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Berishaj K, McDonald MM, Parkhill MR. Effects of Intimate Partner Violence-Related Strangulation on Women Who Report a Disability and Received Forensic Nursing Services. Violence Against Women 2024:10778012241279136. [PMID: 39396545 DOI: 10.1177/10778012241279136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2024]
Abstract
Data on effects of strangulation in victims with a disability are lacking despite this population experiencing intimate partner violence at higher rates than women without a disability. A retrospective review was conducted on medical records of patients seeking care at a community-based, forensic nurse examiner program following an intimate partner violence-related strangulation event. The presence of disability was not associated with differences in reporting other types of victimization, additional abusive events, perpetrator characteristics, strangulation actions, or injury findings. Patients with a disability were more likely to report experiencing anoxic, hypoxic, and other physical symptoms following strangulation compared to patients without a disability.
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Affiliation(s)
- Kelly Berishaj
- School of Nursing, Oakland University, Rochester, MI, USA
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2
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Toccalino D, Haag H(L, Nalder E, Chan V, Moore A, Wickens CM, Colantonio A. "Using the right tools and addressing the right issue": A qualitative exploration to support better care for intimate partner violence, brain injury, and mental health. PLoS One 2024; 19:e0311852. [PMID: 39392833 PMCID: PMC11469540 DOI: 10.1371/journal.pone.0311852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 08/22/2024] [Indexed: 10/13/2024] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is a global public health crisis. Often repetitive and occurring over prolonged periods of time, IPV puts survivors at high risk of brain injury (BI). Mental health concerns are highly prevalent both among individuals who have experienced IPV and those who have experienced BI, yet the interrelatedness and complexity of these three challenges when experienced together is poorly understood. This qualitative study explored care provision for IPV survivors with BI (IPV-BI) and mental health concerns from the perspectives of both survivors and providers. METHODS This qualitative interpretive description study was part of a broader research project exploring employment, mental health, and COVID-19 implications for survivors of IPV-BI. Participants (N = 24), including survivors and service providers, participated in semi-structured group and individual interviews between October 2020 and February 2021. Interviews were recorded, transcribed, and thematically analyzed. FINDINGS Four themes were developed from interview findings: 1) identifying BI and mental health as contributing components to survivors' experiences is critical to getting appropriate care; 2) supporting survivors involves a "toolbox full of strategies" and a flexible approach; 3) connecting and collaborating across sectors is key; and 4) underfunding and systemic barriers hinder access to care. Finally, we share recommendations from participants to better support IPV survivors. CONCLUSIONS Identifying both BI and mental health concerns among IPV survivors is critical to providing appropriate supports. Survivors of IPV experiencing BI and mental health concerns benefit from a flexible and collaborative approach to care; health and social care systems should be set up to support these collaborative approaches.
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Affiliation(s)
- Danielle Toccalino
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
| | - Halina (Lin) Haag
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Emily Nalder
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vincy Chan
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Amy Moore
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Christine M. Wickens
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Angela Colantonio
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Waterloo, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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3
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Tenkorang EY. Kinship, lineage resources (wealth flow transfers), and intimate partner violence among women in Ghana. Soc Sci Med 2024; 354:117078. [PMID: 38968899 DOI: 10.1016/j.socscimed.2024.117078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 05/22/2024] [Accepted: 06/24/2024] [Indexed: 07/07/2024]
Abstract
Previous research has established relationships between lineage and intimate partner violence (IPV). The findings suggest matrilineal women experience less IPV than patrilineal women. However, the IPV outcomes of bilateral women are unknown because of the limited operationalization of lineage with ethnicity. In our study, we used self-reported and multidimensional measures of lineage to explore its relationship with IPV, focusing particularly on the mechanisms linking the two. We hypothesized that wielding resources would be negatively associated with IPV. Furthermore, matrilineal women's access to lineage resources would reduce their vulnerability to IPV relative to patrilineal women. To examine these hypotheses, we collected data from 1700 ever-married Ghanaian women residing in three ecological zones (coastal, middle, northern). Path analysis was used to explore resources as mechanisms linking lineage and IPV. Our findings indicated resources were patterned by lineage. Matrilineal women benefitted more from maternal family members than patrilineal women and vice versa. Consistent with the standard resource theory, women's access to resources protected against IPV, and the effects were stronger for matrilineal than patrilineal women. Irrespective of how lineage was measured, matrilineal women experienced lower levels of IPV than patrilineal women. The IPV outcomes for bilateral women were mixed. Part of matrilineal women's reduced IPV risk was explained through access to maternal resources. While patrilineal women experienced higher levels of IPV, this was reversed with resources from paternal kin members. Our findings suggest that as resources are fundamental to reducing IPV, lineage can serve as a conduit for resource exchange and wealth transfer.
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Affiliation(s)
- Eric Y Tenkorang
- Department of Sociology, Memorial University of Newfoundland, St. John's, NL, A1C 5S7, Canada.
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Namatovu F, Ineland J. Collaboration in providing intimate-partner violence services to women with disabilities. BMC Public Health 2024; 24:1863. [PMID: 38992636 PMCID: PMC11241963 DOI: 10.1186/s12889-024-19352-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 07/03/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND There is a consensus among scholars, policymakers, and implementers that addressing the complex nature of intimate partner violence (IPV) requires a collaborative response. However, there is limited literature on how various professionals work collaboratively to address the needs of women with disabilities who experience IPV. This study combines the perspectives of women with disabilities and those of professionals to understand collaboration in providing IPV services to women with disabilities. METHODS Twenty-nine in-depth interviews were conducted with 18 IPV service providers and 11 women with disabilities. The data were analyzed using reflective thematic analysis. RESULTS The findings are presented under three themes: the first shows a consensus among different IPV service providers and disabled women on the importance of collaboration when supporting victims of IPV with disabilities; the second depicts the common ways in which collaboration occurs when supporting women with disabilities; and the third illuminates the critical elements that boost effective collaboration. CONCLUSION Supporting IPV victims with disabilities requires active collaboration at both an internal and external level. Strengthening collaboration among different actors requires trust, specified roles, and the allocation of adequate resources.
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Affiliation(s)
- Fredinah Namatovu
- Department of Epidemiology and Global Health, Umeå University, Umeå, SE-901 87, Sweden.
- Centre for Demographic and Ageing Research (CEDAR), Umeå University, Umeå, SE-901 87, Sweden.
| | - Jens Ineland
- Department Social Work, Umeå University, Umeå, SE-901 87, Sweden
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Seidu AA, Malau-Aduli BS, McBain-Rigg K, Malau-Aduli AEO, Emeto TI. Sexual lives and reproductive health outcomes among persons with disabilities: a mixed-methods study in two districts of Ghana. Reprod Health 2024; 21:69. [PMID: 38783342 PMCID: PMC11112844 DOI: 10.1186/s12978-024-01810-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION People with disabilities (PwDs) constitute a large and diverse group within the global population, however, their sexual and reproductive health (SRH) needs are often neglected, particularly in low-and middle-income countries. This may result in adverse outcomes, such as sexually transmitted infections (STIs), unintended pregnancies, and experience of interpersonal violence (IV). This study aimed to assess the factors that influence the sexual lives of PwDs in two districts of Ghana. METHODS A sequential explanatory mixed-methods study design was used to collect data from PwDs. Quantitative data were obtained from 402 respondents using a pretested questionnaire, and qualitative data gathered from 37 participants using in-depth interviews. The quantitative data were analysed using descriptive and inferential statistics, while the qualitative data were analysed using inductive thematic analysis. RESULTS Most PwDs (91%) reported that they have ever had sex, which was associated with age, disability severity, and household size. The prevalence of poor SRH status, STIs, unintended pregnancy, pregnancy termination, and unsafe abortion were 10.5%, 5.7%, 6.4%, 21.6%, and 36.9% respectively. These outcomes were influenced by education, income, health insurance subscription, and proximity to a health facility. The prevalence of IV was 65%, which was related to disability type and severity. The qualitative data revealed five main themes: curiosity to engage in sexual activities, feelings of despair and insecurity with abled partners, preference for sexual relationships with other PwDs, IV and its perpetrators, and adverse SRH outcomes. CONCLUSION The study findings indicate that most adult PwDs have ever had sex and they face various challenges in their sexual lives. They experience multiple forms of abuse and neglect from different perpetrators at different levels of society, which have negative impacts on their well-being. There is a need for comprehensive and inclusive interventions that address the SRH needs of PwDs, as well as the underlying social and structural factors that contribute to their vulnerability. Further research is recommended to explore the perspectives of stakeholders on how to improve the SRH outcomes of PwDs.
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Affiliation(s)
- Abdul-Aziz Seidu
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia.
- Department of Population and Health, University of Cape Coast, P.O. Box UC 182, Cape Coast, Ghana.
| | - Bunmi S Malau-Aduli
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2308, Australia
| | - Kristin McBain-Rigg
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia
| | - Aduli E O Malau-Aduli
- School of Environmental and Life Sciences, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Theophilus I Emeto
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia.
- World Health Organization Collaborating Center for Vector-Borne and Neglected Tropical Diseases, James Cook University, Townsville, QLD, 4811, Australia.
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Toccalino D, Asare G, Fleming J, Yin J, Kieftenburg A, Moore A, Haag H(L, Chan V, Babineau J, MacGregor N, Colantonio A. Exploring the Relationships Between Rehabilitation and Survivors of Intimate Partner Violence: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:1638-1660. [PMID: 37776318 PMCID: PMC10913349 DOI: 10.1177/15248380231196807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/02/2023]
Abstract
Intimate partner violence (IPV) is a public health crisis affecting one in three women and one in ten men in their lifetimes. Rehabilitation professionals are highly likely to encounter survivors of IPV in their practice; yet, there exists no formal review assessing the relationship between IPV and rehabilitation. Our objective was to understand the types and contexts of rehabilitation care currently available for survivors of IPV, opportunities identified in the literature for rehabilitation care, and IPV awareness and education among rehabilitation providers. A search strategy related to IPV and four rehabilitation professionals of interest (occupational therapy, physiotherapy, speech-language pathology/therapy, and physiatry) was developed across 10 databases and complemented by a gray literature search. Two reviewers independently assessed articles for inclusion. In all, 44 articles met inclusion criteria, ranging from primary research articles (48%) to clinical newsletters. Included articles predominantly focused on opportunities for rehabilitation care (68%) and occupational therapists as a profession (68%). A minority of studies examined specific interventions for IPV survivors (18%) or assessed for knowledge and attitudes about IPV (16%) among rehabilitation professionals. To our knowledge, this is the first scoping review exploring the rehabilitation literature for IPV survivors. These findings show an awareness of IPV among rehabilitation professionals, the importance of identifying IPV in clients, and the ways in which rehabilitation professionals are uniquely situated to support survivors of IPV. There remains an opportunity to explore interventions designed specifically for IPV survivors.
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Affiliation(s)
| | - Gifty Asare
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jenna Fleming
- University of Toronto, ON, Canada
- Eden Dales Social Work and Counselling Services, Toronto, ON, Canada
| | | | | | - Amy Moore
- National Service Dogs, Kitchener, ON, Canada
| | - Halina (Lin) Haag
- University of Toronto, ON, Canada
- Wilfrid Laurier University, Waterloo, ON, Canada
| | - Vincy Chan
- University of Toronto, ON, Canada
- University Health Network, Toronto, ON, Canada
| | | | | | - Angela Colantonio
- University of Toronto, ON, Canada
- University Health Network, Toronto, ON, Canada
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Sutherland G, Hargrave J, Krnjacki L, Llewellyn G, Kavanagh A, Vaughan C. A Systematic Review of Interventions Addressing the Primary Prevention of Violence Against Women With Disability. TRAUMA, VIOLENCE & ABUSE 2024; 25:1235-1247. [PMID: 37272380 PMCID: PMC10913298 DOI: 10.1177/15248380231175932] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Women with disability experience significantly more violence and abuse than their nondisabled peers. Efforts to implement, evaluate, and scale-up strategies to prevent violence against women are rapidly expanding, but we know less about "what works" to prevent violence against women with disability. While secondary and tertiary prevention aim to identify violence early and prevent further occurrence, this review focuses on primary prevention. In the disability services sector, primary prevention is sometimes referred to as safeguarding and covers a range of activities that aim to address the underlying determinants of violence to prevent it from happening in the first place. The aim of this review is to identify and synthesize research on evaluated interventions addressing the primary prevention of violence against women with disability and explore evidence about their quality and effectiveness. A systematic search across the bibliographic databases of Medline, CINAHL, Embase, and PsychInfo for peer-reviewed literature published in English on or after January 1, 2010, yielded 483 papers of potential interest. Twelve studies met the inclusion criteria and were considered for review. Data were extracted and the quality of the studies was assessed using the Quality Assessment Tool for Quantitative Studies. Most studies reported outcomes from pre- and post-test research designs and received a weak rating of quality. Although interventions targeting awareness, knowledge, and skill development showed evidence of effectiveness, there is a distinct lack of program development that draws on known risk factors for violence such as the intersection of ableism and gender inequality.
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Pirkle CM, Velez MP, Sentell TL, Bassani DG, Domingues MR, Câmara SMA. The contributions of fertility during adolescence to disability across the life-course: hypothesized causal pathways, research gaps, and future directions. Ann Hum Biol 2024; 51:2390829. [PMID: 39206847 PMCID: PMC11371383 DOI: 10.1080/03014460.2024.2390829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 07/19/2024] [Accepted: 07/23/2024] [Indexed: 09/04/2024]
Abstract
CONTEXT Robust associations have been identified between fertility during adolescence and the disablement process, including pathologies, impairments, functional limitations and disability. Limited theoretical or empirical research considers how and why such relationships exist generally or with the individual associated components of disablement. OBJECTIVE To consolidate and critically evaluate literature to describe testable, theory-based hypotheses to guide future research on the mechanisms by which fertility during adolescence contributes to disablement. METHODS Targeted literature review of research from diverse global settings contextualised in two well-accepted theoretical frameworks in life-course epidemiology: the cumulative risk model and the critical period approach. RESULTS Five hypothesised causal pathways linking adolescent fertility to disablement in later life are described: 1) Causal relationship initiated by fertility during adolescence; 2) Common cause(s) for both, such as adverse childhood experiences; 3) Contributing cause(s) to adolescent fertility; 4) Interaction between adolescent fertility and other risk factors; and 5) Critical period effects unique to adolescence. Most research on the topic is on pathologies versus functional limitations and disability. CONCLUSION We highlight promising research avenues to inform future research and interventions on adolescent fertility and the disablement process. This work provides theoretical clarity, identifies research gaps, and offers hypotheses-testing opportunities for future research.
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Affiliation(s)
- Catherine M Pirkle
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Maria P Velez
- Departments of Obstetrics and Gynaecology & Public Health Sciences, Queen's University, Kingston, Canada
| | - Tetine L Sentell
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Diego G Bassani
- Centre for Global Child Health, The Hospital for Sick Children, Department of Paediatrics, Faculty of Medicine & Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Marlos R Domingues
- Postgraduate Programme in Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Saionara M A Câmara
- Postgraduate Program in Physiotherapy, Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte, Natal, Brazil
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Louw H, Nomdo G, Nencel L. 'Every slap demeans me': at the intersection of disability, masculinity and intimate partner violence in the Global South. CULTURE, HEALTH & SEXUALITY 2023; 25:1583-1596. [PMID: 36541734 DOI: 10.1080/13691058.2022.2156616] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
The experiences of heterosexual men with paraplegia who are the victims of intimate partner violence remains an under-researched area. This article responds to the call for more research and offers an analysis of the narratives of five working-class coloured men in Cape Town, South Africa, who acquired spinal cord injuries and then fell victim to intimate partner violence. Narrative interviews were conducted with men and their wives. Drawing on Tarzia's notion of the 'invisible impacts of intimate partner violence', narrative analysis explored the meanings and complexities involved in (re)claiming a sense of identity and sexual intimacy among these men, after their experiences of intimate partner violence. In many cases, the abuse was levelled against them as acts of revenge for having previously been violent non-disabled men. Wives' narratives show nuances that complement the narratives of their partners as they too reflect on what it means to hold a space of safety, emotional stability, intimacy, love, and care for a paralysed husband, after the prior experience of intimate partner violence. Findings provide insight into ways of surviving intimate partner violence and (re)building healthy sexual relationships. At the intersection of intimate partner violence, disability and masculinity, the process of self-healing and (re)building satisfying intimate relations coexists with breaking the silence surrounding intimate partner violence.
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Affiliation(s)
- Helenard Louw
- Sociology, Vrije Universiteit of Amsterdam, Amsterdam, Netherlands
| | - Gideon Nomdo
- Language Development Unit, Academic Development Program Centre for Higher Education Development (CHED), University of Cape Town, Cape Town, South Africa
| | - Lorraine Nencel
- Sociology, Vrije Universiteit of Amsterdam, Amsterdam, Netherlands
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Biggs MA, Schroeder R, Casebolt MT, Laureano BI, Wilson-Beattie RL, Ralph LJ, Kaller S, Adler A, Gichane MW. Access to Reproductive Health Services Among People With Disabilities. JAMA Netw Open 2023; 6:e2344877. [PMID: 38019515 PMCID: PMC10687653 DOI: 10.1001/jamanetworkopen.2023.44877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/14/2023] [Indexed: 11/30/2023] Open
Abstract
Importance People with disabilities face inequitable access to reproductive health (RH) services, yet the national prevalence of barriers to access experienced across disability types and statuses is unknown. Objective To assess the national prevalence of barriers to RH access experienced by people with disabilities. Design, Setting, and Participants This cross-sectional study analyzed results of an online probability-based national survey of RH experiences that was conducted from December 2021 to January 2022. The national sample consisted of English- and Spanish-speaking panel members of a market research firm. Panelists were invited to participate in a survey on their RH experiences and opinions. These participants were aged 15 to 49 years and assigned female at birth (AFAB). Weighted proportions were estimated, and bivariable and multivariable regression analyses were performed to assess associations between disability status and barriers to accessing RH services. Exposure Using 5 of the 6 Washington Group Short Set on Functioning items, 8 dichotomous disability indicators were created: (1) vision, (2) hearing, (3) mobility, (4) activities of daily living, (5) communication, (6) overall disability status (a lot or more difficulty functioning in ≥1 domain), (7) some difficulty functioning (below the disability threshold; some or more difficulty functioning in ≥1 domain), and (8) multiple disabilities (a lot or more difficulty functioning in ≥2 domains). Main Outcomes and Measures Number and types of barriers (logistical, access, cost, privacy, and interpersonal relationship) to accessing RH services in the past 3 years. Results After exclusion, the final sample included 6956 people AFAB, with a mean (SD) age of 36.0 (8.3) years. Of these participants, 8.5% (95% CI, 7.6%-9.5%) met the disability threshold. Participants with disabilities compared with those without disabilities were disproportionately more likely to be non-Hispanic Black (18.8% [95% CI, 14.4%-24.1%] vs 13.2% [95% CI, 11.9%-14.5%]) or Hispanic or Latinx (completed survey in English: 18.1% [95% CI, 14.0%-23.0%] vs 14.6% [95% CI, 13.3%-16.0%]; completed survey in Spanish: 8.9% [95% CI, 6.2%-12.8%] vs 6.2% [95% CI, 5.4%-7.1%]) individuals, to identify as LGBTQAI (lesbian, gay, bisexual, transgender, queer [or questioning], asexual [or allied], intersex; 16.4% [95% CI, 12.3%-21.6%] vs 11.8% [95% CI, 10.6%-13.1%]), to live below the federal poverty level (27.3% [95% CI, 22.3%-32.8%] vs 10.7% [95% CI, 9.7%-11.9%]), and to ever experienced medical mistreatment (49.6% [95% CI, 43.7%-55.5%] vs 36.5% [95% CI, 34.8%-38.2%]). Among those who had ever tried to access RH services (n = 6027), people with disabilities vs without disabilities were more likely to experience barriers (69.0% [95% CI, 62.9%-74.5%] vs 43.0% [95% CI, 41.2%-44.9%]), which were most often logistical (50.7%; 95% CI, 44.2%-57.2%) and access (49.9%; 95% CI, 43.4%-56.4%) barriers. The disability domains with the highest proportion of people who experienced 3 or more barriers in the past 3 years included activities of daily living (75.3%; 95% CI, 61.1%-85.6%), communication (65.1%; 95% CI, 49.5%-78.1%), and multiple (59.9%; 95% CI, 45.6%-72.7%) disabilities. Conclusions and Relevance This cross-sectional study found large disparities in access to RH services among people AFAB with disabilities. Findings indicated a need to alleviate barriers to RH care, including improving the transportation infrastructure and reinforcing patient-centered approaches that engender inclusivity in health care settings.
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Affiliation(s)
- M. Antonia Biggs
- Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco
| | - Rosalyn Schroeder
- Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco
| | - M. Tara Casebolt
- Morrissey College of Arts and Sciences, Boston College, Chestnut Hill, Massachusetts
| | | | | | - Lauren J. Ralph
- Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco
| | - Shelly Kaller
- Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco
| | - Aliza Adler
- Innovating Education in Reproductive Health, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco
| | - Margaret W. Gichane
- Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco
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11
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Amos V, Lyons GR, Laughon K, Hughes RB, Alhusen JL. Reproductive Coercion Among Women With Disabilities: An Analysis of Pregnancy Risk Assessment Monitoring Systems Data. JOURNAL OF FORENSIC NURSING 2023; 19:108-114. [PMID: 37205617 PMCID: PMC10220289 DOI: 10.1097/jfn.0000000000000421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
BACKGROUND/AIMS Reproductive coercion (RC) is a widespread yet understudied type of intimate partner violence that is associated with numerous negative outcomes. Women with disabilities may be at an increased risk of RC; however, little research has been conducted among this population. Using population-based data, we sought to examine the prevalence of RC in postpartum women with disabilities. METHODS This is a secondary analysis of a cross-sectional survey, the Pregnancy Risk Assessment Monitoring System, a nationally representative survey conducted by the Centers for Disease Control and Prevention in partnership with participating states. These analyses include 3,117 respondents who had information on both disability status and experiences of RC. RESULTS Approximately 1.9% of respondents reported experiencing RC (95% CI [1.3, 2.4]). When stratified by disability status, approximately 1.7% of respondents without a disability reported RC whereas 6.2% of respondents with at least one disability reported RC ( p < 0.001). In univariable logistic models, disability, age, education, relationship status, income, and race were all significantly associated with RC. CONCLUSIONS Our findings highlight the need for healthcare providers working with women with disabilities to screen for RC and potentially uncover intimate partner violence and prevent its negative health consequences. All states participating in Pregnancy Risk Assessment Monitoring System data collection are urged to incorporate measures of RC and disability status to better address this significant issue.
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Affiliation(s)
- Vanessa Amos
- University of Virginia School of Nursing, 225 Jeanette Lancaster Avenue, Charlottesville, VA 22903
| | - Genevieve R. Lyons
- University of Virginia Public Health Sciences, 1335 Lee St, Charlottesville, VA 22903
| | - Kathryn Laughon
- University of Virginia School of Nursing, 225 Jeanette Lancaster Avenue, Charlottesville, VA 22903
| | - Rosemary B. Hughes
- University of Montana Rural Institute for Inclusive Communities, 52 Corbin Hall, Missoula, MT, 59812
| | - Jeanne L. Alhusen
- University of Virginia School of Nursing, 225 Jeanette Lancaster Avenue, Charlottesville, VA 22903
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12
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Grace KT, Miller E. Future directions for reproductive coercion and abuse research. Reprod Health 2023; 20:5. [PMID: 36593505 PMCID: PMC9809032 DOI: 10.1186/s12978-022-01550-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/12/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Reproductive coercion and abuse (RCA) is a form of intimate partner violence (IPV) in which people with the capacity for pregnancy experience coercive behaviors that threaten their reproductive autonomy. Behaviors that constitute RCA include contraceptive control/sabotage, pregnancy pressure, and controlling the outcome of a pregnancy. Several areas of RCA study have emerged: associations with IPV, health outcomes resulting from RCA, and demographic and contextual factors associated with experiencing RCA. Current research in these areas is summarized and placed in a global context, including sexual and gender minority groups, use of RCA (exploring perpetration), RCA interventions, RCA in women with disabilities, and the question of whether people assigned male at birth can be RCA victims. CONCLUSION Areas for future exploration include evolving interpretations of pregnancy intention in the setting of fewer options for abortion, RCA in people with disabilities and multiple levels of marginalization, including sexual and gender minorities; intersections between RCA and economic abuse in the context of efforts at economic justice; and community-centered approaches to intervention and prevention.
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Affiliation(s)
- Karen Trister Grace
- grid.22448.380000 0004 1936 8032School of Nursing, College of Public Health, George Mason University, 4400 University Drive, Mailstop 3C4, Fairfax, VA 22030 USA
| | - Elizabeth Miller
- grid.21925.3d0000 0004 1936 9000Adolescent and Young Adult Medicine, University of Pittsburgh, 120 Lytton Avenue, Pittsburgh, PA 15213-1481 USA
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13
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García-Cuéllar MM, Pastor-Moreno G, Ruiz-Pérez I, Henares-Montiel J. The prevalence of intimate partner violence against women with disabilities: a systematic review of the literature. Disabil Rehabil 2023; 45:1-8. [PMID: 35038281 DOI: 10.1080/09638288.2022.2025927] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 12/22/2021] [Accepted: 12/31/2021] [Indexed: 12/31/2022]
Abstract
PURPOSE Although systematic reviews have already been conducted on violence and disability, the evidence is not conclusive in Intimate Partner Violence (IPV). This study examined the prevalence of IPV in women with disabilities, taking account of the different types of violence and disability. METHODS We performed a search in five databases. We included observational studies that analysed the frequency of IPV in women with disabilities compared to women without. Two independent reviewers selected and assessed studies. We made a qualitative synthesis according to the type of IPV analysed in relation to disability. RESULTS We identified 26 articles. The frequency and risk of IPV were greater in women with disabilities than in those without. All of the articles that studied financial violence, 81.3% of those that studied physical violence, 78.5% of those that studied psychological violence, 75% of those that studied physical/sexual violence, 73.3% of those that studied sexual violence and 50% of those that studied any type of violence found a significant association whit disability. CONCLUSIONS Women with disabilities are at higher risk of IPV. Rehabilitation centers and its professionals must have a leading role in the identification of these situations and this should be considered in IPV prevention plans.Implications for rehabilitationPeople with disabilities are at higher risk of multiple types of violence.Violence against women with disabilities therefore involves two public health issues interacting simultaneously.Rehabilitation centers and its professionals should have a leading role in the identification of IPV in women with disabilities.IPV prevention plans should consider rehabilitation centers and its professionals as a main component of interventions in women with disabilities.
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Affiliation(s)
| | - Guadalupe Pastor-Moreno
- Escuela Andaluza de Salud Pública, Granada, Spain
- Consorcio de Investigación Biomédica y en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs. GRANADA), Granada, Spain
| | - Isabel Ruiz-Pérez
- Escuela Andaluza de Salud Pública, Granada, Spain
- Consorcio de Investigación Biomédica y en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs. GRANADA), Granada, Spain
| | - Jesús Henares-Montiel
- Escuela Andaluza de Salud Pública, Granada, Spain
- Consorcio de Investigación Biomédica y en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs. GRANADA), Granada, Spain
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14
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Gupta J, Kanselaar S, Zhang C, Zaidi J. Disability and intimate partner violence in fragile states: A multi-country analysis. Glob Public Health 2023; 18:2204339. [PMID: 37114452 DOI: 10.1080/17441692.2023.2204339] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
The 2030 Sustainable Development Goals call for both the elimination of violence against women and girls and disability-disaggregated data. However, few population-based, multi-country studies have examined how disability impacts intimate partner violence (IPV) in fragile settings. Demographic and Health Survey data from five countries (Pakistan, Timor-Leste, Mali, Uganda, and Haiti) were pooled and analyzed to assess the relationship between disability and IPV (N = 22,984). Pooled analysis revealed an overall disability prevalence of 18.45%, with 42.35% lifetime IPV (physical, sexual and/or emotional), and 31.43% past-year IPV. Women with disabilities reported higher levels of past-year and lifetime IPV compared to those without disabilities (AOR 1.18; 95% CI 1.07, 1.30; AOR 1.31; 95% CI 1.19, 1.44, respectively). Women and girls with disabilities may be disproportionately impacted by IPV in fragile settings. More global attention is needed to address IPV and disability in these settings.
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Affiliation(s)
- Jhumka Gupta
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA
| | - Samantha Kanselaar
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA
| | - Cheyu Zhang
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA
| | - Jaffer Zaidi
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA
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15
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De Beaudrap P, Mouté C, Pasquier E, Tchoumkeu A, Temgoua CD, Zerbo A, Mac-Seing M, Beninguisse G. Burden of and risk factors for sexual violence among women with and without disabilities in two sub-Saharan African countries. Glob Health Action 2022; 15:2077904. [PMID: 35775278 PMCID: PMC9255210 DOI: 10.1080/16549716.2022.2077904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Available data suggest that women with disabilities have an increased risk of sexual violence, but little is known about the situation of those women living in resource-limited settings. Objectives To assess the burden and examine the drivers of sexual violence among women with disabilities. Methods This is a pooled analysis of two population-based surveys conducted in Cameroon and Burundi. Adults with and without disabilities were randomly recruited from the general population. Structured interviews were conducted at both sites to collect data on participants’ functional limitations, life-course history of sexual violence, education, employment, and resources. Only women with disabilities whose impairments started before the age of 10 years (n = 359) and women without disabilities (n = 720) are included in this analysis. The age-adjusted prevalence of violence was computed, and risk factors were assessed using a discrete survival regression and mediation analysis. Results At both sites, the participants with disabilities had a lower education level and had an increased risk of food insecurity. The pooled age-adjusted prevalence of lifetime sexual violence was 19.8% (95%CI:15.3–24.3) among women with disabilities and 11.7% (95%CI:9.3–14.1) among those without disabilities (ORap: 2.0, 95%CI:1.4–2.8). Women with cognitive limitations and those with visual impairments had the highest risk of sexual violence (ORap: 3.5 (95%CI:2.0–6.3) and 2.7 (95%CI:1.4–5.0), respectively). Over the life course, the risk of sexual violence was especially high among women with disabilities who had lived with an intimate partner before the age of 25 years (p < 0.001). Education level mediated approximately one-third of the total association between disability and sexual violence (p = 0.001). There was no evidence of an indirect effect through food insecurity. Conclusion This study provides evidence of the high burden of sexual violence among women with disabilities who live in urban African contexts. The social environment and access to education may be key contributors to this vulnerability.
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Affiliation(s)
- Pierre De Beaudrap
- CEPED, Institut de Recherche pour le Développement, Université Paris Cité, INSERM, Paris, France
| | - Charles Mouté
- CEPED, Institut de Recherche pour le Développement, Université Paris Cité, INSERM, Paris, France.,Direction de la Recherche, de la Coopération et de l'Appui Technique, Institut de Formation et de Recherche Démographique (IFORD), Yaoundé, Cameroon.,Bureau Central des Recensements et des Etudes de Population (BUCREP), Yaoundé, Cameroon
| | - Estelle Pasquier
- Health Department, Initiative HIV/AIDS, Tuberculosis, Malaria, Paris, France.,Department of Public Health and Primary Care, Ghent University, Gent, Belgium.,Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Alice Tchoumkeu
- CEPED, Institut de Recherche pour le Développement, Université Paris Cité, INSERM, Paris, France.,Direction de la Recherche, de la Coopération et de l'Appui Technique, Institut de Formation et de Recherche Démographique (IFORD), Yaoundé, Cameroon
| | - Carole Dongmo Temgoua
- Direction de la Recherche, de la Coopération et de l'Appui Technique, Institut de Formation et de Recherche Démographique (IFORD), Yaoundé, Cameroon
| | - Aida Zerbo
- Health Department, Initiative HIV/AIDS, Tuberculosis, Malaria, Paris, France
| | - Muriel Mac-Seing
- Centre for Global Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Gervais Beninguisse
- Direction de la Recherche, de la Coopération et de l'Appui Technique, Institut de Formation et de Recherche Démographique (IFORD), Yaoundé, Cameroon
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16
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Maher CA, Hayes BE. Association Between Disabilities, Educational Attainment, Literacy, and Intimate Partner Violence: Findings from the Indian National Family Health Surveys. ASIAN JOURNAL OF CRIMINOLOGY 2022; 18:1-20. [PMID: 36337382 PMCID: PMC9628613 DOI: 10.1007/s11417-022-09389-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
Intimate partner violence (IPV) is widespread across the Global South, including India, due to cultural and patriarchal norms that encourage and facilitate such behaviors. These include age at marriage, community- and individual-level encouragement of IPV, and limited access to education across the Global South, particularly for women. Despite this, little research has sought to disentangle the role that disabilities play in affecting women's risk of IPV in India. The current study analyzes a sample of currently married women (N = 114,901) from the nationally representative 2015-2016 and 2019-2021 National Family Health Surveys (NFHS) to assess whether a relationship exists between these dimensions, while controlling for well-known IPV correlates, with physical IPV and controlling behaviors. Logistic regression analyses revealed that persons with cognitive/intellectual disabilities as well as blind respondents were more likely to experience physical IPV. Blind respondents were also more likely to experience controlling behavior. Further, findings indicate that those with no or some education were more likely to experience physical IPV relative to those with higher education. Findings from the current study demonstrate the need for IPV reduction policies to ensure that adequate accommodations are available to facilitate help-seeking behaviors among persons with disabilities. Tailored prevention policies are also needed which consider both context- and location-specific factors associated with risk.
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Affiliation(s)
- Cooper A. Maher
- Department of Criminal Justice, University of Cincinnati, Cincinnati, OH USA
| | - Brittany E. Hayes
- Department of Criminal Justice, University of Cincinnati, Cincinnati, OH USA
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17
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Brown HK, Saunders N, Chen S, Leslie K, Vigod SN, Fung K, Guttmann A, Havercamp SM, Parish SL, Ray JG, Lunsky Y. Disability and Interpersonal Violence in the Perinatal Period. Obstet Gynecol 2022; 140:797-805. [PMID: 36201763 PMCID: PMC9588770 DOI: 10.1097/aog.0000000000004950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/28/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To compare the risk of interpersonal violence experienced by pregnant and postpartum individuals with physical disabilities, sensory disabilities, or intellectual or developmental disabilities with those without disabilities, and to examine whether a prepregnancy history of interpersonal violence puts individuals with disabilities, at excess risk of interpersonal violence in the perinatal period. METHOD This population-based study included all individuals aged 15-49 years with births in Ontario, Canada, from 2004 to 2019. Individuals with physical (n=147,414), sensory (n=47,459), intellectual or developmental (n=2,557), or multiple disabilities (n=9,598) were compared with 1,594,441 individuals without disabilities. The outcome was any emergency department visit, hospital admission, or death related to physical, sexual, or psychological violence between fertilization and 365 days postpartum. Relative risks (RRs) were adjusted for baseline social and health characteristics. Relative excess risk due to interaction (RERI) was estimated from the joint effects of disability and prepregnancy violence history; RERI>0 indicated positive interaction. RESULTS Individuals with physical (0.8%), sensory (0.7%), intellectual or developmental (5.3%), or multiple disabilities (1.8%) were more likely than those without disabilities (0.5%) to experience perinatal interpersonal violence. The adjusted RR was 1.40 (95% CI 1.31-1.50) in those with physical disabilities, 2.39 (95% CI 1.98-2.88) in those with intellectual or developmental disabilities, and 1.96 (95% CI 1.66-2.30) in those with multiple disabilities. Having both a disability and any violence history produced a positive interaction for perinatal interpersonal violence (adjusted RERI 0.87; 95% CI 0.47-1.29). CONCLUSION The perinatal period is a time of relative high risk for interpersonal violence among individuals with pre-existing disabilities, especially those with a history of interpersonal violence.
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Affiliation(s)
- Hilary K. Brown
- Department of Health & Society, University of Toronto Scarborough, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- ICES, Toronto, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, Canada
| | - Natasha Saunders
- ICES, Toronto, Canada
- Hospital for Sick Children, Toronto, Ontario, Canada
- Edwin SH Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | | | - Kelly Leslie
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Simone N. Vigod
- Department of Psychiatry, University of Toronto, Toronto, Canada
- ICES, Toronto, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, Canada
| | | | - Astrid Guttmann
- ICES, Toronto, Canada
- Hospital for Sick Children, Toronto, Ontario, Canada
- Edwin SH Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Susan M. Havercamp
- Center for Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, Columbus, Ohio, United States
| | - Susan L. Parish
- College of Health Professions, Virginia Commonwealth University, Richmond, Virginia, United States
| | - Joel G. Ray
- ICES, Toronto, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Yona Lunsky
- Department of Psychiatry, University of Toronto, Toronto, Canada
- ICES, Toronto, Canada
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction & Mental Health, Toronto, Ontario, Canada
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18
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Meyer SR, Mosha NR, Shakespeare T, Kuper H, Mtolela G, Harvey S, Kapiga S, Mshana G, Stöckl H. Disability and intimate partner violence: a cross-sectional study from Mwanza, Tanzania. Disabil Health J 2022; 16:101404. [PMID: 36522283 DOI: 10.1016/j.dhjo.2022.101404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/12/2022] [Accepted: 11/09/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Women with disabilities are at heightened risk of experiencing intimate partner violence [IPV], although the mechanisms through which disability acts as a risk factor for IPV are not clear. OBJECTIVE We analyzed cross-sectional data (n = 867) from Wave 3 of the MAISHA longitudinal study, conducted in Mwanza, Tanzania, to i) describe the levels of disability and IPV amongst women, and ii) to assess the association between level and type of disability and IPV experience. METHODS IPV was assessed using the WHO Multi-Country study instrument. Levels of disability (none, mild and severe) were categorized based on responses to the Washington Group Short Set questions. We fitted logistic regression models to determine the risk of experiencing each type of IPV according to disability level and type of disability. RESULTS We found significant associations between mild and severe disability and different types of IPV. For example, in multivariate analyses controlling for socio-demographic variables, women reporting severe disability were significantly more likely to report physical and/or sexual IPV, sexual IPV. controlling behaviors, economic IPV, and severe IPV, whereas for mild disability compared to no disability, physical and/or sexual IPV, sexual IPV, and economic IPV were significantly more likely to be reported. Cognitive disability was a significant correlate of all forms of IPV apart from physical IPV. CONCLUSIONS Our findings that specific types of disability and not others were associated with an elevated risk of IPV exposure indicate the need for nuanced measurement and analysis of the association between disability and IPV.
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Affiliation(s)
- Sarah R Meyer
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-Universität München, Elisabeth-Winterhalter-Weg 6, 81377, München, Germany
| | - Neema R Mosha
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-Universität München, Elisabeth-Winterhalter-Weg 6, 81377, München, Germany; Mwanza Intervention Trials Unit, PO Box 11936, Mwanza, Tanzania
| | - Tom Shakespeare
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, Keppel St, London, UK
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, Keppel St, London, UK
| | - Grace Mtolela
- Mwanza Intervention Trials Unit, PO Box 11936, Mwanza, Tanzania
| | - Sheila Harvey
- Mwanza Intervention Trials Unit, PO Box 11936, Mwanza, Tanzania; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, UK
| | - Saidi Kapiga
- Mwanza Intervention Trials Unit, PO Box 11936, Mwanza, Tanzania; Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - Gerry Mshana
- Mwanza Intervention Trials Unit, PO Box 11936, Mwanza, Tanzania; National Institute for Medical Research, Mwanza, Tanzania
| | - Heidi Stöckl
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-Universität München, Elisabeth-Winterhalter-Weg 6, 81377, München, Germany; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, UK.
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19
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Associations between sexual identity, living with disability, bully victimisation, and HIV status and intimate partner violence among residents in Nigeria. BMC Public Health 2022; 22:1756. [PMID: 36114566 PMCID: PMC9479364 DOI: 10.1186/s12889-022-14186-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 09/14/2022] [Indexed: 11/24/2022] Open
Abstract
Background The aim of the study was to determine the associations between sexual identity, disability and HIV status and bullying victimisation, and a history of physical, emotional and sexual violence in Nigeria. Methods This was a secondary analysis of a primary dataset generated through an online survey conducted between February 7 and 19, 2021. The 3197 participants for the primary study were recruited through snowballing. The dependent variables were physical, emotional and sexual violence. The independent variables were sexual identity (heterosexual and sexual minority), HIV status (negative, positive and unknown), bullying victimisation (yes/no) and living with disability (yes/no). A multivariate logistic regression model was developed for each form of IPV. Each model was adjusted for age, sex assigned at birth, marital status and education level. Results Respondents living with HIV had higher odds for physical (AOR: 2.01; 95% CI: 1.46–2.76; p < 0.001), sexual (AOR: 2.17; 95%CI: 1.55–3.05; p < 0.001), and emotional (AOR: 1.59; 95%CI: 1.24–2.06; p < 0.001) violence. Also, those with history of bullying victimisation had higher odds for physical (AOR: 3.79; 95%CI: 2.86 – 5.68; p < 0.001), sexual (AOR: 3.05; 95%CI: 2.27 – 4.10; p < 0.001) and emotional (AOR: 2.66; 95%CI: 2.10 – 3.37; p < 0.001) violence. In addition, females had higher odds of physical (AOR: 1.52; 95%CI: 1.13–2.043; p < 0.001) and sexual (AOR: 1.83; 95%CI: 1.34 – 2.50; p < 0.001) violence; and respondents cohabiting (AOR: 1.95; 95%CI: 1.12 – 3.28; p = 0.012) had higher odds for emotional violence. Respondents who were married have significantly lower odds of experiencing physical (AOR: 0.66; 95%CI: 0.45 – 9.60; p = 0.029), sexual (AOR: 0.40; 95%CI: 0.26 – 0.62; p < 0.001) and emotional (AOR: 0.68; 95%CI: 0.50 – 0.93; p = 0.015) violence when compared to singles. Younger respondents also had lower odds of experiencing sexual violence (AOR: 0.97; 95%CI: 0.95–0.99; p = 0.016). Conclusion HIV positive status and bullying victimisation seem to increase the risk for all forms of IPV while the experience of IPV did not differ by sexual identity and disability status. The associations between age, sex, marital status and IPV may suggest moderating roles of the factors taking cognisance of the cultural context of these relationships. Future relational analysis is necessary to further understand the pathways for the associations found between the variables in this study. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14186-6.
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20
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Akobirshoev I, Valentine A, Zandam H, Nandakumar A, Jewkes R, Blecher M, Mitra M. Disparities in intimate partner violence among women at the intersection of disability and HIV status in South Africa: a cross-sectional study. BMJ Open 2022; 12:e054782. [PMID: 36113942 PMCID: PMC9486199 DOI: 10.1136/bmjopen-2021-054782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Previous research suggests a significant relationship between intimate partner violence (IPV) and HIV infection in women and that the risk of IPV is heightened in women with disabilities. Women with disabilities, particularly those residing in low-income and middle-income countries, may experience additional burdens that increase their vulnerability to IPV. We aimed to examine the association between having disability and HIV infection and the risk of IPV among women in South Africa. DESIGN Using the 2016 South Africa Demographic and Health Survey, we calculated the prevalence of IPV and conducted modified Poisson regressions to estimate the unadjusted and adjusted risk ratios of experiencing IPV by disability and HIV status. PARTICIPANTS Our final analytical sample included 1269 ever-partnered women aged 18-49 years, who responded to the IPV module and received HIV testing. RESULTS The prevalence of IPV was twice as high in women with disabilities with HIV infection compared with women without disabilities without HIV infection (21.2% vs 50.1%). Our unadjusted regression analysis showed that compared with women without disabilities without HIV infection, women with disabilities with HIV infection had almost four times higher odds (OR 3.72, 95% CI 1.27 to 10.9, p<0.05) of experiencing IPV. It appeared that women with disabilities with HIV infection experience compounded disparity. The association was compounded, with the OR for the combination of disability status and HIV status equal to or more than the sum of each of the individual ORs. CONCLUSIONS Women with disabilities and HIV infection are at exceptionally high risk of IPV in South Africa. Given that HIV infection and disability magnify each other's risks for IPV, targeted interventions to prevent IPV and to address the complex and varied needs of doubly marginalised populations of women with disabilities with HIV infection are critical.
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Affiliation(s)
- Ilhom Akobirshoev
- Lurie Institute for Disability Policy, Brandeis University Heller School for Social Policy and Management, Waltham, Massachusetts, USA
| | - Anne Valentine
- Lurie Institute for Disability Policy, Brandeis University Heller School for Social Policy and Management, Waltham, Massachusetts, USA
| | - Hussaini Zandam
- Lurie Institute for Disability Policy, Brandeis University Heller School for Social Policy and Management, Waltham, Massachusetts, USA
| | - Allyala Nandakumar
- Institute for Global Health and Development, Brandeis University Heller School for Social Policy and Management, Waltham, Massachusetts, USA
| | - Rachel Jewkes
- Gender and Health Division, South African Medical Research Council, Pretoria, South Africa
| | - Mark Blecher
- Health and Social Development, National Treasury of South Africa, Cape Town, South Africa
| | - Monika Mitra
- Lurie Institute for Disability Policy, Brandeis University Heller School for Social Policy and Management, Waltham, Massachusetts, USA
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21
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Toccalino D, Haag HL, Estrella MJ, Cowle S, Fuselli P, Ellis MJ, Gargaro J, Colantonio A. Addressing the Shadow Pandemic: COVID-19 Related Impacts, Barriers, Needs, and Priorities to Health Care and Support for Women Survivors of Intimate Partner Violence and Brain Injury. Arch Phys Med Rehabil 2022; 103:1466-1476. [PMID: 35007550 PMCID: PMC8776331 DOI: 10.1016/j.apmr.2021.12.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/03/2021] [Accepted: 12/31/2021] [Indexed: 11/02/2022]
Abstract
Intimate partner violence (IPV) affects 1 in 3 women and has intensified during the COVID-19 pandemic. Although most injuries are to the head, face, and neck, leaving survivors vulnerable to sustaining traumatic brain injury (TBI), the intersection of IPV and TBI remains largely unrecognized. This article reports on COVID-19-related effects, barriers, needs, and priorities to health care and support services for women survivors of IPV-TBI. Using a participatory research model, we engaged 30 stakeholders in virtual meetings drawn from an IPV-TBI Knowledge to Practice Network in two virtual meetings. Stakeholders included women survivors, service providers, researchers, and decision makers across the IPV, TBI, and healthcare sectors. Data were gathered through small group breakout sessions facilitated by the research team using semistructured discussion guides. Sessions were recorded, transcribed verbatim, and analyzed using thematic analysis techniques. Stakeholders were given the opportunity to contribute to the analysis and knowledge transfer through member checking activities. Ethics approval was obtained through the University of Toronto. Stakeholders shared that COVID-19 has increased rates and severity of IPV and barriers to services and help-seeking. These effects have been exacerbated by infrastructure difficulties in rural and remote areas, including limited access to services. They noted the need to carefully consider implications of virtual care such as safety, privacy, and usability. Requests from survivors for peer support have increased significantly, indicating a need for more formalized and better-supported peer roles. Stakeholders further noted that an overwhelming lack of awareness of the intersection of IPV-TBI continues. Increasing education and awareness among health care and IPV service providers, survivors, and the public remains a priority. The COVID-19 pandemic has intensified IPV-TBI, increased challenges for women survivors, and accentuated the continued lack of IPV-TBI awareness. Key recommendations for health care and rehabilitation to address this priority are discussed.
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Affiliation(s)
- Danielle Toccalino
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada.
| | - Halina Lin Haag
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada; Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Waterloo, Ontario, Canada; KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario
| | - Maria Jennifer Estrella
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada; Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario
| | | | | | - Michael J Ellis
- Department of Surgery, Section of Neurosurgery, University of Manitoba, Pan Am Concussion Program, Winnipeg, Manitoba
| | - Judith Gargaro
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario; Ontario Neurotrauma Foundation, Toronto, Ontario
| | - Angela Colantonio
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada; KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario; Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario; Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Mannell J, Lowe H, Brown L, Mukerji R, Devakumar D, Gram L, Jansen HAFM, Minckas N, Osrin D, Prost A, Shannon G, Vyas S. Risk factors for violence against women in high-prevalence settings: a mixed-methods systematic review and meta-synthesis. BMJ Glob Health 2022; 7:e007704. [PMID: 35296455 PMCID: PMC8928330 DOI: 10.1136/bmjgh-2021-007704] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 02/08/2022] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Violence against women (VAW) affects one in three women globally. In some countries, women are at much higher risk. We examined risk factors for VAW in countries with the highest 12-month prevalence estimates of intimate partner violence (IPV) to develop understanding of this increased risk. METHODS For this systematic review, we searched PUBMED, CINAHL, PROQUEST (Middle East and North Africa; Latin America and Iberia; East and South Asia), Web of Science, EMBASE and PsycINFO (Ovid) for records published between 1 January 2000 and 1 January 2021 in English, French and Spanish. Included records used quantitative, qualitative, or mixed-methods, reported original data, had VAW as the main outcome, and focused on at least one of 23 countries in the highest quintile of prevalence figures for women's self-reported experiences of physical and/or sexual violence in the past 12 months. We used critical interpretive synthesis to develop a conceptual model for associations between identified risk factors and VAW. RESULTS Our search identified 12 044 records, of which 241 were included for analysis (2 80 360 women, 40 276 men, 274 key informants). Most studies were from Bangladesh (74), Uganda (72) and Tanzania (43). Several quantitative studies explored community-level/region-level socioeconomic status and education as risk factors, but associations with VAW were mixed. Although fewer in number and representing just one country, studies reported more consistent effects for community-level childhood exposure to violence and urban residence. Theoretical explanations for a country's high prevalence point to the importance of exposure to other forms of violence (armed conflict, witnessing parental violence, child abuse) and patriarchal social norms. CONCLUSION Available evidence suggests that heightened prevalence of VAW is not attributable to a single risk factor. Multilayered and area-level risk analyses are needed to ensure funding is appropriately targeted for countries where VAW is most pervasive. PROSPERO REGISTRATION NUMBER The review is registered with PROSPERO (CRD42020190147).
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Affiliation(s)
| | - Hattie Lowe
- Institute for Global Health, UCL, London, UK
| | - Laura Brown
- Institute for Global Health, UCL, London, UK
| | | | | | - Lu Gram
- Institute for Global Health, UCL, London, UK
| | | | | | - David Osrin
- Institute for Global Health, UCL, London, UK
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Leight J. Intimate partner violence against women: a persistent and urgent challenge. Lancet 2022; 399:770-771. [PMID: 35182474 DOI: 10.1016/s0140-6736(22)00190-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 12/09/2021] [Indexed: 01/28/2023]
Affiliation(s)
- Jessica Leight
- International Food Policy Research Institute, Washington, DC 20005, USA.
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Meyer SR, Stöckl H, Vorfeld C, Kamenov K, García-Moreno C. A scoping review of measurement of violence against women and disability. PLoS One 2022; 17:e0263020. [PMID: 35100320 PMCID: PMC8803172 DOI: 10.1371/journal.pone.0263020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 01/10/2022] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Existing evidence indicates that prevalence of violence against women with disability is elevated compared to women without disability. We conducted a scoping review with a focus on measurement to assess the forms of measurement and study design utilized to explore the intersection of violence against women with disabilities, and to identify strengths and limitations in current approaches to measuring violence against women with disabilities. This scoping review is designed to inform current debates and discussions regarding how to generate evidence concerning violence against women with disabilities. METHODS AND RESULTS We conducted systematic searches of the following databases: PubMed, PsycINFO, Embase, CINAHL, PILOTS, ERIC, Social Work Abstracts, International Bibliography of the Social Sciences, Social Services Abstracts, ProQuest Criminal Justice, and Dissertations & Theses Global, and conducted structured searches of national statistics and surveys and grey literature available on-line. We identified 174 manuscripts or reports for inclusion. n = 113 manuscripts or reports utilized acts-specific measurement of violence. In terms of measurement of disability, we found that amongst the included manuscripts and reports, n = 75 utilized measures of functioning limitations (n = 20 of these were Washington Group questions), n = 15 utilized a single question approach and n = 67 defined participants in the research as having a disability based on a diagnosis or self-report of a health condition or impairment. DISCUSSION This scoping review provides a comprehensive overview of measurement of violence against women with disabilities and measurement of violence within disability-focused research. We identified several important gaps in the evidence, including lack of sex and disability disaggregation, limited evidence concerning adaptation of data collection methods to ensure accessibility of research activities for women with disabilities, and limited evidence concerning differential relationships between types of disability and violence exposure. This scoping review provides directions for sub-analyses of the included studies and further research to address gaps in evidence.
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Affiliation(s)
- Sarah R. Meyer
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Heidi Stöckl
- The Institute for Medical Information Processing, Biometry, and Epidemiology, University of Munich, Munich, Germany
| | - Cecilia Vorfeld
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Kaloyan Kamenov
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Claudia García-Moreno
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Toccalino D, Haag HL, Estrella MJ, Cowle S, Fuselli P, Ellis MJ, Gargaro J, Colantonio A. The Intersection of Intimate Partner Violence and Traumatic Brain Injury: Findings From an Emergency Summit Addressing System-Level Changes to Better Support Women Survivors. J Head Trauma Rehabil 2022; 37:E20-E29. [PMID: 34985037 DOI: 10.1097/htr.0000000000000743] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) occurring during intimate partner violence (IPV) is a largely unrecognized but significant public health crisis. One in 3 women will experience IPV in their lifetime, up to 75% of whom will sustain a TBI as a result. This article reports on the systems-level findings from a national summit to address barriers, needs, and priorities related to healthcare and support services for women survivors of IPV-TBI. OBJECTIVES (1) To identify key needs, facilitators, and barriers to care for women survivors of IPV presenting with TBI; and (2) to cocreate ideas for resources and principles for identification, clinical care, and support for healthcare practitioners who treat women exposed to IPV and TBI. METHODS Using a community-based participatory research approach, we engaged 30 stakeholders-drawn from a national IPV-TBI Knowledge-to-Practice (K2P) Network including diverse women survivors, service providers, researchers, and decision makers-in 2 half-day virtual meetings. Data were gathered through small group breakout sessions using semistructured discussion guides. Sessions were recorded, transcribed verbatim, and analyzed using thematic analysis techniques. Stakeholders contributed to the analysis and knowledge translation through member-checking activities. Ethics approval was obtained through the University of Toronto. FINDINGS Three main systems-level themes arose during these discussions: (1) the need for trauma-informed, anti-racist, and equitable health and social care systems; (2) the need for cross-pollination of knowledge between disciplines; and (3) the need for systems-level support for integrated and coordinated care. This article explores these needs and provides recommendations and suggestions for paths forward. CONCLUSIONS The findings of this project enhance understanding of system-level needs among women survivors and provide a template for a national agenda for IPV-TBI research and practice.
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Affiliation(s)
- Danielle Toccalino
- Institute of Health Policy, Management and Evaluation (Ms Toccalino and Dr Colantonio), Rehabilitation Sciences Institute (Ms Estrella and Dr Colantonio), Department of Occupational Science & Occupational Therapy (Dr Colantonio), and Dalla Lana School of Public Health (Dr Colantonio), University of Toronto, Toronto, Ontario, Canada; Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Waterloo, Ontario, Canada (Ms Haag and Dr Colantonio); KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada (Mss Haag and Gargaro and Dr Colantonio); Parachute, Toronto, Ontario, Canada (Mss Cowle and Fuselli); Pan Am Concussion Program, Section of Neurosurgery, Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada (Dr Ellis); and Ontario Neurotrauma Foundation, Toronto, Ontario, Canada (Ms Gargaro)
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26
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Noer KU, Chadijah S, Rudiatin E. There is no trustable data: the state and data accuracy of violence against women in Indonesia. Heliyon 2021; 7:e08552. [PMID: 34934848 DOI: 10.1016/j.heliyon.2021.e08552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 12/19/2020] [Accepted: 12/01/2021] [Indexed: 11/15/2022] Open
Abstract
The number of violence against women in Indonesia continues to increase every year, this can be seen from data released by the National Commission on Violence Against Women and the State Ministry of Women's Empowerment and Child Protection. The problem is, although the two state institutions regularly release data on violence against women, the data released does not nationally represent the data on violence. This study aims to find reasons on why data on violence in Indonesia cannot be used as material for policy making. By using ethnographic methods in the National Commission on Violence Against Women, the Ministry, and six partner institutions, this study found a number of facts why the data on violence in Indonesia is so unreliable. At the ministry level, the main constraints are with the forms that are difficult to fill in, the model of tiered bureaucracy that is useful for reporting, but with the higher the level, the less violence data there are, the limited number of registrar. Whereas National Commission on Violence Against Women data are constrained by a centralized and voluntary data collection model, that more than 65% of partners do not return the data collection forms. This results in both the Ministry and the Komnas Perempuan data being just the tip of the iceberg of the problem of violence against women in Indonesia.
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Affiliation(s)
- Khaerul Umam Noer
- Department of Public Administration, Faculty of Social and Political Sciences, University of Muhammadiyah Jakarta, South Tangerang, 15419, Indonesia
| | - Siti Chadijah
- School of Graduate Program, University of Muhammadiyah Jakarta, South Tangerang, 15419, Indonesia
| | - Endang Rudiatin
- Department of Social Welfare, Faculty of Social and Political Sciences, University of Muhammadiyah Jakarta, South Tangerang, 15419, Indonesia
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Fanslow JL, Malihi ZA, Hashemi L, Gulliver PJ, McIntosh TKD. Lifetime Prevalence of Intimate Partner Violence and Disability: Results From a Population-Based Study in New Zealand. Am J Prev Med 2021; 61:320-328. [PMID: 34419229 DOI: 10.1016/j.amepre.2021.02.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 01/22/2023]
Abstract
INTRODUCTION There is no population-based study on prevalence rates for all forms of intimate partner violence experienced by people with different types of disabilities in New Zealand. This study compares the reported lifetime prevalence of intimate partner violence (physical, sexual, psychological, controlling behaviors, and economic abuse) for people with different types of disabilities with that reported by those without disabilities and tests whether there is a gender difference. METHODS From March 2017 to March 2019, a total of 2,888 women and men aged ≥16 years participated in a cross-sectional study in New Zealand using a cluster random sampling method. Face-to-face interviews were used for data collection. The WHO Multi-country Study questionnaire was employed as the data collection tool. Logistic regression was conducted, and AORs were reported. RESULTS Those with any disability reported significantly higher rates of most forms of intimate partner violence than those without disabilities, among both genders, including physical intimate partner violence (AOR=1.80, 95% CI=1.32, 2.47 for women, AOR=2.44, 95% CI=1.72, 3.45 for men) and psychological and economic abuse. Women with disabilities were more likely to report experiences of sexual intimate partner violence than men (range =13.5-17.1% vs 4.0%-21.2% in men). Men with intellectual disability were more likely to report physical intimate partner violence than women with intellectual disability (60.5% in men and 36.0% in women). CONCLUSIONS People with disabilities report experiencing a significantly high lifetime prevalence of intimate partner violence compared with people without disabilities. The results warrant policy and practice changes to identify early signs of abuse and intervene accordingly and warrant an investment in targeted violence prevention programs.
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Affiliation(s)
- Janet L Fanslow
- Social and Community Health, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
| | - Zarintaj A Malihi
- Social and Community Health, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Ladan Hashemi
- Social and Community Health, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Pauline J Gulliver
- Social and Community Health, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Tracey K D McIntosh
- School of Māori Studies and Pacific Studies, Faculty of Arts, The University of Auckland, Auckland, New Zealand
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Gibbs A, Dunkle K, Ramsoomar L, Willan S, Jama Shai N, Chatterji S, Naved R, Jewkes R. New learnings on drivers of men's physical and/or sexual violence against their female partners, and women's experiences of this, and the implications for prevention interventions. Glob Health Action 2020; 13:1739845. [PMID: 32202227 PMCID: PMC7144308 DOI: 10.1080/16549716.2020.1739845] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 02/29/2020] [Indexed: 11/09/2022] Open
Abstract
Background: Understanding the drivers of intimate partner violence (IPV), perpetrated by men and experienced by women, is a critical task for developing effective prevention programmes.Objectives: To provide a comprehensive assessment of the drivers of IPV.Methods: A comprehensive review of the drivers of IPV, at the end of a six-year programme of research through the What Works to Prevent Violence Against Women and Girls Global Programme with reference to other important research in the field.Results: Broadly, we argue that IPV is driven by poverty, patriarchal privilege, and the normative use of violence in interpersonal relationships. These factors also increase childhood trauma, poor mental health and substance misuse, and poor communication and conflict in relationships, which in turn impact on IPV. Disability status, and contexts of armed conflict, or post-conflict, further reinforce and exacerbate these risks. We move beyond describing associations towards describing the causal pathways through which these factors operate to increase IPV.Conclusions: Specific recommendations about the future of further research on drivers of IPV include a greater focus on understanding the causal pathways from drivers to IPV and clearly delineating association from causality in studies, particularly for women and girls with disabilities, in armed conflicts, and adolescent girls and young women. To achieve this, we recommend extensive in-depth qualitative research, and complex quantitative modeling studies. Understanding drivers and causal pathways better will enable the identification of points of entry for the development of more effective IPV prevention interventions.
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Affiliation(s)
- Andrew Gibbs
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Kristin Dunkle
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Leane Ramsoomar
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Samantha Willan
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Nwabisa Jama Shai
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Sangeeta Chatterji
- Johns Hopkins School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Ruchira Naved
- Health Systems and Population Studies Division, Icddr,b, Dhaka, Bangladesh
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
- Office of the Executive Scientist, South African Medical Research Council, Cape Town, South Africa
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Dunkle K, Gibbs A, Chirwa E, Stern E, Van Der Heijden I, Washington L. How do programmes to prevent intimate partner violence among the general population impact women with disabilities? Post-hoc analysis of three randomised controlled trials. BMJ Glob Health 2020; 5:e002216. [PMID: 33277296 PMCID: PMC7722374 DOI: 10.1136/bmjgh-2019-002216] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 08/28/2020] [Accepted: 08/29/2020] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Women with disabilities experience higher rates of intimate partner violence (IPV) than women without disabilities. There remains limited evidence about whether IPV prevention interventions for the general population have benefits for women with disabilities that compare to those for women without disabilities. Using data from IPV prevention randomised controlled trials in diverse locations (Rwanda, South Africa and Afghanistan), we assess whether outcomes differed by disability status. METHODS We assessed disability at baseline in three IPV prevention trials. We performed post-hoc analysis of intervention impacts at endline (22 or 24 months post-baseline) stratified by disability status at study baseline and tested an interaction term for disability at baseline by intervention arm for three sets of outcomes: (1) past year experiences of physical, sexual and severe IPV; (2) economic and livelihood outcomes; and (3) health, mental health and substance use outcomes. RESULTS At baseline between 17.7% and 26.2% of women reported being disabled. For IPV prevention, in seven out of eight tests across three studies, women with and without disabilities had similar outcomes. For economic, health and substance use outcomes, there was more variation, with women with disabilities reporting both better and worse outcomes than women without disabilities; however there was no clear pattern in these differential results. CONCLUSION IPV prevention programmes targeting general populations can prevent IPV among women with disabilities participants with benefits that mirror those for women without disabilities. Benefits for participants with and without disabilities on secondary programme outcomes related to economic empowerment and health may be more varied and should be explicitly monitored.
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Affiliation(s)
- Kristin Dunkle
- Gender and Health Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Andrew Gibbs
- Gender and Health Research Unit, South African Medical Research Council, Tygerberg, South Africa
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Esnat Chirwa
- Gender and Health Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Erin Stern
- Gender and Health Research Unit, South African Medical Research Council, Tygerberg, South Africa
- Gender Violence and Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Ingrid Van Der Heijden
- Gender and Health Research Unit, South African Medical Research Council, Tygerberg, South Africa
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