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Wilson IM, Willoughby B, Tanyos A, Graham K, Walker M, Laslett AM, Ramsoomar L. A global review of the impact on women from men's alcohol drinking: the need for responding with a gendered lens. Glob Health Action 2024; 17:2341522. [PMID: 38700277 PMCID: PMC11073422 DOI: 10.1080/16549716.2024.2341522] [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: 08/17/2023] [Accepted: 04/07/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Global evidence shows that men's harmful alcohol use contributes to intimate partner violence (IPV) and other harms. Yet, interventions that target alcohol-related harms to women are scarce. Quantitative analyses demonstrate links with physical and verbal aggression; however, the specific harms to women from men's drinking have not been well articulated, particularly from an international perspective. AIM To document the breadth and nature of harms and impact of men's drinking on women. METHODS A narrative review, using inductive analysis, was conducted of peer-reviewed qualitative studies that: (a) focused on alcohol (men's drinking), (b) featured women as primary victims, (c) encompassed direct/indirect harms, and (d) explicitly featured alcohol in the qualitative results. Papers were selected following a non-time-limited systematic search of key scholarly databases. RESULTS Thirty papers were included in this review. The majority of studies were conducted in low- to middle-income countries. The harms in the studies were collated and organised under three main themes: (i) harmful alcohol-related actions by men (e.g. violence, sexual coercion, economic abuse), (ii) impact on women (e.g. physical and mental health harm, relationship functioning, social harm), and (iii) how partner alcohol use was framed by women in the studies. CONCLUSION Men's drinking results in a multitude of direct, indirect and hidden harms to women that are cumulative, intersecting and entrench women's disempowerment. An explicit gendered lens is needed in prevention efforts to target men's drinking and the impact on women, to improve health and social outcomes for women worldwide.
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Affiliation(s)
- Ingrid M. Wilson
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
- Judith Lumley Centre, Latrobe University, Melbourne, Australia
| | - Bree Willoughby
- Centre for Alcohol Policy Research, Latrobe University, Melbourne, Australia
| | - Amany Tanyos
- Centre for Alcohol Policy Research, Latrobe University, Melbourne, Australia
| | - Kathryn Graham
- Institute of Mental Health Policy Research,Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Mary Walker
- Politics, Media and Philosophy, Latrobe University, Melbourne, Australia
| | - Anne-Marie Laslett
- Institute of Mental Health Policy Research,Centre for Addiction and Mental Health, Toronto, Canada
| | - Leane Ramsoomar
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
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Nyemgah CA, Ranganathan M, Nabukalu D, Stöckl H. Prevalence and severity of physical intimate partner violence during pregnancy among adolescents in eight sub-Saharan Africa countries: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002638. [PMID: 39012924 PMCID: PMC11251595 DOI: 10.1371/journal.pgph.0002638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 06/23/2024] [Indexed: 07/18/2024]
Abstract
Globally, intimate partner violence (IPV) is highly prevalent, with adolescents being particularly vulnerable, especially during pregnancy. This study examines the prevalence and severity of physical IPV among pregnant adolescents in sub-Saharan Africa (SSA). We analyzed data from Demographic Health Surveys collected between 2017-2021 from eight SSA countries, involving 2,289 ever-pregnant adolescents aged 15-19. Physical IPV during pregnancy was defined as experiencing physical harm while pregnant by a husband, former partner, current boyfriend, or former boyfriend. Severity of physical IPV included experiences such as kicking, choking, weapon threats, and serious injuries. Logistic regression analysis was conducted, with results presented as unadjusted and adjusted odds ratios with 95% confidence intervals. The prevalence of physical IPV during pregnancy among adolescents in the eight SSA countries ranged from 2.9% to 12.6%, with 5.6% experiencing severe lifetime physical IPV and 6.3% severe physical injuries. We found a strong association between physical IPV during pregnancy and severe lifetime physical IPV (aOR: 6.8, 95% CI: 4.5-10.4) and severe injuries (aOR: 9.2, 95% CI: 6.0-14.2), even after adjusting for covariates. Physical IPV during pregnancy is common among adolescents in SSA and is associated with severe physical lifetime IPV. Addressing this issue in low-resource settings requires collaborative efforts among community stakeholders, health system practitioners, and policymakers to protect vulnerable adolescent girls during pregnancy.
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Affiliation(s)
- Caroline Adjimi Nyemgah
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Meghna Ranganathan
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Doreen Nabukalu
- Department of Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Heidi Stöckl
- Institute of Medical Information Processing, Biometry and Epidemiology, Public Health and Health Services Research, Faculty of Medicine, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
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Forbes C, Alderson H, Domoney J, Papamichail A, Berry V, McGovern R, Sevdalis N, Rankin J, Newburn M, Healey A, Easter A, Heslin M, Feder G, Hudson K, Wilson CA, Melendez-Torres GJ, Howard LM, Trevillion K. A survey and stakeholder consultation of Independent Domestic Violence Advisor (IDVA) programmes in English maternity services. BMC Pregnancy Childbirth 2023; 23:404. [PMID: 37264300 DOI: 10.1186/s12884-023-05731-1] [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: 12/09/2022] [Accepted: 05/23/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Healthcare-based Independent Domestic Violence Advisors (hIDVA) are evidence-based programmes that provide emotional and practical support to service users experiencing domestic abuse. hIDVA programmes are found to improve health outcomes for service users and are increasingly delivered across a range of healthcare settings. However, it is unclear how hIDVA programmes are implemented across maternity services and the key facilitators and barriers to their implementation. The aim of this study was to identify; how many English National Health Service (NHS) Trusts with maternity services have a hIDVA programme; which departments within the Trust they operate in; what format, content, and variation in hIDVA programmes exist; and key facilitators and barriers of implementation in maternity services. METHODS A national survey of safeguarding midwives (Midwives whose role specifically tasks them to protect pregnant women from harm including physical, emotional, sexual and financial harm and neglect) within all maternity services across England; descriptive statistics were used to summarise responses. A World Café event (a participatory method, which aims to create a café atmosphere to facilitate informal conversation) with 38 national key stakeholders to examine barriers and facilitators to hIDVA programme implementation. RESULTS 86/124 Trusts (69%) with a maternity service responded to the survey; 59(69%) of respondents reported that they had a hIDVA programme, and 47(55%) of the hIDVA programmes operated within maternity services. Key facilitators to implementation of hIDVA programmes included training of NHS staff about the hIDVA role and regular communication between Trust staff and hIDVA staff; hIDVA staff working directly from the Trust; co-creation of hIDVA programmes with experts by experience; governance and middle- and senior-management support. Key barriers included hIDVA staff having a lack of access to a private space for their work, insecure funding for hIDVA programmes and issues with recruitment and retention of hIDVA staff. CONCLUSIONS Despite hIDVA programmes role in improving the health outcomes of service users experiencing domestic abuse, increased funding and staff training is needed to successfully implement hIDVA staff in maternity services. Integrated Care Board commissioning of acute and mental health trust services would benefit from ensuring hIDVA programmes and clinician DVA training are prioritised.
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Zhang X, Wu L, Wang J, Mao F, Sun J, Cao D, Cao F. The Independent and Joint Effects of Different Childhood Abuse Types on Subjective Prospective and Retrospective Memory Impairment During Pregnancy. Front Psychol 2021; 12:753008. [PMID: 34867646 PMCID: PMC8639514 DOI: 10.3389/fpsyg.2021.753008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/15/2021] [Indexed: 11/18/2022] Open
Abstract
Background and Objective: Childhood abuse is considered a risk factor in various health outcomes during pregnancy. However, no study has explored the relationship between childhood abuse and memory impairment during pregnancy. This study is the first to explore the relationship between childhood abuse and subjective memory impairment. Participants, Setting, and Methods: A total of 1,825 pregnant women were recruited from a comprehensive hospital in Shandong province, China, and completed a questionnaire survey. Multivariable linear regression analysis was used to explore the relationship between childhood abuse and subjective prospective and retrospective memory. Results: Pregnant women with high total childhood abuse scores had high prospective and retrospective memory impairment. Among pregnant women reporting only emotional abuse, only physical abuse, or only sexual abuse, women reporting only emotional abuse were found to have high prospective and retrospective memory impairment. Women with all three childhood abuse types also had high prospective and retrospective memory impairment. Conclusion: Women who experienced childhood abuse, especially childhood emotional abuse, had high subjective memory impairment during pregnancy. It is important to ask pregnant women about their experiences of childhood abuse, especially emotional abuse, during early prenatal care, as such abuse is likely to have negative effects on memory during pregnancy.
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Affiliation(s)
- Xuan Zhang
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Liuliu Wu
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Juan Wang
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Fangxiang Mao
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Jiwei Sun
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Danfeng Cao
- Shandong Province Qianfoshan Hospital, Jinan, China
| | - Fenglin Cao
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
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Childhood Neglect and Psychological Distress Among Pregnant Women: The Chain Multiple Mediation Effect of Perceived Social Support and Positive Coping. J Nerv Ment Dis 2020; 208:764-770. [PMID: 32740144 DOI: 10.1097/nmd.0000000000001210] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study aimed to investigate the association between childhood neglect and psychological distress in pregnant women and to assess whether perceived social support and coping styles mediated this association. Pregnant women (N = 276) recruited from the prenatal clinic of a comprehensive hospital in China participated in this study. Participants reported their experiences of childhood neglect and abuse, depression, anxiety, perceived social support, and coping styles. Childhood neglect was positively associated with psychological distress. Perceived social support mediated the relationship between childhood neglect and psychological distress. Perceived social support and positive coping acted as chain mediators between childhood neglect and psychological distress. Childhood neglect is a risk factor for psychological distress during pregnancy independent of childhood abuse; perceived social support and positive coping can influence this relationship.
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Zhang X, Sun J, Wang J, Chen Q, Cao D, Wang J, Cao F. Suicide ideation among pregnant women: The role of different experiences of childhood abuse. J Affect Disord 2020; 266:182-186. [PMID: 32056874 DOI: 10.1016/j.jad.2020.01.119] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/15/2019] [Accepted: 01/20/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Childhood abuse has a negative effect on mental health during pregnancy; however, the association between childhood abuse and suicide ideation has received relatively little attention. METHOD Women at 28 weeks or more into their pregnancy were recruited from a prenatal clinic in Shandong province, China. Suicide ideation was measured using item 9 of the Patient Health Questionnaire-9. Childhood abuse was measured using childhood abuse subscales of the Childhood Trauma Questionnaire. RESULTS Women with any experience of childhood abuse had high risk of suicide ideation (OR = 2.44, 95%CI: 1.31-4.55). The association of continuous childhood abuse scores with suicide ideation was consistent with the finding using dichotomous childhood abuse (OR = 1.07, 95%CI: 1.02-1.12). After adjustment for depression, pregnant women with only physical abuse experience had high risk of suicide ideation (OR = 3.63, 95%CI: 1.32-10.03). Pregnant women with both childhood abuse and depression had increased risk of suicide ideation compared to those with neither risk factor (OR = 17.78, 95%CI 7.20-43.92). LIMITATIONS Using a self-report measure to assess childhood abuse is susceptible to recall bias. Using a single item to measure suicide ideation and assessing only suicide ideation were limitations of the study. CONCLUSIONS Pregnant women who experienced childhood abuse, especially physical abuse, had a high risk of suicide ideation during pregnancy. Screening for both childhood abuse and antenatal depression may be an effective way to identify high-risk groups with suicide ideation.
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Affiliation(s)
- Xuan Zhang
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong Province 250012, China
| | - Jiwei Sun
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong Province 250012, China
| | - Juan Wang
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong Province 250012, China
| | - Qingyi Chen
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong Province 250012, China
| | - Danfeng Cao
- Shandong Province Qianfoshan Hospital, No. 16766 Jingshi Road, Jinan, Shandong Province 250014, China
| | - Jianwen Wang
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong Province 250012, China
| | - Fenglin Cao
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong Province 250012, China.
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Community Stakeholders' Perspectives on Intimate Partner Violence during Pregnancy-A Qualitative Study from Ethiopia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234694. [PMID: 31775343 PMCID: PMC6926756 DOI: 10.3390/ijerph16234694] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 11/16/2019] [Accepted: 11/17/2019] [Indexed: 11/20/2022]
Abstract
Intimate partner violence (IPV) in pregnancy adversely affects the health of women and unborn children. To prevent this, the community responses, societal systems, and structures to support victims of IPV in pregnancy are vital. Objectives: to explore community stakeholders’ perspectives related to IPV in pregnancy in Jimma, Ethiopia, and if needed, create the knowledge base for interventions. Methods: using an exploratory design, this qualitative study had a maximum-variation (multiple spectrum sources) sampling strategy with 16 semi-structured interviews of purposively selected key informants representing different community institutions. Guided by Connell’s theory of gender and power, a content analysis of the translated interviews was conducted using Atlas.ti 7 software. Results: reconciliation between IPV victims and their abusers was the solution promoted by almost all the respondents. There was limited awareness of the adverse impacts IPV in pregnancy has on the health of the woman and the foetus. Despite regular encounters with victims, there is no organized or structured operational response to support IPV victims between the participating institutions. Conclusion: the potential danger of IPV for the mother or the unborn child was not well understood by the members of the studied Ethiopian community. Neither coordinated efforts to support IPV victims nor links among relevant agencies existed. The study demonstrated the dire need of coordinated practical action, changes in current socio-cultural norms, formal training and capacity building, awareness creation, clear intervention guidelines, and facilitation of support networks among relevant institutions in Ethiopian communities.
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Apolot RR, Ekirapa E, Waldman L, Morgan R, Aanyu C, Mutebi A, Nyachwo EB, Seruwagi G, Kiwanuka SN. Maternal and newborn health needs for women with walking disabilities; "the twists and turns": a case study in Kibuku District Uganda. Int J Equity Health 2019; 18:43. [PMID: 30866957 PMCID: PMC6416885 DOI: 10.1186/s12939-019-0947-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 03/05/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND In Uganda 13% of persons have at least one form of disability. The United Nations' Convention on the Rights of Persons with Disabilities guarantees persons with disabilities the same level of right to access quality and affordable healthcare as persons without disability. Understanding the needs of women with walking disabilities is key in formulating flexible, acceptable and responsive health systems to their needs and hence to improve their access to care. This study therefore explores the maternal and newborn health (MNH)-related needs of women with walking disabilities in Kibuku District Uganda. METHODS We carried out a qualitative study in September 2017 in three sub-counties of Kibuku district. Four In-depth Interviews (IDIs) among purposively selected women who had walking disabilities and who had given birth within two years from the study date were conducted. Trained research assistants used a pretested IDI guide translated into the local language to collect data. All IDIs were audio recorded and transcribed verbatim before analysis. The thematic areas explored during analysis included psychosocial, mobility, health facility and personal needs of women with walking disabilities. Data was analyzed manually using framework analysis. RESULTS We found that women with walking disabilities had psychosocial, mobility, special services and personal needs. Psychosocial needs included; partners', communities', families' and health workers' acceptance. Mobility needs were associated with transport unsuitability, difficulty in finding transport and high cost of transport. Health facility needs included; infrastructure, and responsive health services needs while personal MNH needs were; personal protective wear, basic needs and birth preparedness items. CONCLUSIONS Women with walking disabilities have needs addressable by their communities and the health system. Communities, and health workers need to be sensitized on these needs and policies to meet and implement health system-related needs of women with disability.
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Affiliation(s)
- Rebecca R. Apolot
- Department of Health Policy Planning and Management, Makerere University School of Public Health, P.O.Box 7072, Kampala, Uganda
| | - Elizabeth Ekirapa
- Department of Health Policy Planning and Management, Makerere University School of Public Health, P.O.Box 7072, Kampala, Uganda
| | - Linda Waldman
- Institute of Development Studies, Library Road, Brighton, BN1 9RE UK
| | - Rosemary Morgan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | - Christine Aanyu
- Department of Health Policy Planning and Management, Makerere University School of Public Health, P.O.Box 7072, Kampala, Uganda
| | - Aloysius Mutebi
- Department of Health Policy Planning and Management, Makerere University School of Public Health, P.O.Box 7072, Kampala, Uganda
| | - Evelyne B. Nyachwo
- Department of Health Policy Planning and Management, Makerere University School of Public Health, P.O.Box 7072, Kampala, Uganda
| | - Gloria Seruwagi
- Department of Health Policy Planning and Management, Makerere University School of Public Health, P.O.Box 7072, Kampala, Uganda
| | - Suzanne N. Kiwanuka
- Department of Health Policy Planning and Management, Makerere University School of Public Health, P.O.Box 7072, Kampala, Uganda
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Wilson IM, Eurenius E, Lindkvist M, Edin K, Edvardsson K. Is there an association between pregnant women's experience of violence and their partner's drinking? A Swedish population-based study. Midwifery 2019; 69:84-91. [DOI: 10.1016/j.midw.2018.10.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 10/24/2018] [Accepted: 10/29/2018] [Indexed: 10/28/2022]
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Choi KW, Sikkema KJ. Childhood Maltreatment and Perinatal Mood and Anxiety Disorders: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2016; 17:427-453. [PMID: 25985988 DOI: 10.1177/1524838015584369] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Perinatal mood and anxiety disorders (PMADs) compromise maternal and child well-being and may be influenced by traumatic experiences across the life course. A potent and common form of trauma is childhood maltreatment, but its specific impact on PMADs is not well understood. A systematic review was undertaken to synthesize empirical literature on the relationship between maternal histories of childhood maltreatment and PMADs. Of the 876 citations retrieved, 35 reports from a total of 26,239 participants met inclusion criteria, documenting substantial rates of childhood maltreatment and PMADs. Robust trends of association were observed between childhood maltreatment and perinatal depression, as well as post-traumatic stress disorder, but findings for anxiety were less consistent. Examining multivariate results suggested that childhood maltreatment predicts PMADs above and beyond sociodemographic, psychiatric, perinatal, and psychosocial factors, but may also be partially mediated by variables such as later victimization and moderated by protective early relationships. Future research should test mediating and moderating pathways using prospective cohorts, expanding to cross-cultural settings and other disorder outcomes. Treatment and prevention of childhood maltreatment and its sequelae may help mitigate risk for perinatal psychopathology and its impact on maternal and child outcomes.
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Affiliation(s)
- Karmel W Choi
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Kathleen J Sikkema
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
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