Rural disparity in domestic violence prevalence and access to resources

Intimate Partner Violence Survivorship, Posttraumatic Stress Disorder and Disaster: Implications for Future Disasters

This study investigated posttraumatic stress disorder (PTSD) prevalence among a sample of intimate partner violence (IPV) survivors (n  =  77) who filed for restraining orders in rural Louisiana during the COVID-19 pandemic. IPV survivors were individually interviewed to assess their self-reported levels of perceived stress, resilience, potential PTSD, COVID-19-related experiences, and sociodemographic characteristics. Data were analyzed to differentiate group membership between two groups; non-PTSD and probable PTSD. Results suggest the probable PTSD group had lower levels of resilience and higher levels of perceived stress compared to the non-PTSD group. Findings suggest the importance of providing services during disaster to reduce PTSD for IPV survivors.

Diverse Intimate Partner Violence Survivors' Experiences Seeking Help from the Police: A Qualitative Research Synthesis

Intimate partner violence (IPV), inclusive of all forms of abuse, is an ongoing public health and criminal-legal issue that transcends social boundaries. However, there is a lack of equitable representation of diverse populations who experience IPV in the literature. To garner a holistic knowledge of diverse IPV survivor populations' experiences with seeking help from the police, the current review utilized a qualitative research synthesis methodology to explore police interactions among six IPV survivor populations that are underrepresented in the current literature: women with substance use issues, immigrant women, women in rural localities, heterosexual men, racially/ethnically minoritized women, and sexual minority women. Seven electronic databases were searched to identify peer-reviewed articles on IPV survivors' narrative descriptions (qualitative or mixed-methods) of their encounters with law enforcement. The final analysis included 28 studies that were then coded with an iterative coding strategy. The analysis uncovered the following themes: (a) revictimization by the police, (b) police negligence, (c) discrimination, (d) cultural differences, and (e) positive experiences. These themes demonstrated that while some experiences with law enforcement were shared between under-researched survivor groups, some experiences were explicitly tied to some aspects of survivors' identities. Recognizing the potential law enforcement has to support survivors, the findings of the current review reiterate the need for ongoing efforts to improve law enforcement knowledge and overall response to IPV, especially for diverse populations of IPV survivors.

Population-Level Surveillance of Domestic Assaults in the Home Using the National Emergency Medical Services Information System (NEMSIS)

Violence in the home, including partner violence, child abuse, and elder abuse, is pervasive in the United States. An informatics approach allowing automated analysis of administrative data to identify domestic assaults and release timely and localized data would assist preventionists to identify geographic and demographic populations of need and design tailored interventions. This study examines the use of an established national dataset, the NEMSIS 2019, as a potential annual automated data source for domestic assault surveillance. An algorithm was used to identify individuals who utilized emergency medical services (EMS) for a physical assault in a private residence (N = 176,931). Descriptive analyses were conducted to define the identified population and disposition of patients. A logistic regression was performed to predict which characteristics were associated with consistent domestic assault identification by the on-scene EMS clinician and dispatcher. The sample was majority female (52.2%), White (44.7%), urban (85.5%), and 21-29 years old (24.4%). A disproportionate number of those found dead on scene were men (74.5%), and female patients more often refused treatment (57.8%) or were treated and then released against medical advice (58.4%). Domestic assaults against children and seniors had higher odds of being consistently identified by both the dispatcher and EMS clinician than those 21-49, and women had lower odds of consistent identification than men. While a more specific field to identify the type of domestic assault (e.g., intimate partner) would help inform specialized intervention planning, these data indicate an opportunity to systematically track domestic assaults in communities and describe population-specific needs.

Understanding Intimate Partner Violence Service Delivery for Latinx Survivors in Rural Areas

Using a statewide survey, this exploratory, cross-sectional study examined 78 domestic violence (DV) service organizations' service delivery practices and perceived challenges to serving Latinx survivors in the context of rurality. Findings showed that DV organizations in rural areas perceived more challenges to delivering culturally appropriate services for Latinx survivors compared to those in other geographic settings even after accounting for client characteristics, service provision characteristics, and community resources. The study finding offers critical insights to ensure and enhance the provision of linguistically and culturally accessible services for rural Latinx survivors of intimate partner violence.

Harnessing Health Information Technology in Domestic Violence in the United States: A Scoping Review

Objectives

The following scoping review aims to identify and map the existing evidence for HIT interventions among women with DV experiences in the United States. And provide guidance for future research, and facilitate clinical and technical applications for healthcare professionals.

Methods

Five databases, PubMed, EBSCOhost CINAHL, Ovid APA PsycINFO, Scopus and Google Scholar, were searched from date of inception to May 2023. Reviewers extracted classification of the intervention, descriptive details, and intervention outcomes, including physical safety, psychological, and technical outcomes, based on representations in the included studies.

Results

A total of 24 studies were included, identifying seven web-based interventions and four types of abuse. A total of five studies reported safety outcomes related to physical health. Three studies reported depression, anxiety, and post-traumatic stress disorder as psychological health outcomes. The effectiveness of technology interventions was assessed in eight studies.

Conclusion

Domestic violence is a major public health issue, and research has demonstrated the tremendous potential of health information technology, the use of which can support individuals, families, and communities of domestic violence survivors.

Intimate Partner Violence-Related Brain Injury: Unmasking and Addressing the Gaps

Intimate partner violence (IPV) is a significant, global public health concern. Women, individuals with historically underrepresented identities, and disabilities are at high risk for IPV and tend to experience severe injuries. There has been growing concern about the risk of exposure to IPV-related head trauma, resulting in IPV-related brain injury (IPV-BI), and its health consequences. Past work suggests that a significant proportion of women exposed to IPV experience IPV-BI, likely representing a distinct phenotype compared with BI of other etiologies. An IPV-BI often co-occurs with psychological trauma and mental health complaints, leading to unique issues related to identifying, prognosticating, and managing IPV-BI outcomes. The goal of this review is to identify important gaps in research and clinical practice in IPV-BI and suggest potential solutions to address them. We summarize IPV research in five key priority areas: (1) unique considerations for IPV-BI study design; (2) understanding non-fatal strangulation as a form of BI; (3) identifying objective biomarkers of IPV-BI; (4) consideration of the chronicity, cumulative and late effects of IPV-BI; and (5) BI as a risk factor for IPV engagement. Our review concludes with a call to action to help investigators develop ecologically valid research studies addressing the identified clinical-research knowledge gaps and strategies to improve care in individuals exposed to IPV-BI. By reducing the current gaps and answering these calls to action, we will approach IPV-BI in a trauma-informed manner, ultimately improving outcomes and quality of life for those impacted by IPV-BI.

Can This Provider Be Trusted? A Review of the Role of Trustworthiness in the Provision of Community-Based Services for Intimate Partner Violence Survivors

While there is a growing literature on intimate partner violence (IPV) survivors and service providers, it is limited by its largely atheoretical and descriptive nature, and its emphasis on individual-level survivors' help-seeking. We seek to broaden our understanding by shifting the focus onto organizations and service systems and introducing the concept of these providers' trustworthiness toward survivors. Provider trustworthiness in delivering services includes benevolence (locally available and caring), fairness (accessible to all and non-discriminatory), and competence (acceptable and effective in meeting survivors' needs). Guided by this conceptualization, we conducted an integrative review drawing on four databases: PsycINFO, PubMed, Web of Science, and Westlaw. We identified studies for inclusion that were published between January 2005 and March 2022, and we examined the trustworthiness of community-based providers serving adult IPV survivors in the United States, including domestic violence services, health and mental health care, the legal system, and economic support services (N = 114). Major findings include (1) many survivors live in communities with no shelter beds, mental health care, or affordable housing; (2) many services are inaccessible because they lack, for example, bilingual staff, sliding fees, or telehealth options; (3) too many providers are harmful or discriminatory toward survivors, especially those who are, for example, sexual or gender minorities, immigrants or non-English-speaking, poor, or Native, Black, or Latinx; (4) many providers appear to be incompetent, lack evidence-based training, and are ineffective in meeting survivors' needs. We call on researchers, advocates, and providers to examine provider trustworthiness, and we offer an introduction to measuring it.

Rural/urban differences in rates and predictors of intimate partner violence and abuse screening among pregnant and postpartum United States residents

OBJECTIVE

To describe rates and predictors of perinatal intimate partner violence (IPV) and rates and predictors of not being screened for abuse among rural and urban IPV victims who gave birth.

DATA SOURCES AND STUDY SETTING

This analysis utilized 2016-2020 Pregnancy Risk Assessment Monitoring System (PRAMS) data from 45 states and three jurisdictions.

STUDY DESIGN

This is a retrospective, cross-sectional study using multistate survey data.

DATA COLLECTION/EXTRACTION METHODS

This analysis included 201,413 survey respondents who gave birth in 2016-2020 (n = 42,193 rural and 159,220 urban respondents). We used survey-weighted multivariable logistic regression models, stratified by rural/urban residence, to estimate adjusted predicted probabilities and 95% confidence intervals (CIs) for two outcomes: (1) self-reported experiences of IPV (physical violence by a current or former intimate partner) and (2) not receiving abuse screening at health care visits before, during, or after pregnancy.

PRINCIPAL FINDINGS

Rural residents had a higher prevalence of perinatal IPV (4.6%) than urban residents (3.2%). Rural respondents who were Medicaid beneficiaries, 18-35 years old, non-Hispanic white, Hispanic (English-speaking), or American Indian/Alaska Native had significantly higher predicted probabilities of experiencing perinatal IPV compared with their urban counterparts. Among respondents who experienced perinatal IPV, predicted probabilities of not receiving abuse screening were 21.3% for rural and 16.5% for urban residents. Predicted probabilities of not being screened for abuse were elevated for rural IPV victims who were Medicaid beneficiaries, 18-24 years old, or unmarried, compared to urban IPV victims with those same characteristics.

CONCLUSIONS

IPV is more common among rural birthing people, and rural IPV victims are at higher risk of not being screened for abuse compared with their urban peers. IPV prevention and support interventions are needed in rural communities and should focus on universal abuse screening during health care visits and targeted support for those at greatest risk of perinatal IPV.

"I Need Help With the Abortion, so I Won't Have to Ever See or Hear From Him Again": Relationship Barriers Faced by Abortion Fund Applicants in the Rocky Mountain West

To explore the factors impacting abortion access for abortion fund clients, data from 816 applicants was analyzed using a summative content analysis approach. Nine relationship themes emerged for applicants who cited their partner as a significant factor in their abortion decision-making, including (a) power and control, (b) fear and safety concerns, (c) leaving the relationship, (d) barriers to accessing care, (e) sexual violence, (f) perpetration and victimization, (g) having an unsupportive partner, (h) being partnerless, and (i) having a supportive partner. Abortion funds are a potential resource for those experiencing intimate partner violence and can support survivors through confidential care and referrals.

Rural-urban differences in social and emotional protective factors and their association with child health and flourishing

BACKGROUND

Children in rural communities experience higher mortality rates and less access to health care services than those in urban communities. Protective factors like social support also vary by geography, but their contribution to differences in child health is understudied. Understanding geographic variation in protective health factors could provide insight into their impact on health and guide future intervention strategies.

RESEARCH OBJECTIVE

To examine protective factors' association with child flourishing and child health status in rural and urban communities.

METHODS

Publicly available data from the National Survey of Children's Health, 2018-2021, with nonmissing geographic data (N = 150,493) were used to assess the relationship between protective factors and child flourishing and health by rurality. Multivariate survey-weighted probit models examined these relationships, adjusting for child and caregiver characteristics.

FINDINGS

More than a third of children were not flourishing, according to parental report. An estimated 62% of rural children were flourishing compared to 66% of urban children (P<0.001). Urban caregivers also were more likely to report better adult mental and physical health status. Nevertheless, rural children were reported to receive more social support than urban children, while their caregivers reported more emotional support and living in supportive and safe neighborhoods (P<0.001). Rural caregivers reported more support from places of worship and less from counselors/other mental health care providers than urban caregivers.

CONCLUSIONS

Despite higher reported caregiver emotional support and child social support, fewer rural children are flourishing. Health systems and community organizations able to leverage these existing social and emotional protective factors in rural communities could help close this gap.

Female Homicide Victims in Cook County, Illinois: A Retrospective Review

ABSTRACT

Female homicide is a broad term that includes any homicide in which the victim is a female, representing the most extreme form of violence against women. This study investigated the characteristics of female homicides to determine the types and characteristics of injury, circumstances of the events, and other aspects in this specific population. The Cook County Medical Examiner's Office files were searched for homicides in female subjects between January 2017 and January 2022, with no limits for age, race, or cause of death. A total of 527 cases met the criteria. Most homicides occurred in Chicago during the summer. The most common cause of death was firearm(s) wounds, followed by sharp force traumas, asphyxia, and blunt force injuries. The remaining deaths were due to combined and "other" mechanisms. Different patterns of injuries were observed at the autopsy. Alleged offenders were mostly male subjects and were frequently in a romantic relationship with the victim, and the reasons for homicide were related to jealousy and personal conflicts. This study offers an overview of homicidal deaths in female subjects in a large metropolitan area.

Intimate Partner Violence Among Service Members and Veterans: Differences by Sex and Rurality

Among military service members and veterans (SMVs), factors unique to military service may contribute to an elevated risk of experiencing intimate partner violence (IPV) victimization. Although rurality has been established as a risk factor for IPV, differences in IPV victimization by rural- urban dwelling location, SMV status, and sex have not been explored. The purpose of this study was to estimate the rate of IPV victimization in rural and urban areas in the United States by SMV status and sex. We obtained Behavioral Risk Factor Surveillance System data (BRFSS; n = 18,755); fit a mixed-effects, multilevel generalized linear model to the data for IPV victimization; and linked the model to U.S. Census Bureau population count data. We generated predicted estimates of IPV for SMVs and civilians separately by sex in rural and urban areas. The direct IPV victimization prevalence rate for the entire BRFSS sample was 16.90%. Substantial variation in model-based IPV prevalence was observed across subgroups. Female SMVs (rural = 23.54%, 95% confidence interval [CI] [17.33, 30.02]; urban = 23.34%, 95% CI [17.48, 30.17]) had higher IPV victimization rates than female civilians (rural = 14.55%, 95% CI [13.06, 16.37]; urban = 14.50%, 95% CI [13.19, 16.34]), whereas male civilians (rural = 8.06%, 95% CI [7.19, 9.08]; urban = 8.02%, 95% CI [7.27, 9.02]) had higher IPV victimization rates than male SMVs (rural = 7.21%, 95% CI [6.03, 8.47]; urban = 7.17%, 95% CI [6.00, 8.41]). Programming for preventing and assisting in recovering from IPV exposure should target rural-dwelling female SMVs.

Knowledge and attitudes of rural healthcare providers regarding domestic violence against women: a systematic review

BACKGROUND

Specific types of violence such as intimate partner sexual violence and intimate partner homicide occur more frequently in rural areas.

OBJECTIVE

This study aimed to systematically review the literature on the knowledge and attitudes of rural healthcare providers regarding cases of domestic violence against women.

DESIGN AND SETTING

Systematic review developed at Universidade Federal de Uberlândia.

METHODS

We conducted an electronic search of six databases, which only included observational studies, regardless of the year, language, or country of publication, except for studies that used secondary data and were exclusively qualitative. Two reviewers performed the selection, data extraction, and risk of bias assessment using a specific Joanna Briggs Institute tool.

RESULTS

Six studies met the inclusion criteria. All the studies had a low risk of bias. Approximately 38% of these professionals identified injuries caused by violence in patients. When asked about knowing the correct attitude to take in cases of confirmed violence, between 12% and 64% of rural healthcare providers answered positively; most of them would refer to specialized institutions and promote victim empowerment and counseling. The number of professionals with an educational background in the field ranged from 16% to 98%.

CONCLUSIONS

The evident disparity across studies shows that some professionals have suboptimal knowledge and require training to adopt the correct attitude when identifying female victims of domestic violence in clinical practice.

SYSTEMATIC REVIEW REGISTRATION

This systematic review was registered in the Open Science Framework Database under the registration http://doi.org/10.17605/OSF.IO/B7Q6S.

Tightened social distancing measures and increased violence during the COVID-19 pandemic in South Korea

Introduction

In 2020, the South Korean government introduced social distancing measures, varied by region, to address the pandemic. We captured variations in social distancing measures among regions in South Korea and investigated the association between the stringency of measures and the increased incidence of violence.

Methods

Incidence reports from calls to violence hotlines, including school and domestic violence and sexual harassment, from 2016 to 2021 were retrieved. The regional per capita incidence rates for each violence hotlines were calculated. Difference-in-difference design with fixed effects was used to elucidate different trends in the incidence rate of violence between regions with stringent social distancing measures and regions with looser measures.

Results

Social distancing measures led to a decreased incidence rate of school violence and an increased incidence rate of domestic violence and sexual harassment. Different trends in the incidence of violence were noted between regions with strict social distancing measures and regions with more lenient measures. Tightened measures caused surges in domestic violence and sexual harassment.

Conclusion

Social distancing measures have been an inevitable mitigation strategy against virus transmission throughout the pandemic. However, women residing in tightened social distancing measures, in particular urban areas, need more support against domestic violence.

Reproductive Autonomy in Appalachia: An Investigation into Perceived Contraceptive Pressure

The reproductive autonomy of persons who can give birth can be impeded through forms of interpersonal violence and coercion. Moreover, macro-level factors (e.g., poverty, discrimination, community violence, legislative policies) may impede the reproductive autonomy of entire communities. This study investigates a form of violence we term perceived contraceptive pressure in Appalachia, an understudied region of the Eastern U.S., regarding reproductive health and decision-making. Through targeted Meta advertising, participants (N = 632) residing in Appalachian zip codes completed an online survey on reproductive health. The focus of this study was to investigate the prevalence of perceived contraceptive pressure, who was at increased risk of experiencing pressure, and the source(s) of perceived pressure. Binomial regressions were conducted on three different dependent variables: perceived pressure to be sterilized, perceived pressure to use birth control, and perceived pressure not to use birth control. Approximately half of all respondents (49.5%) reported experiencing at least one type of pressure targeting contraceptive decision-making. The most prevalent source of perceived pressure to use birth control was from the healthcare provider (67.4%), and the most prevalent source of perceived pressure not to use birth control was the respondent's partner (51.1%). Recommendations for providers serving clients in the Appalachian region include pursuing education regarding contraceptive pressure at the individual level and macro-level. In addition, Appalachian residents may benefit from educational programming on reproductive autonomy, healthy relationships, and how to navigate pressure in relationships.

The Evaluation of a Domestic Abuse Response Team Program in an Emergency Department

Purpose

Domestic abuse (e.g., family violence) occurs globally and increases the risk for lifelong adverse health outcomes for all members involved. Although victims of domestic abuse often refrain from seeking support due to various reasons (e.g., fear), health centers such as emergency departments (EDs) can serve as outlets for assistance. The Domestic Abuse Response Team (DART) is a program working collaboratively with a regional hospital center in Alberta, Canada, uniquely providing immediate, expert, and patient-oriented services (e.g., safety plans) to domestic abuse victims within the ED. This study aimed to evaluate the DART program by: (1) using administrative data to characterize ED and DART patient characteristics and (2) examining staff perceptions about DART's operations, effectiveness, challenges, and improvements.

Methods

A mixed-methods approach was used to collect data from April 1st, 2019 to March 31st, 2020. Quantitative data consisted of descriptive statistics on patient and staff characteristics and qualitative data was collected through two surveys to determine perceptions of the DART program.

Results

Approximately 60% of ED patients were screened for domestic abuse and 1% were referred to DART, of which 86% were female. All referrals received support within an hour and were provided patient-oriented assistance. Qualitative data revealed that the DART program offers important support to patient victims, increases comfort around dealing with domestic abuse, and decreases ED staff workloads.

Conclusions

The DART program offers valuable support to domestic abuse victims. Staff reported that DART is effective in providing victims with immediate care and services while also supporting ED staff.

Needs and unmet needs for support services for recently pregnant intimate partner violence survivors in Ethiopia during the COVID-19 pandemic

BACKGROUND

Globally, 2-14% of women experience intimate partner violence (IPV) during pregnancy. Timely response to IPV is critical to mitigate related adverse health outcomes. Barriers to accessing limited IPV support services are pervasive in low- and middle-income countries (LMICs), such as Ethiopia; key barriers include mistrust, stigmatization, and self-blame, and discourage women from disclosing their experiences. Infection control measures for COVID-19 have the potential to further disrupt access to IPV services.

METHODS

In-depth qualitative interviews were undertaken from October-November 2020 with 24 women who experienced IPV during recent pregnancy to understand the needs and unmet needs of IPV survivors in Ethiopia amid the COVID-19 pandemic. Trained qualitative interviewers used a structured note-taking tool to allow probing of experiences, while permitting rapid analysis for timely results. Inductive thematic analysis identified emergent themes, which were organized into matrices for synthesis.

RESULTS

Qualitative themes center around knowledge of IPV services; experiences of women in seeking services; challenges in accessing services; the impact of COVID-19 on resource access; and persistent unmet needs of IPV survivors. Notably, few women discussed the violence they experienced as unique to pregnancy, with most referring to IPV over an extended period, both prior to and during COVID-19 restrictions. The majority of IPV survivors in our study heavily relied on their informal network of family and friends for protection and assistance in resolving the violence. Though formal IPV services remained open throughout the pandemic, restrictions resulted in the perception that services were not available, and this perception discouraged survivors from seeking help. Survivors further identified lack of integrated and tailored services as enduring unmet needs.

CONCLUSIONS

Results reveal a persistent low awareness and utilization of formal IPV support and urge future policy efforts to address unmet needs through expansion of services by reducing socio-cultural barriers. COVID-19 impacted access to both formal and informal support systems, highlighting needs for adaptable, remote service delivery and upstream violence prevention. Public health interventions must strengthen linkages between formal and informal resources to fill the unmet needs of IPV survivors in receiving medical, psychosocial, and legal support in their home communities.

Rural and Urban/Suburban Victim Professionals' Perceptions of Gender-Based Violence, Victim Challenges, and Safety Advice During the COVID-19 Pandemic

This study surveyed a national sample of victim service professionals (N  =  222) and compared rural versus urban/suburban participants' perceptions of a variety of issues, such as the impact of the pandemic on gender-based violence victimization and safety advice for isolated victims. Increased interference with victim employment and the abuser monitoring of online activities were reported by participants across all communities. However, urban/suburban participants rated the magnitude of all victim challenges as greater, while more rural participants noted child abuse as a particular problem in their communities. The results highlight the importance of community context for improving coordinated responses to gender-based violence (n  =  101).

"He Will Not Leave Us Alone and I Need the Courts to Help": Defendants' Use of Nonphysical Violence in Domestic Violence Protective Order Cases

District court judges who make final determinations in domestic violence protective order (DVPO) cases in North Carolina indicate often using heuristics, such as the presence of visible injury, to guide their assessment of violence severity. This approach is concerning as it minimizes nonphysical intimate partner violence. We conducted a thematic analysis of DVPO plaintiff complaints to identify the types of nonphysical vioence described and its effects on plaintiff health outcomes. Most case files included descriptions of nonphysical violence and plaintiffs described fear as a significant mental health outcome. Findings highlight the potentially deleterious impact of nonphysical violence on the well-being of DVPO plaintiffs.

Rural Differences in Victim Vulnerability and Revictimization of Intimate Partner Violence

The aim of this study was to examine the association between the victim vulnerability factors included in the intimate partner violence (IPV) risk assessment tool used by the Swedish police (Brief Spousal Assault Form for the Evaluation of Risk [B-SAFER]) and rates of IPV revictimization among female victims living in rural towns, countryside, or remote areas. This study also aimed to examine the interaction between rurality and IPV revictimization in relation to victim vulnerability. The sample consisted of 695 cases of male-to-female perpetrated IPV, which had been reported to the Swedish police and subjected to a B-SAFER assessment. Rates of revictimization were examined in police registers. The results demonstrated that several vulnerability factors could discriminate between IPV revictimization across rurality. There was also an interaction effect between rurality and IPV revictimization in relation to the number of victim vulnerability factors present, where revictimization was more common for victims with many vulnerability factors living in more sparsely populated areas.

Comparison of Intimate Partner Violence and Correlates at Urgent Care Clinics and an Emergency Department in a Rural Population

This paper describes the prevalence of and factors associated with intimate partner violence (IPV) in the urgent care setting and an academic emergency department in Appalachia. A questionnaire assessing social support, mental and physical health status, substance use, and intimate partner violence was administered to 236 women seeking care in an academic emergency department or two affiliated urgent care clinics. Data collected were compared to IPV screening data from medical records. Separate logistic regression models were fit to estimate the association between sociodemographic and health-related factors and lifetime physical and sexual intimate partner violence, adjusted for the clinical setting. Of the 236 participating women, 63 were seen in the emergency department and 173 were seen in an urgent care clinic. Emergency department patients were significantly more likely to report lifetime threatened physical, physical, or sexual abuse. Based on medical records, over 20% of participants had not been screened for IPV by clinical staff during their healthcare visit. Of those that were screened, none disclosed IPV, despite a substantial proportion reporting IPV on the survey. Although survey reports of IPV were lower in the urgent care clinics, this remains an important location to introduce screenings and resources.

Understanding the Geography of Victimization: A Spatial Analysis of Intimate Partner Violence in India

Most studies on intimate partner violence (IPV) and its drivers have focused on individual-and household-level characteristics of the victim. Recent studies have acknowledged that it is a community-level phenomenon, using spatial analytical methods to analyze community-level determinants of IPV and its geographic dimensions. Such studies provide mixed evidence on the impact of different factors and need to be supplemented by similar studies-particularly in South Asian countries where IPV is common. The present study examines district-level variations in the incidence of various forms of IPV and identifies its determinants in India, a fast-growing South Asian country with poor gender indicators. The study combines data from the National Family Health Survey, District Level Household Survey, and the decadal Census. It applies spatial analytical methods such as the Global Moran's I, Getis-ord statistic, and Multivariate Local Geary to determine the nature of the spatial distribution of different categories of IPV. Spatial regression models are used to identify the community-level predictors of each category of IPV. The study finds non-random overlapping spatial clusters in the eastern part of India. The study also finds that neighborhoods characterized by low empowerment levels, and with a high child sex ratio, road connectivity, and proportion of socially marginalized groups are more likely to exhibit high levels of all types of IPV-although the impact of these determinants varies across districts. Furthermore, spill-overs in the incidence of IPV between neighboring districts are also observed. The study concludes by recommending the use of localized policies, rather than broad national or state policies, in reducing IPV.

Exploring Help-Seeking Predictors Among Colombian Victims of Intimate Partner Violence in Different Age Groups

This study examined the extent, source, and individual, microsystem, exosystem, and macrosystem-level (Heise's Ecological Model) predictors of help-seeking behaviors among women of different age groups in Colombia. Data on 12,915 married or cohabitating women who had experienced diverse forms of intimate partner violence (IPV) were obtained from the Colombia Demographic Health Survey 2015. More than half of the Colombian women who reported some form of IPV experience did not seek any help. Women aged 25-39 were less likely to seek help. Type of violence and experience of IPV and education were the strongest predictors of help-seeking among women in all age groups. Implications for research and programming are discussed.

Navigating multiple pandemics: A critical analysis of the impact of COVID-19 policy responses on gender-based violence services

COVID-19 illustrated what governments can do to mobilise against a global threat. Despite the strong governmental response to COVID-19 in Canada, another 'pandemic', gender-based violence (GBV), has been causing grave harm with generally insufficient policy responses. Using interpretive description methodology, 26 interviews were conducted with shelter staff and 5 focus groups with 24 executive directors (EDs) from GBV service organizations in Ontario, Canada. Five main themes were identified and explored, namely that: (1) there are in fact four pandemics at play; (2) the interplay of pandemics amplified existing systemic weaknesses; (3) the key role of informal partnerships and community support, (4) temporary changes in patterns of funding allocation; and (5) exhaustion as a consequence of addressing multiple and concurrent pandemics. Implications and recommendations for researchers, policy makers, and the GBV sector are discussed.

A cross-sectional study of women's autonomy and modern contraception use in Zambia

BACKGROUND

Modern contraceptive use effectively prevents unwanted pregnancies, promoting maternal and child health and improving the socio-economic well-being of women and their families. Women's autonomy has been shown to increase the uptake of modern contraception use. This research aimed to investigate the relationship between measures of women's autonomy and modern contraception use among partnered women in Zambia.

METHODS

This cross-sectional survey study used data from the health census, the 2018 Zambia Demographic Health Survey. We measured women's autonomy using three indices: women's participation in decision-making, women's attitude towards wife-beating and women's household status. Information from 6727 women in a relationship, not pregnant, not planning pregnancy and aged between 15 and 49 years old were analyzed using descriptive statistics and adjusted odds ratios (AOR).

RESULTS

The mean age of respondents was 32 years. Most women lived in rural areas (65%), and 81% were protestant. Current modern contraception use among partnered women was 8.8%. Women's autonomy was significantly associated with modern contraception use. Women with moderate autonomy (AOR = 1.054, P value = 0.004, 95% CI 1.048-1.312) and high autonomy (AOR = 1.031, P value = 0.001, 95% CI 1.013-1.562) had higher odds of using modern contraception compared to those with low autonomy. Other factors related to modern contraception use included a higher level of education (AOR = 1.181, P value = 0.012, 95% CI 1.091-1.783), increased wealth index (AOR = 1.230, P value = 0.006, 95% CI 1.105-1.766) and age, 15-24 (AOR = 1.266, P value = 0.007, 95% CI 1.182-2.113,) and 25-34 (AOR = 1.163, P value = 0.002, 95% CI 1.052-1.273).

CONCLUSION

This study argues that increasing women's assertiveness to make independent decisions within the household is cardinal to enhancing the uptake of modern contraception in Zambia and other low-and-middle-income countries. Governments and other stakeholders must therefore consider rolling out programs to boost women's autonomy, which in turn would support gender equality and reproductive health.

Resilience is more than Nature: An Exploration of the Conditions that Nurture Resilience Among Rural Women who have Experienced IPV

Purpose

Intimate partner violence (IPV) is a significant public health concern exacerbated by the pandemic. Experiences of violence vary based on geographic location and living in rural communities has been found, in some contexts, to amplify consequences of IPV. Resilience, the ability to survive and thrive despite facing adversity, has long been a dominant narrative within IPV literature, yet little is known about how resilience is cultivated among rural women experiencing violence. The purpose of this study was to explore how rural women experiencing IPV cultivate resilience.

Methods

Using Interpretive Description, in-depth qualitative interviews were conducted with 14 women who experienced IPV and 12 staff from women's shelters across rural communities in Ontario, Canada to elicit perspectives about women's resilience and environmental conditions that may shape resilience in the context of IPV.

Results

Women's resilience was cultivated by personal changes aimed at surviving or thriving, and aspects of their environment that enabled or created barriers for resilience. Women adopted a positive, hopeful mindset and bolstered their inner strength through living from a place of integrity, being resolute in decisions, and using mental resistance when faced with doubt. Women faced barriers to resilience in the form of unhelpful help and COVID-19 public health guidelines. Paradoxically, living in a rural community both cultivated and undermined resilience.

Conclusions

Supporting women to cultivate resilience through modifying environmental factors to enable personal strengths to flourish is paramount in supporting women who have experienced IPV, particularly in rural contexts.

Perceptions of Risk for Dating Violence Among Rural Adolescent Males: An Interpretive Analysis

About one in eight U.S. high school students in Grades 9 to 12 report experiencing teen dating violence (TDV) in the form of physical, sexual, or psychological dating violence in the past year in person, on school grounds, and online. Compared with their urban counterparts, rural teens face nearly double the rate of physical dating abuse and an elevated risk of experiencing multiple forms of violence. Rural young males are exposed to regional masculinities and gender norms that may simultaneously promote female subordination (a prelude to dating violence) while impeding help-seeking intentions. We used an interpretive and dialectical approach grounded in Relational Dialectics Theory to explore how rural young males perceive and describe their own risk of experiencing and perpetrating dating violence and the factors contributing to their help-seeking intentions and behaviors. Data from three focus groups and individual interviews with 27 rural young males (ages 15-24) were collated. We identified two central dialectical themes described as (a) Social Tension Dialectics (subthemes include: Abusive vs. Unhealthy Relationships: A Dialectic of Language; #MeToo vs. #WeToo: A Dialectic of Victimhood; "It's All Country Boys": A Dialectic of Masculinity) and (b) Help-Seeking Dialectics demonstrating the dual roles Religion, School Guidance Counselors, Peer Mentors, and Social Cohesion play in promoting or preventing dating violence. Overall, we found dialectic tensions in rural youth risk perceptions about dating violence. These findings bear implications for advocates and practitioners working with rural youth in planning developmentally and culturally appropriate TDV prevention programs, offering policy and research-relevant insight.

The Association Between Resources, Accessibility, and Female Victim Intimate Partner Homicide at the County-Level in Florida

Limited research has been conducted to understand possible relationships that exist between IPH and access to DV services. The current study adds to the literature by expanding traditional measures of DV services to capture presence, as well as access, and examines the impact on female IPH victimization across 67 Florida counties between 2005 and 2015. Using exposure reduction arguments, we shed light on factors associated with female victim IPH rates and support previous research findings showing a continuation in the disparity of IPH rates between urban and rural areas within county boundaries. We also demonstrate the importance of accessible shelter and safe homes in combating IPV and IPH rates.

"Helping Somebody Else Has Helped Me Too": Resilience in Rural Women With Disabilities With Experiences of Interpersonal Violence

The concept of resilience, the ability to "bounce back," from adversity, can inform interpersonal violence interventions and victim assistance services. Unfortunately, though women with disabilities (WWD) experience high rates of all forms of violence and multiple layers of adversity, existing resilience research overlooks this populations' experiences, perspectives, and resilience strategies. The impairment, socially misperceived as a personal tragedy, precludes individuals with disabilities from being considered resilient; rather, they are designated almost universally as "at risk" or "vulnerable." This study aims to remedy this gap in understanding and scholarship. This qualitative study engaged 33 rural women with diverse disabilities who experienced violence to learn about how they cultivated resilience to support recovery and growth after experiencing abuse. Women described key personal qualities and supportive networks and services, such as internal drive, connectedness, dedication, healthy and helpful outlets, and an evolution of thoughts and behaviors. Counter to prevailing perceptions of WWD as dependent and helpless, women described how living with a disability honed strengths fundamental to their resilience. Women also described an "altruism born of suffering" wherein their experiences of violence contributed to a desire to give back and help others in difficult circumstances.Women's insights help to build a more comprehensive understanding of effective strategies and supports to bolster WWD's resilience. These findings inform interventions and promote approaches to build on women's strengths and resourcefulness.

Legitimacy, incipience, and perception of informal social control of intimate partner violence: Experiment on a Korean parent sample

Evidence from a growing research literature on the causes and effects of informal social control (ISC) and bystander interventions carried out by nonprofessionals against intimate partner violence (IPV) shows anomalies and unexplained counterintuitive findings. This study employs a new experimental vignette design to examine the hypothesis: high bystander legitimacy (in the eyes of potential perpetrators) will moderate the effects of (1) incipient ISC and (2) perceived ISC, on parent's self-estimated likelihood of perpetrating IPV. The data consist of 210 rural Korean parents randomly drawn from Kyunggi province using a three-stage cluster probability proportional to size approach. Parents were randomly assigned to low and high incipient ISC, perceived ISC, and collective legitimacy conditions, following a 2 × 2 × 2 experimental vignette approach. Hypotheses were tested using regression models with standard errors corrected for district clusters. Incipient ISC was associated with significantly less self-estimated likelihood of perpetrating IPV. An interaction between high bystander legitimacy and incipient ISC was negative (B = -8.88, p < 0.01). The interaction between perceived ISC and legitimacy was not significant. However, the interaction between perceived ISC and female gender was positively associated with self-estimated likelihood of perpetrating IPV (B = 8.61, p < 0.05). The findings suggest that the presence of a legitimate bystander (whom the potential perpetrator believes has a legitimate right to be concerned about his or her family) may deter parents from perpetrating IPV. Programs to boost ISC and bystander intervention should include modules that strengthen collective legitimacy.

Providing therapeutic services to women and children who have experienced intimate partner violence during the COVID-19 pandemic: Challenges and learnings

BACKGROUND

In the face of the COVID-19 pandemic, many therapeutic services for children and their parents who had experienced intimate partner violence (IPV) were required to rapidly transition to telehealth.

OBJECTIVE

The current study aims to explore parents' experiences of participating in a parent-child telehealth intervention during the COVID-19 pandemic. The study also aimed at exploring clinicians' experiences of delivering the service, including key strengths and challenges.

PARTICIPANTS AND SETTING

Participants were five mothers who took part in Berry Street's Restoring Childhood service during the COVID-19 pandemic in Melbourne, Australia, and 14 Restoring Childhood clinicians, delivering the service across metropolitan and regional sites.

METHODS

Semi-structured qualitative interviews were conducted, and data were analysed using thematic analysis to determine key themes and sub-themes within the data.

RESULTS

Parents identified several strengths and benefits of Restoring Childhood delivered via telehealth including improvements in parenting skills and confidence, parent-child relationships, and children's emotional-behavioural functioning. Both parents and clinicians noted the creativity utilised during the online approach, and the increased accessibly it offered for families. However, challenges to the telehealth approaches were also noted. Clinicians discussed important considerations for telehealth within this context including safety and confidentiality, technology challenges, and challenges working from home.

CONCLUSIONS

The current study highlights the promise of telehealth interventions for parents and children who have experienced IPV. It also poses several important considerations for the use of telehealth within this setting and emphasises the need for rigorous evaluations of telehealth services for children exposed to IPV.

Online Conversations About Abuse: Responses to IPV Survivors from Support Communities

Purpose

Intimate partner violence (IPV) impacts the lives of millions, damaging survivors and families. Many survivors are unsure how to get help, and have limited access to resources. In recent years, those affected by IPV have turned online for answers, support, and to share their experiences. This study examined the online dialogue between survivors of violence and those who respond to their posts.

Method

Data consisted of 451 responses to IPV survivors on the website Reddit in a domestic violence subgroup. Responses were analyzed using a combination of grounded theory coding techniques with content analysis tools to generate categories and subcategories.

Results

Three main categories emerged from the data, including support, sharing experiences, and sharing information. The subcategories included specific types of help, advice, understanding, and were overwhelmingly positive in their tone and content.

Conclusions

Findings suggest that online forums may help bridge the gap between survivors and resources. Professionals who work with IPV or create policies can use these findings to understand how to help survivors find support. This may include encouraging survivors to connect with informal supports such as family and friends, or access formal support such as hotlines, therapy, or legal counsel. The findings also suggest that more research is needed to understand what types of questions survivors of violence have, and what outcomes result from online support.

Assessment of geographic access to monoclonal antibodies in the United States

Using spatial modeling techniques, we highlight disparities in access to monoclonal antibodies (mAbs) used to treat COVID-19 patients. Fifteen million individuals in the United States must travel over 30 min to access mAbs. Areas with lower COVID-19 vaccination rates have worse access to essential COVID-19 therapeutics.

Dating Violence Among Rural Adolescents: Perpetration and Victimization by Gender

Adolescent dating violence (ADV) is a serious concern with various negative impacts on adolescent development. Research on ADV has predominantly been conducted in urban areas and has generally focused on physical and sexual forms of violence. The purpose of this study was to assess prevalence rates of various forms of ADV by gender in the rural context. A convenience sample of rural adolescents responded to an online survey. In total, 131 responses were used for this study. Participants reported perpetration and victimization experiences of physical abuse, sexual abuse, threatening behavior, relational aggression, verbal abuse, and cyber dating abuse. Descriptive statistics and chi-square analyses were used to determine gender differences in proportion and frequency of ADV. Results reveal that various forms of ADV are occurring in the rural context, with many of both males and females reporting perpetration and victimization. Overall, verbal and cyber ADV are the most common. Gender analysis reveals that males were significantly more likely to be victimized by physical abuse victimization, whereas females were significantly more likely to be victimized by sexual abuse. Though the proportion of adolescents reporting ADV were high in this study, most participants reported lower frequencies of ADV. Results support the urgent need in rural areas for education and prevention that target physical, sexual, and psychological components of healthy relationships. Rural dating violence prevention efforts must emphasize the importance of mutual respect across gender, rather than solely presenting this lesson to males in a traditional gendered manner. Results also suggest the need for rural areas to adopt comprehensive sex education that details sexual relationships that are consensual and healthy.

Association between Sociodemographic Factors and Abuse by a Parent or Intimate Partner Violence among Haitian Women: A Population-Based Study

One in three Haitian women, and two in three Haitian children, experience physical abuse. This study aims to assess characteristics of abused Haitian women and identify effective sources of support. This cross-sectional study used multiple logistic regression models to analyze sociodemographic characteristics of Haitian women, associations with abuse-exposure from a parent/intimate partner (IPV)/any perpetrator, and impacts of seeking help for abuse, from police/doctors/family. About 9.1% experienced abuse by a parent, 8.6% from IPV. Women abused by a parent were less likely to be employed (OR = 0.74, [95% CI = 0.59–0.93]) and more likely to have an often-drunk partner (2.10, [1.54–2.87]). IPV-exposed women were more likely to have primary education (1.56, [1.12–2.16]), an often-drunk partner (3.07, [2.24–4.22]) and less likely to live rurally (0.65, [0.47–0.89]). Seeking help from own family for IPV exposure was strongly associated with having a job (2.00, [1.04–3.89]) (P for interaction = 0.039) and seeking help from partner’s family for IPV was strongly associated with having an often-drunk husband (8.80, [3.07–25.23]) (p for interaction <0.001). We recommend family-based interventions targeting men’s perceptions about abuse and their alcohol consumption, introducing programs/policies integrating women into the workforce, and havens for abuse victims to confidentially receive individualized support.

Mitigating the Impact of the Coronavirus Pandemic on Rural Low-Income Families

The COVID-19 pandemic has disrupted rural communities and is exacerbating the economic, health, and social inequality for poor Americans in rural areas. Mounting job losses and illness in these communities are also pushing low-income families further into poverty. Based on previous research on rural poverty, this paper highlights the difficulties that marginalized rural families could experience due to the current pandemic. We focus on five major areas that affect the lives of the rural poor: economic security, family well-being, food insecurity, health security, and the challenges of rural living with a special focus on racial and ethnic minority families. We provide tangible recommendations on what can be done in the short term to enable rural families to cope with the consequences of the pandemic. We also discuss long-term policy recommendations that would be necessary for rural communities to thrive after the pandemic and survive future outbreaks.

Longitudinal Patterns in Adolescent Intentions to Seek Help for Dating Violence: A Latent Transition Analysis

As a persistent public health problem affecting thousands of adolescents every year, teen dating violence has been studied extensively. However, gaps remain in the knowledge on what adolescents think about seeking help for violence in a dating relationship and how these attitudes might change over time. This study adopts a longitudinal person-oriented approach to explore configurations of help-seeking preferences in a sample of rural adolescents (N at wave 1 = 580, M_age = 13 years, SD = 1.48; 52.7% female; 46.6% African American, 39.4% White, 14% Hispanic and other minorities), surveyed annually for four years, with each assessment approximately 12 months apart. Latent class analyses uncovered variation in adolescents' willingness to disclose dating violence, captured by six groups: (a) Multi-help-seekers (19%), (b) Reluctant help-seekers (15%), (c) Selective help-seekers (16%), (d) Parent confidants (11%), (e) Friends confidants (22%), and (f) Moderate help-seekers (17%). Follow-up analyses revealed that select sociodemographic characteristics (age, gender, and family income) were unevenly distributed among the identified groups, pointing to the need to account for individual and contextual influences in understanding heterogeneity in help-seeking attitudes. Latent transition models further showed that although individual membership in latent classes was generally stable between middle and high school, transitions between help-seeking classes were common as well. The article concludes by discussing these findings in the context of further research and programming to promote help-seeking among developing adolescents, including targeted strategies to address the needs of adolescents who think differently about disclosing dating abuse.

Development, validation, and pilot implementation of the minimum datasheet for a domestic violence registry system: The case of a developing country

Background

Domestic violence (DV) is a universal issue and an important public health priority. Establishing a DV Registry System (DVRS) can help to systematically integrate data from several sources and provide valid and reliable information on the scope and severity of harms. The main objective of this study was to develop, validate, and pilot-test a minimum datasheet for a DVRS to register DV victims in medical facilities.

Materials and methods

This study was conducted in two main phases. Phase one includes developing the datasheet for registration of DV in the DVRS. In phase two, the datasheet designed in the previous step was used in a pilot implementation of the DVRS for 12 months to find practical challenges. The preliminary datasheet was first developed using information on similar registry programs and guidelines of the World Health Organization (WHO) and then reviewed by four expert panels. Through a two-round Delphi technique, experts evaluated the instrument using the Content Validity Index (CVI) and Content Validity Ratio (CVR). The consistency of the responses was evaluated by test-retest analysis. Finally, two physicians in two forensic medical clinics registered the victims of physical and/or sexual violence perpetrated by a family member.

Results

Preliminary datasheet consisted of 31 items. In the first round of Delphi, fifteen items had good content validity (I-CVI and CVR) and were kept, and seven items were moved to the next round. Also, in the first round of Delphi, experts suggested adding three items, including history of the violence, custody of the child, and custody of the elderly. All items evaluated in the second round were kept due to good CVR and CVI scores. As a result of Test-retest correlation coefficients for self-reprted items, two items including perpetrator’s alcohol and drug use status were excluded (r(30) = +.43, and +.38, p< .01, two-tailed, respectively). Finally, 24 items were included in the datasheet including 15 items for individuals’ characteristics (victims’ characteristics and perpetrators’ characteristics), eight items for incidents’ characteristics, and one item for past history of violence experience. A total of 369 cases were registered from September 23, 2019, to July 21, 2020. The majority of the reported cases were female (82%) and were 19–40 years old. No physical and/or sexual violence was reported from rural areas, which calls upon researchers to explore how services for detecting and treating the victims can be made accessible to these areas.

Conclusion

DVRS can show trends in DV by age, sex, the context of the violence, and incidence characteristics at every point in time. This is particularly valuable in planning and prioritizing research areas and interventions for DV prevention. Additionally, DVRS can be linked to other disease registry programs which can contribute to continuity and coordination of care, and major research in the future. Although a DVRS can be a promising initiative in identifying the areas in need of urgent interventions, there is no guarantee for its proper implementation due to limited resources and other challenges.

Same-Sex Intimate Partner Violence in Canada: Prevalence, Characteristics, and Types of Incidents Reported to Police Services

During the past 50 years, there has been an increase in research and programming initiatives focusing on the issue of heterosexual intimate partner violence (Het-IPV). In comparison, less attention has been paid to same-sex intimate partner violence (SS-IPV). Furthermore, of the existing research, the majority focuses on SS-IPV incidents in the United States which, due to social and legal differences, cannot yield an accurate picture of SS-IPV in Canada. This descriptive study sought to understand the prevalence, characteristics, and types of SS-IPV and Het-IPV within a Canadian context, with an emphasis on understanding the differences and similarities of incidents reported to police services. It explores the influences of heteronormativity and hegemonic masculinity on SS-IPV reporting and recognition. To assess this, data from Statistics Canada's 2007-2011 Uniform Crime Reporting (UCR) Surveys were utilized. Participation in this survey is mandatory for all police services and, therefore, the sample used contains over 99% of incidents of IPV reported in Canada during the 4-year period (N = 346,565). The results indicate that 4% of incidents of intimate partner violence reported to the UCR involved people engaged in same-sex relationships. It demonstrates that SS-IPV incidents are similar to Het-IPV incidents in reported prevalence, and the findings also show that there are differences in the types of violations reported and several incident characteristics, including levels of victim injury, and the population density of the offense location. These findings can provide a foundation for future research and raise further questions about how SS-IPV is responded to by the criminal justice system after it has been reported to police services.

Is consanguineous marriage related to spousal violence in India? Evidence from the National Family Health Survey, 2015-16

Violence against women is a global phenomenon, and intimate partner violence is the most common form of violence faced by women in the world. Around 30% of women in the world, on average, and 33% in India experience intimate partner violence during their lifetime. The main aim of this study was to investigate whether consanguinity protects women from spousal violence. National Family Health Survey 2015-16 (NFHS-4) data were used. The study sample comprised 60,824 currently married women aged 15-49 years. The results of the logistic regression model showed that the likelihood of all types of spousal violence against women was higher among consanguineous unions compared with non-consanguineous unions in India. The association between consanguineous marriage and spousal violence was found to be positive and significant in the southern and eastern regions of India and among Scheduled Castes and Scheduled Tribes. The association was not significant among Muslims. Differences in socio-cultural norms and practices across the regions of India, and among different socio-cultural groups, can perhaps explain these variations. Women belonging in higher age groups, from Other Backward Castes, those who were working and those with a low level of educational attainment and socioeconomic standing had a higher risk of experiencing intimate partner violence. Couples in a consanguineous marriage should be given adequate counselling to reduce intimate partner violence in India, and similarly culturally diverse countries. This would also help reach Target 5.2 of the Sustainable Development Goals by 2030.

Continuity and change: Violations of private patriarchal practices and domestic violence against rural wives in China

We investigated how violations of private patriarchal practices affect physical, psychological, and sexual violence against rural wives. The sample was drawn from nationally representative data from the third wave survey on the Social Status of Women in China. We found that (1) women making a similar income or more than their husbands were more likely to experience psychological and physical violence, respectively; (2) the wife's migration experience increased her risk of psychological and sexual violence; (3) husband doing more housework decreased the odds of psychological violence, and equal distribution of housework reduced the likelihood of physical and psychological violence; (4) infertility or having given birth to only daughters was not associated with any form of violence; and (5) equal marital power decreased the wife's likelihood to suffer three forms of violence. A balanced conjugal power structure may effectively prevent domestic violence against wives in societies with traditional and modern influences.

Rural young males' acceptance & receptiveness to technology-based interventions for dating violence prevention: A qualitative descriptive study

INTRODUCTION

Rural youth are twice as likely as urban youth to experience some forms of teen dating violence (TDV), and significant barriers to accessing support services for physical, psychological, sexual violence. However, rural youth remain understudied and undersampled. Rural young men, in particular, are at risk for experiencing or perpetrating dating violence influenced by regional and sociocultural risk factors that promote male supremacy ideals while also impeding male help-seeking. Technology-based interventions circumvent some of these risk factors by offering confidential and reliable support. This study investigates rural young males' acceptability of technology-based interventions for fostering healthy relationships and preventing dating abuse, including their preferences for intervention content and features.

METHODS

Three online focus groups (n = 14) and phone interviews (n = 13) were conducted with rural young males. Participants were stratified by age (15-17 and 18-24 year-olds). Most were White (81%) from the United States Midwest (65%). Semi-structured interview data were analyzed using Qualitative Description (QD), guided by the Unified Theory of Acceptance and Use of Technology (UTAUT).

RESULTS

Three themes identified were (1) Scarcity of Useful Resources, (2) Socio-Structural Challenges for Intervention Uptake, with two subthemes (2a) Rural-Specific Structural Barriers and (2b) Rural Masculinity Disrupting Help-seeking; (3) Finally, participants discussed Functionality and Design Needs, itemizing their intervention "must-have" in terms of content, resources, and features.

CONCLUSION

This qualitative study identified obstacles and facilitators to using technology-based interventions for dating violence prevention among young rural males and offers pragmatic "ready-to-use" recommendations for the development of technology-based anti-dating violence interventions for rural youth.

Intimate partner violence among pregnant women attending antenatal care services in the rural Gambia

BACKGROUND

Intimate partner violence (IPV) refers to any behavior by either a current or ex-intimate partner or would-be rejected lover that causes physical, sexual, or psychological harm. It is the most common form of violence in women's lives. According to a World Health Organization report, about 1 in 3 women worldwide experience at least one form of IPV from an intimate partner at some point in her life. In the Gambia, about 62% of pregnant women experience at least one form of violence from an intimate partner. IPV has severe physical and mental health consequences on a woman ranging from minor bodily injury to death. It also increases the risk of low birth weight, premature delivery, and neonatal death.

METHODS

A health facility-based cross-sectional study design was carried out to assess the magnitude and factors associated with intimate partner violence among pregnant women seeking antenatal care in the rural Gambia. The study enrolled 373 pregnant women, and a multi-stage sampling technique was used to select the respondents. An interviewer-administered structured questionnaire was used to obtain information from the study participants. The collected data were analyzed using SPSS Ver.22. Bivariate and multivariate logistic regression were used to determine the association between dependent and independent variables. Odds ratio with 95% confidence interval (CI) was computed to determine the presence and strength of associated factors with IPV.

RESULT

The study reveals that the prevalence of IPV in The Gambia is 67%, with psychological violence (43%) being the most common form of IPV reported by the respondents. The multivariate logistic regression result reveals that being aged 35 years or older [AOR 5.1(95% CI 1.5-17.8)], the experience of parents quarreling during childhood [AOR 1.7(95% CI 1.0-2.75)], and having cigarette smoking partners [AOR 2.3 (95% CI 1.10-4.6)] were significantly associated with IPV during pregnancy.

CONCLUSION

This study has demonstrated that all forms of IPV in rural Gambia are frequent. Women older than 35 years, had experienced parents quarreling, had a partner who smoked, and a partner who fight with others were more likely report IPV compared to other pregnant women in the study. We recommend that IPV screening should be included as an integral part of routine antenatal care services in The Gambia. Community-based interventions that include indigenous leaders, religious leaders, and other key stakeholders are crucial to create awareness on all forms of IPV and address the risk factors found to influence the occurrence of IPV in rural Gambia.

IPV in Rural Pennsylvania and Magisterial Courts: Case Study

Research on the criminal justice system's response to the problem of intimate partner violence (IPV) largely focuses on police and prosecutorial decision making. Fewer studies are dedicated to exploring how IPV cases are processed by the courts. This study examines the perspectives of judges in the Magisterial Courts in rural counties of Pennsylvania. Semistructured interviews were conducted with 27 magisterial court judges. The findings shed light on magisterial court judges' experiences with IPV cases, the challenges that they face and the factors that influence their determination whether the cases will be prosecuted, dismissed, or proceed to the Court of Common Pleas.

Intimate Partner Violence and Structural Violence in the Lives of Incarcerated Women: A Mixed-Method Study in Rural New Mexico

Intimate partner violence (IPV) is a common feature in the lives of incarcerated women returning to rural communities, enhancing their risk of mental ill-health, substance use, and recidivism. Women's experiences of IPV intersect with challenges across multiple social-ecological levels, including risky or criminalizing interpersonal relationships, geographic isolation, and persistent gender, racial, and economic inequities. We conducted quantitative surveys and qualitative interviews with 99 incarcerated women in New Mexico who were scheduled to return to micropolitan or non-core areas within 6 months. Quantitative and qualitative data were analyzed separately and then triangulated to identify convergences and divergences in data. The findings underscore how individual and interpersonal experiences of IPV, substance use, and psychological distress intersect with broad social inequities, such as poverty, lack of supportive resources, and reluctance to seek help due to experiences of discrimination. These results point to the need for a more proactive response to the mutually constitutive cycle of IPV, mental distress, incarceration, and structures of violence to improve reentry for women returning to rural communities. Policy and treatment must prioritize socioeconomic marginalization and expand community resources with attention to the needs of rural women of color.

Coercive Control Between Intimate Partners: An Application to Nonfatal Strangulation

Nonfatal strangulation between intimate partners represents an extreme controlling form of violent behavior, increasing the risk that intimate partner violence (IPV) becomes lethal. Guided by Dutton and Goodman's conceptualization of coercive control, the present research explored the relation between death threats and subsequent nonfatal strangulation to amplify the credibility of those threats, using a large sample of IPV perpetrators (n = 6,488). Logistic regression analyses determined the relation between overt threats to a partner's life during an initial incident arrest and subsequent nonfatal strangulation postincident arrest, accounting for perpetrator characteristics and assessed risk. Results showed the highly gendered nature of this violent behavior, noting that men were significantly more likely than women to persist in nonfatal strangulation. Given the potential lethality of this violent behavior, the analysis also explored whether treatment service recommendations (family violence education, counseling, and mental health evaluation) mitigate these patterns. These preliminary findings support the further exploration of treatment and intervention efforts for reducing nonfatal strangulation.

A Web of Disheartenment With Hope on the Horizon: Intimate Partner Violence in Rural and Northern Communities

Intimate partner violence (IPV) has become a worldwide epidemic, yet little is known about the experiences of women survivors living in rural and Northern Canadian communities. Existing statistics suggest that women living in rural areas of the Canadian Prairie Provinces and Northwest Territories (NWT) are at a significantly higher risk of experiencing IPV. To better understand the experiences of IPV in these regions, qualitative interviews were conducted with service providers, including the Royal Canadian Mounted Police (RCMP), Victims Services, Shelter Services, counselors, and others (e.g., physicians). In total, 122 participants were interviewed. These interviews were analyzed using a grounded theory approach where the data/results were transformed into a pictorial matrix that documents the struggles that service providers endure. The matrix/results highlight how social issues, such as isolation and poverty, contribute to social oppressions, such as lack of resources, transportation, and/or services. As service providers struggle against these forces, they begin to develop feelings of disheartenment. Yet, they continue to fight because there are opposing forces, such as Emergency Intervention Orders, police transportation, and Victim Services, that demonstrate how societal response is improving the lives and increasing safety in rural and Northern communities. Ultimately, the results suggest that to reduce the incidences of IPV, we must go beyond the violent acts and deal with the social contexts in which IPV resides.

Rapid Review on the Associations of Social and Geographical Isolation and Intimate Partner Violence: Implications for the Ongoing COVID-19 Pandemic

While the COVID-19 pandemic forced millions of people to stay home and minimize their social contacts, newspaper reports worldwide raised concerns as they reported an increasing rate of intimate partner violence (IPV). One link of the measures enforced to control the pandemic to IPV might be a possible side effect of those measures, namely social and geographical isolation. As there was no scientific data investigating the association of IPV and social and geographical isolation in the context of epidemics or pandemics at the time of conducting this rapid review, we aimed at investigating a broader range of contexts of social as well as geographical isolation and its association with IPV to draw conclusions regarding the COVID-19 pandemic. We searched Embase, PubMed, PsycINFO, and Web of Science (core collection). A research strategy was developed and observational studies were included if they considered men and/or women, estimates of social and geographical isolation, and IPV as a primary outcome. Of the 526 identified studies, 11 were included in this review. The included studies involved 15,695 women and were conducted in the USA, Sweden, Ethiopia, Egypt, Spain, and Turkey. Indicators of social isolation such as lack of social, emotional, or informational support or the frequency and quality of social contacts were narratively assessed. Geographical isolation was primarily assessed by physical distance to the next town or support service. Both social and geographic isolation were found to be associated with an increased risk of IPV. Recommendations made by the individual studies include the following: (a) improving access to social networks outside the victims' own group, (b) improving their economic circumstances, (c) asserting the responsibility for those in contact with the victims, and (d) increasing the focus on access to preventive services and programs need to be taken into account. Therefore, considering the particular infrastructure and legislation of the countries affected by the pandemic, policies need to ensure constant access to shelters and other help services and increase awareness for IPV in the society. In addition, future studies are warranted to assess prevalence rates and risk factors of IPV during the COVID-19 pandemic.

A global collaboration to study intimate partner violence-related head trauma: The ENIGMA consortium IPV working group

Intimate partner violence includes psychological aggression, physical violence, sexual violence, and stalking from a current or former intimate partner. Past research suggests that exposure to intimate partner violence can impact cognitive and psychological functioning, as well as neurological outcomes. These seem to be compounded in those who suffer a brain injury as a result of trauma to the head, neck or body due to physical and/or sexual violence. However, our understanding of the neurobehavioral and neurobiological effects of head trauma in this population is limited due to factors including difficulty in accessing/recruiting participants, heterogeneity of samples, and premorbid and comorbid factors that impact outcomes. Thus, the goal of the Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Consortium Intimate Partner Violence Working Group is to develop a global collaboration that includes researchers, clinicians, and other key community stakeholders. Participation in the working group can include collecting harmonized data, providing data for meta- and mega-analysis across sites, or stakeholder insight on key clinical research questions, promoting safety, participant recruitment and referral to support services. Further, to facilitate the mega-analysis of data across sites within the working group, we provide suggestions for behavioral surveys, cognitive tests, neuroimaging parameters, and genetics that could be used by investigators in the early stages of study design. We anticipate that the harmonization of measures across sites within the working group prior to data collection could increase the statistical power in characterizing how intimate partner violence-related head trauma impacts long-term physical, cognitive, and psychological health.

"Now We Are Seeing the Tides Wash In": Trauma and the Opioid Epidemic in Rural Appalachian Ohio

Background: Ohio's opioid epidemic continues to progress, severely affecting its rural Appalachian counties-areas marked by high mortality rates, widespread economic challenges, and a history of extreme opioid overprescribing. Substance use may be particularly prevalent in the region due to interactions between community and interpersonal trauma. Purpose/Objectives: We conducted qualitative interviews to explore the local context of the epidemic and the contributing role of trauma. Methods: Two interviewers conducted in-depth interviews (n = 34) with stakeholders in three rural Appalachian counties, including healthcare and substance use treatment professionals, law enforcement officials, and judicial officials. Semi-structured interview guides focused on the social, economic, and historical context of the opioid epidemic, perceived causes and effects of the epidemic, and ideas for addressing the challenge. Results: Stakeholders revealed three pervasive forms of trauma related to the epidemic in their communities: environmental/community trauma (including economic and historical distress), physical/sexual trauma, and emotional trauma. Traumas interact with one another and with substance use in a self-perpetuating cycle. Although stakeholders in all groups discussed trauma from all three categories, their interpretation and proposed solutions differed, leading to a fragmented epidemic response. Participants also discussed the potential of finding hope and community through efforts to address trauma and substance use. Conclusions: Findings lend support to the cyclical relationship between trauma and substance use, as well as the importance of environmental and community trauma as drivers of the opioid epidemic. Community-level and trauma-informed interventions are needed to increase stakeholder consensus around treatment and prevention strategies, as well as to strengthen community organization networks and support community resilience. Supplemental data for this article is available online at https://doi.org/10.1080/10826084.2021.1887248.