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Grigaitė U, Klidziūtė G, Aluh DO, Pedrosa B, Santos-Dias M, Silva M, Cardoso G, Caldas-de-Almeida JM. Responding to the needs of survivors of intimate partner violence in Lithuania: perceptions of mental health and social care professionals. Women Health 2024:1-14. [PMID: 39039018 DOI: 10.1080/03630242.2024.2382419] [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: 02/02/2024] [Accepted: 07/15/2024] [Indexed: 07/24/2024]
Abstract
Around eight-out-of-ten survivors of domestic violence in Lithuania are women, and of those, eight-out-of-ten suffer violence specifically from their intimate partners (IPV). Women who experience IPV are at higher risk of having mental health conditions. This study aims to explore the perspectives of mental health and social care professionals regarding the provision of mental health support to IPV survivors in Lithuania. Four focus groups were conducted among 29 service providers from across the country. Audio-recordings were transcribed verbatim and analyzed thematically using MAXQDA software. The five main themes derived from the analysis reveal: 1) low levels of IPV awareness among IPV survivors who seek support with their mental health; 2) a lack of specialized training among professionals as a barrier to effective support; 3) a low prioritization on the national level; 4) little inter-sectoral collaboration which undermines the complexity of needed responses; 5) broader systemic problems. The provision of mental health support to IPV survivors lacks the recognition that IPV is gender-based violence and a major public (mental) health problem. The complexity of needed services is absent. Further research needs to explore the utilization of mental health services by IPV survivors and their perceptions concerning it.
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Affiliation(s)
- Ugnė Grigaitė
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, National School of Public Health, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Greta Klidziūtė
- Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Deborah Oyine Aluh
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, National School of Public Health, Universidade NOVA de Lisboa, Lisboa, Portugal
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Bárbara Pedrosa
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, National School of Public Health, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Margarida Santos-Dias
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, National School of Public Health, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Manuela Silva
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre (CHRC), Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - Graça Cardoso
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre (CHRC), Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - José Miguel Caldas-de-Almeida
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre (CHRC), Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
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Collins A, Maselko J, Hagaman A, Bates L, Haight SC, Kachoria AG, Gupta S, Bhalotra S, Sikander S, Bibi A. Disability severity and risk of new or recurrent intimate partner violence - Evidence from a cohort study in rural Pakistan. Disabil Health J 2024:101673. [PMID: 39095292 DOI: 10.1016/j.dhjo.2024.101673] [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: 03/05/2024] [Revised: 06/12/2024] [Accepted: 07/18/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND People with disabilities are more likely to experience intimate partner violence (IPV) than those without. Most research examining the relationship between disability and IPV, however, is cross-sectional and approaches disability as a binary variable. This relationship is also important to consider in a South Asian context, where it may be affected by cultural norms surrounding IPV, and resources for people with disabilities. OBJECTIVE To estimate the degree to which disability severity increases the risk of subsequent IPV among a cohort of mothers living in rural Pakistan. METHODS Mothers from the Bachpan study (N = 869) with data for at least two consecutive waves between 1-, 2-, 3-, and 6-years postpartum were included in this study. Modified Poisson regression models were used to estimate the relationship between disability level in the preceding wave and psychological, physical, and sexual IPV in the following wave. RESULTS For psychological IPV, the risk ratio (RR) for medium severity was 1.27 (95 % CI: 1.10, 1.46) and the RR for high severity was 1.23 (95 % CI: 1.02, 1.48), relative to low severity. Physical IPV had a medium severity RR of 1.44 (95 % CI: 1.00, 2.06) and high severity RR of 1.60 (95 % CI: 1.02, 2.53). For sexual IPV, the medium severity RR was 1.35 (95 % CI: 1.05, 1.75) and the high severity RR was 1.53 (95 % CI: 1.11, 2.10). CONCLUSIONS This study supports that, in a low-income, rural South Asian context, mothers with disabilities are particularly susceptible to future psychological, physical, and sexual IPV.
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Affiliation(s)
- Amanda Collins
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, McGavran-Greenberg Hall, Chapel Hill, NC, 27516, USA; Cecil G. Sheps Center for Health Services Research, University of North Carolina, Rural Health Research and Policy Analysis Center, 725 M.L.K. Jr Blvd, Chapel Hill, NC, 27516, USA.
| | - Joanna Maselko
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, McGavran-Greenberg Hall, Chapel Hill, NC, 27516, USA; Carolina Population Center, University of North Carolina, 123 West Franklin St., Suite 210, Chapel Hill, NC, 27516, USA
| | - Ashley Hagaman
- Department of Social and Behavioral Sciences, Yale School of Public Health, Laboratory of Epidemiology and Public Health, 60 College St, New Haven, CT, 06510, USA; Center for Methods in Implementation and Prevention Science, Yale School of Public Health, Laboratory of Epidemiology and Public Health, 60 College St, New Haven, CT, 06510, USA
| | - Lisa Bates
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY, 10032, USA
| | - Sarah C Haight
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, McGavran-Greenberg Hall, Chapel Hill, NC, 27516, USA
| | - Aparna G Kachoria
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Dr, Chapel Hill, NC, 27599, USA
| | - Sugandh Gupta
- Department of Anthropology, University of North Carolina, 207 E. Cameron Ave, Chapel Hill, NC, 27599, USA
| | - Sonia Bhalotra
- Department of Economics, University of Warwick, Coventry, CV4 7AL, UK
| | - Siham Sikander
- Department of Primary Care & Mental Health, University of Liverpool, Waterhouse Building, Block B, Brownlow Street, Liverpool, L69 3GF, UK; Pakistan Institute of Living and Learning, Suite 201, 2nd Floor, Doctors Plaza, Khayaban-e-Iqbal, Block 9 Clifton, Karachi, Karachi City, Sindh, 75600, Pakistan
| | - Amina Bibi
- Human Development Research Foundation, 963W+WWV, Boocha, Rawalpindi, Punjab, Pakistan
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Fredericksen RJ, Mixson LS, Drumright LN, Nance RM, Delaney JAC, Ruderman SA, Whitney BM, Hahn A, Ma J, Mayer KH, Christopoulos KA, Willig AL, Napravnik S, Bamford L, Cachay E, Eron JJ, Saag M, Jacobson J, Kitahata MM, Crane HM. Correlates of Intimate Partner Violence, Including Psychological Partner Violence, in a Multisite U.S. Cohort of People in HIV Care. AIDS Behav 2024:10.1007/s10461-024-04402-2. [PMID: 39014029 DOI: 10.1007/s10461-024-04402-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2024] [Indexed: 07/18/2024]
Abstract
We examined past-year intimate partner violence (IPV), including psychological violence without physical/sexual violence, and health outcomes among people with HIV (PWH) in care in a multi-site U.S. cohort. Between 2016 and 2022, PWH reported 12-month psychological, physical, and sexual IPV in a routine assessment. We used linear and logistic regression models adjusted for age, race/ethnicity, and site to examine relationships with health outcomes. Among 9748 PWH (median age 50 years, 81% cisgender male/16% cisgender female/1% transgender female; 44% non-Hispanic white/36% non-Hispanic Black/15% Hispanic), 9.3% (n = 905) reported any IPV in the past 12 months; half reported psychological IPV without physical/sexual IPV (n = 453). PWH reporting any type of IPV were on average younger than those who did not experience IPV. In adjusted models, any IPV was associated with increased likelihood of unstable housing, HIV viral load detection (HIV viral load ≥ 75 copies/mL), moderate-to-severe depressive symptoms, anxiety with panic symptoms, substance use (methamphetamines, cocaine/crack, illicit opioids, marijuana, heavy episodic/hazardous drinking), and concern about exposure to sexually transmitted infection. PWH reporting any IPV in the past 12 months had 4.2% lower adherence to antiretroviral therapy, 2.4 more HIV-related symptoms, a 1.9 point higher HIV stigma score, and a 9.5% lower quality of life score than those without IPV. We found similar associations among PWH reporting only psychological IPV, without physical/sexual IPV. IPV was common among PWH. Half reporting IPV reported only psychological IPV and had similarly poor outcomes as those reporting physical/sexual IPV, demonstrating the need to assess psychological as well as physical and sexual IPV.
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Affiliation(s)
- R J Fredericksen
- Department of Medicine, University of Washington, Seattle, WA, USA.
| | - L S Mixson
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - L N Drumright
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - R M Nance
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - J A C Delaney
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - S A Ruderman
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - B M Whitney
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - A Hahn
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - J Ma
- Department of Medicine, University of Washington, Seattle, WA, USA
| | | | - K A Christopoulos
- Department of Medicine, University of California, San Francisco, CA, USA
| | - A L Willig
- Department of Medicine, University of Alabama, Birmingham, AL, USA
| | - S Napravnik
- University of North Carolina, Chapel Hill, NC, USA
| | - L Bamford
- University of California, San Diego, CA, USA
| | - E Cachay
- University of California, San Diego, CA, USA
| | - J J Eron
- University of North Carolina, Chapel Hill, NC, USA
| | - M Saag
- Department of Medicine, University of Alabama, Birmingham, AL, USA
| | - J Jacobson
- Case Western Reserve University, Cleveland, OH, USA
| | - M M Kitahata
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - H M Crane
- Department of Medicine, University of Washington, Seattle, WA, USA
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Corboz J, Dartnall E, Brown C, Fulu E, Gordon S, Tomlinson M. Co-creating a global shared research agenda on violence against women in low- and middle-income countries. Health Res Policy Syst 2024; 22:71. [PMID: 38914999 PMCID: PMC11194916 DOI: 10.1186/s12961-024-01153-3] [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: 05/21/2023] [Accepted: 05/22/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Despite a large growth in evidence on violence against women (VAW) over the last 25 years, VAW persists, as do gaps in the field's knowledge of how to prevent and respond to it. To ensure that research on VAW in low- and middle-income countries (LIMCs) is addressing the most significant gaps in knowledge, and to prioritise evidence needs to reduce VAW and better support victims/survivors, the Sexual Violence Research Initiative (SVRI) and Equality Institute (EQI) led a process of developing a global shared research agenda (GSRA) on VAW in LMICs. METHODS The GSRA was developed through a six-stage adaptation of the Child Health and Nutrition Research Initiative (CHNRI) method, which draws on the principle of the 'wisdom of the crowd'. These steps included: a review of the literature on VAW in LMICs and development of domains; the generation of research questions within four domains by an Advisory Group; the consolidation of research questions; scoring of research questions by a Global Expert Group and the Advisory Group according to three criteria (applicability, effectiveness and equity); consultation and validation of the findings with the Advisory Group; and wide dissemination of the findings. RESULTS The highest ranked research questions in the GSRA pertain to the domain of Intervention research, with some highly ranked questions also pertaining to the domain of Understanding VAW in its multiple forms. Questions under the other two domains, Improving existing interventions, and Methodological and measurement gaps, were not prioritised as highly by experts. There was strong consistency in top ranked research questions according to experts' characteristics, albeit with some important differences according to experts' gender, occupation and geographical location. CONCLUSIONS The GSRA findings suggest that currently the VAW field is shifting towards intervention research after several decades of building evidence on understanding VAW, including prevalence, drivers and impacts of violence. The findings also suggest a strong emphasis on under-served populations, and under-researched forms of VAW. Future priority setting exercises in LMICs that seek to decolonise knowledge should ensure that methodologies, and modalities of engagement, put diverse voices at the centre of engagement. Trial registration Not applicable.
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Affiliation(s)
| | | | - Chay Brown
- The Equality Institute, Melbourne, Australia
| | - Emma Fulu
- The Equality Institute, Melbourne, Australia
| | - Sarah Gordon
- Stellenbosch University, Stellenbosch, South Africa
| | - Mark Tomlinson
- Stellenbosch University, Stellenbosch, South Africa
- Queens University, Belfast, United Kingdom
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5
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Spaducci G, Oram S, Thiara R, Robson D, Peeren S, Gibbs A, Trevillion K. The mental health and substance use treatment experiences of racially and ethnically minoritised women who have experienced sexual violence. Int J Ment Health Nurs 2024; 33:546-559. [PMID: 38131433 DOI: 10.1111/inm.13276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 11/09/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
The mental health and substance use treatment experiences of racially and ethnically minoritised women who have experienced sexual violence is not well understood. To address this we conducted a systematic review and meta-synthesis of qualitative studies. Our search strategy included electronic searches of 18 databases and grey literature, citation tracking and reference list screening. Studies were eligible if they presented qualitative data from racially and/or ethnically minoritised women or girls, who had experienced sexual violence at any age and described their experiences of receiving treatment from statutory mental health and/or substance use services. Studies were analysed using meta-ethnography. Fourteen papers based on 12 individual studies were included. Analysis developed three main themes: (1) understanding minoritised women holistically, (2) processing the trauma and beginning the healing and (3) the need for social connectedness and empowering relationships. For minoritised women to benefit from treatment, mental health and substance use services need to challenge the dynamics of the multiple traumas minoritised women experience. Knowledge and understanding of the racial trauma minoritised women experience is limited and many are subjected to further harm from racist practices occurring in some treatment services. Offering culturally safe, trauma-informed care which promotes anti-racist practices may help improve mental health and substance use service responses to minoritised women who have experienced sexual violence.
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Affiliation(s)
- Gilda Spaducci
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sian Oram
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Debbie Robson
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Siofra Peeren
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Kylee Trevillion
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Joseph AL, Jerram MW, Valera EM. Emotional Clarity and Psychopathology in Women Who Have Experienced Physical Intimate Partner Violence. Violence Against Women 2024:10778012241254852. [PMID: 38784989 DOI: 10.1177/10778012241254852] [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: 05/25/2024]
Abstract
Intimate partner violence (IPV) is a chronic, traumatic stressor related to posttraumatic stress (PTS), depression, and anxiety. As psychological symptoms are exacerbated in those with poor emotional clarity, the present study evaluates the relationship between emotional clarity and PTS, dissociation, depression, and worry in women who experienced at least one instance of physical IPV (n = 88). Hierarchical regression analyses, controlling for childhood trauma, IPV abuse severity, and IPV-related brain injury, found that lack of emotional clarity was significantly related to greater PTS, dissociative experiences, depression, and worry. Results suggest that emotional clarity may be a relevant therapeutic target for individuals with a history of IPV and psychological distress.
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Affiliation(s)
- Annie-Lori Joseph
- Department of Psychology, Suffolk University, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | | | - Eve M Valera
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Grimes KEL, Ebasone PV, Dzudie A, Nash D, Pence BW, Wainberg M, Yotebieng M, Ajeh R, Parcesepe AM. Intimate partner violence, depression, hazardous alcohol use, and social support among people with HIV initiating HIV care in Cameroon. PLoS One 2024; 19:e0304114. [PMID: 38771851 PMCID: PMC11108227 DOI: 10.1371/journal.pone.0304114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 05/06/2024] [Indexed: 05/23/2024] Open
Abstract
Intimate partner violence (IPV) has been associated with poor mental health among people with HIV (PWH) globally. Social support may be a strategy to foster mental health among PWH. Little is known about whether the relationship between IPV and mental health differs by IPV type or level of social support. Interviews were conducted with 426 PWH initiating HIV care in Cameroon. Log binomial regression analyses were used to estimate the association between four types of IPV (controlling behavior and emotional, physical, and sexual IPV) and symptoms of depression or hazardous alcohol use, separately by IPV type and level of social support. Over half (54.8%) of respondents experienced moderate/high levels of controlling behavior, 42.0% experienced emotional IPV, 28.2% experienced physical IPV and 23.7% experienced sexual IPV. Controlling behavior was associated with greater prevalence of depressive symptoms. This relationship did not vary meaningfully by level of social support (low: aPR 2.4 [95% CI 1.2, 4.9]; high: 1.7 [95% CI 1.0, 2.7]). Emotional and physical IPV were associated with greater prevalence of depressive symptoms among those with low social support (emotional IPV: aPR 1.9 [95% CI 1.0, 3.4]; physical IPV: aPR 1.8 [95% CI 1.2, 2.8]), but not among those with high social support (emotional IPV: aPR 1.0 [95% CI 0.7, 1.6]; physical IPV: aPR 1.0 [95% CI 0.6, 1.6]). Controlling behavior, emotional IPV, and physical IPV were associated with a greater prevalence of hazardous alcohol use, with moderately larger effect estimates among those with high compared to low social support. Sexual IPV was not associated with depressive symptoms or hazardous alcohol use. Services to screen and care for people experiencing IPV are urgently needed among PWH in Cameroon. Future research to identify barriers, feasibility, acceptability, and organizational readiness to integrate IPV and mental health services into HIV care settings is needed.
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Affiliation(s)
- Kathryn E. L. Grimes
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | | | - Anastase Dzudie
- Clinical Research Education Networking and Consultancy, Yaoundé, Cameroon
| | - Denis Nash
- Institute for Implementation Science in Population Health, City University of New York, New York, NY, United States of America
| | - Brian W. Pence
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Milton Wainberg
- Department of Psychiatry, Columbia University, New York, NY, United States of America
- New York State Psychiatric Institute, New York, NY, United States of America
| | - Marcel Yotebieng
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Rogers Ajeh
- Clinical Research Education Networking and Consultancy, Yaoundé, Cameroon
| | - Angela M. Parcesepe
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
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Montesanti S, Sehgal A, Zaeem L, McManus C, Squires S, Silverstone P. Assessing primary health care provider and organization readiness to address family violence in Alberta, Canada: development of a Delphi consensus readiness tool. BMC PRIMARY CARE 2024; 25:146. [PMID: 38684969 PMCID: PMC11059610 DOI: 10.1186/s12875-024-02396-3] [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] [Received: 10/06/2023] [Accepted: 04/18/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Family violence, which includes intimate partner abuse, child abuse, and elder abuse, is a serious public health concern. Primary healthcare (PHC) offers a vital opportunity to identify and address family violence, yet barriers prevent the effective implementation of family violence interventions in PHC settings. The purpose of this study is to improve family violence identification and response in Alberta's PHC settings by exploring readiness factors. METHODS An integrated knowledge translation approach, combining implementation science and participatory action research, was employed to develop a readiness assessment tool for addressing family violence within PHC settings in Alberta. The research involved three phases: phase 1 involved a rapid evidence assessment, phase 2 engaged a panel of healthcare and family violence experts to explore readiness components in the Alberta context, and phase 3 utilized a 3-round Delphi consensus-building process to refine readiness indicators. RESULTS Phase 1 findings from a rapid evidence assessment highlighted five main models/tools for assessing readiness to implement family violence interventions in PHC settings. In phase 2, additional concepts were identified through exploration with healthcare and family violence expert panel members, resulting in a total of 16 concepts for assessing family violence readiness within the Alberta PHC context. The 3-round Delphi consensus-building process in Phase 3 involved nine panelists, who collectively agreed on the inclusion of all concepts and indicators, yielding a total of 60 items for the proposed readiness assessment tool for addressing family violence in PHC within Alberta. CONCLUSION The current study lays the groundwork for future family violence intervention programs, offering insights into key components that promote readiness for implementing comprehensive programs and supporting PHC organizations in effectively addressing family violence.
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Affiliation(s)
- Stephanie Montesanti
- School of Public Health, University of Alberta, Edmonton, AB, Canada.
- Centre for Healthy Communities, School of Public Health, University of Alberta, Edmonton, AB, Canada.
| | - Anika Sehgal
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Lubna Zaeem
- Islamic Family and Social Services Association, Edmonton, AB, Canada
| | - Carrie McManus
- Sagesse Domestic Violence Prevention Society, Calgary, AB, Canada
| | - Suzanne Squires
- Westgrove Clinic, Westview Primary Care Network, Spruce Grove, AB, Canada
| | - Peter Silverstone
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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9
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Schalk D, Fernandes C. How Health Professionals Identify and Respond to Perpetrators of Domestic and Family Violence in a Hospital Setting: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380241246783. [PMID: 38656268 DOI: 10.1177/15248380241246783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
There is heightened awareness that a whole-of-systems approach to perpetrator responses is key to addressing domestic and family violence (DFV). This paper reports on the findings from a scoping review which mapped the international literature on how health professionals identify and respond to perpetrators of DFV within a hospital setting. A comprehensive scoping review methodology was used. The search, spanning January 2010 to January 2022, yielded 12,380 publications from four databases. Eligibility for inclusion included peer-reviewed literature with any reference to inpatient hospital health professionals identifying or responding to perpetrators of DFV. Fourteen articles were included in the final review. The review presents the literature categorized by levels of prevention, from primary, secondary, through to tertiary preventive interventions. An additional category "other practices" is added to capture practices which did not fit into existing levels. Despite glimpses into how health professionals can identify, and respond to perpetrators of DFV, the current knowledge base is sparse. The review did not identify any mandated or formal procedures for identifying and/screening or responding to perpetration of abuse in hospitals. Rather, responses to perpetrators are inconsistent and rely on the motivation, skill, and self-efficacy of health professionals rather than an embedded practice that is driven and informed by hospital policy or procedures. The literature paints a picture of missed opportunities for meaningful work with perpetrators of DFV in a hospital setting and highlights a disjuncture between policy and practice.
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Affiliation(s)
- Danielle Schalk
- Fiona Stanley Hospital, South Metropolitan Health Service, Perth, Australia
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10
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Metheny N, Mkhize SP, Scott D, Hatcher A. Violence Victimization and Depressive Symptoms Among a Sub-Sample of Sexual and Gender Minority Adults in a Population-Based South African Study. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241243348. [PMID: 38654528 DOI: 10.1177/08862605241243348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Sexual and gender minority (SGM) adults in South Africa face high levels of violence and poor mental health outcomes. Interventions to prevent these negative health implications are hampered by a lack of representative data among this population. This study aims to quantify the associations between three forms of violent victimization and depressive symptoms in a sub-sample of SGM drawn from a population-based cross-sectional study in Gauteng, South Africa. Data come from the sixth Quality of Life survey conducted in South Africa's Gauteng province. Brief screeners assessed childhood sexual abuse (CSA), past-year intimate partner violence (IPV), non-partner violence, and depressive symptoms. Three survey-weighted logistic regression analyses were fit to model associations between elevated depressive symptoms and CSA, past-year IPV, and past-year non-partner violence, controlling for socio-demographics (age, race, sex, area of residence, education, socioeconomic status, and recent employment). N = 1,328 SGM respondents were included. Over 40% (n = 537) reported depressive symptoms, while 17% (n = 222) reported CSA, 5% (n = 67) reported IPV, and 16% (n = 208) reported non-partner violence. CSA and non-partner violence were associated with significantly higher odds of reporting depressive symptoms (aOR: 1.51, 95% CI [1.03, 2.23]; aOR: 1.84, [1.24, 2.73], respectively). IPV was not associated with elevated depressive symptoms (aOR: 1.17, [0.64, 2.16]). In all models, employment in the past 7 days was associated with significantly lower odds of reporting depressive symptoms. Recent and childhood violence is a major burden that is associated with elevated symptoms of depression among SGM in urban South Africa. Community-tailored interventions and policy-related advocacy related to employment and violence prevention may alleviate depressive symptoms in SGM adults in Gauteng.
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Affiliation(s)
| | - Sthembiso Pollen Mkhize
- University of Johannesburg, South Africa
- University of the Witwatersrand, Johannesburg, South Africa
| | | | - Abigail Hatcher
- University of the Witwatersrand, Johannesburg, South Africa
- University of North Carolina, Chapel Hill, USA
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11
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Hernández W, Ortega J. Beyond the Surface: Intimate Partner Violence Typology and Recent Depression. Violence Against Women 2024:10778012241248452. [PMID: 38646738 DOI: 10.1177/10778012241248452] [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: 04/23/2024]
Abstract
Depression and intimate partner violence (IPV) are highly related. However, it is unclear what drives this relationship: the form of violence (psychological, physical, or sexual) or its severity. In this study, we first identify patterns of combined forms and severity of violence and then estimate the effects of IPV on depression. We use the DHS and focus on Peru, a country with high IPV rates. Five classes of IPV were identified. The more intense the IPV class, the higher the effect on recent depression. However, the effect on depression tends to be smaller when levels of depression are higher.
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Affiliation(s)
- Wilson Hernández
- University of Pennsylvania, Philadelphia, PA, USA
- GRADE-Group for the Analysis of Development, Lima, Peru
| | - Jhon Ortega
- Universidad Nacional Mayor de San Marcos, Lima, Peru
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Karamitanha F, Ahmadi F, Fallah Abadi V. Geographic pattern of the prevalence of intimate partner violence against women in Zanjan (Iran). Front Psychol 2024; 15:1347077. [PMID: 38708015 PMCID: PMC11067525 DOI: 10.3389/fpsyg.2024.1347077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/25/2024] [Indexed: 05/07/2024] Open
Abstract
Introduction Intimate partner violence (IPV) against women is a serious public health issue and refers to physically, sexually and psychologically harmful behaviors as well as emotionally controlling behaviors and financial abuse that occur in the form of marriage or cohabitation. Knowing the current situation of the IPV prevalence against women and high-risk areas in the Zanjan city, Iran, can help policymakers to establish better health programs for risk reduction. Methods This population-based cross-sectional study consisted of married women aged 18-55 years living in Zanjan city in 2021. 760 married women covered by 19 urban comprehensive health service centers (UCHSCs) were selected by the stratified systematic random sampling method. The prevalence of IPV against women was measured in four types: psychological, physical, sexual, and economic. Results Mean (SD) age of the women was 35.49 (8.76) years. 606 women (79.7%) experienced one type of IPV. The highest and lowest IPV prevalence against women were psychological (76.6%) and economic (12%), respectively. The highest and lowest prevalence of psychological violence were observed in CUHSCs 2 and 17, physical violence in CUHSCs 1 and 14, sexual violence in CUHSCs 2 and 17, and economic violence in CUHSCs 2 and 8, respectively. The severity of violence was higher among self-employment or workers husbands, with low monthly household income, and among younger women. Discussion The IPV rate in the target population is high, and the highest rate is related to psychological violence. These results highlight the need to intervention in the society and high-risk women for policymakers of the health system.
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Affiliation(s)
- Farzaneh Karamitanha
- Department of Community Medicine, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Farzane Ahmadi
- Department of Biostatistics and Epidemiology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Vahid Fallah Abadi
- Department of Environmental Health Engineering, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
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Capasso A, Tozan Y, DiClemente RJ, Pahl K. Childhood Violence, High School Academic Environment, and Adult Alcohol Use Among Latinas and Black Women: A Structural Equation Modeling Study. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241243372. [PMID: 38587260 DOI: 10.1177/08862605241243372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
OBJECTIVE Young Latinas and Black women drink less than women of other racial/ethnic groups but experience more alcohol-related problems in midlife. This study aims to identify modifiable factors to prevent adult onset of alcohol use disorder (AUD) in this population. METHODS Data were collected at six time points as part of the Harlem Longitudinal Development Study from 365 Latinas (47%) and Black (53%) women (mean age at time 1 = 14, standard deviation 1.3). Structural equation modeling was used to test hypothesized pathways from childhood physical and sexual abuse to AUD via depressive mood, anxiety disorders, and somatic complaints in the 20s. We also tested the moderation effect of the high school academic environment by including in the structural equation model two latent variable interaction terms between the school environment and each of the abuse variables. RESULTS Childhood physical and sexual abuse was positively associated with depressive mood, anxiety disorders, and somatic complaints when participants were in the 20s. Depressive mood mediated childhood abuse and AUD when women were in the 30s. The high school academic environment attenuated the effect of physical, but not sexual abuse, on depressive mood (β = -0.59, B = -9.38, 95% CI [-14.00, -4.76]), anxiety symptoms (β = -0.61, B = -14.19, 95% CI [-21.76, -6.61]), appetite loss (β = -0.41, B = -10.52, 95% CI [-15.61, -5.42]), and sleeplessness (β = -0.50, B = -9.56, 95% CI [-13.95, -5.17]) in the early 20s. CONCLUSIONS Our findings underscore the need to invest in early violence prevention interventions and in education to ensure equitable access to quality, academically oriented, and safe schools.
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Affiliation(s)
- Ariadna Capasso
- NYU School of Global Public Health, New York University, USA
- Health Resources in Action, Boston, MA, USA
| | - Yesim Tozan
- NYU School of Global Public Health, New York University, USA
| | | | - Kerstin Pahl
- Department of Psychiatry, New York University School of Medicine, USA
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
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Grigaitė U, Azeredo-Lopes S, Cardoso G, Pedrosa B, Aluh DO, Santos-Dias M, Silva M, Xavier M, Caldas-de-Almeida JM. Mental health conditions and utilisation of mental health services by survivors of physical intimate partner violence in Portugal: Results from the WHO world mental health survey. Psychiatry Res 2024; 334:115801. [PMID: 38402741 DOI: 10.1016/j.psychres.2024.115801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 02/27/2024]
Abstract
The aim of this article is to study mental health conditions among survivors of severe physical intimate partner violence (IPV) and their utilisation of mental health services. This study is an integrated part of the World Mental Health Survey Initiative-Portugal, for which data was collected from a nationally representative adult sample using well-validated scales. Logistic regression models were used in the analysis. The most common statistically significant mental health conditions among IPV survivors were suicide ideation, PTSD, major depressive episode, and generalised anxiety disorder. More than one in three survivors developed PTSD. Suicide ideation was likely to occur after first experiencing IPV. Almost a half of survivors received specialised mental health treatment; in most cases, delivered by a psychiatrist. Over 60 % addressed their mental health issues consulting general physicians or other healthcare professionals. Those who experienced family violence in childhood had greater odds of also experiencing IPV; survivors of IPV with this experience were more likely to receive mental health treatment. The need to promote greater awareness and competencies of not only mental health professionals but also of general physicians and other healthcare professionals to provide support more effectively to survivors of any type of IPV deserves to be emphasised.
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Affiliation(s)
- Ugnė Grigaitė
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal; National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal.
| | - Sofia Azeredo-Lopes
- Comprehensive Health Research Centre/NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal; Department of Statistics and Operational Research, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Graça Cardoso
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Bárbara Pedrosa
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal; National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Deborah Oyine Aluh
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal; National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal; Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria Nsukka, Nigeria
| | - Margarida Santos-Dias
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Manuela Silva
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Miguel Xavier
- Comprehensive Health Research Centre/NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - José Miguel Caldas-de-Almeida
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Centre/NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
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Hisasue T, Kruse M, Hietamäki J, Raitanen J, Martikainen V, Pirkola S, Rissanen P. Health-Related Costs of Intimate Partner Violence: Using Linked Police and Health Registers. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:1596-1622. [PMID: 37978834 DOI: 10.1177/08862605231211932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
This study aims to estimate direct health-related costs for victims of intimate partner violence (IPV) using nationwide linked data based on police reports and two healthcare registers in Finland from 2015 to 2020 (N = 21,073). We used a unique register dataset to identify IPV victims from the data based on police reports and estimated the attributable costs by applying econometric models to individual-level data. We used exact matching to create a reference group who had not been exposed to IPV. The mean, unadjusted, attributable healthcare cost for victims of IPV was €6,910 per individual over the 5-year period after being first identified as a victim. When adjusting for gender, age, education, occupation, and mental-health- and pregnancy-related diagnoses, the mean attributable health-related cost for the 5 years was €3,280. The annual attributable costs of the victims were consistently higher than those for nonvictims during the entire study period. Thus, our results suggest that the adverse health consequences of IPV persist and are associated with excess health service use for 5 years after exposure to IPV. Most victims of IPV were women, but men were also exposed to IPV, although the estimates were statistically significant only for female victims. Victims of IPV were over-represented among individuals outside the labor force and lower among those who were educated. The total healthcare costs of victims of IPV varied according to the socioeconomic factors. This study highlights the need for using linked register data to understand the characteristics of IPV and to assess its healthcare costs. The study results suggest that there is a significant socioeconomic gradient in victimization, which could also be useful to address future IPV prevention and resource allocation.
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Affiliation(s)
- Tomomi Hisasue
- Tampere University, Finland
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Marie Kruse
- University of Southern Denmark, Odense C, Denmark
| | - Johanna Hietamäki
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- University of Eastern Finland, Kuopio, Finland
| | - Jani Raitanen
- Tampere University, Finland
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Visa Martikainen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Sami Pirkola
- Tampere University, Finland
- Tampere University Central Hospital, Finland
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Johnson SL, Rasmussen JM, Mansoor M, Ibrahim H, Rono W, Goel P, Vissoci JRN, Von Isenburg M, Puffer ES. Correlates of Intimate Partner Violence Victimization and Perpetration in Adolescents and Young Adults in Sub-Saharan Africa: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:1168-1183. [PMID: 37226506 DOI: 10.1177/15248380231173428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Intimate partner violence (IPV) is a global public health crisis with long-term adverse consequences for both victims and perpetrators. Patterns of violence often begin during adolescence, yet most interventions target adult relationships. A systematic review was conducted to identify correlates of IPV victimization and perpetration among adolescents and young adults in sub-Saharan Africa (SSA). Eligible studies included participants 10 to 24 years old, took place in SSA, and tested a statistical association between a correlate and an IPV outcome. Correlates were defined as any condition or characteristic associated with statistically significant increased or decreased risk of IPV victimization or perpetration. PsycInfo, PubMed, Embase, and African Index Medicus were searched and included studies published between January 1, 2000 and February 4, 2022. The search resulted in 3,384 original studies, of which 55 met inclusion criteria and were analyzed. Correlates were first qualitatively synthesized by developmental period (e.g., early adolescence, older adolescence, and young adulthood) and then organized in a conceptual framework by correlate type (e.g., socio-demographic; health, behavior, and attitudes; relational; or contextual). Over two decades of literature reveals variability in evidence by developmental period but also substantial overlap in the correlates of victimization and perpetration. This review identifies multiple points for intervention and results suggest the urgent need for earlier, developmentally appropriate prevention efforts among younger adolescents as well as combined approaches that target both victimization and perpetration of IPV.
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Affiliation(s)
- Savannah L Johnson
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
| | - Justin M Rasmussen
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
| | | | - Hawo Ibrahim
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Wilter Rono
- Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Pari Goel
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - João R N Vissoci
- Duke Global Health Institute, Durham, NC, USA
- Department of Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Megan Von Isenburg
- Duke University Medical Center Library, Duke University Medical Center Archives, Durham, NC, USA
| | - Eve S Puffer
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
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Micklitz HM, Glass CM, Bengel J, Sander LB. Efficacy of Psychosocial Interventions for Survivors of Intimate Partner Violence: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:1000-1017. [PMID: 37148270 DOI: 10.1177/15248380231169481] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Survivors of intimate partner violence (IPV) face serious health-related, social and economic consequences. Prior meta-analyses indicate efficacy of psychosocial interventions for support of IPV survivors, but their results are affected by methodological limitations. Extensive subgroup analyses on the moderating effects of intervention and study characteristics are lacking. To address these limitations in an up-to-date and comprehensive meta-analytic review, four literature databases (PsycInfo, Medline, Embase, and CENTRAL, March 23, 2022) were searched for randomized-controlled trials examining the efficacy of psychosocial interventions compared to control groups in improving safety-related, mental health, and psychosocial outcomes in IPV survivors. Weighted effects on IPV, depression, posttraumatic stress disorder (PTSD), and psychosocial outcomes were calculated under random-effects assumption. Subgroup analyses were performed to investigate moderating effects of predefined intervention and study characteristics. Study quality was rated. In all, 80 studies were included in qualitative synthesis, and 40 studies in meta-analyses. Psychosocial interventions significantly reduced symptoms of depression (SMD: -0.15 [95% confidence interval, CI [-0.25, -0.04]; p = .006], I2 = 54%) and PTSD (SMD: -0.15 [95% CI [-0.29, -0.01]; p = .04], I2 = 52%), but not IPV reexperience (SMD: -0.02 [95% CI [ -0.09, 0.06]; p = .70], I2 = 21%) compared to control conditions at post. High-intensive and integrative interventions, combining advocacy-based and psychological components, were favorable subgroups. Yielded effects were modest and not maintained long term. The quality of evidence was low and potential harms remain unclear. Future research should adopt higher standards of research conduct and reporting and must account for the complexity and diversity of IPV experiences.
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Affiliation(s)
- Hannah M Micklitz
- Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Carla M Glass
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Jürgen Bengel
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Lasse B Sander
- Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Wei X, Wang W, Law YW, Zhang H. The Impacts of Intimate Partner Violence on Postpartum Depression: An Updated Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:1531-1550. [PMID: 37480328 DOI: 10.1177/15248380231188068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Abstract
The associations between intimate partner violence (IPV) and postpartum depression (PPD) have been well established in previous reviews. However, none has explored potential differences between IPV subtypes or exposure times, which could help healthcare providers recognize the adverse impacts of various IPV subtypes and conduct comprehensive IPV screening. This study aimed to estimate the impacts of overall IPV and its subtypes (physical, psychological, and sexual) on PPD using an updated meta-analysis and to examine the potential role of IPV exposure time and regional income levels. Four English databases (Medline, PsycINFO, PubMed, and Web of Science) and two Chinese databases (China National Knowledge Infrastructure [CNKI] and Wanfang Database) were systematically searched. We included 76 studies with 388,966 samples. Random-effects models were used to pool the odds ratios (ORs) across studies. Overall, IPV and its subtypes had statistically significant impacts on PPD (overall: OR = 2.50, physical: OR = 2.31, psychological: OR = 2.22, sexual: OR = 1.75). A higher impact of IPV on PPD was observed in middle- and low-income regions (OR = 3.01) than in high-income regions (OR = 1.92). IPV during pregnancy (OR = 2.73) had a greater impact on PPD than lifetime IPV (OR = 2.24). This study provides updated evidence for the significant impact of IPV and its subtypes and exposure time on PPD. Women at risk of exposure to physical IPV, especially during pregnancy, are in urgent need of support to reduce the risk of PPD.
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Affiliation(s)
- Xinyi Wei
- The University of Hong Kong, Pokfulam, Hong Kong
| | | | - Yik Wa Law
- The University of Hong Kong, Pokfulam, Hong Kong
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Ishitsuka K, Yamamoto-Hanada K, Mezawa H, Yang L, Saito-Abe M, Nishizato M, Sato M, Miyaji Y, Kumasaka N, Ohya Y, Kamijima M, Yamazaki S, Kishi R, Yaegashi N, Hashimoto K, Mori C, Ito S, Yamagata Z, Inadera H, Nakayama T, Iso H, Shima M, Nakamura H, Suganuma N, Kusuhara K, Katoh T. Teenage and young adult pregnancy and depression: findings from the Japan environment and children's study. Arch Womens Ment Health 2024; 27:293-299. [PMID: 37989798 DOI: 10.1007/s00737-023-01400-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023]
Abstract
Teenage pregnancy increases the threat of depression because of its many factors. Pregnancy during young adulthood may also have several risk factors for depression compared to older pregnancies. However, data on depression in young adult pregnancies are lacking. This study investigated the association between teenage and young adult pregnancy and depression. Data from the Japan Environment and Children's study was used as a nationwide multicenter prospective cohort study. A multivariate logistic regression was performed to investigate the association between age groups (14-19, 20-24, 25-29, 30-34, ≥ 35 years) and depression, adjusted for behavioral and sociodemographic characteristics. Depression was assessed using the Kessler Psychological Distress Scale. In total, 96,808 pregnant women responded to the questionnaire. Teenage (14-19 years) and young adult (20-24 years) pregnancy were associated with an increased risk of depression compared to older pregnancy (≥ 35 years) (teenage: OR 4.28, 95% confidence interval, CI [3.24-5.64]; young adult: OR 3.00, 95% CI [2.64-3.41]). After adjusting for covariates, the magnitude of the risk of depression was attenuated. However, teenage and young adult pregnancy remained at a significantly increased risk of depression compared to older pregnancy (teenage: OR 2.38, 95% CI [1.77-3.21]; young adult: OR 2.14, 95% CI [1.87-2.46]). Our findings indicate that teenage and young adults' pregnancy are at an increased risk of depression compared to older pregnancy. These findings suggest prioritizing teenage and young pregnant women for prevention and interventions related to depression.
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Affiliation(s)
- Kazue Ishitsuka
- JECS Medical Support Center, National Center for Child Health and Development, Tokyo, Japan.
- Department of Social Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-Ku, Tokyo, 1578535, Japan.
| | - Kiwako Yamamoto-Hanada
- JECS Medical Support Center, National Center for Child Health and Development, Tokyo, Japan
| | - Hidetoshi Mezawa
- JECS Medical Support Center, National Center for Child Health and Development, Tokyo, Japan
| | - Limin Yang
- JECS Medical Support Center, National Center for Child Health and Development, Tokyo, Japan
| | - Mayako Saito-Abe
- JECS Medical Support Center, National Center for Child Health and Development, Tokyo, Japan
| | - Minaho Nishizato
- JECS Medical Support Center, National Center for Child Health and Development, Tokyo, Japan
| | - Miori Sato
- JECS Medical Support Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yumiko Miyaji
- JECS Medical Support Center, National Center for Child Health and Development, Tokyo, Japan
| | - Natsuhiko Kumasaka
- JECS Medical Support Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yukihiro Ohya
- JECS Medical Support Center, National Center for Child Health and Development, Tokyo, Japan
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Okoror TA, Nyamuame BM, Martin-Ikpe C, Gilani Y, Nyamuame SE. "… He's not beating me"-Socio-cultural construction of intimate partner violence and traditional birth attendants: implications for maternal & child health in rural communities in Hohoe, Ghana. Front Glob Womens Health 2024; 5:1352793. [PMID: 38567108 PMCID: PMC10985337 DOI: 10.3389/fgwh.2024.1352793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Most research on Intimate Partner Violence (IPV) focuses on the physical, sexual and psychological abuse, with less focus on the financial abuse. This study explores nursing mothers' experiences and perceptions of financial and material support from their significant others and traditional birth attendants' (TBA) observations of support to nursing mothers in their communities. Methods Using purposive sampling, focus groups and interviews were conducted primarily in Ewe language among nursing mothers and TBAs in rural communities in Hohoe, Volta region, Ghana. All discussions were audio-recorded and transcribed for analysis. Thematic analysis guided by the social constructivist framework was used in data analysis. Results Twenty-seven women participated in the study, ranging in ages from 19 to 82 (20 nursing mothers; 7 TBAs). Most participants were married (19) and about 65% reported working outside the home (10 nursing mothers; 7 TBAs). Two themes emerged from the data analysis: Lack of support from partners for housekeeping chores and finances; and TBAs as mediators. Nursing mothers who reported lack of financial support did not perceive it as abuse, rather as hinderance to their efforts to care for their children. TBAs act as mediators interceding on behalf of nursing mothers with their husbands and fathers of their children, while also seeking resources to support them. Discussion Understanding the perceptions and socio-cultural meanings women attached to IPV experience is essential for effective intervention to reduce IPV. In addition, TBAs can be a resource in intervening to alleviate IPV in their communities, thereby improving maternal and child health.
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Affiliation(s)
- Titilayo A. Okoror
- Department of Africana Studies & Global Public Health Program, Binghamton, NY, United States
- Center for Health Equity and Evaluation Research (CHEER), School of Public Health, Texas A&M University, College Station, TX, United States
| | - Bless M. Nyamuame
- Department of Midwifery, Nursing & Midwifery Training College, Hohoe, Ghana
| | - Cordelia Martin-Ikpe
- Department of Africana Studies & Global Public Health Program, Binghamton, NY, United States
- Center for Health Equity and Evaluation Research (CHEER), School of Public Health, Texas A&M University, College Station, TX, United States
| | - Yasmeen Gilani
- Department of Africana Studies & Global Public Health Program, Binghamton, NY, United States
| | - Samuel Elikem Nyamuame
- Department of Africana Studies, Binghamton University (SUNY), Vestal Parkway East, Binghamton, NY, United States
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Ayebeng C, Dickson KS, Ameyaw EK, Adde KS, Paintsil JA, Yaya S. Influence of type of violence on women's help-seeking behaviour: Evidence from 10 countries in sub-Saharan Africa. PLoS One 2024; 19:e0297308. [PMID: 38457385 PMCID: PMC10923450 DOI: 10.1371/journal.pone.0297308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 01/03/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is a major public health concern that mostly impacts women's health and social well-being. This study explored how the various types of IPV (physical, sexual, and emotional) including women's experience of childhood violence influence their help-seeking behavior in sub-Saharan Africa (SSA). METHODS We analyzed data from the most recent Demographic and Health Surveys (DHS), carried out between 2018 and 2021. The outcome variable was help-seeking behavior. Descriptive and inferential analyses were carried out. The descriptive analysis looked at the bivariate analysis between the country and outcome variables. Using a binary logistic regression model, a multivariate analysis was utilized to determine the association between the outcome variable and the explanatory variables. Binary logistic regression modelling was used based on the dichotomous nature of the outcome variable. The results were sample-weighted to account for any under- or over-sampling in the sample. RESULTS The proportion of women who sought help for intimate partner violence was 36.1 percent. This ranged from 19.2 percent in Mali to 49.6 percent in Rwanda. Women who experienced violence in childhood (OR = 0.75, CI = 0.69, 0.82) have a lower likelihood of seeking help compared to those who did not experience violence in their childhood. Women who had experienced emotional violence (OR = 1.94, CI = 1.80, 2.08), and physical violence (OR = 1.37, CI = 1.26, 1.48) have a higher likelihood of seeking help compared to those who have not. Women with secondary educational levels (aOR = 1.13, CI = = 1.02, 1.24) have a higher likelihood of seeking help compared to those with no education. Cohabiting women have a higher likelihood (aOR = 1.22, CI = 1.10, 1.35) of seeking help compared to married women. CONCLUSION The study highlights the importance of early identification of IPV and fit-for-purpose interventions to demystify IPV normalization to enhance women's willingness to seek help. The study's findings suggest that education is crucial for increasing women's awareness of the legalities surrounding IPV and available structures and institutions for seeking help.
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Affiliation(s)
- Castro Ayebeng
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | | | - Edward Kwabena Ameyaw
- Institute of Policy Studies and School of Graduate Studies, Lingnan University, Tuen Mun, Hong Kong
- L & E Research Consult Ltd, Upper West Region, Ghana
| | - Kenneth Setorwu Adde
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Jones Arkoh Paintsil
- Department of Economics, Howard University, Washington, DC, United States of America
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
- The George Institute for Global Health, Imperial College London, London, United Kingdom
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22
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Beck JG, Griffith EL, Majeed R, Beyer MS, Bowen ME, Free BL. Social problem-solving in intimate partner violence victims: Exploring the relative contributions of shame and PTSD symptoms. J Clin Psychol 2024. [PMID: 38447035 DOI: 10.1002/jclp.23675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 12/29/2023] [Accepted: 02/26/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE This study examined the contributions of shame and posttraumatic stress disorder (PTSD) symptoms to two dimensions of social problem-solving. METHOD A sample of 426 women who were seeking mental health assistance following experiences of intimate partner violence completed self-report and clinician measures. Separate path analyses were conducted for problem orientation and problem-solving styles. RESULTS In the model examining problem orientation, higher levels of shame were significantly associated with lower levels of positive problem orientation (f2 = 0.32) and higher levels of negative problem orientation (f2 = 0.92), with large effects noted. PTSD symptoms were significantly, positively associated with negative problem orientation (f2 = 0.3, large effect). When examining problem-solving styles, shame showed a significant negative association with rational style (f2 = 0.08, small effect) and significant positive associations with impulsive style (f2 = 0.45, large effect) and avoidant style (f2 = 0.48, large effect). PTSD symptoms did not return significant associations with any of the three problem-solving styles. CONCLUSION Results indicate that shame holds notable associations with both dimensions of social problem-solving, relative to PTSD symptoms, and are discussed in light of current models of post-trauma functioning. Implications for clinical care and early intervention efforts are highlighted.
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Affiliation(s)
- J Gayle Beck
- Department of Psychology, University of Memphis, Memphis, Tennessee, USA
| | | | - Rimsha Majeed
- Department of Psychology, University of Memphis, Memphis, Tennessee, USA
| | - Melissa S Beyer
- Department of Psychology, University of Memphis, Memphis, Tennessee, USA
| | - Mya E Bowen
- Department of Psychology, University of Memphis, Memphis, Tennessee, USA
| | - Bre'Anna L Free
- Department of Psychology, University of Memphis, Memphis, Tennessee, USA
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23
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Chattopadhyay A, Kumar Sharma S, Vishwakarma D, Jungari S. Prevalence and risk factors of physical violence against husbands: evidence from India. J Biosoc Sci 2024; 56:391-411. [PMID: 37823273 DOI: 10.1017/s0021932023000196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
As the proportion of women being victims of spousal violence in India is higher than men, laws are usually framed to safeguard women. However, men who have experienced physical spousal violence are not unheard of. The study aims to provide the nationwide prevalence of physical violence against husbands and the risk factors for such violence, using large-scale nationally representative 'National Family Health Survey' (NFHS 4) data. The study used descriptive, bivariate, logistic, and multilevel regression models with a random intercept clustering within states and households to explain the physical violence against husband. Sample size for the analysis was 62,716 currently married women aged 15-49 years. Findings revealed that in most of the states of India, physical spousal violence has increased over time. Behavioural characteristics like marital control, alcoholism, and childhood experience of parental violence have a consistent and strong role in explaining the experience of physical violence across states. With age, experience of violence against husbands increases. Differences in socio-economic characteristics do not have unidirectional effect on violence experienced by husbands across regions of India. Working women who are earning cash and having access to mobile phones perpetrate more physical violence in selected regions. Education shows a gradient on such violence perpetration, indicating that only after achieving a certain level of education, chances of violence reduce. Regionally contrasting social and economic risk factors in explaining violence strengthen the argument that violence is space and culture-specific, and development alone may not resolve violence unless the system is addressing the behavioural aspects. There is a need for supporting men experiencing domestic violence within the existing system facilities. Revisiting the present domestic violence laws and programmes for inclusivity is the need of the hour.
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Affiliation(s)
- Aparajita Chattopadhyay
- Department of Population and Development, International Institute for Population Sciences, Mumbai, India
| | | | - Deepanjali Vishwakarma
- Senior Associate Monitoring & Evaluation, International Institute for Population Sciences, Mumbai, India
| | - Suresh Jungari
- Department of Public Health & Mortality Studies, International Institute for Population Sciences, Mumbai, India
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24
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Pebole MM, Iverson KM, Fortier CB, Werner KB, Fonda JR, Currao A, Whitworth JW, McGlinchey RE, Galovski TE. Associations Between Head Injury, Strangulation, Cardiometabolic Health, and Functional Disability Among Female Survivors of Intimate Partner Violence. Womens Health Issues 2024; 34:208-216. [PMID: 38102057 DOI: 10.1016/j.whi.2023.11.002] [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: 04/24/2023] [Revised: 10/30/2023] [Accepted: 11/08/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE Head injury and strangulation are highly prevalent in intimate partner violence (IPV) contexts, but there is little research examining the potential implications of these injuries on physical health and functional status. This pilot study explored the extent to which injury type (head injury, strangulation) and severity (no injury, subconcussive head injury, traumatic brain injury; no strangulation, strangulation, strangulation with loss of consciousness) were associated with biomarkers of cardiometabolic health and self-reported functioning among female survivors of IPV. METHODS Participants were 51 individuals assigned female at birth who experienced IPV during their lifetime and screened positive for probable posttraumatic stress disorder (PTSD) on the PTSD Checklist for DSM-5 (average age = 32.6 years, SD = 7.1). RESULTS Head injury was associated with statistically significant increases in blood glucose levels (p = .01, d = 1.10). Shifts toward more high-risk values with moderate-strong effect sizes were also found in high-density lipoprotein, low-density lipoprotein, and waist-to-hip ratio (ps: .06-.13; ds: 0.51-1.30). Strangulation was associated with increased cholesterol levels, with a moderate effect size (p = .20, d = 0.59). Regression models accounting for age, education, PTSD symptoms, childhood trauma, strangulation, and head injuries predicted functional disability status (R2 = 0.37, p < .01) and several of its associated domains: cognition (R2 = 0.34, F(8,42) = 2.73, p = .01), mobility (R2 = 0.47, F(8,42) = 4.82, p < .001), and participation in society (R2 = 0.33, F(8,42) = 2.59, p = .02). CONCLUSIONS Findings suggest the need to develop integrated treatments that address physical health comorbidities among female survivors of IPV with a history of head injury to improve daily function and quality of life.
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Affiliation(s)
- Michelle M Pebole
- The Translational Research Center for TBI and Stress Disorders (TRACTS), Veterans Affairs Boston Healthcare System, Boston, Massachusetts.
| | - Katherine M Iverson
- National Center for PTSD Women's Health Sciences Division at VA Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Catherine B Fortier
- The Translational Research Center for TBI and Stress Disorders (TRACTS), Veterans Affairs Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Kimberly B Werner
- College of Nursing, University of Missouri-St. Louis, St. Louis, Missouri
| | - Jennifer R Fonda
- The Translational Research Center for TBI and Stress Disorders (TRACTS), Veterans Affairs Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Alyssa Currao
- The Translational Research Center for TBI and Stress Disorders (TRACTS), Veterans Affairs Boston Healthcare System, Boston, Massachusetts
| | - James W Whitworth
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts; National Center for PTSD Behavioral Health Science Division at VA Boston Healthcare System, Boston, Massachusetts
| | - Regina E McGlinchey
- The Translational Research Center for TBI and Stress Disorders (TRACTS), Veterans Affairs Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Tara E Galovski
- National Center for PTSD Women's Health Sciences Division at VA Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
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25
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Sinko L, Dubois C, Thorvaldsdottir KB. Measuring Healing and Recovery After Gender-Based Violence: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380241229745. [PMID: 38407100 DOI: 10.1177/15248380241229745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Healing after gender-based violence (GBV) is multidimensional, with varying instruments used in the scientific literature to capture this phenomenon quantitively in survivor populations. The purpose of this scoping review was to (a) describe quantitative measures used to evaluate recovery after GBV, (b) compare these findings with domains uncovered in a qualitative metasynthesis about survivors' perspectives about healing after GBV, and (c) summarize recovery relationships found. We searched Pubmed, PsycInfo, and Violence/Criminology/Family Studies Abstracts. Studies were included for review if they (a) used quantitative methods, (b) evaluated healing or recovery in survivors of GBV, (c) were available in English, and (d) were empirical articles in peer-reviewed journals. Two thousand nine hundred thirty-five articles were reviewed by title and abstract, and 92 articles were reviewed by full text. Twenty-six articles were included in this review. Eight studies used an alleviation of adverse symptomology as a proxy for recovery, eight used growth-related outcomes, and ten used a combination of both types of measures. While the quantitative instruments synthesized in this review seemed to map onto some of the recovery domains identified through qualitative metasynthesis, no study synthesized measured all domains simultaneously. Studies synthesized identified that recovery-related outcomes may be influenced by social support, symptom burden, disclosure, and various therapeutic intervention programs tested in the literature to date. Synthesizing research on recovery after GBV is an essential step to understand gaps in measurement and understanding. Streamlining and using holistic recovery outcome measurement can aid in the development of evidence-based interventions to promote healing in survivor populations.
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Affiliation(s)
- Laura Sinko
- Temple University College of Public Health, Philadelphia, PA, USA
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26
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Ford-Gilboe M, Varcoe C, Scott-Storey K, Browne AJ, Jack SM, Jackson K, Mantler T, O'Donnell S, Patten-Lu N, Smye V, Wathen CN, Perrin N. Longitudinal effectiveness of a woman-led, nurse delivered health promotion intervention for women who have experienced intimate partner violence: iHEAL randomized controlled trial. BMC Public Health 2024; 24:398. [PMID: 38326832 PMCID: PMC10848348 DOI: 10.1186/s12889-023-17578-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/25/2023] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Intimate partner violence (IPV) threatens the safety, health and quality of life of women worldwide. Comprehensive IPV interventions that are tailored, take a long-term view of women's needs, including health concerns, and maximize choice and control, have the potential to effectively address heath and safety concerns. Few such interventions have been tested, including in the Canadian context. METHODS A parallel randomized controlled trial of adult (age 19 + years), English-speaking, Canadian women with histories of IPV randomized either to iHEAL, a tailored health promotion intervention delivered by Registered Nurses over 6-7 months, or to community service information (usual care control). Primary (Quality of Life, PTSD symptoms) and secondary outcomes (Depression, Confidence in Managing Daily Life, Chronic Pain, IPV Severity) were measured at baseline and 6, 12 and 18 months post-intervention via an online survey. Generalized estimating equations were used to test for differences by study arm in intention-to-treat (full sample) and per protocol (1 + iHEAL visit) analyses focussing on short-term (immediately post-intervention) and longer-term (1 year post-intervention) effects. Selected process evaluation data were summarized using descriptive statistics. RESULTS Of 331 women enrolled, 175 were randomized to iHEAL (135 who engaged in 1 + visits) and 156 to control. Women who received iHEAL showed significantly greater short-term improvement in Quality of Life compared to the control group, with these effects maintained 1 year later. Changes in PTSD Symptoms also differed significantly by group, with weaker initial effects that were stronger 1 year post-intervention. Significant moderate, short- and longer-term group effects were also observed for Depression and Confidence in Managing Daily Life. IPV Severity decreased for both groups, with significant immediate effects in favour of the intervention group that grew stronger 1 year post-intervention. There were no changes in Chronic Pain. CONCLUSION iHEAL is an effective, acceptable and safe intervention for diverse groups of women with histories of IPV. Trial results provide a foundation for implementation and ongoing evaluation in health care settings and systems. Delayed effects noted for PTSD Symptoms and IPV Severity suggest that longer-term assessment of these outcomes may be needed in trials of IPV interventions. TRIAL REGISTRATION Clinicaltrials.gov ID NCT03573778 (Registered on June 29, 2018).
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Affiliation(s)
- Marilyn Ford-Gilboe
- Arthur Labatt Family School of Nursing, Western University, 1151 Richmond St, London, ON, NBA 5C1, Canada.
| | - Colleen Varcoe
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Kelly Scott-Storey
- Faculty of Nursing, University of New Brunswick, Fredericton, NB, Canada
| | - Annette J Browne
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Susan M Jack
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Kim Jackson
- Arthur Labatt Family School of Nursing, Western University, 1151 Richmond St, London, ON, NBA 5C1, Canada
| | - Tara Mantler
- School of Health Studies, Western University, London, ON, Canada
| | - Sue O'Donnell
- Faculty of Nursing, University of New Brunswick, Fredericton, NB, Canada
| | - Noël Patten-Lu
- Arthur Labatt Family School of Nursing, Western University, 1151 Richmond St, London, ON, NBA 5C1, Canada
| | - Victoria Smye
- Arthur Labatt Family School of Nursing, Western University, 1151 Richmond St, London, ON, NBA 5C1, Canada
| | - C Nadine Wathen
- Arthur Labatt Family School of Nursing, Western University, 1151 Richmond St, London, ON, NBA 5C1, Canada
| | - Nancy Perrin
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
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Lu C, Georgousopoulou E, Baloch S, Walton-Sonda D, Hegarty K, Sethna F, Brown NAT. Identifying the barriers faced by obstetricians and registrars in screening or enquiry of intimate partner violence in pregnancy: A systematic review of the primary evidence. Aust N Z J Obstet Gynaecol 2024; 64:19-27. [PMID: 37786258 DOI: 10.1111/ajo.13747] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 08/10/2023] [Indexed: 10/04/2023]
Abstract
INTRODUCTION Intimate partner violence (IPV) disproportionally affects women compared to men. The impact of IPV is amplified during pregnancy. Screening or enquiry in the antenatal outpatient setting regarding IPV has been fraught with barriers that prevent recognition and the ability to intervene. AIMS The aim of this systematic review was to determine the barriers that face obstetricians/gynaecologists regarding enquiry of IPV in antenatal outpatient settings. The secondary objective was to determine facilitators. METHODS Primary evidence was searched using Ovid MEDLINE, Ovid Maternity and Infant Care, PubMed and Proquest from 1993 to May 2023. The included studies comprised empirical studies published in English language targeting a population of doctors providing antenatal outpatient care. The review was PROSPERO-registered (CRD42020188994). Independent screening and review was performed by two authors. The findings were analysed thematically. RESULTS Nine studies addressing barriers and two studies addressing facilitators were included: three focus-group or semi-structured interviews, six surveys and two randomised controlled trials. Barriers for providers centred at the system level (time, training), provider level (personal beliefs, cultural bias, experience) and provider-perceived patient level (fear of offending, patient readiness to disclose). Increased experience and the use of validated tools were strong facilitators. CONCLUSION Barriers to screening reflect multi-level obstruction to the identification of women exposed to IPV. Although the antenatal outpatient clinic setting addresses a particular population vulnerable to IPV, the barriers for obstetricians are not unique. The use of validated cueing tools provides an evidence-based method to facilitate enquiry of IPV among antenatal women, assisting in identification by clinicians. Together with education and human resources, such aids build capacity in women and obstetric providers.
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Affiliation(s)
- Corrine Lu
- Canberra Health Services, Canberra, Australian Capital Territory, Australia
| | | | - Surriya Baloch
- University of Melbourne Royal Women's Hospital, Parkville, Victoria, Australia
| | | | - Kelsey Hegarty
- University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Farah Sethna
- Canberra Health Services, Canberra, Australian Capital Territory, Australia
| | - Nick A T Brown
- Canberra Health Services, Canberra, Australian Capital Territory, Australia
- University of Canberra, Canberra, Australian Capital Territory, Australia
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28
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Karr JE, Leong SE, Logan T. Head Injury Due to Intimate Partner Violence: Injury Characteristics, Subacute Symptoms, and Receipt of Care. J Neurotrauma 2024; 41:464-474. [PMID: 37485600 PMCID: PMC10837033 DOI: 10.1089/neu.2023.0194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Women survivors of intimate partner violence (IPV) have increased risk of repetitive neurotrauma in their lifetime but have received less research focus compared with populations of athletes, veterans, and emergency department patients. The current study examined the importance of IPV as a contextual mechanism of injury, by comparing women survivors of IPV based on whether they experienced a head injury due to IPV or a head injury not due to IPV. The analyses involved archival data from in-person interviews conducted with women who received a protective order against an intimate partner in Kentucky from 2001 to 2004 (n = 641). Women were excluded if they reported no head injury history (n = 268), resulting in two groups compared based on a retrospective cohort design: 255 women with at least one self-reported IPV-related head injury (M = 33.8 ± 9.0 years old, range: 19-65; 87.5% White) and 118 women with self-reported head injuries due to reasons other than IPV (M = 32.2 ± 9.1 years old, range: 18-62; 89.0% White). Participants were compared on injury characteristics, lifetime physical and sexual IPV severity, subacute symptoms of head injury, and receipt of care for head injury. Compared with women with head injuries unrelated to IPV, women with IPV-related head injuries reported a higher number of lifetime head injuries (Mdn[range]: IPV-related = 3[1-515] vs. non-IPV-related = 1[1-13], p < 0.001, r = 0.51) and a higher number of head injuries involving loss of consciousness (Mdn[range]: IPV-related = 1[1-35] vs. non-IPV-related = 1[1-4], p < 0.001, r = 0.27), but lower rates of hospitalization (IPV-related = 56.1% vs. non-IPV-related = 73.7%, p = 0.001, odds ratio [OR] = 2.20 [95% confidence interval (CI): 1.36, 3.55]) and formal rehabilitation (IPV-related = 3.2% vs. non-IPV-related = 9.4%, p = 0.011, OR = 3.18 [1.24, 8.13]) following head injury. Women with IPV-related head injuries had greater lifetime severity of physical IPV (p < 0.001, d = 0.64 [0.41, 0.86]) and sexual IPV (p < 0.001, d = 0.38 [0.16, 0.60]). Women with IPV-related head injuries endorsed all symptoms at greater rates than women with non-IPV-related head injuries (ps < 0.001), including physical (e.g., headaches: OR = 3.15 [1.81, 5.47]; dizziness: OR = 2.65 [1.68, 4.16]), cognitive (e.g., trouble problem solving: OR = 2.66 [1.53, 4.64]; inattention: OR = 2.39 [1.52, 3.78]), and emotional symptoms (e.g., depression: OR = 7.39 [4.48, 12.20]; anxiety: OR = 4.60 [2.82, 7.51]). The total count of symptoms endorsed was higher for women with IPV-related head injury than women with head injuries unrelated to IPV (p < 0.001, d = 0.71 [0.49, 0.94]). When controlling for lifetime physical and sexual IPV, IPV-related head injury was independently associated with symptom count (β = 0.261, p < 0.001) and accounted for additional variance in symptom count (ΔR2 = 0.06, p < 0.001). Among women survivors of IPV, those reporting IPV-related head injuries reported greater subacute symptoms, but a lower likelihood of being hospitalized or receiving rehabilitative care. Women with self-reported IPV-related head injuries represent an underserved population that is often unevaluated following injury and may have many unmet care needs. Future studies should examine persistent symptoms following IPV-related head injuries and interventions that would be most beneficial for this population.
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Affiliation(s)
- Justin E. Karr
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - Sharon E. Leong
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - T.K. Logan
- Department of Behavioral Science, University of Kentucky, Lexington, Kentucky, USA
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29
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White SJ, Sin J, Sweeney A, Salisbury T, Wahlich C, Montesinos Guevara CM, Gillard S, Brett E, Allwright L, Iqbal N, Khan A, Perot C, Marks J, Mantovani N. Global Prevalence and Mental Health Outcomes of Intimate Partner Violence Among Women: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:494-511. [PMID: 36825800 PMCID: PMC10666489 DOI: 10.1177/15248380231155529] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The aim of this systematic review was to assess the magnitude of the association between types of intimate partner violence (IPV) and mental health outcomes and shed light on the large variation in IPV prevalence rates between low- to middle-income countries and high-income countries. The study is a systematic review and meta-analysis. The following databases were searched for this study: Cochrane, MEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and the Applied Social Sciences Index and Abstracts. The inclusion criteria for this study are as follows: quantitative studies published from 2012 to 2020 on IPV exposure in women aged 16+, using validated measures. Random effects meta-analyses and subgroup analysis exploring heterogeneity across population groups in different economic contexts are used in this study. In all, 201 studies were included with 250,599 women, primarily from high-income countries. Higher prevalence rates were reported for women's lifetime IPV than past year IPV. Lifetime psychological violence was the most prevalent form of IPV. Women in the community reported the highest prevalence for physical, psychological, and sexual violence in the past year compared to clinical groups. Perinatal women were most likely to have experienced lifetime physical IPV. Prevalence rates differed significantly (p = .037 to <.001) for "any IPV" and all subtypes by income country level. Meta-analysis suggested increased odds for all mental health outcomes associated with IPV including depression (odds ratio [OR] = 2.04-3.14), posttraumatic stress disorder (PTSD) (OR = 2.15-2.66), and suicidality (OR = 2.17-5.52). Clinical and community populations were exposed to high prevalence of IPV and increased likelihood of depression, PTSD, and suicidality. Future research should seek to understand women's perspectives on service/support responses to IPV to address their mental health needs. Work with IPV survivors should be carried out to develop bespoke services to reduce IPV in groups most at risk such as pregnant and/or help-seeking women.
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Affiliation(s)
| | | | | | | | | | | | | | - Emma Brett
- Anglia Ruskin University ARU, Cambridge, UK
| | | | | | | | - Concetta Perot
- King’s College London, London, UK
- Survivor Panel, London, UK
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30
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Alquaiz AM, Kazi A, Almeneessier A, Alhalal E, Almuneef M, AlHabib Y. Relationship Between Violence Against Women, Social Support, Self-Esteem, and Mental Health in Riyadh, Saudi Arabia. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:431-457. [PMID: 37688473 DOI: 10.1177/08862605231197135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/11/2023]
Abstract
The objectives of this study were to measure the prevalence of mental distress and to explore the relationship between violence against women (VAW), social support, self-esteem, and mental distress in women in Riyadh, Saudi Arabia. A questionnaire-guided, cross-sectional, interview-based study was conducted with 1,932 women, in primary healthcare centers. Around 29% reported moderate to severe distress levels, whereas 40% of women reported lifetime exposure to at least one type of violence. Linear regression analysis found that VAW was positively associated with mental distress with a unit increase associated with a 0.13 (0.58, 1.15) increase in distress level, whereas, for both social support and self-esteem, a unit increase in violence was associated with -0.23 (-0.47, -0.32) and -0.22 (-0.49, -0.33) unit decrease in the mental distress. Structural equation modeling found that violence had direct significant negative effects on social support (β = -.156, p < .001) and self-esteem (β = -.135, p < .001). Both social support (β = -.266, p < .001) and self-esteem (β = -.183, p < .001) had direct significant negative effects on distress. VAW exerted a direct significant positive effect on distress (β = .171, p < .001) as well as an indirect effect (β = .068, p < .001). Both social support (β = .044, p < .001) and self-esteem (β = .025, p < .001) were significant mediators of the effect of violence on mental distress. VAW can lead to mental distress and low self-esteem. Identification, counseling, and social support for women are important to improve their self-confidence and reduce the adverse effects of violence.
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Affiliation(s)
- Aljohara M Alquaiz
- Princess Nora Bent Abdullah Chair for Women's Health Research, King Saud University, Riyadh, Kingdom of Saudi Arabia
- Department of Family & Community Medicine, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Ambreen Kazi
- Princess Nora Bent Abdullah Chair for Women's Health Research, King Saud University, Riyadh, Kingdom of Saudi Arabia
- Department of Family & Community Medicine, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Aljohara Almeneessier
- Department of Family & Community Medicine, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Eman Alhalal
- Community and Mental Health Department, College of Nursing, King Saud University Medical city, Riyadh, Kingdom of Saudi Arabia
| | - Maha Almuneef
- Princess Nora Bent Abdullah Chair for Women's Health Research, King Saud University, Riyadh, Kingdom of Saudi Arabia
- King Abdullah Specialized Children's Hospital, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Yara AlHabib
- Princess Nora Bent Abdullah Chair for Women's Health Research, King Saud University, Riyadh, Kingdom of Saudi Arabia
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31
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Maclin BJ, Peitzmeier S, Krammer NK, Todd KP, Bonar EE, Gamarel KE. Toward the conceptualization and measurement of transphobia-driven intimate partner violence. Soc Sci Med 2024; 341:116532. [PMID: 38160607 PMCID: PMC10872231 DOI: 10.1016/j.socscimed.2023.116532] [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: 07/28/2023] [Revised: 11/17/2023] [Accepted: 12/18/2023] [Indexed: 01/03/2024]
Abstract
Transgender and gender expansive (trans) people face high rates of violence, including unique forms of abuse from intimate partners that specifically leverage transphobia. Past qualitative studies have explored trans-specific intimate partner violence (IPV) and transgender IPV; we propose a new term, transphobia-driven IPV, investigated in this paper. The goals of this study were two-fold: (1) to qualitatively identify the subdomains and boundaries of transphobia-driven IPV with the explicit intention of new scale development; and (2) to examine the degree to which existing trans-focused IPV measurement scales adequately assess the construct. We recruited US-based, English-speaking trans survivors of IPV, aged 18 years and older, online through community-based organizations and Facebook/Instagram advertising. Twenty people participated in the study, of which 60 percent were white, 55 percent were assigned female at birth, and 60 percent were nonbinary. Through thematic analysis of the 20 in-depth interviews, we identified four subdomains of transphobia-driven IPV: pressure to perform, disrupting gender affirmation, belittling gender identity, and intentional misgendering. When examining nine existing screening tools and measures that ask about IPV related to the survivor's trans identity, only one measure included questions related to all four subdomains. Further, the existing measures were either not psychometrically validated, only validated with a subpopulation of the trans community, or validated with a larger LGBTQ sample of which trans survivors comprised a small percentage. This study lays a foundation for new valid measures of transphobia-driven IPV that reflect the various ways in which transphobia can be leveraged by abusers and may be relevant across subpopulations of the trans community.
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Affiliation(s)
- Beth J Maclin
- Behavioral & Community Health Sciences, School of Public Health, University of Pittsburgh, 130 De Soto St, Pittsburgh, PA, 15261, USA; Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave NW #2, Washington, DC, 20052, USA.
| | - Sarah Peitzmeier
- Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 426 N Ingalls St, Ann Arbor, MI, 48104, USA; Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Natalie K Krammer
- College of Literature, Sciences, and the Arts, University of Michigan, 500 S State St #2005, Ann Arbor, MI, 48109, USA
| | - Kieran P Todd
- Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 426 N Ingalls St, Ann Arbor, MI, 48104, USA
| | - Erin E Bonar
- Addiction Center, Department of Psychiatry, University of Michigan Medical School, 2800 Plymouth Rd., Bldg. 16, Rm. 016-219W, Ann Arbor, MI, 48109, USA
| | - Kristi E Gamarel
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
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Morrison AM, Campbell JK, Sharpless L, Martin SL. Intimate Partner Violence and Immigration in the United States: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:846-861. [PMID: 37078533 PMCID: PMC10666473 DOI: 10.1177/15248380231165690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This systematic review sought to describe the prevalence of intimate partner violence (IPV) victimization among immigrants in the United States (U.S.) and the prevalence of IPV perpetration among immigrants in the U.S. PsycInfo, PubMed, Global Health and Scopus databases were searched for peer-reviewed literature that quantitatively examined IPV in relation to immigration. Twenty-four articles were included in the final review. Past-year IPV victimization rates among immigrants ranged from 3.8% to 46.9% and lifetime IPV victimization rates ranged from 13.9% to 93%; past-year IPV perpetration rates ranged from 3.0% to 24.8% and the one lifetime IPV perpetration rate was 12.8%. Estimates varied widely by country of origin, type of violence measured, and measure used to quantify IPV. Reliance on small convenience samples is problematic when trying to determine the true prevalence of IPV among immigrants. Epidemiological research is needed to improve the accuracy and representativeness of findings.
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Woodward MJ, Griffith EL, Free BL, Bowen ME, Majeed R, Beyer MS, Beck JG. Do latent profiles of self-reported anxiety, depression, and PTSD map onto clinician ratings? An examination with intimate partner violence survivors. J Anxiety Disord 2024; 101:102806. [PMID: 38061324 DOI: 10.1016/j.janxdis.2023.102806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/10/2023] [Accepted: 12/01/2023] [Indexed: 01/17/2024]
Abstract
OBJECTIVE Studies exploring latent profiles of mental health in trauma survivors have largely relied on self-report, making it unclear whether these patterns correspond with clinician-assessed psychopathology. The purpose of the current study was to examine latent profiles of self-reported PTSD, depression, and anxiety in a sample of 387 women who had experienced intimate partner violence (IPV) and investigate whether profiles mapped onto clinician-rated measures of the same outcomes. METHOD Participants completed a series of semi-structured interviews and self-report measures assessing PTSD, depression, and anxiety. RESULTS Latent profile analyses revealed a 3-profile solution characterized by Low (22.48 %), Moderate (37.98 %), and High (39.53 %) self-reported symptomology. Clinician ratings were significant predictors of membership in the low vs. moderate vs. high symptomology profiles. However, normalized means showed discrepancies between self-report and clinician assessment regarding which issue was rated most severe. CONCLUSIONS Results suggest that while latent modeling approaches relying on self-report may adequately approximate common underlying patterns of psychopathology, they have limitations in identifying which disorders are most salient for clinical intervention.
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Spencer CM, Keilholtz BM, Palmer M, Vail SL. Mental and Physical Health Correlates for Emotional Intimate Partner Violence Perpetration and Victimization: A Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:41-53. [PMID: 36458866 DOI: 10.1177/15248380221137686] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Approximately 50% of both men and women will experience emotional intimate partner violence (IPV) in their lifetime-a form of violence highly associated with other forms of IPV-making it important to develop further understanding of for assessment and treatment purposes. The bio-psycho-social model was used to guide the study. Utilizing data from 181 studies, yielding 348 effect sizes, we conducted a meta-analysis examining mental and physical health correlates with emotional IPV perpetration and victimization. We also examined if mental and physical health correlates were significantly stronger for emotional IPV perpetration or victimization, as well as if correlates were stronger for men or women. Suicidal ideation, post-traumatic stress, anxiety, depressive symptoms, borderline personality disorder (PD), psychological distress, physical pain, trauma, anger, shame, poor physical health, antisocial PD, and somatic symptoms were significantly associated with emotional IPV victimization. Borderline PD, narcissism, emotional dysregulation, anger, post-traumatic stress, antisocial PD, psychopathy, depressive symptoms, anxiety symptoms, and trauma were significantly associated with emotional IPV perpetration. Anger, emotional dysregulation, and psychopathology were stronger correlates for emotional IPV perpetration compared to victimization, and post-traumatic stress disorder (PTSD) and psychological distress were stronger correlates for victimization. PTSD and suicidal ideation were stronger correlates of IPV victimization for women than men, and anger was a significantly stronger correlate of IPV perpetration for women than men. This study highlights the importance of a holistic approach when working with victims and perpetrators of IPV, focusing on the importance of taking all aspects of the bio-psycho-social model into account.
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Wamue-Ngare G, Okemwa P, Kimunio I, Miruka O, Okong'o G, Kamau P, Maina L, Njuguna J, Kiruja L, Okoth S. Estimating the economic impact of gender-based violence on women survivors: A comparative study of support program interventions in Makueni and Naivasha, Kenya. Aten Primaria 2023:S0212-6567(23)00273-1. [PMID: 38142161 DOI: 10.1016/j.aprim.2023.102840] [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: 07/31/2023] [Revised: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 12/25/2023] Open
Abstract
OBJECTIVE To estimate the economic cost of GBV from the perspective of a women survivor who sought help from two identified programs (Makueni GBVRC and Life Bloom Services International [LBSI]). DESIGN A mixed method research design combining qualitative and quantitative approaches. SITE: Makueni GBVRC in Makueni County, overseen by the Makueni County government, and LBSI in Naivasha, Nakuru County, a non-profit organization devoted to serving local communities. PARTICIPANTS Study participants include women survivors of GBV, aged 18 and above, actively seeking services at Makueni GBVRC and LBSI. INTERVENTIONS The study adopts a qualitative approach to delve into the intricate economic costs of GBV on survivors. Additionally, quantitative data analysis employs an accounting model to ascertain the financial implications. MAIN MEASUREMENTS The costs analyses were done from the perspective of the women survivors. An accounting model was utilized to evaluate the cost of GBV on selected survivors. Furthermore, the research explores the enduring consequences for survivors, including psychological trauma and susceptibility to stress-related diseases. RESULTS The findings reveal substantial economic costs linked to GBV, adversely affecting survivors, their children, and society at large. These costs encompass direct expenditures on medical care, legal representation, and counseling, as well as indirect costs, such as lost productivity. CONCLUSIONS Beyond immediate and indirect costs, the study underscores the existence of opportunity costs-what survivors and affected children could attain in the absence of GBV.
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Bentley A, Riutort-Mayol G. The association between intimate partner violence type and mental health in migrant women living in Spain: findings from a cross-sectional study. Front Public Health 2023; 11:1307841. [PMID: 38145064 PMCID: PMC10740158 DOI: 10.3389/fpubh.2023.1307841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 11/21/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction The association between intimate partner violence (IPV) and mental health has been clearly established in the literature, however the differential associations between IPV type and mental health are less well understood, particularly in migrant groups who are at increased risk of both IPV and poor mental health. Under-studied and emerging forms of violence such as economic abuse and technology-facilitated abuse must be considered alongside more traditionally studied forms of IPV in order to fully understand the complex nature of violence. This study makes a novel contribution to the literature by assessing multiple forms of IPV including psychological, physical, sexual, economic and technology-facilitated IPV and their relationship with symptoms of depression and anxiety in migrant women, disaggregated by IPV type. Methods A cross-sectional survey of migrant women living in the Valencian Community of Spain was conducted, to assess experiences of IPV and symptoms of mental health. Regression analysis from the Bayesian perspective was performed. Results 1,998 women accessed the survey. They had an average age of 37, and came predominantly from Europe (49%), namely Western Europe, followed by Latin America (38%). The majority had been in Spain between 1 and 3 years, and 80% had resident status. A total of 1,156 responded to questions on violence and mental health. Results showed that the prevalence of IPV was high, with 59% of women reporting any experience of violence. Economic abuse was the most commonly reported form of violence, and showed the strongest relationship with symptoms of depression. Sexual violence was the strongest predictor of anxiety. In both cases, in the presence of violence, the odds of having more severe symptoms of depression and anxiety increases by over 2.25. Technology-facilitated abuse was as detrimental to women's mental health as face-to-face violence. Discussion The findings from the study are relevant to researchers, policy-makers and service providers. They highlight the complex nature of IPV experiences faced by migrant women and the importance of understanding how different types of IPV can impact migrant mental health, in order to ensure survivors receive adequate care.
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Affiliation(s)
- Abigail Bentley
- Instituto de Investigación en Políticas de Bienestar Social (Polibienestar), University of Valencia, Valencia, Spain
| | - Gabriel Riutort-Mayol
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain
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Amaoui S, Marín-Morales A, Martín-Pérez C, Pérez-García M, Verdejo-Román J, Morawetz C. Intrinsic neural network dynamics underlying the ability to down-regulate emotions in male perpetrators of intimate partner violence against women. Brain Struct Funct 2023; 228:2025-2040. [PMID: 37689595 PMCID: PMC10587320 DOI: 10.1007/s00429-023-02696-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/09/2023] [Indexed: 09/11/2023]
Abstract
Research has pointed to difficulties in emotion regulation as a risk factor for perpetrating intimate partner violence against women (IPVAW). While efforts have been made to understand the brain mechanisms underlying emotion regulation strategies such as reappraisal, little is known about the intrinsic neural dynamics supporting this strategy in male perpetrators. Resting-state functional magnetic resonance imaging was used to characterise the network dynamics underlying reappraisal. Spectral dynamic causal modelling was performed to examine the effective connectivity (EC) within a predefined reappraisal-related brain network. 26 men convicted for an IPVAW crime [male perpetrators] were compared to 29 men convicted of other crimes [other offenders] and 29 men with no criminal records [non-offenders]. The ability to down-regulate emotions in response to IPVAW stimuli was used as a covariate to explore its association with male perpetrators' EC. The analysis revealed that (1) compared to non-offenders, both convicted groups exhibited increased EC within prefrontal areas, enhanced EC from prefrontal to temporoparietal regions and decreased EC in the opposite direction; (2) male perpetrators compared to other offenders showed increased EC from temporoparietal to prefrontal regions and, increased EC from the supplementary motor area to frontal areas; (3) connections involving dorsolateral prefrontal cortex were found to be potential predictors of the ability to down-regulate emotions. The study provides a deeper characterisation of the brain architecture of the processes that underlie IPVAW. This knowledge could inform the work of adaptive emotion regulation strategies in intervention programmes for male perpetrators in order to reduce the high recidivism rates.
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Affiliation(s)
- Sofia Amaoui
- Mind, Brain and Behavior Research Center (CIMCYC), Granada, Spain
- Department of Personality, Evaluation & Psychological Treatment, University of Granada, Granada, Spain
| | - Agar Marín-Morales
- Mind, Brain and Behavior Research Center (CIMCYC), Granada, Spain
- Department of Personality, Evaluation & Psychological Treatment, University of Granada, Granada, Spain
- Department of Psychobiology, University of Valencia, Valencia, Spain
| | - Cristina Martín-Pérez
- Department of Psychology, Universidad de Valladolid, Campus María Zambrano. Plaza de la Universidad 1, 40005, Segovia, Spain.
| | - Miguel Pérez-García
- Mind, Brain and Behavior Research Center (CIMCYC), Granada, Spain
- Department of Personality, Evaluation & Psychological Treatment, University of Granada, Granada, Spain
| | - Juan Verdejo-Román
- Mind, Brain and Behavior Research Center (CIMCYC), Granada, Spain
- Department of Personality, Evaluation & Psychological Treatment, University of Granada, Granada, Spain
| | - Carmen Morawetz
- Department of Psychology, University of Innsbruck, Innsbruck, Austria
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Edwards LM, Torres L, Lewis KD, Loyo K. Hope as a Moderator of Intimate Partner Violence and Suicide Risk Behaviors Among Latinas. Violence Against Women 2023; 29:3143-3157. [PMID: 37710990 DOI: 10.1177/10778012231200476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
The current study investigated the role of hope in the relationship between intimate partner violence (IPV) and suicide risk behaviors among a community sample of Latinas (N = 180). Moderation analyses revealed significant interaction effects demonstrating that both aspects of hope-agency and pathways-were associated with suicide risk behaviors at high levels of IPV. Results suggest hope may be helpful when IPV is at low levels, but it may exacerbate suicide risk when high levels of IPV are experienced among Latinas. Future directions and implications are discussed, including the importance of understanding the unique cultural context in which Latina survivors exist.
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Affiliation(s)
- Lisa M Edwards
- Department of Counselor Education and Counseling Psychology, Marquette University, Milwaukee, WI, USA
| | - Lucas Torres
- Department of Psychology, Marquette University, Milwaukee, WI, USA
| | - Kayla Deanna Lewis
- Department of Counselor Education and Counseling Psychology, Marquette University, Milwaukee, WI, USA
| | - Karina Loyo
- Department of Psychology, Marquette University, Milwaukee, WI, USA
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Spencer CN, Khalil M, Herbert M, Aravkin AY, Arrieta A, Baeza MJ, Bustreo F, Cagney J, Calderon-Anyosa RJC, Carr S, Chandan JK, Coll CVN, de Andrade FMD, de Andrade GN, Debure AN, Flor LS, Hammond B, Hay SI, Knaul FN, Lim RQH, McLaughlin SA, Minhas S, Mohr JK, Mullany EC, Murray CJL, O'Connell EM, Patwardhan V, Reinach S, Scott D, Sorenson RJD, Stein C, Stöckl H, Twalibu A, Vasconcelos N, Zheng P, Metheny N, Chandan JS, Gakidou E. Health effects associated with exposure to intimate partner violence against women and childhood sexual abuse: a burden of proof study. Nat Med 2023; 29:3243-3258. [PMID: 38081957 PMCID: PMC10719101 DOI: 10.1038/s41591-023-02629-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 10/04/2023] [Indexed: 12/17/2023]
Abstract
The health impacts of intimate partner violence against women and childhood sexual abuse are not fully understood. Here we conducted a systematic review by comprehensively searching seven electronic databases for literature on intimate partner violence-associated and childhood sexual abuse-associated health effects. Following the burden of proof methodology, we evaluated the evidence strength linking intimate partner violence and/or childhood sexual abuse to health outcomes supported by at least three studies. Results indicated a moderate association of intimate partner violence with major depressive disorder and with maternal abortion and miscarriage (63% and 35% increased risk, respectively). HIV/AIDS, anxiety disorders and self-harm exhibited weak associations with intimate partner violence. Fifteen outcomes were evaluated for their relationship to childhood sexual abuse, which was shown to be moderately associated with alcohol use disorders and with self-harm (45% and 35% increased risk, respectively). Associations between childhood sexual abuse and 11 additional health outcomes, such as asthma and type 2 diabetes mellitus, were found to be weak. Although our understanding remains limited by data scarcity, these health impacts are larger in magnitude and more extensive than previously reported. Renewed efforts on violence prevention and evidence-based approaches that promote healing and ensure access to care are necessary.
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Affiliation(s)
- Cory N Spencer
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Mariam Khalil
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Molly Herbert
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Aleksandr Y Aravkin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Applied Mathematics, University of Washington, Seattle, WA, USA
| | - Alejandra Arrieta
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - María Jose Baeza
- School of Medicine, The Pontifical Catholic University of Chile, Santiago, Chile
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Flavia Bustreo
- Fondation Botnar, Basel, Switzerland
- Partnership for Maternal, Newborn and Child Health, Geneva, Switzerland
| | - Jack Cagney
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | - Sinclair Carr
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Jaidev Kaur Chandan
- Warwick Medical School, University of Warwick, Coventry, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Carolina V N Coll
- Department of Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Human Development and Violence Research Center, Federal University of Pelotas, Pelotas, Brazil
| | | | | | - Alexandra N Debure
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Luisa S Flor
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Ben Hammond
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Felicia N Knaul
- Institute for the Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA
| | - Rachel Q H Lim
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Susan A McLaughlin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Sonica Minhas
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jasleen K Mohr
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Erin C Mullany
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Erin M O'Connell
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Vedavati Patwardhan
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Center on Gender Equity and Health, UC San Diego School of Medicine, San Diego, CA, USA
| | | | - Dalton Scott
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Reed J D Sorenson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Caroline Stein
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Heidi Stöckl
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Munich, Germany
| | - Aisha Twalibu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | | | - Peng Zheng
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Nicholas Metheny
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Joht Singh Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Emmanuela Gakidou
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
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Salimi H, Hosseinkhani A, Beeble ML, Samavi SA. Examining the Psychometric Properties of the Revised Scale of Economic Abuse among Iranian Women. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:12067-12088. [PMID: 37565355 DOI: 10.1177/08862605231190667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
Economic abuse, in the context of intimate relationships, is a pervasive form of violence that merits further empirical attention. We know from limited research that the rates of economic abuse appear to be high in Iran; however, there is a lack of culturally appropriate measures that can assess the extent to which women experience economic harm as a result of their partners' actions. The present study was conducted with the aims of (a) investigating the psychometric properties of the 14-item Revised Scale of Economic Abuse (SEA2) which was translated into Persian for this study and (b) examining the prevalence of economic abuse among a sample of 371 married housewives in Qazvin, Iran. Confirmatory factor analysis supports the two-factor structure of the SEA2, with the exception of one item. Composite reliability and Cronbach's alpha demonstrated good internal consistency. The average variance extracted method, along with correlations with other financial variables, demonstrated evidence of good convergent validity. Correlations with related, but distinct forms of abuse, support the scale's discriminant validity. Based on the collective findings, this measure can be used as a reliable and valid tool to study economic abuse among Iranian women which, within our sample, appears to be a common phenomenon. Implications for future research and practice are discussed.
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Affiliation(s)
- Hadi Salimi
- Department of Counseling, University of Hormozgan, Bandar Abbas, Iran
| | | | - Marisa L Beeble
- Department of Interdisciplinary Studies, Russell Sage College, Albany, NY, USA
| | - S Abdolvahab Samavi
- Department of Educational Sciences, University of Hormozgan, Bandar Abbas, Iran
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Mootz JJ, Spencer CM, Ettelbrick J, Kann B, Fortunato dos Santos P, Palmer M, Stith SM. Risk Markers for Victimization and Perpetration of Male-to-Female Physical Intimate Partner Violence in Sub-Saharan Africa: A Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:3433-3444. [PMID: 36373646 PMCID: PMC10583092 DOI: 10.1177/15248380221129589] [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: 06/16/2023]
Abstract
Exposure to intimate partner violence (IPV) incurs significant public health consequences. Understanding risk markers can accelerate prevention and response efforts, important in settings like Sub-Saharan Africa (SSA) where resources are scarce. In this study, four databases were searched to identify studies that examined risk markers for male-to-female physical IPV. With application of the socioecological model, we analyzed 11 risk markers for male physical IPV perpetration (with 71 effect sizes) and 16 risk markers for female physical IPV victimization (with 131 effect sizes) in SSA from 51 studies. For male IPV perpetration, we found medium-to-large effect sizes for six risk markers: perpetrating emotional abuse and sexual IPV, witnessing parental IPV, being abused as a child, cohabitating (not married), and exhibiting controlling behaviors. We found small effect sizes for substance use. Employment, age, marital status, and education were not significant risk markers. For female IPV victimization, a medium effect size was found for post-traumatic stress symptoms. Small effect sizes were found for reporting depressive symptoms, being abused as a child, witnessing parental IPV, and reporting drug and alcohol use. Rural residence, approval of violence, length of relationship, income, education, employment, age, marital status, and religiosity were not significant risk markers. Findings highlight opportunities for screening and intervention at the couple level, show the need to test and incorporate interventions for IPV in mental health treatment, and emphasize the importance of further research on sociodemographic risk markers and the interventions that target them.
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Affiliation(s)
- Jennifer J. Mootz
- Columbia University, New York, NY, USA
- New York State Psychiatric Institute, USA
| | | | | | - Bianca Kann
- Columbia University, New York, NY, USA
- New York State Psychiatric Institute, USA
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Aboagye RG, Seidu AA, Cadri A, Salihu T, Arthur-Holmes F, Sam ST, Ahinkorah BO. Ending violence against women: Help-seeking behaviour of women exposed to intimate partner violence in sub-Saharan Africa. PLoS One 2023; 18:e0291913. [PMID: 37796947 PMCID: PMC10553277 DOI: 10.1371/journal.pone.0291913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 09/08/2023] [Indexed: 10/07/2023] Open
Abstract
INTRODUCTION Intimate partner violence is a serious public health problem that transcends cultural boundaries in sub-Saharan Africa. Studies have reported that violence characteristics and perception are strong predictors of help-seeking among women. We assessed the prevalence and factors associated with help-seeking among female survivors of intimate partner violence in sub-Saharan Africa. METHODS We pooled data from the most recent Demographic and Health Surveys (DHS) of eighteen sub-Saharan African countries. The data were extracted from the women's files in countries with datasets from 2014 to 2021. A weighted sample of 33,837 women in sexual relationships: married or cohabiting who had ever experienced intimate partner violence within the five years preceding the survey were included in the analysis. Percentages with 95% confidence interval (CI) were used to present the results of the prevalence of help-seeking for intimate partner violence. We used a multilevel binary logistic regression analysis to examine the factors associated with help-seeking among survivors of intimate partner violence. The results were presented using adjusted odds ratio (AOR) with their respective 95% CI. Statistical significance was set at p<0.05. RESULTS Out of the 33,837 women who had ever experienced intimate partner violence in sub-Saharan Africa, only 38.77% (95% CI = 38.26-39.28) of them sought help. Ethiopia had the lowest prevalence of women who sought help after experiencing intimate partner violence (19.75%; 95% CI = 17.58-21.92) and Tanzania had the highest prevalence (57.56%; 95% CI = 55.86-59.26). Marital status, educational level, current working status, parity, exposure to interparental violence, women's autonomy in household decision-making, mass media exposure, intimate partner violence justification, wealth index, and place of residence were associated with help-seeking behaviour of intimate partner violence survivors. CONCLUSION The low prevalence of help seeking among women who have experienced intimate partner violence in sub-Saharan Africa calls for the intensification of formal and informal sources of assistance. Education can play a critical role in empowering girls, which may increase future help-seeking rates. Through media efforts aimed at parental awareness, the long-term benefits of females enrolling in school could be achieved. However, concentrating solely on individual measures to strengthen women's empowerment may not bring a significant rise in help-seeking as far as patriarchal attitudes that permit violence continue to exist. Consequently, it is critical to address intimate partner violence from the dimensions of both the individual and violence-related norms and attitudes. Based on the findings, there should be public awareness creation on the consequences of intimate partner violence. Respective governments must increase their coverage of formal support services to intimate partner violence survivors especially those in rural communities.
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Affiliation(s)
- Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Abdul-Aziz Seidu
- College of Public Health, Medical and Veterinary Services, James Cook University, Townsville, Australia
- Centre For Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana
- REMS Consultancy Services, Sekondi-Takoradi, Western region, Ghana
| | - Abdul Cadri
- Department of Social and Behavioural Science, School of Public Health, University of Ghana, Legon, Accra, Ghana
- Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Tarif Salihu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Francis Arthur-Holmes
- Department of Sociology and Social Policy, Lingnan University, Tuen Mun, Hong Kong, China
| | - Sarah Tara Sam
- Department of Sociology and Social Policy, Lingnan University, Tuen Mun, Hong Kong, China
| | - Bright Opoku Ahinkorah
- REMS Consultancy Services, Sekondi-Takoradi, Western region, Ghana
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), SWSLHD and Ingham Institute
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
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43
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Rodrigues P, Fernet M, Cousineau MM, Philibert M. Associations between small-area sociodemographic characteristics and intimate partner violence in Montréal, Québec. J Public Health Res 2023; 12:22799036231208326. [PMID: 37941655 PMCID: PMC10629306 DOI: 10.1177/22799036231208326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/29/2023] [Indexed: 11/10/2023] Open
Abstract
Background Intimate partner violence (IPV) affects many individuals and can have a significant impact on their health and well-being. In order to inform prevention strategies, several studies have focused on the determinants of IPV. However, knowledge on the association between neighbourhood characteristics and IPV remains scarce. The social disorganization theory posits that certain neighbourhood characteristics are associated with violent behaviours. This theory has been used to explain spatial variations in IPV, but most studies have been conducted in the United States. Little is known about the effect of neighbourhood factors in urban contexts outside of the United States. Design and methods Using police data from 2016 and 2017, this study estimated the association between sociodemographic characteristics of neighbourhoods (socioeconomic status, single-parenthood, residential instability and ethnocultural heterogeneity) and IPV victimization in Montréal, Québec. Results Results suggest a neighbourhood-level variation in IPV, and that neighbourhood-level characteristics are associated with IPV victimization. Specifically, the likelihood of IPV is higher in neighbourhoods with the lowest SES level (OR = 2.80, 95%CI: 2.47-3.17, p < 0.001) and the lowest level of residential instability (OR = 0.81, 95%CI: 0.70-0.93, p = 0.003) as well as the highest proportion of single-parent households (OR = 1.88, 95%CI: 1.65-2.15, p < 0.001). Conclusion Although neighbourhood-level interventions to reduce IPV are rare, our results highlight the importance of developing such preventive strategies. Prevention programs targeting high-risk neighbourhoods may prove effective in reducing IPV.
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Affiliation(s)
- Paul Rodrigues
- Institut Santé et Société, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Mylène Fernet
- Institut Santé et Société, Université du Québec à Montréal, Montréal, Québec, Canada
- Département de Sexologie, Université du Québec à Montréal, Montréal, Québec, Canada
| | | | - Mathieu Philibert
- Institut Santé et Société, Université du Québec à Montréal, Montréal, Québec, Canada
- Département de Sexologie, Université du Québec à Montréal, Montréal, Québec, Canada
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Draxler H, Hjärthag F, Tillfors M, Almqvist K. Changes in Psychiatric Symptoms in Swedish Mothers Who Took Part in Project Support: An Intervention for Mothers Exposed to Intimate Partner Violence With Children Who Have Developed Conduct Problems. Violence Against Women 2023:10778012231203622. [PMID: 37750224 DOI: 10.1177/10778012231203622] [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: 09/27/2023]
Abstract
Project Support (PS) is an evidence-based individual support and parenting program developed for mothers exposed to intimate partner violence (IPV) whose children have developed conduct disorders. This Swedish feasibility study focuses on changes in the mothers' psychiatric symptoms, in relation to social and emotional support received as part of PS. In a within-subject design in a naturalistic setting (i.e., 10 social service units), mothers (n = 35) reported a significant decrease in symptoms, but from an individual perspective, most mothers still suffered from clinical levels of psychiatric symptoms. The need for additional interventions for mothers exposed to IPV is discussed.
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Affiliation(s)
- Helena Draxler
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
| | - Fredrik Hjärthag
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
| | - Maria Tillfors
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
| | - Kjerstin Almqvist
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
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Bacchus LJ, d'Oliveira AFPL, Pereira S, Schraiber LB, Aguiar JMD, Graglia CGV, Bonin RG, Feder G, Colombini M. An evidence-based primary health care intervention to address domestic violence against women in Brazil: a mixed method evaluation. BMC PRIMARY CARE 2023; 24:198. [PMID: 37749549 PMCID: PMC10519067 DOI: 10.1186/s12875-023-02150-1] [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] [Received: 10/27/2022] [Accepted: 09/01/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Health systems have a critical role in a multi-sectoral response to domestic violence against women (DVAW). However, the evidence on interventions is skewed towards high income countries, and evidence based interventions are not easily transferred to low-and middle-income countries (LMIC) where significant social, cultural and economic differences exist. We evaluated feasibility and acceptability of implementation of an intervention (HERA-Healthcare Responding to Violence and Abuse) to improve the response to DVAW in two primary health care clinics (PHC) in Brazil. METHODS The study design is a mixed method process and outcome evaluation, based on training attendance records, semi-structured interviews (with 13 Primary Health Care (PHC) providers, two clinic directors and two women who disclosed domestic violence), and identification and referral data from the Brazilian Epidemiological Surveillance System (SINAN). RESULTS HERA was feasible and acceptable to women and PHC providers, increased providers' readiness to identify DVAW and diversified referrals outside the health system. The training enhanced the confidence and skills of PHC providers to ask directly about violence and respond to women's disclosures using a women centred, gender and human rights perspective. PHC providers felt safe and supported when dealing with DVAW because HERA emphasised clear roles and collective action within the clinical team. A number of challenges affected implementation including: differential managerial support for the Núcleo de Prevenção da Violência (Violence Prevention Nucleus-NPV) relating to the allocation of resources, monitoring progress and giving feedback; a lack of higher level institutional endorsement prioritising DVAW work; staff turnover; a lack of feedback from external support services to PHC clinics regarding DVAW cases; and inconsistent practices regarding documentation of DVAW. CONCLUSION Training should be accompanied by system-wide institutional change including active (as opposed to passive) management support, allocation of resources to support roles within the NPV, locally adapted protocols and guidelines, monitoring progress and feedback. Communication and coordination with external support services and documentation systems are crucial and need improvement. DVAW should be prioritised within leadership and governance structures, for example, by including DVAW work as a specific commissioning goal.
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Affiliation(s)
- Loraine J Bacchus
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, Faculty of Public Health & Policy, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Ana Flávia Pires Lucas d'Oliveira
- Preventive Medicine Department, Faculty of Medicine, University of São Paulo, Av. Dr. Arnaldo, 455 Cerqueira César, 01246 903, São Paulo, Brasil.
| | - Stephanie Pereira
- Preventive Medicine Department, Faculty of Medicine, University of São Paulo, Av. Dr. Arnaldo, 455 Cerqueira César, 01246 903, São Paulo, Brasil
| | - Lilia Blima Schraiber
- Preventive Medicine Department, Faculty of Medicine, University of São Paulo, Av. Dr. Arnaldo, 455 Cerqueira César, 01246 903, São Paulo, Brasil
| | - Janaina Marques de Aguiar
- Preventive Medicine Department, Faculty of Medicine, University of São Paulo, Av. Dr. Arnaldo, 455 Cerqueira César, 01246 903, São Paulo, Brasil
| | - Cecilia Guida Vieira Graglia
- Preventive Medicine Department, Faculty of Medicine, University of São Paulo, Av. Dr. Arnaldo, 455 Cerqueira César, 01246 903, São Paulo, Brasil
| | - Renata Granusso Bonin
- Preventive Medicine Department, Faculty of Medicine, University of São Paulo, Av. Dr. Arnaldo, 455 Cerqueira César, 01246 903, São Paulo, Brasil
| | - Gene Feder
- Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Manuela Colombini
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, Faculty of Public Health & Policy, 15-17 Tavistock Place, London, WC1H 9SH, UK
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46
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Rock A, McNaughton Reyes HL, Go V, Maman S, Perez M, Donastorg Y, Kerrigan D, Barrington C. Relationships Between Stigma and Intimate Partner Violence Among Female Sex Workers Living With HIV: Social and Economic Exclusion. Violence Against Women 2023; 29:1971-1997. [PMID: 36344251 PMCID: PMC10387732 DOI: 10.1177/10778012221127722] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Violence against female sex workers (FSWs) perpetrated by their intimate (i.e., non-commercial) partners, particularly against FSWs living with HIV, is understudied. Stigma can deplete the economic resources, social relationships, and mental well-being of stigmatized people, which may increase their intimate partner violence (IPV) risk. We quantitatively assessed relationships between HIV stigma and sex work stigma and IPV victimization among FSWs living with HIV in the Dominican Republic (n = 266). Enacted HIV stigma, in the form of job loss, and anticipated HIV stigma, in the form of fear of exclusion by family, were associated with increased IPV risk. Potential association mechanisms, including increased economic vulnerability and social isolation, and programmatic responses are discussed.
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Affiliation(s)
- Amelia Rock
- Department of Health Behavior, UNC Gillings School of Global Public Health, USA
| | | | - Vivian Go
- Department of Health Behavior, UNC Gillings School of Global Public Health, USA
| | - Suzanne Maman
- Department of Health Behavior, UNC Gillings School of Global Public Health, USA
| | - Martha Perez
- HIV Vaccine Research Unit, Instituto Dermatológico y Cirurgia de Piel Dr. Humberto Bogaert Diaz, Dominican Republic
| | - Yeycy Donastorg
- HIV Vaccine Research Unit, Instituto Dermatológico y Cirurgia de Piel Dr. Humberto Bogaert Diaz, Dominican Republic
| | - Deanna Kerrigan
- Department of Prevention and Community Health, GWU Milken Institute School of Public Health, USA
| | - Clare Barrington
- Department of Health Behavior, UNC Gillings School of Global Public Health, USA
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47
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Puno A, Kim R, Jeong J, Kim J, Kim R. Intergenerational transmission of intimate partner violence among women: Evidence from the 2017 Philippines National Demographic and Health Survey. SSM Popul Health 2023; 23:101392. [PMID: 37691979 PMCID: PMC10492160 DOI: 10.1016/j.ssmph.2023.101392] [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: 01/19/2023] [Revised: 03/27/2023] [Accepted: 03/31/2023] [Indexed: 09/12/2023] Open
Abstract
Intimate partner violence (IPV) substantially harms women's overall health worldwide. The intergenerational cycle of IPV among women remains underexplored from the perspective of victimization and perpetration, and by types of subsequent IPV. The 2017 Philippines National Demographic and Health Survey dataset of 12,248 currently in-union (married or cohabiting) women aged 15 to 49 were utilized in this study. The main exposure variable was measured by the question: "as far as you know, did your father ever beat your mother?". Multivariate logistic regression was performed to investigate the association between being ever exposed to parental IPV and (1) women's IPV victimization (by types: any, physical, sexual, and emotional) and (2) IPV perpetration (physical) by women against their husbands or male partners. Further, multinomial logistic regression examined the association between exposure to parental IPV and the experience of being an IPV victim only, perpetrator only, or both. We have found that women who were exposed to parental IPV were more likely to experience IPV victimization (OR: 2.1, 95% CI: 1.9, 2.4 for any IPV; OR: 2.3, 95% CI: 2.0, 2. for physical IPV; OR: 2.0, 95% CI: 1.6, 2.4 for sexual IPV; and OR: 2.0, 95% CI: 1.8, 2.2 for emotional IPV), and also perpetrate physical IPV themselves (OR: 2.1, 95% CI: 1.9, 2.4) compared to those unexposed to parental IPV. Moreover, women exposed to parental IPV were three times more likely to be both a perpetrator and a victim of IPV (OR: 3.1, 95% CI: 2.7, 3.7), much higher than the odds of being a victim only (OR: 1.9, 95% CI: 1.8, 2.2) or a perpetrator only (OR: 1.9, 95% CI: 1.6, 2.). In summary, exposure to parental IPV was associated with Filipino women being victims and perpetrators of IPV themselves. The integration of violence prevention within parenting and community programs can be considered to prevent the perpetuation of the intergenerational cycle of IPV.
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Affiliation(s)
- Abigail Puno
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
- Division of Biological Sciences, University of the Philippines Visayas, Miagao, Iloilo, Philippines
| | - Ranyeong Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Joshua Jeong
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jinho Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
- Division of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea
| | - Rockli Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
- Division of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea
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48
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Burd C, McLean I, MacGregor JCD, Mantler T, Veenendaal J, Wathen CN. "Our services are not the same": the impact of the COVID-19 pandemic on care interactions in women's shelters. BMC Womens Health 2023; 23:427. [PMID: 37568155 PMCID: PMC10422783 DOI: 10.1186/s12905-023-02541-7] [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: 09/08/2022] [Accepted: 07/12/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Guidelines and regulations in response to the COVID-19 pandemic have significantly impacted the health care sector. We explore these impacts in the gender-based violence (GBV) services sector and, more specifically, in the context of women's shelters. METHODS Using an interpretive description and integrated knowledge mobilization approach, we interviewed 8 women's shelter clients, 26 staff, and conducted focus groups with 24 Executive Directors. RESULTS We found that pandemic responses challenged longstanding values that guide work in women's shelters, specifically feminist and anti-oppressive practices. Physical distancing, masking, and closure of communal spaces intended to slow or stop the spread of the novel coronavirus created barriers to the provision of care, made it difficult to maintain or create positive connections with and among women and children, and re-traumatized some women and children. Despite these challenges, staff and leaders were creative in their attempts to provide quality care, though these efforts, including workarounds, were not without their own challenges. CONCLUSIONS This research highlights the need to tailor crisis response to sector-specific realities that support service values and standards of care.
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Affiliation(s)
- Caitlin Burd
- Faculty of Information and Media Studies, Western University, 1151 Richmond St, N6A 5B7, London, ON, Canada.
| | - Isobel McLean
- School of Architecture and Landscape Architecture, University of British Columbia, Vancouver, BC, Canada
| | | | - Tara Mantler
- School of Health Studies, Western University, London, ON, Canada
| | - Jill Veenendaal
- Faculty of Information and Media Studies, Western University, 1151 Richmond St, N6A 5B7, London, ON, Canada
| | - C Nadine Wathen
- Mobilizing Knowledge on Gender-Based Violence, Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
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49
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Micklitz HM, Nagel Z, Jahn S, Oertelt-Prigione S, Andersson G, Sander LB. Digital self-help for people experiencing intimate partner violence: a qualitative study on user experiences and needs including people with lived experiences and services providers. BMC Public Health 2023; 23:1471. [PMID: 37533005 PMCID: PMC10394820 DOI: 10.1186/s12889-023-16357-5] [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: 03/28/2023] [Accepted: 07/20/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is a prevalent public health issue associated with multiple physical and mental health consequences for survivors. Digital interventions can provide low-threshold support to those experiencing IPV, but existing digital interventions have limited efficacy in improving the safety and mental health of IPV survivors. Digitally adapting an integrative intervention with advocacy-based and psychological content holds promise for increasing the efficacy of digital interventions in the context of IPV. METHODS This study examines the needs, acceptability and usability of an integrative digital intervention for people affected by IPV. We used the think-aloud method and semi-structured interviews with a sample of six people with lived experiences of IPV and six service providers. We analyzed the data using thematic analysis. RESULTS We identified the increasing general acceptance of digital support tools and the limited capacity of the current support system as societal context factors influencing the acceptance of and needs regarding digital interventions in the context of IPV. An integrative digital self-help intervention offers several opportunities to complement the current support system and to meet the needs of people affected by IPV, including the reduction of social isolation, a space for self-reflection and coping strategies to alleviate the situation. However, potentially ongoing violence, varying stages of awareness and psychological capacities, and as well as the diversity of IPV survivors make it challenging to develop a digital intervention suitable for the target group. We received feedback on the content of the intervention and identified design features required for intervention usability. CONCLUSION An integrative digital self-help approach, with appropriate security measures and trauma-informed design, has the potential to provide well-accepted, comprehensive and continuous psychosocial support to people experiencing IPV. A multi-modular intervention that covers different topics and can be personalized to individual user needs could address the diversity of the target population. Providing guidance for the digital intervention is critical to spontaneously address individual needs. Further research is needed to evaluate the efficacy of an integrative digital self-help intervention and to explore its feasibility it in different settings and populations.
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Affiliation(s)
- Hannah M Micklitz
- Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Hebelstraße 29, 79104, Freiburg, Germany.
| | - Zoë Nagel
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Stella Jahn
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Sabine Oertelt-Prigione
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Sex- and Gender-Sensitive Medicine, Medical Faculty OWL, University of Bielefeld, Bielefeld, Germany
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Lasse B Sander
- Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Hebelstraße 29, 79104, Freiburg, Germany
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50
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Kennedy N, Win TL, Bandyopadhyay A, Kennedy J, Rowe B, McNerney C, Evans J, Hughes K, Bellis MA, Jones A, Harrington K, Moore S, Brophy S. Insights from linking police domestic abuse data and health data in South Wales, UK: a linked routine data analysis using decision tree classification. Lancet Public Health 2023; 8:e629-e638. [PMID: 37516479 DOI: 10.1016/s2468-2667(23)00126-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Exposure to domestic abuse can lead to long-term negative impacts on the victim's physical and psychological wellbeing. The 1998 Crime and Disorder Act requires agencies to collaborate on crime reduction strategies, including data sharing. Although data sharing is feasible for individuals, rarely are whole-agency data linked. This study aimed to examine the knowledge obtained by integrating information from police and health-care datasets through data linkage and analyse associated risk factor clusters. METHODS This retrospective cohort study analyses data from residents of South Wales who were victims of domestic abuse resulting in a Public Protection Notification (PPN) submission between Aug 12, 2015 and March 31, 2020. The study links these data with the victims' health records, collated within the Secure Anonymised Information Linkage databank, to examine factors associated with the outcome of an Emergency Department attendance, emergency hospital admission, or death within 12 months of the PPN submission. To assess the time to outcome for domestic abuse victims after the index PPN submission, we used Kaplan-Meier survival analysis. We used multivariable Cox regression models to identify which factors contributed the highest risk of experiencing an outcome after the index PPN submission. Finally, we created decision trees to describe specific groups of individuals who are at risk of experiencing a domestic abuse incident and subsequent outcome. FINDINGS After excluding individuals with multiple PPN records, duplicates, and records with a poor matching score or missing fields, the resulting clean dataset consisted of 8709 domestic abuse victims, of whom 6257 (71·8%) were female. Within a year of a domestic abuse incident, 3650 (41·9%) individuals had an outcome. Factors associated with experiencing an outcome within 12 months of the PPN included younger victim age (hazard ratio 1·183 [95% CI 1·053-1·329], p=0·0048), further PPN submissions after the initial referral (1·383 [1·295-1·476]; p<0·0001), injury at the scene (1·484 [1·368-1·609]; p<0·0001), assessed high risk (1·600 [1·444-1·773]; p<0·0001), referral to other agencies (1·518 [1·358-1·697]; p<0·0001), history of violence (1·229 [1·134-1·333]; p<0·0001), attempted strangulation (1·311 [1·148-1·497]; p<0·0001), and pregnancy (1·372 [1·142-1·648]; p=0·0007). Health-care data before the index PPN established that previous Emergency Department and hospital admissions, smoking, smoking cessation advice, obstetric codes, and prescription of antidepressants and antibiotics were associated with having a future outcome following a domestic abuse incident. INTERPRETATION The results indicate that vulnerable individuals are detectable in multiple datasets before and after involvement of the police. Operationalising these findings could reduce police callouts and future Emergency Department or hospital admissions, and improve outcomes for those who are vulnerable. Strategies include querying previous Emergency Department and hospital admissions, giving a high-risk assessment for a pregnant victim, and facilitating data linkage to identify vulnerable individuals. FUNDING National Institute for Health Research.
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Affiliation(s)
- Natasha Kennedy
- National Centre for Population Health and Wellbeing Research, Swansea, UK.
| | | | | | - Jonathan Kennedy
- National Centre for Population Health and Wellbeing Research, Swansea, UK; Administrative Data Research Wales, Swansea, UK; Data Lab, National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, UK
| | - Benjamin Rowe
- South Wales Police, South Wales Police Head Quarters Cowbridge Road, Bridgend, UK
| | - Cynthia McNerney
- Administrative Data Research Wales, Swansea, UK; SAIL Databank, Swansea, UK
| | | | | | - Mark A Bellis
- WHO Collaborating Centre for Violence Prevention, Liverpool John Moores University, Liverpool, UK
| | | | - Karen Harrington
- National Centre for Population Health and Wellbeing Research, Swansea, UK
| | - Simon Moore
- Security, Crime & Intelligence Innovation Institute and Violence Research Group, School of Dentistry, Cardiff University, Heath Park, Cardiff, UK
| | - Sinead Brophy
- National Centre for Population Health and Wellbeing Research, Swansea, UK; Health Data Research UK, Swansea, UK; Administrative Data Research Wales, Swansea, UK
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