPV exposure time and regional income levels. Four English databases (Medline, PsycINFO, PubMed, and Web of Science) and two Chinese databases (China National Knowledge Infrastructure [CNKI] and Wanfang Database) were systematically searched. We included 76 studies with 388,966 samples. Random-effects models were used to pool the odds ratios (ORs) across studies. Overall, IPV and its subtypes had statistically significant impacts on PPD (overall: OR = 2.50, physical: OR = 2.31, psychological: OR = 2.22, sexual: OR = 1.75). A higher impact of IPV on PPD was observed in middle- and low-income regions (OR = 3.01) than in high-income regions (OR = 1.92). IPV during pregnancy (OR = 2.73) had a greater impact on PPD than lifetime IPV (OR = 2.24). This study provides updated evidence for the significant impact of IPV and its subtypes and exposure time on PPD. Women at risk of exposure to physical IPV, especially during pregnancy, are in urgent need of support to reduce the risk of PPD.
Collapse
Affiliation(s)
- Xinyi Wei
- The University of Hong Kong, Pokfulam, Hong Kong
| | | | - Yik Wa Law
- The University of Hong Kong, Pokfulam, Hong Kong
| | | |
Collapse
|
14
|
Kristine Hegaard H, Sharif H, Ankerstjerne LBS, Serhatlioglu S, Schroll AM, Midtgaard J, Renault KM, Broberg L. Violence among pregnant women in Denmark from 2019 to 2021 - A hospital-based cross-sectional study. SEXUAL & REPRODUCTIVE HEALTHCARE 2024; 39:100943. [PMID: 38104502 DOI: 10.1016/j.srhc.2023.100943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 12/05/2023] [Accepted: 12/09/2023] [Indexed: 12/19/2023]
Abstract
We examined the prevalence of lifetime physical and any recent violence and related maternal characteristics and health in pregnant women. We used Patient Reported Outcomes data retrieved from the Copenhagen Pregnancy Cohort (n = 7,361). The prevalence of lifetime physical and any recent violence was 4.0 % and 1.6 %, respectively. For both lifetime and any recent violence, the highest prevalence rates were seen among women aged 18-24, non-cohabiting, smokers, low levels of educational attainment, and women with chronic medical and psychiatric disease and lower psychological well-being. The prevalence may potentially be underestimated in this study, highlighting the need for improving screening for violence.
Collapse
Affiliation(s)
- Hanne Kristine Hegaard
- Department of Obstetrics, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; The Interdisciplinary Research Unit of Women's, Children's and Families' Health, The Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; University of Copenhagen, Faculty of Health and Medical Sciences, Department of Clinical Medicine, Denmark, Blegdamsvej 3, 2200 Copenhagen N, Denmark.
| | - Heidi Sharif
- Department of Obstetrics, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
| | - Lea B S Ankerstjerne
- Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 3., 5000 Odense, Denmark; Department of Gynaecology and Obstetrics, Odense University Hospital, J. B. Winsløws Vej 4, 5000 Odense, Denmark.
| | - Seda Serhatlioglu
- The Interdisciplinary Research Unit of Women's, Children's and Families' Health, The Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; Antalya Bilim University, Faculty of Health Sciences, Department of Midwifery, No:290 A Dösemealti, 07121 Antalya, Turkey
| | - Anne-Mette Schroll
- The Danish Association of Midwives, Sankt Annae Plads 30, 1250 Copenhagen K, Denmark.
| | - Julie Midtgaard
- University of Copenhagen, Faculty of Health and Medical Sciences, Department of Clinical Medicine, Denmark, Blegdamsvej 3, 2200 Copenhagen N, Denmark; Centre for Applied Research in Mental Health Care (CARMEN), Mental Health Centre Glostrup, Nordstjernevej 41, 2600 Glostrup, Denmark.
| | - Kristina M Renault
- Department of Obstetrics, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; University of Copenhagen, Faculty of Health and Medical Sciences, Department of Clinical Medicine, Denmark, Blegdamsvej 3, 2200 Copenhagen N, Denmark.
| | - Lotte Broberg
- Department of Obstetrics, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; Center for Clinical Research and Prevention, Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark.
| |
Collapse
|
15
|
Fan XM, Kim HW. The status of intimate partner violence against pregnant women in contemporary China: a scoping review. WOMEN'S HEALTH NURSING (SEOUL, KOREA) 2024; 30:41-55. [PMID: 38650326 PMCID: PMC11073557 DOI: 10.4069/whn.2024.03.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/15/2024] [Accepted: 03/16/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE This review explored the status of publications on intimate partner violence (IPV) against pregnant women in contemporary China. METHODS The PubMed, Cochrane Library, Embase, CINAHL, and PsycInfo databases were searched using the terms "IPV," "pregnant woman," "Chinese," and synonyms in English, along with related keywords for Chinese publications. All literature pertaining to IPV during pregnancy, conducted in China, and published between 1987 and September 2023 was included. RESULTS A total of 37 articles from 30 studies were selected. The prevalence of IPV during pregnancy ranged from 2.5% to 31.3%, with psychological violence being the most common form. Frequently identified risk factors included unintended pregnancy, poor family economic conditions, male partners engaging in health risk behaviors, poor employment status of women or their partners, low education levels among women, physical or mental health issues, strained couple relationships, and in-law conflicts. IPV during pregnancy primarily led to mental health problems for the victims and could result in adverse obstetric outcomes, as well as negative effects on the temperament and development of the offspring. Victims in China demonstrated a low willingness to seek help from professionals. Furthermore, relevant research in mainland China is scarce, with a limited number of studies and non-standardized research methodologies. CONCLUSION Future research should investigate IPV in pregnancy from various perspectives, identify factors unique to IPV during pregnancy, and focus on high-risk groups. Considering the conditions in China, there is a pressing need to increase public awareness of IPV and to investigate interventions aimed at addressing this issue.
Collapse
Affiliation(s)
- Xue Mei Fan
- College of Nursing, Seoul National University, Seoul, Korea
| | - Hae Won Kim
- College of Nursing, The Research Institute of Nursing Science, Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, Seoul National University, Seoul, Korea
| |
Collapse
|
16
|
Sharps P, Bullock L, Perrin N, Campbell J, Hill K, Kanu I, Norling M, Russell NG. Comparison of different methods of screening to identify intimate partner violence: A randomized controlled trial. Public Health Nurs 2024; 41:328-337. [PMID: 38265246 DOI: 10.1111/phn.13279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 12/20/2023] [Accepted: 01/11/2024] [Indexed: 01/25/2024]
Abstract
OBJECTIVE Screening for intimate partner violence in the home is often challenging due to the lack of privacy. The aim of this study was to compare two different screening methods (paper-pencil vs. tablet) for identifying intimate partner violence during perinatal home visits. DESIGN Randomized control trial. SAMPLE Pregnant women (N = 416) in perinatal home visiting programs were randomized to either paper-pencil or computer assisted, intimate partner violence screening. MEASUREMENTS The Abuse Assessment Screen was used to screen for physical and sexual IPV and Women's Experiences with Battering for emotional intimate partner violence. RESULTS No significant differences in prevalence were found between the screening methods. Intimate partner violence prevalence rates for the year before and/or during pregnancy using paper-pencil was 21.8% versus 24.5% using tablets (p = .507). There were significant differences in prevalence among the three race/ethnic groups (Caucasian, 36.9%; African American, 26.7%; Hispanics, 10.6%; p < .001) and significant differences in rates across three geographical areas: urban 16.0%; rural 27.6%, suburban women 32.3% (p < .001). CONCLUSIONS This study provides evidence that both methods are useful for identifying intimate partner violence during perinatal home visits.
Collapse
Affiliation(s)
- Phyllis Sharps
- Community and Public Health, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Linda Bullock
- University of Virginia School of Nursing, Charlottesville, Virginia, USA
| | - Nancy Perrin
- Community and Public Health, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Jacquelyn Campbell
- Community and Public Health, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Kimberly Hill
- Community and Public Health, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Iye Kanu
- Community and Public Health, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Meg Norling
- University of Virginia School of Nursing, Charlottesville, Virginia, USA
| | - Nancy G Russell
- Community and Public Health, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| |
Collapse
|
17
|
Opiro K, Pebalo FP, Scolding NJ, Scolding C. Can reproductive health services be used to screen for sexual and gender-based violence in post-conflict Northern Uganda? - a pilot study. Afr Health Sci 2024; 24:104-111. [PMID: 38962327 PMCID: PMC11217829 DOI: 10.4314/ahs.v24i1.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2024] Open
Abstract
Background Sexual and gender-based violence (SGBV), including rape and child sexual abuse, remains a significant challenge in post-conflict northern Uganda. Many victims have never sought help. Consequently, the scale of the problem is not known, and SGBV victims' injuries, both psychological and physical, remain hidden and unresolved. Objectives We aimed to explore whether health workers in rural Reproductive Health Services (RHS), following specific training, could provide a valuable resource for SGBV screening and subsequent referral to targeted services. Methods Our project had three elements. First, RHS workers were trained to use a questionnaire to screen subjects for past SGBV Second, the screening questionnaire was used by RHS workers over a 3-month period, and the data collected were analysed to explore whether the screening approach was an effective one in this setting, and to record the scale and nature of the problem. Third, victims detected were offered referral as appropriate to hospital services or to a dedicated SGBV ActionAid shelter. Results Of 1656 women screened, 778 (47%) had suffered SGBV: 123 rape, and 505 non-sexual violence. 1,254 (76%) had been directly or indirectly affected by conflict experiences; 1066 had lived in internally displaced persons camps. 145 (9%) requested referral to Gulu SGBV Shelter; 25 attended the shelter and received assistance, and 20 others received telephone counselling. Conclusion Undetected SGBV remains a significant problem in post-conflict northern Uganda. RHS workers, following specific training, can effectively screen for and identify otherwise unrecognised survivors of SGBV. This matters because without ongoing detection, survivors have no opportunity for resolution, healing or help.
Collapse
Affiliation(s)
| | | | - Neil J Scolding
- Faculty of Medicine, Gulu University, Uganda
- University of Bristol, UK
| | | |
Collapse
|
18
|
Hawkins SS. Screening for Intimate Partner Violence. J Obstet Gynecol Neonatal Nurs 2024; 53:106-119. [PMID: 38367961 DOI: 10.1016/j.jogn.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2024] Open
Abstract
More than a decade has passed since the Affordable Care Act (ACA) required screening for intimate partner violence (IPV) and related counseling with no co-payment and eliminated insurers' ability to deny coverage based on preexisting conditions, including IPV. While screening for IPV and coverage of services became more feasible after implementation of the ACA, in theory, gaps remain. Nearly half of women in the United States report that they have experienced IPV in their lifetime, but the true number is likely even higher. In this column, I review screening recommendations for IPV and related policies, gaps in research on groups at higher risk, systems-level approaches to increase screening, and recommendations from professional organizations on screening and supporting IPV survivors.
Collapse
|
19
|
Rucker A, Watson A, Badolato G, Jarvis L, Patel SJ, Goyal MK. Social Navigation for Adolescent Emergency Department Patients: A Randomized Clinical Trial. J Adolesc Health 2024; 74:292-300. [PMID: 37804303 DOI: 10.1016/j.jadohealth.2023.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 10/09/2023]
Abstract
PURPOSE Adolescent emergency department (ED) patients have unmet social needs that contribute to ED use. This study aimed to evaluate the effect of social needs navigation for adolescents on subsequent ED visits and community resource use and to identify characteristics associated with elevated social risk. METHODS Between July 2017 and August 2019, we used a random date generator to establish intervention and control group enrollment dates. All adolescents completed a social needs survey. Adolescents enrolled on intervention dates received in-person, risk-tailored social needs navigation. Those enrolled on control dates received a preprinted resource guide. We used chart review and follow-up calls to assess 12-month ED revisits and community resource use. Logistic regression was used to compare these outcomes between groups. We measured the association between ≥3 reported unmet needs and characteristics hypothesized a priori to be associated with elevated social risk (nonurgent visits, obesity, or any of nine "socially sensitive" chief complaints) using logistic regression. RESULTS A total of 399 adolescents were randomized. There was no difference between groups in the number of ED revisits. There was increased community resource use in the intervention group (adjusted odds ratio [aOR]: 3.5 [95% confidence interval {CI}: 1.5, 8.2]). Adolescents with a socially sensitive chief complaint had increased odds of ≥3 unmet needs (aOR: 2.2 [95% CI: 1.3, 3.6]), as did those with food insecurity in a post hoc analysis (aOR: 9.9 [95% CI: 4.0, 24.6]). DISCUSSION Social needs navigation increased community resource use but not subsequent ED visits. Adolescents with socially sensitive chief complaints or food insecurity reported increased unmet needs.
Collapse
Affiliation(s)
- Alexandra Rucker
- Division of Emergency Medicine, Children's National Hospital, Washington, D.C; School of Medicine and Health Sciences, The George Washington University, Washington, D.C.
| | - Ar'Reon Watson
- Division of Emergency Medicine, Children's National Hospital, Washington, D.C
| | - Gia Badolato
- Division of Emergency Medicine, Children's National Hospital, Washington, D.C
| | - Lenore Jarvis
- Division of Emergency Medicine, Children's National Hospital, Washington, D.C; School of Medicine and Health Sciences, The George Washington University, Washington, D.C
| | - Shilpa J Patel
- Division of Emergency Medicine, Children's National Hospital, Washington, D.C; School of Medicine and Health Sciences, The George Washington University, Washington, D.C
| | - Monika K Goyal
- Division of Emergency Medicine, Children's National Hospital, Washington, D.C; School of Medicine and Health Sciences, The George Washington University, Washington, D.C
| |
Collapse
|
20
|
Kelly RJ, Gillis BT, El-Sheikh M. Longitudinal relations between interpartner aggression and internalizing symptoms among couples: The moderating role of sleep. J Sleep Res 2024; 33:e14013. [PMID: 37572050 DOI: 10.1111/jsr.14013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 08/14/2023]
Abstract
Recipients of interpartner aggression often experience internalizing symptoms. However, individual differences exist, and elucidation of factors that attenuate or exacerbate risk are needed to explicate relations and better inform interventions aimed at reducing mental health sequelae of interpartner aggression. Sleep problems compromise coping abilities and are known to exacerbate risk for mental health problems in the context of family risk. We examined whether sleep problems moderated the extent to which the recipients of interpartner aggression experience internalizing symptoms over time. At the first wave, 194 couples participated (M age [women] = 41.81 years, SD = 5.85; M age [men] = 43.75 years, SD = 6.74; 71% White/European American, 26% Black/African American, 3% other race/ethnicity). Two years later, couples returned for a second wave. Psychological and physical forms of interpartner aggression were measured using self- and partner-reports. Sleep duration (minutes) and sleep quality (efficiency) were derived using actigraphy, and subjective sleep/wake problems were also assessed. Individuals self-reported on their own internalizing symptoms. After controlling for autoregressive effects, sleep moderated the extent to which the recipients of interpartner aggression experienced internalizing symptoms longitudinally. Lower sleep efficiency and more subjective sleep/wake problems among women exacerbated the extent to which interpartner aggression forecasted their internalizing symptoms. Lower sleep efficiency among men magnified relations between interpartner aggression and their internalizing symptoms. Findings help understand the multiplicative influence that family risk and sleep problems have on mental health over time.
Collapse
Affiliation(s)
- Ryan J Kelly
- University of New Mexico, Albuquerque, New Mexico, USA
| | | | | |
Collapse
|
21
|
Edwards LM, Torres L, Lewis KD, Loyo K. Hope as a Moderator of Intimate Partner Violence and Suicide Risk Behaviors Among Latinas. Violence Against Women 2023; 29:3143-3157. [PMID: 37710990 DOI: 10.1177/10778012231200476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
The current study investigated the role of hope in the relationship between intimate partner violence (IPV) and suicide risk behaviors among a community sample of Latinas (N = 180). Moderation analyses revealed significant interaction effects demonstrating that both aspects of hope-agency and pathways-were associated with suicide risk behaviors at high levels of IPV. Results suggest hope may be helpful when IPV is at low levels, but it may exacerbate suicide risk when high levels of IPV are experienced among Latinas. Future directions and implications are discussed, including the importance of understanding the unique cultural context in which Latina survivors exist.
Collapse
Affiliation(s)
- Lisa M Edwards
- Department of Counselor Education and Counseling Psychology, Marquette University, Milwaukee, WI, USA
| | - Lucas Torres
- Department of Psychology, Marquette University, Milwaukee, WI, USA
| | - Kayla Deanna Lewis
- Department of Counselor Education and Counseling Psychology, Marquette University, Milwaukee, WI, USA
| | - Karina Loyo
- Department of Psychology, Marquette University, Milwaukee, WI, USA
| |
Collapse
|
22
|
Jarvis L, Randell KA. The Health Care Provider's Role in Addressing Adolescent Relationship Abuse. Pediatr Clin North Am 2023; 70:1087-1102. [PMID: 37865432 DOI: 10.1016/j.pcl.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
Adolescent relationship abuse (ARA) is highly prevalent across all sociodemographic groups with negative outcomes in multiple domains of health. Using a healing-centered engagement approach, health care providers can support healthy adolescent relationships and connect ARA survivors to resources and supports to ensure health and well-being. Essential components of health care support for adolescents experiencing ARA include validation of disclosure, assessing safety, a warm hand-off to advocacy resources, addressing immediate and long-term health needs, and connection to a trusted adult. Informing adolescents about limits of confidentiality and use of shared decision-making after ARA disclosure recognizes adolescents' lived experiences and emerging autonomy.
Collapse
Affiliation(s)
- Lenore Jarvis
- Children's National Hospital, The George Washington University School of Medicine and Health Sciences, 111 Michigan Avenue Northwest, Washington, DC 20010, USA
| | - Kimberly A Randell
- Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO 64110, USA; University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA; University of Kansas School of Medicine, Kansas City, KS, USA.
| |
Collapse
|
23
|
Amiri-Farahani L, Shahbazi Sighaldeh S, Allahqoli L, Ranjbar F, Rouzafzoon M, Gharacheh M. Psychometric properties of Persian version of the infertile women's exposure to violence determination scale (IWEVDS). HUM FERTIL 2023; 26:927-935. [PMID: 34986755 DOI: 10.1080/14647273.2021.2021592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/28/2021] [Indexed: 11/04/2022]
Abstract
To identify violence among infertile women, a specific tool is needed. "Infertile Women's Exposure to Violence Determination Scale" (IWEVDS) is the only specific tool to assess violence against infertile women. The aim of this study was to determine psychometric properties of the Persian version of the IWEVDS. In this methodological study, content validity of the scale was determined following backward, forward translation. To assess the construct validity, confirmatory factor analysis (CFA) was used through Partial Least Squares (PLS). To do so, the Persian version of the IWEVDS was administered to a continuous sample of 310 infertile women referred to a women's hospital in Tehran. The results of the CFA confirmed the model and demonstrated a good fit on the scale. The Goodness of Fit (GOF) index and the Standardised Root Mean Residual (SRMR) with values of 0.42 and 0.056, respectively, indicate the adequacy of the overall model. The reliability of the scale is confirmed by the acceptable values of Cronbach's alpha, composite reliability, communality coefficient and Spearman correlation coefficient. The values of Cronbach's alpha were 0.90 for domains domestic violence, 0.85 for social pressure, 0.86 for punishment, 0.7 for exposure to traditional practices, and 0.87 for exclusion. The results of the study revealed that the Persian version of the IWEVDS is a 28-item scale with good validity and reliability among Iranian infertile women. Therefore, healthcare professionals can use it to evaluate the infertile women's exposure to violence.
Collapse
Affiliation(s)
- Leila Amiri-Farahani
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | | | - Leila Allahqoli
- Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ranjbar
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Mozhgan Rouzafzoon
- Reproductive Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Gharacheh
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
24
|
Gregory K, Fingarson A, Pierce MC, Budde S, Lorenz D, Charleston E, Rosado N. Examining Cases of Child Physical Abuse Evaluations to Identify Opportunities to Improve Intimate Partner Violence Screening in Pediatric Emergency Departments. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:11429-11444. [PMID: 37421199 DOI: 10.1177/08862605231182379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2023]
Abstract
The association between child maltreatment and intimate partner violence (IPV) is well supported. Universal IPV screening has been recommended by the American Academy of Pediatrics and the United States Preventative Task Force, and many children's hospitals have established screening protocols. However, the yield and best screening method in families undergoing a child physical abuse (PA) evaluation have not been fully explored. To determine if there is a discrepancy in IPV disclosures between universal IPV screening completed during pediatric emergency department (PED) triage ("triage screening") and IPV screening by a social worker ("social work screening") in families of children who were evaluated for PA. Caregivers of children who presented to an urban tertiary PED and underwent an evaluation for PA via a child abuse pediatrics consult. A retrospective chart review was completed. Data collection included: caregiver responses to both triage screening and social work screening, interview setting details and participants, the child's injuries, and details of the family's reported IPV experiences. Our study (N = 329) revealed that social work screening produced significantly more positive IPV disclosures than triage screening (14.0% vs. 4.3%, p < .001). Additionally, non-IPV violence concerns were identified in 35.7% (n = 5) of the positive triage screens, whereas social work screens had none. These results highlight the benefits of IPV screening by social work in high-risk scenarios, such as child PA evaluations, regardless of universal IPV screening results. Exploring differences between the two screening methods can inform decisions about screening protocols to improve IPV identification in high-risk populations.
Collapse
Affiliation(s)
- Kelsey Gregory
- Ann & Robert H. Lurie Children's Hospital of Chicago, IL, USA
| | | | | | - Stephen Budde
- Juvenile Protective Association, Chicago, IL, USA
- University of Chicago Crown Family School of Social Work, Policy and Practice, IL, USA
| | - Douglas Lorenz
- University of Louisville School of Public Health and Information Science, KY, USA
| | | | - Norell Rosado
- Ann & Robert H. Lurie Children's Hospital of Chicago, IL, USA
| |
Collapse
|
25
|
Engström M, Lindqvist S, Janson S, Feldman I, Dubowitz H, Lucas S. Validation of the Swedish version of the safe environment for every kid (SEEK) parent screening questionnaire. BMC Public Health 2023; 23:1989. [PMID: 37828478 PMCID: PMC10571478 DOI: 10.1186/s12889-023-16792-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Psychosocial risk factors in the home may impair children's health and development and increase the risk of maltreatment. The Safe Environment for Every Kid (SEEK) model was developed to provide pediatric primary care professionals with a structured way to identify common psychosocial problems. The SEEK model includes use of the Parent Screening Questionnaire (SEEK-PSQ) at routine preventive child health visits, discussion with parents about their responses and, when indicated, referral to relevant services. The SEEK-PSQ has not previously been available in Swedish. The aim of the present study was to evaluate the psychometric properties of an adapted Swedish version of the SEEK-PSQ (PSQ-S). METHODS This study is part of a cluster-randomised controlled trial of SEEK in the Swedish child health services. To validate the PSQ-S, parents (n = 852) with children 0-18 months of age were invited to complete a survey including the PSQ-S as well as evidence-based standardized instruments for the targeted psychosocial risk factors: economic worries, depressive symptoms, parental stress, alcohol misuse and intimate partner violence (IPV). Baseline data from 611 (72%) parents were analysed regarding sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for each risk factor. RESULTS As a whole, the PSQ-S had a sensitivity of 93%, specificity of 52%, PPV of 67% and NPV of 87%. For mothers and fathers combined, sensitivity was 80% for economic worries, 89% for depressive symptoms, 78% for parental stress, 47% for intimate partner violence (IPV) and 70% for alcohol misuse. Specificity was highest for IPV and alcohol misuse (91%) and lowest for depressive symptoms (64%). NPV values were high (81-99%) and PPV values were low to moderate (22-69%) for the targeted problems. Sensitivity was higher for mothers compared to fathers for economic worries, depressive symptoms and IPV. This difference was particularly evident for IPV (52% for mothers, 27% for fathers). CONCLUSION The SEEK-PSQ-S demonstrated good psychometric properties for identifying economic worries, depressive symptoms, parental stress and alcohol misuse but low sensitivity for IPV. The PSQ-S as a whole showed high sensitivity and NPV, indicating that most parents with or without the targeted psychosocial risk factors were correctly identified. TRIAL REGISTRATION ISRCTN registry, study record 14,429,952 ( https://doi.org/10.1186/ISRCTN14429952 ) Registration date 27/05/2020.
Collapse
Affiliation(s)
- Maria Engström
- Department of Women's and Children's Health, Uppsala University, SE-751 85, Uppsala, Sweden.
| | - Sara Lindqvist
- Department of Women's and Children's Health, Uppsala University, SE-751 85, Uppsala, Sweden
| | - Staffan Janson
- Division of Public Health Sciences, Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Inna Feldman
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Howard Dubowitz
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Steven Lucas
- Department of Women's and Children's Health, Uppsala University, SE-751 85, Uppsala, Sweden
| |
Collapse
|
26
|
Katz CC, Okpych NJ, Charles P, Wall E, Courtney ME. Prevalence and Predictors of Intimate Partner Violence Among Youth With Foster Care Histories. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:10611-10639. [PMID: 37300333 DOI: 10.1177/08862605231175910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A small but growing body of research suggests that adolescents and young adults involved with the child welfare system and those transitioning out of foster care are at heightened risk of experiencing intimate partner violence (IPV). Understanding the factors that place youth at risk of IPV is central to prevention and treatment of this public health problem. However, questions remain about the prevalence and correlates of IPV among youth in foster care. Additionally, emotional abuse, a particular form of IPV in intimate partnerships, remains an understudied area in this population. This study aimed to address these gaps in research by exploring factors associated with IPV using longitudinal data from a representative sample of older youth in California Foster Care who participated in the California Youth Transitions to Adulthood Study (CalYOUTH). Our IPV outcome measures included victimization, perpetration, bidirectional IPV, and emotional abuse. Findings suggest that approximately one-fifth (20.4%) of CalYOUTH respondents had experienced some form of IPV at age 23, with emotional abuse and bidirectional violence being the most commonly reported types of IPV. Females reported emotional abuse, as well as bidirectional violence, at nearly double the rates of their male counterparts. Self-identified sexual minority youth (SMY; lesbian, gay, bisexual, transgender, queer, or questioning) were more likely to report IPV victimization, IPV perpetration, and bidirectional violence than their non-SMY peers. Youth with histories of emotional abuse, caregiver IPV victimization, sexual abuse in foster care, placement instability, substance use, anxiety, and incarceration were also at heightened risk of IPV involvement. Emotional abuse was most prevalent with SMY. The findings contribute to the growing research on IPV among transition-age foster youth with important implications for future research, practice, and policy.
Collapse
|
27
|
Willie TC, Alexander KA, Sharpless L, Zemlak JL, Smith MV, Kershaw TS. Recent Economic Intimate Partner Violence and Posttraumatic Stress Symptoms Among a Racially and Ethnically Diverse Sample of U.S. Women Experiencing Intimate Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:11091-11116. [PMID: 37387530 DOI: 10.1177/08862605231178357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a prevalent consequence of physical and sexual intimate partner violence (IPV); however, little is known about the unique contributions of economic IPV. Furthermore, women's economic self-sufficiency may explicate the potential relationship between economic IPV and PTSD symptoms. Guided by the Stress Process Theory and Intersectionality, this study examined associations between economic IPV and women's PTSD symptoms and assessed economic self-sufficiency as a mediator. Participants were 255 adult women experiencing IPV recruited from metropolitan Baltimore, MD, and the state of CT who participated in two different studies. Participants completed surveys on IPV, economic self-sufficiency, and PTSD. Path analyses were conducted to examine direct and indirect associations of economic IPV with economic self-sufficiency and PTSD. Economic IPV was uniquely associated with PTSD symptoms while controlling for other forms of IPV. Economic self-sufficiency significantly partially mediated the association between economic IPV and PTSD symptoms such that economic IPV was associated with PTSD symptoms through economic self-sufficiency. Economic IPV may limit women's ability to make autonomous decisions related to finances, which could be distressing. The mental health impact of economic IPV may be particularly debilitating for women with low economic self-sufficiency as their posttraumatic stress occurs within the context of feeling unable to meet their financial goals and also having a partner control their economic resources. Fostering economic empowerment and asset building may be a strengths-based approach to reduce the PTSD symptomatology among women experiencing IPV.
Collapse
Affiliation(s)
- Tiara C Willie
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | - Megan V Smith
- Yale School of Public Health, New Haven, CT, USA
- Yale School of Medicine, New Haven, CT, USA
| | | |
Collapse
|
28
|
Janczewski C, Mersky J, Plummer Lee C. Intergenerational transmission of child protective services involvement: Exploring the role of ACEs and domestic violence among families who receive home visiting services. CHILD ABUSE & NEGLECT 2023; 144:106384. [PMID: 37542996 DOI: 10.1016/j.chiabu.2023.106384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are associated with negative outcomes over the life course and across generations, including domestic violence (DV) and child maltreatment. However, no studies have examined the connection between parents' ACEs and their child's risk of child protective services (CPS) involvement or possible mechanisms of transmission. OBJECTIVE In addition to describing the prevalence and correlates of CPS involvement, our primary aims are to test whether parental adversity in childhood is associated with CPS involvement and whether DV victimization mediates the ACE-CPS association. PARTICIPANTS AND SETTING The sample included 3039 primary caregivers and 3343 children served by home visiting programs in Wisconsin between 2014 and 2019. METHODS Using matched home visiting and CPS records, we generated prevalence estimates of screened-in CPS reports and assessed bivariate associations between CPS involvement and ACEs, DV, and household demographics. We then conducted a two-stage path analysis to test the association between ACEs and CPS involvement and whether DV mediated the ACE-CPS association. RESULTS Overall, 22.8 % of caregivers had a screened-in report. Prevalence rates were higher among women who endured ACEs and DV, and they varied by demographic characteristics. ACEs were directly linked to DV and CPS involvement, and there was an indirect pathway linking ACEs to CPS involvement through DV exposure. CONCLUSIONS Home visiting programs serve families that frequently interact with the child welfare system. By enhancing the trauma-responsive potential of these interventions, it may be possible to interrupt intergenerational mechanisms that contribute to child abuse and neglect and CPS involvement.
Collapse
Affiliation(s)
- Colleen Janczewski
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, 2400 E. Hartford Ave., Milwaukee, WI 53211, United States of America.
| | - Joshua Mersky
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, 2400 E. Hartford Ave., Milwaukee, WI 53211, United States of America
| | - CheinTi Plummer Lee
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, 2400 E. Hartford Ave., Milwaukee, WI 53211, United States of America
| |
Collapse
|
29
|
Llenas-García J, Masiá M, Pascual Perez R, González-Cuello I, Agulló Re V, Romero Nieto M, Amat Díaz M, Padilla Urrea S, Rodríguez Lucena FJ, Wikman-Jorgensen P. Systematic screening of gender violence and domestic violence among HIV-positive patients: the VIHOLETA study. AIDS Care 2023; 35:1443-1451. [PMID: 36169405 DOI: 10.1080/09540121.2022.2125929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 09/13/2022] [Indexed: 10/14/2022]
Abstract
We conducted a multicentre observational study in people living with HIV (PLHIV) on antiretroviral therapy in Alicante (Spain) from 2019 to 2020 aiming to analyse the prevalence of abuse and assess treatment adherence according to this variable. We used the Abuse Assessment Screen tool, the simplified medication adherence questionnaire and the medication possession ratio to assess outcomes.. Of the 161 included PLHIV, 53 (32.9%) had suffered abuse (27 emotional abuse, 6 physical abuse, 3 sexual abuse, 13 emotional and physical abuse, 4 unknown type). Seven (4.3%) had suffered abuse in the last year (5 emotional, 2 physical). Abuse had lasted a median of 48 months (interquartile range 12-81). HIV status was considered as a cause of violence by 9.4% of victims. In the multivariable analysis, only abuse was independently associated with non-adherence [adjusted odds ratio (aOR) 3.92; 95% confidence interval (CI) 1.80-8.84; p = 0.0007]. Abuse (aOR 6.14; 95% CI 1.63-27.70; p = 0.001) and previous incarceration (aOR 15.08 95% CI 2.71-104.71; p = 0.003) were associated with detectable viral load. In conclusion, the prevalence of abuse is high in PLHIV, hampering adherence and virological success. Abuse screening tools should be incorporated into routine HIV care.
Collapse
Affiliation(s)
- Jara Llenas-García
- Internal Medicine, Hospital Vega Baja-FISABIO, Orihuela, Spain
- Clinical Medicine Department, Universidad Miguel Hernández, Elche, Spain
| | - Mar Masiá
- Clinical Medicine Department, Universidad Miguel Hernández, Elche, Spain
- Infectious Diseases Unit, Hospital General Universitario de Elche-FISABIO, Elche, Spain
| | - Reyes Pascual Perez
- Clinical Medicine Department, Universidad Miguel Hernández, Elche, Spain
- Infectious Diseases Unit, Hospital General Universitario de Elda-FISABIO, Elda, Spain
| | | | - Vanesa Agulló Re
- Clinical Medicine Department, Universidad Miguel Hernández, Elche, Spain
- Infectious Diseases Unit, Hospital General Universitario de Elche-FISABIO, Elche, Spain
| | - Mónica Romero Nieto
- Clinical Medicine Department, Universidad Miguel Hernández, Elche, Spain
- Infectious Diseases Unit, Hospital General Universitario de Elda-FISABIO, Elda, Spain
| | - María Amat Díaz
- Farmacology Department, Hospital General Universitario de Elda-FISABIO, Elda, Spain
| | - Sergio Padilla Urrea
- Clinical Medicine Department, Universidad Miguel Hernández, Elche, Spain
- Infectious Diseases Unit, Hospital General Universitario de Elche-FISABIO, Elche, Spain
| | | | - Philip Wikman-Jorgensen
- Internal Medicine, Hospital Universitario San Juan de Alicante-FISABIO, Sant Joan d'Alacant, Spain
| |
Collapse
|
30
|
Christia F, Larreguy H, Parker-Magyar E, Quintero M. Empowering women facing gender-based violence amid COVID-19 through media campaigns. Nat Hum Behav 2023; 7:1740-1752. [PMID: 37550411 DOI: 10.1038/s41562-023-01665-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 06/23/2023] [Indexed: 08/09/2023]
Abstract
COVID-19 heightened women's exposure to gender-based and intimate partner violence, especially in low-income and middle-income countries. We tested whether edutainment interventions shown to successfully combat gender-based and intimate partner violence when delivered in person can be effectively delivered using social (WhatsApp and Facebook) and traditional (TV) media. To do so, we randomized the mode of implementation of an intervention conducted by an Egyptian women's rights organization seeking to support women amid COVID-19 social distancing. We found WhatsApp to be more effective in delivering the intervention than Facebook but no credible evidence of differences across outcomes between social media and TV dissemination. Our findings show little credible evidence that these campaigns affected women's attitudes towards gender or marital equality or on the justifiability of violence. However, the campaign did increase women's knowledge, hypothetical use and reported use of available resources.
Collapse
Affiliation(s)
- Fotini Christia
- SSRC, IDSS and Department of Political Science, MIT, Cambridge, MA, USA
| | - Horacio Larreguy
- Departments of Economics and Political Science, Instituto Tecnológico Autónomo de México, Mexico City, Mexico.
| | | | - Manuel Quintero
- Department of Pure Mathematics and Mathematical Statistics, University of Cambridge, Cambridge, UK
| |
Collapse
|
31
|
Rathnayake JC, Mat Pozian N, Carroll JA, King J. Barriers Faced by Australian and New Zealand Women When Sharing Experiences of Family Violence with Primary Healthcare Providers: A Scoping Review. Healthcare (Basel) 2023; 11:2486. [PMID: 37761683 PMCID: PMC10531433 DOI: 10.3390/healthcare11182486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023] Open
Abstract
Despite the Australian Government's attempts to reduce domestic violence (DV) incidences, impediments within the social and health systems and current interventions designed to identify DV victims may be contributing to female victims' reluctance to disclose DV experiences to their primary healthcare providers. This scoping review aimed to provide the state of evidence regarding reluctance to disclose DV incidents, symptoms and comorbidities that patients present to healthcare providers, current detection systems and interventions in clinical settings, and recommendations to generate more effective responses to DV. Findings revealed that female victims are reluctant to disclose DV because they do not trust or believe that general practitioners can help them to solve their issues, and they do not acknowledge that they are in an abusive relationship, and are unaware that they are in one, or have been victims of DV. The most common symptoms and comorbidities victims present with are sleep difficulties, substance use and anxiety. Not all GPs are equipped with knowledge about comorbidities signalling cases of DV. These DV screening programs are the most prominent intervention types within Australian primary health services and are currently not sufficiently nuanced nor sensitive to screen with accuracy. Finally, this scoping review provides formative evidence that in order for more accurate and reliable data regarding disclosure in healthcare settings to be collected, gender power imbalances in the health workforce should be redressed, and advocacy of gender equality and the change of social structures in both Australia and New Zealand remain the focus for reducing DV in these countries.
Collapse
Affiliation(s)
| | | | - Julie-Anne Carroll
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove Campus, Victoria Park Road, Kelvin Grove, QLD 5069, Australia; (J.C.R.); (N.M.P.); (J.K.)
| | | |
Collapse
|
32
|
Larsen A, Pintye J, Abuna F, Bhat A, Dettinger JC, Gomez L, Marwa MM, Ngumbau N, Odhiambo B, Phipps AI, Richardson BA, Watoyi S, Stern J, Kinuthia J, John-Stewart G. Risks of adverse perinatal outcomes in relation to maternal depressive symptoms: A prospective cohort study in Kenya. Paediatr Perinat Epidemiol 2023; 37:489-504. [PMID: 37186316 PMCID: PMC10524238 DOI: 10.1111/ppe.12978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 03/02/2023] [Accepted: 03/22/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Evidence gaps remain regarding the influence of prenatal psychosocial factors on adverse pregnancy outcomes. OBJECTIVE The objective of this study is to evaluate relationships between psychosocial factors and adverse perinatal outcomes among Kenyan women. METHODS We analysed data from a prospective cohort study enrolling HIV-negative women in pregnancy (NCT03070600) in 20 antenatal clinics in Western Kenya. Study nurses assessed depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CESD-10), social support using the Medical Outcomes Survey scale (MOS-SSS), intimate partner violence (IPV) with the Hurt, Insult, Threaten, Scream scale (HITS), and pregnancy outcomes at 6 weeks postpartum. Cox proportional hazards models were used to evaluate relationships between depressive symptoms (moderate-to-severe [MSD, CESD-10 ≥10] and mild-to-severe [Mild-SD, CESD-10 ≥5]), low social support (MOS-SSS <72), and IPV (HITS ≥10) with adverse perinatal outcomes of pregnancy loss, stillbirth, preterm birth (PTB), small for gestational age, and neonatal mortality. We also estimated the population attributable risk. RESULTS Among 4153 women, 23.9% (n = 994) had MSD, 54.7% (n = 2273) mild-SD, 37.3% (n = 1550) low social support, and 7.8% (n = 323) experienced IPV. Pregnancy loss was 5-fold higher among women with MSD (adjusted hazard ratio [HR] 5.04, 95% confidence interval [CI] 2.44, 10.42); 37.4% of losses were attributable to MSD. Mild-SD was associated with PTB (HR 1.39, 95% CI 1.03, 1.87). Stillbirth risk more than doubled among women reporting low social support (HR 2.37, 95% CI 1.14, 4.94). CONCLUSIONS Adverse perinatal outcomes were common and associated with prenatal depressive symptoms and low social support in this large cohort of Kenyan mother-infant pairs.
Collapse
Affiliation(s)
- Anna Larsen
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Psychiatry and Behavioral Services, University of Washington, School of Medicine, Seattle, WA, USA
| | - Jillian Pintye
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, USA
| | | | - Amritha Bhat
- Department of Psychiatry and Behavioral Services, University of Washington, School of Medicine, Seattle, WA, USA
| | | | - Laurén Gomez
- Department of Global Health, University of Washington, Seattle, WA, USA
| | | | - Nancy Ngumbau
- Department of Research and Programs, Kenyatta National Hospital, Nairobi, Kenya
| | | | - Amanda I. Phipps
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Barbra A. Richardson
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | | | - Joshua Stern
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - John Kinuthia
- Department of Global Health, University of Washington, Seattle, WA, USA
- The University of Nairobi, Nairobi, Kenya
- Department of Research and Programs, Kenyatta National Hospital, Nairobi, Kenya
| | - Grace John-Stewart
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Pediatrics, University of Washington, School of Medicine, Seattle, WA, USA
| |
Collapse
|
33
|
Misgina KH, Levine L, Boezen HM, Bezabih AM, van der Beek EM, Groen H. Influence of perinatal distress on adverse birth outcomes: A prospective study in the Tigray region, northern Ethiopia. PLoS One 2023; 18:e0287686. [PMID: 37440555 PMCID: PMC10343148 DOI: 10.1371/journal.pone.0287686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 06/09/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND In low-income countries, where socioeconomic adversities and perinatal distress are common, adverse birth outcomes are significant public health problems. In these settings, perinatal distress, i.e., high symptoms of anxiety, depression, and/or stress during pregnancy, may be linked with adverse birth outcomes. However, few prospective studies have investigated the impact of perinatal distress on adverse birth outcomes such as preterm birth (gestational age <37 weeks), low birth weight (<2.5 kg), and small for gestational age birth (birth weight below the 10th percentile for gestational age and sex). OBJECTIVES Our main objective was to assess the influence of perinatal distress on adverse birth outcomes. Secondly, to investigate if perinatal distress is an independent risk factor or a mediator in the pathway between socioeconomic adversity and adverse birth outcomes. METHODS In a prospective cohort study following 991 women from before 20 weeks of gestation until delivery in northern Ethiopia, we collected self-reported data on distress at a mean of 14.8 (standard deviation [SD] = 1.9) and 33.9 (SD = 1.1) weeks of gestation. Distress was measured using the Edinburgh Postnatal Depression Scale, the anxiety subscale of the Hospital Anxiety and Depression Scale, and the Perceived Stress Scale. To determine birth outcomes, gestational age was estimated from the last menstrual period, fundal palpation, and/or ultrasound, while birth weight was obtained from delivery records and measured within three days after birth for those delivered at home. Logistic regression and mediation analysis were employed to evaluate the impact of perinatal distress on adverse birth outcomes. RESULTS Perinatal anxiety (OR [95% CI] 1.08 [1.02, 1.13]), depression (1.07 [1.03, 1.11]), stress (1.14 [1.07, 1.22]), and total distress (1.15 [1.07, 1.23]) were all associated with low birth weight, and small for gestational age birth but none did with preterm birth. Mediation analysis demonstrated that perinatal distress was a mediator in the pathway between socioeconomic adversity and adverse birth outcomes. CONCLUSION Our study revealed that perinatal distress was linked with adverse birth outcomes and acted as a mediator between socioeconomic adversity and these outcomes. Our findings highlight the importance of screening women for distress and providing appropriate interventions, focusing on women experiencing socioeconomic adversity. Integrating mental health services into primary maternal care in low-income countries could be an effective approach to achieve this.
Collapse
Affiliation(s)
- Kebede Haile Misgina
- Department of Public Health, University of Aksum, Axum, Ethiopia
- Department of Epidemiology, Faculty of Medical Sciences, University of Groningen, Groningen, The Netherlands
| | - Lindsay Levine
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - H. Marike Boezen
- Department of Epidemiology, Faculty of Medical Sciences, University of Groningen, Groningen, The Netherlands
| | | | - Eline M. van der Beek
- Department of Paediatrics, Faculty of Medical Sciences, University of Groningen, Groningen, The Netherlands
| | - Henk Groen
- Department of Epidemiology, Faculty of Medical Sciences, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
34
|
Moore BC, Clements C, Turton E. Intimate Partner Violence Victimization, Mental Health, and Unemployment: Year One of the Covid-19 Pandemic. Violence Against Women 2023:10778012231182413. [PMID: 37394788 PMCID: PMC10315874 DOI: 10.1177/10778012231182413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
We assessed the impact of mental health and participant and partner unemployment on physical, sexual, and psychological intimate partner violence (IPV). Data were collected within 1 month of individual state Covid-19 mandates (Time I) and 2 months after mandates eased (Time II). Sexual IPV was highest when both partners were unemployed for reasons other than Covid-19 while physical IPV was highest when both partners were unemployed due to Covid-19. Physical IPV victims reported more depression and somatization at Time II than at Time I. Nonvictims did not. There were no differences in IPV prevalence during and after restrictions. Clinical and policy implications are discussed.
Collapse
Affiliation(s)
- Brittanie C. Moore
- Department of Psychology, University of North Carolina Wilmington, Wilmington, NC, USA
| | - Caroline Clements
- Department of Psychology, University of North Carolina Wilmington, Wilmington, NC, USA
| | - Emma Turton
- Department of Psychology, University of North Carolina Wilmington, Wilmington, NC, USA
| |
Collapse
|
35
|
Price A, Couch K. Patient-Centered Intimate Partner Violence Screening, Brief Intervention, and Referral to Treatment. Nurs Womens Health 2023:S1751-4851(23)00120-4. [PMID: 37321558 DOI: 10.1016/j.nwh.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 02/12/2023] [Accepted: 05/10/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To increase rates of screening for intimate partner violence (IPV), education, and follow-up of women being seen at a private obstetrics and gynecology clinic to 52% in 90 days. DESIGN Quality improvement project. SETTING/LOCAL PROBLEM IPV screening was not the standard of care at a private suburban obstetric and gynecologic practice. METHODS This project used an evidence-backed model for improvement that incorporated plan-do-study-act cycles to implement four core interventions. INTERVENTIONS The Hurt, Insult, Threaten, Scream (HITS) screening tool, the investigator-developed Duluth model tool, a case management log, and a team engagement plan were implemented. RESULTS Implementation of the HITS screening tool was associated with an increase in IPV screening to 94.7% from a baseline of 2.5%. In addition, the IPV disclosure rate increased 7.5% over the course of the initiative. The majority of staff (64%) participated in IPV educational offerings, and an increase in IPV knowledge was noted in team surveys, on which scores increased from 68% to 76.9%. CONCLUSION The combined use of the HITS screening tool and the Duluth model tool were associated with increased rates of IPV screening. Women who screened positive for IPV were referred to appropriate resources. These findings can be used as a guide for clinics to implement IPV screening into practice.
Collapse
|
36
|
Qiao S, Wilcox S, Olatosi B, Li X. COVID-19 challenges, responses, and resilience among rural Black women: a study protocol. Front Public Health 2023; 11:1156717. [PMID: 37333566 PMCID: PMC10275362 DOI: 10.3389/fpubh.2023.1156717] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/12/2023] [Indexed: 06/20/2023] Open
Abstract
Despite the aggregated burdens and challenges experienced by rural Black women during the COVID-19 pandemic, many likely also demonstrated strength and resilience to overcome challenges. A mixed methodology and a community-based participatory approach will be used to collect multilevel data on challenges, responses, resilience, and lessons during the pandemic from Black women, community health workers, and community leaders in rural areas in South Carolina (SC). Specifically, the unique circumstances and lived experiences of rural Black women during the COVID-19 pandemic will be documented to understand their needs regarding effective management of social, physical, and mental health challenges through focus group discussions and in-depth interviews with Black women, community health workers, and local community leaders recruited from rural SC communities. Barriers, facilitators, and potential impacts of multilevel resilience development will be identified through a survey administered among rural Black women recruited from 11 rural counties (with one as site for a pilot testing of the questionnaire). A report for public health practice will be developed, including recommended strategies to optimize health systems' emergency preparedness and responses through triangulation of qualitative and quantitative data from multiple sources. Findings in the proposed study will provide valuable references in terms of addressing social determinants of health factor challenges during the pandemic, fostering resilience, and informing evidence-based decision-making for policymakers. The study will contribute to the development of public health emergency preparedness plans, which can promote the resilience of women, their families, and local communities as well as optimize effective preparedness and response of health systems for rural Black women and their families during infectious disease outbreaks and other public health emergencies.
Collapse
Affiliation(s)
- Shan Qiao
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, United States
| | - Sara Wilcox
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- Prevention Research Center, University of South Carolina, Columbia, SC, United States
| | - Bankole Olatosi
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, United States
- Department of Health System Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Xiaoming Li
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, United States
| |
Collapse
|
37
|
Larsen A, Pintye J, Odhiambo B, Mwongeli N, Marwa MM, Watoyi S, Kinuthia J, Abuna F, Gomez L, Dettinger J, Bhat A, John-Stewart G. Comparing depression screening tools (CESD-10, EPDS, PHQ-9, and PHQ-2) for diagnostic performance and epidemiologic associations among postpartum Kenyan women: Implications for research and practice. J Affect Disord 2023; 324:637-644. [PMID: 36586607 PMCID: PMC9990497 DOI: 10.1016/j.jad.2022.12.101] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 08/24/2022] [Accepted: 12/23/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Identifying optimal depression screening tools for use in maternal health clinics could improve maternal and infant health. We compared four tools for diagnostic performance and epidemiologic associations. METHODS This study was nested in a cluster-randomized trial in Kenya. Women in 20 maternal health clinics were evaluated at 6 weeks postpartum with Center for Epidemiologic Studies Depression Scale (CESD-10), Edinburgh Postnatal Depression Scale (EPDS), Patient Health Questionnaire-9 and -2 (PHQ-9, PHQ-2) for moderate-to-severe depressive symptoms (MSD) [CESD-10 ≥ 10, EPDS≥13, PHQ-9 ≥ 10, or PHQ-2 ≥ 3]. We assessed area under the curve (AUC) per scale (CESD-10, EPDS) against probable major depressive disorder (MDD) using the PHQ-9 scoring algorithm. Associations between MSD and intimate partner violence (IPV) were compared between scales. RESULTS Among 3605 women, median age was 24 and 10 % experienced IPV. Prevalence of MSD symptoms varied by tool: 13 % CESD-10, 9 % EPDS, 5 % PHQ-2, 3 % PHQ-9. Compared to probable MDD, the CESD-10 (AUC:0.82) had higher AUC than the EPDS (AUC:0.75). IPV was associated with MSD using all scales: EPDS (RR:2.5, 95%CI:1.7-3.7), PHQ-2 (RR:2.3, 95%CI:1.6-3.4), CESD-10 (RR:1.9, 95%CI:1.2-2.9), PHQ-9 (RR:1.8, 95%CI:0.8-3.8). LIMITATIONS Our study did not include clinical diagnosis of MDD by a specialized clinician, instead we used provisional diagnosis of probable MDD classified by the PHQ-9 algorithm as a reference standard in diagnostic performance evaluations. CONCLUSION Depression screening tools varied in detection of postpartum MSD. The PHQ-2 would prompt fewer referrals and showed strong epidemiologic association with a cofactor.
Collapse
Affiliation(s)
- Anna Larsen
- University of Washington, Department of Epidemiology, United States of America.
| | - Jillian Pintye
- University of Washington, Department of Global Health, United States of America
| | - Ben Odhiambo
- University of Nairobi/Kenyatta National Hospital, Kenya
| | | | - Mary M Marwa
- University of Nairobi/Kenyatta National Hospital, Kenya
| | | | - John Kinuthia
- University of Nairobi/Kenyatta National Hospital, Kenya
| | - Felix Abuna
- University of Nairobi/Kenyatta National Hospital, Kenya
| | - Laurén Gomez
- University of Washington, Department of Global Health, United States of America
| | - Julia Dettinger
- University of Washington, Department of Global Health, United States of America
| | - Amritha Bhat
- University of Washington, Department of Psychiatry and Behavioral Sciences, United States of America
| | - Grace John-Stewart
- University of Washington, Department of Epidemiology, United States of America; University of Washington, Department of Global Health, United States of America; University of Washington, Department of Medicine, United States of America; University of Washington, Department of Pediatrics, United States of America
| |
Collapse
|
38
|
Catalao R, Chapota H, Chorwe-Sungani G, Hall J. The impact of depression at preconception on pregnancy planning and unmet need for contraception in the first postpartum year: a cohort study from rural Malawi. Reprod Health 2023; 20:36. [PMID: 36849991 PMCID: PMC9972717 DOI: 10.1186/s12978-023-01576-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 01/25/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND The impact of depression on women's use of contraception and degree of pregnancy planning in low-income settings has been poorly researched. Our study aims to explore if symptoms of depression at preconception are associated with unplanned pregnancy and nonuse of contraception at the point of conception and in the postpartum period. METHODS Population-based cohort of 4244 pregnant women in rural Malawi were recruited in 2013 and were followed up at 28 days, 6 months and 12 months postpartum. Women were asked about symptoms of depression in the year before pregnancy and assessed for depression symptoms at antenatal interview using the Self-Reporting Questionnaire-20, degree of pregnancy planning using the London Measure of Unplanned Pregnancy and use of contraception at conception and the three time points postpartum. RESULTS Of the 3986 women who completed the antenatal interview, 553 (13.9%) reported depressive symptoms in the year before pregnancy and 907 (22.8%) showed current high depression symptoms. History of depression in the year before pregnancy was associated with inconsistent use of contraception at the time of conception [adjusted relative risk (adjRR) 1.52; 95% confidence interval (1.24-1.86)] and higher risk of unplanned [adjRR 2.18 (1.73-2.76)] or ambivalent [adj RR 1.75 (1.36-2.26)] pregnancy. At 28 days post-partum it was also associated with no use of contraception despite no desire for a further pregnancy [adjRR 1.49 (1.13-1.97)] as well as reduced use of modern contraceptives [adj RR 0.74 (0.58-0.96)]. These results remained significant after adjusting for socio-demographic factors known to impact on women's access and use of family planning services, high depression symptoms at antenatal interview as well as disclosure of interpersonal violence. Although directions and magnitudes of effect were similar at six and 12 months, these relationships were not statistically significant. CONCLUSIONS Depression in the year before pregnancy impacts on women's use of contraception at conception and in the early postpartum period. This places these women at risk of unplanned pregnancies in this high fertility, high unmet need for contraception cohort of women in rural Malawi. Our results call for higher integration of mental health care into family planning services and for a focus on early postnatal contraception.
Collapse
Affiliation(s)
- Raquel Catalao
- grid.37640.360000 0000 9439 0839King’s College London and South London and the Maudsley NHS Foundation Trust, London, UK
| | - Hilda Chapota
- Parent and Child Health Initiative Trust (PACHI) Program, Lilongwe, Malawi
| | - Genesis Chorwe-Sungani
- grid.10595.380000 0001 2113 2211Mental Health at Kamuzu College of Nursing, University of Malawi, Lilongwe, Malawi
| | | |
Collapse
|
39
|
Morris JR, Kawwass JF, Hipp HS. Physical intimate partner violence among women reporting prior fertility treatment: a survey of U.S. postpartum women. Fertil Steril 2023; 119:277-288. [PMID: 36347311 DOI: 10.1016/j.fertnstert.2022.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine the prevalence of physical intimate partner violence (IPV) among postpartum women reporting preconception fertility treatment compared with those who conceived without the use of assisted reproduction. DESIGN Retrospective cross-sectional population-based study. SETTING Not applicable. PATIENT(S) Postpartum respondents of the Centers for Disease Control Pregnancy Risk Assessment Monitoring System survey. INTERVENTION Preconception fertility treatment utilization. MAIN OUTCOME MEASURES Physical IPV. RESULTS Of the 43,999 respondents included in this analytic sample, roughly 2% reported physical IPV. Respondents reporting preconception fertility treatment (12.6%) were less likely to endorse physical IPV than those who conceived without fertility treatment exposure (odds ratio, 0.5; 95% confidence interval, 0.4-0.7). In the multivariate regression model, the odds of physical IPV were similar among postpartum women regardless of the fertility treatment exposure (adjusted odds ratio, 1.2; 95% confidence interval, 0.8-2.0). Residing in a household with an income under the federal poverty level and increased preconception stressors were predictive of reported physical IPV. There was no difference in the type of fertility treatment and report of physical IPV. Among women exposed to fertility treatment, predictors of physical IPV included self-identification of Black or Hispanic race and ethnicity as well as report of 4 or more stressors in the 12 months before the most recent delivery. CONCLUSION The use of fertility treatment did not confer greater risk of physical IPV within this postpartum population. However, there are many individuals with infertility who never present for an assessment, proceed with treatment, or are unsuccessful, thus the extent to which infertility and fertility treatment exposure is associated with physical IPV remains to be elucidated. Women reporting a greater number of stressors may be uniquely at risk despite the access and exposure to fertility treatment. The preconception period, inclusive of encounters with infertility specialists, represents a novel opportunity to screen and counsel all women for IPV.
Collapse
Affiliation(s)
- Jerrine R Morris
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California-San Francisco, San Francisco, California.
| | - Jennifer F Kawwass
- Division of Reproductive Endocrinology and Infertility, Emory University School of Medicine, Atlanta, Georgia
| | - Heather S Hipp
- Division of Reproductive Endocrinology and Infertility, Emory University School of Medicine, Atlanta, Georgia
| |
Collapse
|
40
|
Mehr JB, Bennett ER, Price JL, de Souza NL, Buckman JF, Wilde EA, Tate DF, Marshall AD, Dams-O'Connor K, Esopenko C. Intimate partner violence, substance use, and health comorbidities among women: A narrative review. Front Psychol 2023; 13:1028375. [PMID: 36778165 PMCID: PMC9912846 DOI: 10.3389/fpsyg.2022.1028375] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/14/2022] [Indexed: 01/28/2023] Open
Abstract
Exposure to intimate partner violence (IPV), including physical, sexual, and psychological violence, aggression, and/or stalking, impacts overall health and can have lasting mental and physical health consequences. Substance misuse is common among individuals exposed to IPV, and IPV-exposed women (IPV-EW) are at-risk for transitioning from substance misuse to substance use disorder (SUD) and demonstrate greater SUD symptom severity; this too can have lasting mental and physical health consequences. Moreover, brain injury is highly prevalent in IPV-EW and is also associated with risk of substance misuse and SUD. Substance misuse, mental health diagnoses, and brain injury, which are highly comorbid, can increase risk of revictimization. Determining the interaction between these factors on the health outcomes and quality of life of IPV-EW remains a critical need. This narrative review uses a multidisciplinary perspective to foster further discussion and research in this area by examining how substance use patterns can cloud identification of and treatment for brain injury and IPV. We draw on past research and the knowledge of our multidisciplinary team of researchers to provide recommendations to facilitate access to resources and treatment strategies and highlight intervention strategies capable of addressing the varied and complex needs of IPV-EW.
Collapse
Affiliation(s)
- Jacqueline B. Mehr
- School of Environmental and Biological Sciences, Rutgers University – New Brunswick, New Brunswick, NJ, United States
| | - Esther R. Bennett
- School of Social Work, Rutgers University - New Brunswick, New Brunswick, NJ, United States
| | - Julianne L. Price
- Department of Kinesiology and Health, Rutgers University - New Brunswick, New Brunswick, NJ, United States
- Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers University - New Brunswick, New Brunswick, NJ, United States
| | - Nicola L. de Souza
- School of Graduate Studies, Biomedical Sciences, Rutgers Biomedical and Health Sciences, Newark, NJ, United States
- Department of Rehabilitation and Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, United States
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Jennifer F. Buckman
- Department of Kinesiology and Health, Rutgers University - New Brunswick, New Brunswick, NJ, United States
- Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers University - New Brunswick, New Brunswick, NJ, United States
| | - Elisabeth A. Wilde
- Department of Neurology, School of Medicine, The University of Utah, Salt Lake City, UT, United States
- George E. Wahlen, VA Salt Lake City Healthcare System, Research Care Line, Salt Lake City, UT, United States
| | - David F. Tate
- Department of Neurology, School of Medicine, The University of Utah, Salt Lake City, UT, United States
- George E. Wahlen, VA Salt Lake City Healthcare System, Research Care Line, Salt Lake City, UT, United States
| | - Amy D. Marshall
- Department of Psychology, College of the Liberal Arts, The Pennsylvania State University, State College, PA, United States
| | - Kristen Dams-O'Connor
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Carrie Esopenko
- Department of Rehabilitation and Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, United States
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| |
Collapse
|
41
|
Testa A, Lee J, Neumann A, Jackson DB. Physical intimate partner violence and oral health problems during pregnancy. J Am Dent Assoc 2023; 154:293-300.e1. [PMID: 36707273 DOI: 10.1016/j.adaj.2022.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/17/2022] [Accepted: 11/29/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND The aim of this study was to assess the association between physical intimate partner violence (IPV) during pregnancy and reports of prenatal oral health problems among a sample of mothers in the United States. METHODS Data were obtained from the Pregnancy Risk Assessment Monitoring System from 7 sites (Kentucky, Mississippi, New Hampshire, New York, Puerto Rico, Utah, West Virginia) for 2016 through 2020. The authors used multivariable logistic regression to examine the relationship between physical IPV and respondent self-reports of whether they needed to see a dentist for several oral health problems during pregnancy: (1) needing to have a tooth restored; (2) painful, red, or swollen gingivae; (3) toothache; (4) needing to have a tooth extracted; (5) having an injury to the mouth, teeth, or gingivae; or (6) another problem with teeth or gingivae. RESULTS Women who experienced physical IPV during pregnancy had elevated rates of oral health problems during pregnancy compared with women who did not experience IPV. The findings detailed associations between physical IPV and oral health problems that may stem from physical violence, including painful, red, or swollen gingivae; toothache; and mouth, teeth, or gingivae injury. CONCLUSIONS The results of this study highlight a connection between physical IPV during pregnancy and oral health problems consistent with orofacial injuries. PRACTICAL IMPLICATIONS The association between physical IPV and elevated rates of oral health problems and orofacial injuries highlights the critical role of oral health care providers in screening for, detecting, and intervening in IPV among pregnant women.
Collapse
|
42
|
Collins K, Kochuparambil Sebastian S, Franck G. Improving Domestic Violence Screening and Follow-Up in a Community Health Clinic. J Prim Care Community Health 2023; 14:21501319231189074. [PMID: 37503785 PMCID: PMC10387764 DOI: 10.1177/21501319231189074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 06/02/2023] [Accepted: 06/30/2023] [Indexed: 07/29/2023] Open
Abstract
PURPOSE To implement an improved DV screening and follow-up protocol at a suburban community health clinic that is consistently used by staff with appropriate female patients as well as to assess provider/staff barriers to this. METHODS The project was completed at a community health clinic and included 2 presentations: the first to outline current practices as well as the intervention plan at the pre-intervention time point and then to review results of the intervention and elicit feedback post intervention. Provider/staff barrier surveys were completed at both time points. The intervention consisted of completion of the HITS DV screening tool on all appropriate female patients and a system-level algorithm-based follow-up care plan for positive cases. RESULTS Eligible patient screening increased by 3.1% and patients screening positive increased from 0 to 1 from baseline to intervention. Average scores on the barrier surveys improved for all questions and improved significantly for 3 of the questions. The algorithm implemented was utilized for the positive screening. CONCLUSIONS Use of a DV screening tool, that has shown good concurrent and construct validity in the literature, a system-level algorithm for follow-up care and addressing provider/staff barriers to screening and follow-up are essential components of a successful DV screening and follow-up program.
Collapse
Affiliation(s)
| | | | - Gwyneth Franck
- The University of Illinois at Chicago College of Nursing, USA
| |
Collapse
|
43
|
Zapata-Calvente AL, Martín-de-las-Heras S, Bueno Cavanillas A, Andreasen K, Rasch V, Khan KS. E-health psychological intervention in pregnant women exposed to intimate partner violence (eIPV): A protocol for a pilot randomised controlled trial. PLoS One 2023; 18:e0282997. [PMID: 36930616 PMCID: PMC10022801 DOI: 10.1371/journal.pone.0282997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 12/09/2022] [Indexed: 03/18/2023] Open
Abstract
Intimate partner violence (IPV) during pregnancy, a condition as common as obstetrics conditions like gestational diabetes, is associated with maternal and neonatal complications. Systematic detection of IPV is not well established in antenatal screening probably because the effectiveness of protective interventions has not been evaluated. E-health interventions may be beneficial among mothers exposed to IPV. Prior to performing a full-scale effectiveness trial for such an intervention, a pilot study is required to assess the feasibility of randomising a sufficiently large number of women exposed to IPV during pregnancy. The eIPV trial is a randomised pilot study nested within a cohort of consenting mothers who screen positive for IPV in the first antenatal visit at <12 weeks' gestation and accept an e-health package (psychological counselling by videoconference) in Spain and Denmark. Twenty eligible mothers from the above cohort will be randomised to either intervention or control. The intervention group will receive the e-health package as part of the cohort. The control group will be invited to accept a delay in the intervention (e-health package eight weeks later). After consenting to delay, the control group will provide comparative data without losing the opportunity of obtaining the intervention. We will determine estimates of rates of informed consent to randomization, and the rates of adherence and dropout following randomization. Qualitative interviews will be conducted to examine the women's perception about the benefit of the intervention, reasons for acceptability and non-adherence, and obstacles to recruitment, randomisation and consent. The results will inform the trial feasibility and variance of key clinical outcome measures for estimation of sample size of the full-scale effectiveness trial.
Collapse
Affiliation(s)
| | - Stella Martín-de-las-Heras
- Department of Forensic Medicine, University of Malaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
- * E-mail:
| | - Aurora Bueno Cavanillas
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Karen Andreasen
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Vibeke Rasch
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Khalid S. Khan
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| |
Collapse
|
44
|
Gupta G, Sachdeva A, Kumar M, Singh M. Spectrum of intimate partner violence in patients with psychiatric illness-From victimization to perpetration. Int J Psychiatry Med 2023; 58:20-36. [PMID: 35048727 DOI: 10.1177/00912174211053726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Persons with psychiatric illness are vulnerable to be the victims of intimate partner violence (IPV) and at risk of perpetrating IPV. OBJECTIVES To estimate the prevalence and association of IPV in patients with psychiatric disorders, both as victims and as perpetrators. METHODOLOGY We conducted a questionnaire based, cross-sectional study using systematic random sampling at psychiatric Outpatient Department (OPD) in a tertiary care hospital, in Haryana, India. A total of 500 participants diagnosed with psychiatric disorder were assessed using Operational WHO Criteria for IPV Victimization assessment and IPV Perpetration Assessment scale by Rhodes et al. RESULTS The prevalence of IPV victimization was 16% during the last year and 26% during lifetime. IPV victimization was found significantly more in females (especially sexual), young and unemployed participants, during the initial 10 years of marriage and 10 years of the illness. Sexual IPV was the most common. The prevalence of IPV perpetration by the participants was 6% during last year and 10.6% in lifetime. Perpetrators were more likely to be males of higher age (40-50 years), unemployed, having lower income, belonging to joint family, and residing in rural areas. Diagnosis of a psychiatric illness, especially psychosis increased chances of perpetration. As the duration of illness increased, prevalence of IPV perpetration increased. CONCLUSION Intimate partner violence among persons with psychiatric disorders is common and they are more vulnerable to being victims of IPV, rather than perpetrating IPV. Vulnerability and risk factors for IPV should be taken into account and optimized strategies should be devised for prevention.
Collapse
Affiliation(s)
- Geetanjali Gupta
- Department of Psychiatry, 425957ESIC Medical College and Hospital, Faridabad, India
| | - Ankur Sachdeva
- Department of Psychiatry, 425957ESIC Medical College and Hospital, Faridabad, India
| | - Manoj Kumar
- Department of Psychiatry, 425957ESIC Medical College and Hospital, Faridabad, India
| | - Mitasha Singh
- Department of Community Medicine, 425957ESIC Medical College and Hospital, Faridabad, India
| |
Collapse
|
45
|
Alsalman Z, Shafey M, Al Ali L. Intimate Partner Violence; Are Saudi Physicians in Primary Health Care Setting Ready to Identify, Screening, and Respond? Int J Womens Health 2023; 15:623-633. [PMID: 37096173 PMCID: PMC10122482 DOI: 10.2147/ijwh.s401926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/16/2023] [Indexed: 04/26/2023] Open
Abstract
Introduction Intimate partner violence (IPV) is a growing hot topic in Saudi Arabia and primary health care (PHC) physicians play a significant role in preventing it. Our objective was to assess the PHC Physicians' readiness and barriers to identify, screen, and respond to IPV in Saudi Arabia. Methods A cross-sectional study recruited physicians working in PHC centers in Saudi Arabia. Data was collected using a modified online self-administered questionnaire based on the PREMIS "The Physician Readiness to Identify and Manage IPV." The questionnaire consisted of respondent profile, perceived preparedness and knowledge, actual knowledge, practice issues, and opinion regarding barriers. Results Among 169 PHC physicians, 60.9% had never experienced any formal IPV training. Around one-fifth of participants have a good perceived and actual knowledge, whereas one-third have a good perceived preparedness. Nearly half of the participants (46.7%) do not screen for IPV and two-thirds of them (66.3%) have never identified an IPV case during the previous 6 months. The logistic regression model showed that family physicians were 2.27 times more likely to have a good knowledge than a general practitioner, and participants with IPV training were more likely to have a good level of perceived preparedness, perceived knowledge, and more likely to perform screening of IPV. Conclusion The low level of PHC physicians' readiness to identify and respond to IPV is worrisome. Findings emphasize the urgent need for an IPV training program, a supportive work environment, and a clear referral system in order to help the practitioner to provide comprehensive services and ensure safety plans for abused women.
Collapse
Affiliation(s)
- Zaenb Alsalman
- Departments of Family and Community Medicine, College of Medicine, King Faisal University, Al Ahsa, Saudi Arabia
- Correspondence: Zaenb Alsalman, Departments of Family and Community Medicine, College of Medicine, King Faisal University, Po Box 3311, Al Ahsa, 36346, Saudi Arabia, Tel +966545611633, Email ;
| | - Marwa Shafey
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | |
Collapse
|
46
|
Alexander EF, Backes BL, Johnson MD. Evaluating Measures of Intimate Partner Violence Using Consensus-Based Standards of Validity. TRAUMA, VIOLENCE & ABUSE 2022; 23:1549-1567. [PMID: 33969760 DOI: 10.1177/15248380211013413] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The assessment of intimate partner violence (IPV) by mental health, medical, and criminal justice practitioners occurs routinely. The validity of the assessment instrument they use impacts practitioners' ability to judge ongoing risk, establish the type of IPV occurring, protect potential victims, and intervene effectively. Yet, there is no known compendium of existing assessment measures. The purpose of this article is threefold: (1) to present a systematic review of measures used to identify or predict IPV, (2) to determine which of these measures have psychometric evidence to support their use, and (3) to determine whether any existing measure is capable of differentiating between situational couple violence and intimate terrorism. A systematic search was conducted using PsycINFO, PsycARTICLES, PubMed, and MEDLINE. Studies on the reliability or validity of specific measures of IPV were included, regardless of format, length, discipline, or type of IPV assessed. A total of 222 studies, on the psychometric properties of 87 unique measures, met our a priori criteria and were included in the review. We described the reliability and validity of the 87 measures. We rated the measures based on the Consensus-based Standards for the Selection of Health Measurement Instruments-revised criteria and other established validity criteria, which allowed us to generate a list of recommended measures. We also discussed measures designed to differentiate IPV types. We conclude by describing the strengths and weaknesses of existing measures and by suggesting new avenues for researchers to enhance the assessment of IPV.
Collapse
Affiliation(s)
- Erin F Alexander
- Department of Psychology, 14787Binghamton University (SUNY), NY, USA
| | - Bethany L Backes
- Department of Criminal Justice, School of Social Work, University of Central Florida, Orlando, FL, USA
| | - Matthew D Johnson
- Department of Psychology, 14787Binghamton University (SUNY), NY, USA
| |
Collapse
|
47
|
Mishkin KE, Ahmed HM, Maqsood SS. Factors associated with experiencing lifetime intimate partner violence among pregnant displaced women living in refugee camps in Erbil, Iraq. Glob Public Health 2022; 17:3455-3464. [PMID: 35259066 DOI: 10.1080/17441692.2022.2048409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
According to the World Health Organization, intimate partner violence (IPV) affects 35% of women worldwide and 40% of pregnant women, often resulting in maternal and infant death and harm. Displaced persons are at higher risk of abuse compared to the general population. While few studies have explored IPV in Iraq, research from Erbil, Iraq showed nearly 60% of women reported experiencing IPV in their lifetime. No publications examining IPV among displaced women in Iraq exist. Considering the severe impacts of IPV in pregnancy and the associated risks for IPV among women in refugee camps, this paper presents the first analysis of prevalence and factors associated with lifetime IPV among displaced pregnant women in two Iraqi refugee camps. Thirteen percent of women reported experiencing any abuse and experiencing IPV was associated with receiving fewer years of schooling (p = 0.04), not having a private doctor (p = 0.002), attending the first prenatal visit during the third trimester (p = 0.03), feeling pressure to have a child (p = 0.003), knowing someone who was physically injured by their husband (p = 0.05), experiencing suicidal ideation (p = 0.02), and being worried about harming one's baby (p = 0.02). Policy and programme recommendations for screening and prevention of IPV in resource-limited settings are provided.
Collapse
Affiliation(s)
| | - Hamdia Mirkhan Ahmed
- College of Health Sciences, Center for Research and Women's Health, Hawler Medical University, Erbil, Iraq
| | | |
Collapse
|
48
|
Bevilacqua KG, Williams A, Wood SN, Wamue-Ngare G, Thiongo M, Gichangi P, Decker MR. Sexual harassment before and during the COVID-19 pandemic among adolescent girls and young women (AGYW) in Nairobi, Kenya: a cross-sectional study. BMJ Open 2022; 12:e066777. [PMID: 36253036 PMCID: PMC9577274 DOI: 10.1136/bmjopen-2022-066777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/23/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Sexual harassment among adolescent girls and young women (AGYW) is a prevalent and understudied form of gender-based violence (GBV) with negative impacts on health and well-being. The COVID-19 pandemic raised global concern about GBV within homes; less is known about how it affected GBV in public spaces. METHODS Present analyses use cross-sectional data from a cohort of adolescents and young adults residing in Nairobi, Kenya, restricted to female participants. Data were collected August-October 2020 via phone after implementation of COVID-19 restrictions. Prevalence of past-year sexual harassment and harassment relative to COVID-19 restrictions were calculated for overall sample, and by individual, household, and pandemic-related factors. Multivariate negative binomial regression models examine correlates of (1) past-year sexual harassment and (2) increases in sexual harassment relative to COVID-19 restrictions. RESULTS Overall, 18.1% of AGYW experienced past-year sexual harassment at the 2020 survey. Among this group, 14.6% experienced sexual harassment pre-COVID-19 only, 18.8% after only and 66.6% at both time points. Among the latter group, 34.9% reported more occurrences following COVID-19 restrictions, 20.5% reported less occurrences and 44.7% reported no change in occurrence. Overall, 42.0% of AGYW experienced an increase in sexual harassment while 58.0% experienced no increase since COVID-19. In adjusted models, past-year sexual harassment was associated with higher educational attainment (adjusted risk ratio, aRR 2.11; 95% CI 1.27 to 3.52) and inability to meet basic financial needs (aRR 1.67; 95% CI 1.05 to 2.66). Increased sexual harassment since COVID-19 was associated with having full control to leave the home (aRR 1.69; 95% CI 1.00 to 2.90). CONCLUSIONS Sexual harassment among AGYW in Nairobi, Kenya was prevalent before and during COVID-19 restrictions. Safety in public spaces remains a highly gendered issue that impacts women's safety and ability to participate in public life. Prevention and support services to address sexual harassment remain an important element in ensuring safe, sustainable public spaces.
Collapse
Affiliation(s)
- Kristin G Bevilacqua
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - A Williams
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Shannon N Wood
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Bill & Melinda Gates Institute for Population and Reproductive Health, Baltimore, Maryland, USA
| | - G Wamue-Ngare
- Department of Sociology, Gender and Development Studies, Kenyatta University, Nairobi, Kenya
- Women's Economic Empowerment Hub, Kenyatta University, Nairobi, Kenya
| | - Mary Thiongo
- International Centre for Reproductive Health Kenya, Mombasa, Kenya
| | - P Gichangi
- International Centre for Reproductive Health Kenya, Mombasa, Kenya
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
| | - Michele R Decker
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Bill & Melinda Gates Institute for Population and Reproductive Health, Baltimore, Maryland, USA
| |
Collapse
|
49
|
Hing N, O’Mullan C, Mainey L, Greer N, Breen H. An integrative review of research on gambling and domestic and family violence: Fresh perspectives to guide future research. Front Psychol 2022; 13:987379. [PMID: 36312076 PMCID: PMC9606773 DOI: 10.3389/fpsyg.2022.987379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
This paper presents an integrative review of research on domestic and family violence (DFV), including intimate partner violence (IPV), experienced by victims and perpetrators with a gambling problem. It aims to review, critique, and synthesize research on this topic to generate fresh and alternative perspectives to guide future research. Based on a systematic search of the academic literature and a targeted search of gray literature, the paper summarizes findings from empirical studies pertaining to the prevalence of perpetration and victimization, characteristics of perpetrators and victims, and explanations for this violence. Based on this review, the paper suggests several potential improvements that can be considered in future studies. These include a shift from focusing on situational violence to also include coercive control; greater sensitivity in research design and interpretation to gender differences in experiences of violence; and the need to include economic abuse as a form of DFV/IPV. Adopting a public health lens is also recommended to broaden the research focus from victims and perpetrators to also consider contextual factors. In particular, gambling research should examine the contribution of gambling products, practices, environments, and marketing to DFV/IPV and how this might be ameliorated. While research to date has drawn much needed attention to the risks that gambling presents for DFV/IPV, this review provides some suggestions for future research so that it can provide more nuanced findings to inform policy and practice.
Collapse
Affiliation(s)
- Nerilee Hing
- School of Health, Medical and Applied Sciences, Central Queensland University, Bundaberg, QLD, Australia
- *Correspondence: Nerilee Hing,
| | - Cathy O’Mullan
- School of Health, Medical and Applied Sciences, Central Queensland University, Bundaberg, QLD, Australia
| | - Lydia Mainey
- School of Nursing and Midwifery, Central Queensland University, Cairns, QLD, Australia
| | - Nancy Greer
- School of Health, Medical and Applied Sciences, Central Queensland University, Bundaberg, QLD, Australia
| | - Helen Breen
- Faculty of Business and Law and Arts, Southern Cross University, Lismore, NSW, Australia
| |
Collapse
|
50
|
Sabola S, Kim J, Sheppard CC. Perinatal Care for Individuals With a History of Sexual Trauma. Nurs Womens Health 2022; 26:371-378. [PMID: 36087641 DOI: 10.1016/j.nwh.2022.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 04/18/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Abstract
Many women and individuals assigned female at birth experience sexual assault or abuse in their lives leading to sexual trauma. In this article, we review the effects of sexual trauma and resulting chronic stress on the body and during the perinatal period. Maternal, fetal, and neonatal health implications are discussed. Routine screening for sexual assault and violence can assist with early identification and intervention. A variety of modalities and methods for managing the effects of sexual trauma have been identified, including pharmacologic treatment, psychotherapy, complementary and alternative medicine, and shared decision-making. Further research regarding different treatments is essential to find additional tools to aid clinicians providing care to this vulnerable population. When nurses care for individuals with a history of sexual trauma, incorporating trauma-informed care can help prevent retraumatization and promote a healthy perinatal experience.
Collapse
|