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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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Anderson JC, Nguyen MU, Huynh W, Sharif K, Moret JED. Enhancing Campus Safety: Exploring Student Perspectives on a Text Message-Delivered Intervention for Addressing Sexual Violence and Alcohol Use. JOURNAL OF FORENSIC NURSING 2024; 20:30-42. [PMID: 38019029 PMCID: PMC10922041 DOI: 10.1097/jfn.0000000000000454] [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: 11/30/2023]
Abstract
BACKGROUND Alcohol-related sexual violence, including sexual coercion, nonconsensual contact, and rape, is prevalent on college campuses. AIM The purpose of the study was to investigate college students' feedback and recommendations regarding content for a text-message-delivered harm reduction intervention to jointly address alcohol use and alcohol's role in sexual violence risk. METHODS This qualitative thematic study used focus groups and individual interviews to collect feedback from 61 college students between February 2019 and July 2020. RESULTS Targeted recruitment resulted in a sample that was nearly half queer/ lesbian, gay, bisexual (46.2%) or trans* (9.8%) identified students. Participants endorsed text messaging as an effective way to reach college students but diverged in specific content they felt was relevant and appropriate for a universal education intervention. Students preferred content describing individual strategies versus those requiring collaboration from friends or potential sex partners. Students also preferred content phrased as suggestions or questions versus declarative statements. Although most participants recognized the value of content related to consent, sexual violence, sexual health, and resources, a few male-identifying participants failed to recognize that content as important to their experience. Maintaining brevity while discussing consent in the overlapping settings of drinking and interpersonal relationships was described as a particular challenge. IMPACT OF THIS WORK ON CAMPUS SEXUAL ASSAULT AND FORENSIC NURSING Students in our sample highlighted the challenges of sharing sexual violence and alcohol-related harm reduction text messaging because of the complexities of rape culture, consent, and interpersonal dynamics during college student drinking events.
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Affiliation(s)
- Jocelyn C. Anderson
- Associate Professor; College of Nursing, University of Arkansas for Medical Science; 4301 West Markhan Street, Slot 529, Little Rock, AR 72205
| | - Meghan U. Nguyen
- Undergraduate Research Assistant; Ross and Carol Nese College of Nursing, Pennsylvania State University
| | - Wendy Huynh
- Undergraduate Research Assistant; Ross and Carol Nese College of Nursing, Pennsylvania State University
| | - Khadeeja Sharif
- Undergraduate Research Assistant; Ross and Carol Nese College of Nursing, Pennsylvania State University
| | - Jessica E. Draughon Moret
- Associate Professor; Betty Irene Moore School of Nursing, University of California, Davis @DrDraughon
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Alhusen J, McDonald M, Emery B. Intimate partner violence: A clinical update. Nurse Pract 2023; 48:40-46. [PMID: 37643145 DOI: 10.1097/01.npr.0000000000000088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
ABSTRACT Intimate partner violence (IPV) is a significant public health issue associated with substantial morbidity and mortality. NPs are ideally positioned to screen for and intervene in IPV, thereby mitigating the health risks IPV carries for women, infants, and young children. Safety planning and appropriate referrals to community-based resources are critical components of addressing IPV.
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van Gelder NE, Ligthart SA, van Rosmalen-Nooijens KAWL, Prins JB, Oertelt-Prigione S. Key Factors in Helpfulness and Use of the SAFE Intervention for Women Experiencing Intimate Partner Violence and Abuse: Qualitative Outcomes From a Randomized Controlled Trial and Process Evaluation. J Med Internet Res 2023; 25:e42647. [PMID: 37603391 PMCID: PMC10477920 DOI: 10.2196/42647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 05/18/2023] [Accepted: 06/30/2023] [Indexed: 08/22/2023] Open
Abstract
BACKGROUND Many women experience at least one type of intimate partner violence and abuse (IPVA), and although various support options are available, we still know relatively little about web-based interventions for IPVA survivors. We conducted a qualitative evaluation of the SAFE eHealth intervention for women experiencing IPVA in the Netherlands, complementing the quantitative evaluation of self-efficacy, depression, anxiety, and multiple feasibility aspects. OBJECTIVE This study assessed users' experiences and what, according to them, were useful and helpful aspects of the intervention. METHODS The intervention consisted of modules with information on relationships and IPVA, help options, physical and mental health, and social support. It also contained interactive elements such as exercises, stories from survivors, a chat, and a forum. A randomized controlled trial was conducted with an intervention arm receiving the complete version of the intervention and a control arm receiving only a static version with the modules on relationships and IPVA and help options. We gathered data through open questions from surveys (for both study arms; n=65) and semistructured interviews (for the intervention study arm; n=10), all conducted on the web, during the randomized controlled trial and process evaluation. Interview data were coded following the principles of open thematic coding, and all qualitative data were analyzed using qualitative content analysis. RESULTS Overall, most users positively rated the intervention regarding safety, content, and suiting their needs, especially participants from the intervention study arm. The intervention was helpful in the domains of acknowledgment, awareness, and support. However, participants also identified points for improvement: the availability of a simplified version for acute situations; more attention for survivors in the aftermath of ending an abusive relationship; and more information on certain topics, such as technological IPVA, support for children, and legal affairs. Furthermore, although participants expressed a prominent need for interactive contact options such as a chat or forum, the intervention study arm (the only group that had these features at their disposal) mainly used them in a passive way-reading instead of actively joining the conversation. The participants provided various reasons for this passive use. CONCLUSIONS The positive outcomes of this study are similar to those of other web-based interventions for IPVA survivors, and specific points for improvement were identified. The availability of interactive elements seems to be of added value even when they are used passively. This study provides in-depth insight into the experiences of female IPVA survivors with the SAFE eHealth intervention and makes suggestions for improvements to SAFE and comparable web-based interventions for IPVA as well as inspiring future research. Furthermore, this study shows the importance of a varied assessment of an intervention's effectiveness to understand the real-world impact on its users. TRIAL REGISTRATION Netherlands Trial Register NTR7313; https://tinyurl.com/3t7vwswz.
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Affiliation(s)
- Nicole E van Gelder
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Suzanne A Ligthart
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Karin A W L van Rosmalen-Nooijens
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Judith B Prins
- Department of Medical Psychology, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Sabine Oertelt-Prigione
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
- Arbeitsgruppe 10 Geschlechtersensible Medizin, Medical Faculty Ostwestfalen-Lippe, Bielefeld University, Bielefeld, Germany
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5
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van Gelder NE, Ligthart SA, van Rosmalen-Nooijens KA, Prins JB, Oertelt-Prigione S. Effectiveness of the SAFE eHealth Intervention for Women Experiencing Intimate Partner Violence and Abuse: Randomized Controlled Trial, Quantitative Process Evaluation, and Open Feasibility Study. J Med Internet Res 2023; 25:e42641. [PMID: 37368485 DOI: 10.2196/42641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 03/27/2023] [Accepted: 04/20/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Intimate partner violence and abuse (IPVA) is a pervasive societal issue that impacts many women globally. Web-based help options are becoming increasingly available and have the ability to eliminate certain barriers in help seeking for IPVA, especially in improving accessibility. OBJECTIVE This study focused on the quantitative evaluation of the SAFE eHealth intervention for women IPVA survivors. METHODS A total of 198 women who experienced IPVA participated in a randomized controlled trial and quantitative process evaluation. Participants were largely recruited on the internet and signed up through self-referral. They were allocated (blinded for the participants) to (1) the intervention group (N=99) with access to a complete version of a help website containing 4 modules on IPVA, support options, mental health, and social support, and with interactive components such as a chat, or (2) the limited-intervention control group (N=99). Data were gathered about self-efficacy, depression, anxiety, and multiple feasibility aspects. The primary outcome was self-efficacy at 6 months. The process evaluation focused on themes, such as ease of use and feeling helped. In an open feasibility study (OFS; N=170), we assessed demand, implementation, and practicality. All data for this study were collected through web-based self-report questionnaires and automatically registered web-based data such as page visits and amount of logins. RESULTS We found no significant difference over time between groups for self-efficacy, depression, anxiety, fear of partner, awareness, and perceived support. However, both study arms showed significantly decreased scores for anxiety and fear of partner. Most participants in both groups were satisfied, but the intervention group showed significantly higher scores for suitability and feeling helped. However, we encountered high attrition for the follow-up surveys. Furthermore, the intervention was positively evaluated on multiple feasibility aspects. The average amount of logins did not significantly differ between the study arms, but participants in the intervention arm did spend significantly more time on the website. An increase in registrations during the OFS (N=170) was identified: the mean amount of registrations per month was 13.2 during the randomized controlled trial and 56.7 during the OFS. CONCLUSIONS Our findings did not show a significant difference in outcomes between the extensive SAFE intervention and the limited-intervention control group. It is, however, difficult to quantify the real contribution of the interactive components, as the control group also had access to a limited version of the intervention for ethical reasons. Both groups were satisfied with the intervention they received, with the intervention study arm significantly more so than the control study arm. Integrated and multilayered approaches are needed to aptly quantify the impact of web-based IPVA interventions for survivors. TRIAL REGISTRATION Netherlands Trial Register NL7108 NTR7313; https://trialsearch.who.int/Trial2.aspx?TrialID=NTR7313.
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Affiliation(s)
- Nicole E van Gelder
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Suzanne A Ligthart
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Karin Awl van Rosmalen-Nooijens
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Judith B Prins
- Department of Medical Psychology, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Sabine Oertelt-Prigione
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands
- Arbeitsgruppe 10 Sex- and Gender-sensitive Medicine, Medical Faculty Ostwestfalen-Lippe, University of Bielefeld, Bielefeld, Germany
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Storer HL, Nyerges EX. The Rapid Uptake of Digital Technologies at Domestic Violence and Sexual Assault Organizations During the COVID-19 Pandemic. Violence Against Women 2023; 29:1085-1096. [PMID: 35938220 PMCID: PMC9950030 DOI: 10.1177/10778012221094066] [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: 11/15/2022]
Abstract
Emerging evidence suggests that the COVID-19 pandemic disproportionately impacted survivors of domestic violence and sexual assault (DV/SA). This research note explores DV/SA service providers' (n = 20) perceptions of how their organizations responded to the pandemic. Results of a thematic content analysis indicated that survivors were adversely affected by sheltering with abusive partners and by external environmental conditions. Organizations responded to shifting community needs by adapting face-to-face services to virtual formats and revising pre pandemic safety planning protocols. School-based prevention programming required significant adjustments. Therefore, the pandemic catalyzed the integration and optimization of emerging technologies and provided opportunities for organizational innovation.
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Affiliation(s)
- Heather L. Storer
- University of
Louisville, Kent School of Social Work, Louisville, KY, USA,Heather L. Storer, University of
Louisville, Kent School of Social Work, 2217 S 3rd St, Louisville, KY 40292,
USA.
| | - Eva X. Nyerges
- University of
Louisville, Kent School of Social Work, Louisville, KY, USA
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Crawford AD, Hutson TS, Kim M. Mobile Health Applications Addressing Health Disparities for Women on Community Supervision: A Scoping Review. Subst Use Misuse 2023; 58:765-779. [PMID: 36924060 DOI: 10.1080/10826084.2023.2188414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
BACKGROUND Mobile health applications have gained popularity in assisting high-risk, hard-to-reach groups in self-management of health conditions. One such population with high rates of health disparities comprises women under community supervision. In this review, we examine the literature on mHealth applications to address health disparities among women under community supervision. METHODS We searched CINAHL, PubMed, and PsycInfo for peer-reviewed research articles conducted in the U.S. After removal of duplicates, review of 231 article titles and abstracts and 36 articles for full-text review yielded five articles for analysis. Extracted data include author, year, design, sample, objectives, conclusions, measures, interventions and analytic approach. RESULTS Of the five studies that addressed health disparities of individuals under community supervision, one was done with participants on probation, four with participants on medication therapy for substance use disorder, and one with participants in a drug court program. Only one article was specific to women or controlled for ethnicity. No studies were done with those on parole. None done with populations outside the U.S. CONCLUSION Few studies focused on health disparities of women under community supervision. mHealth applications that address substance use, reproductive and sexual health, and safety issues specific to women under community supervision are warranted.
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Affiliation(s)
| | - Tara S Hutson
- The University of Texas at Austin School of Nursing, Austin, Texas, USA
| | - Miyong Kim
- The University of Texas at Austin School of Nursing, Austin, Texas, USA
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Philbrick W, Milnor J, Deshmukh M, Mechael P. Information and communications technology use to prevent and respond to sexual and gender-based violence in low- and middle-income countries: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1277. [PMID: 36908839 PMCID: PMC9595343 DOI: 10.1002/cl2.1277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND The use of information and communications technologies (ICT) in low- and middle-income countries (LMIC) has increased significantly in the last several years, particularly in health, including related areas such as preventing and responding to sexual and gender-based violence (SGBV) against women and children. While the evidence for ICT effectiveness has grown significantly in the past 5 years in other aspects of health, it has not for effectiveness of using ICT for the prevention and response to SGBV against women and children in LMIC. OBJECTIVES The primary goal of this evidence and gap map (EGM) is to establish a baseline for the state of the evidence connected with the use of ICT for preventing and responding to SGBV against women and children in LMIC. Objectives that contribute to the achievement of this goal are: (1)identifying evidence of effectiveness for the use of ICT targeting the prevention of, and response to, SGBV against women and children in LMIC;(2)identifying key gaps in the available ICT for SGBV prevention and/or response evidence;(3)identifying research methodology issues reflected in the current evidence;(4)identifying any clusters of evidence in one or more ICT interventions suitable for systematic review;(5)identifying enabling factors associated with effective interventions using ICT for the prevention of, and response to, SGBV against women and children in LMIC; and(6)providing a structured and accessible guide to stakeholders for future investment into interventions and research using ICT for SGBV prevention and response in LMIC. SEARCH METHODS The date of the last search from which records were evaluated, and any studies identified were incorporated into the EGM was July 11, 2021. Twenty (20) databases were searched, and identified under "Methods." SELECTION CRITERIA We conducted systematic searches of multiple academic databases using search terms and criteria related to the use of ICT for prevention and/or response to SGBV against women and children. Although excluded, we did consider studies conducted in higher-income countries (HIC) only to provide context and contrast for the EGM discussion of the eligible studies from LMIC. DATA COLLECTION AND ANALYSIS The EGM search process included five phases: (1) initial search of academic databases conducted by two researchers simultaneously; (2) comparison of search results, and abstract screening by two researchers collaboratively; (3) second screening by reviewing full articles of the studies identified in the first screening by two reviewers independently; (4) comparison of results of second screening; resolution of discrepancies of screening results; and (5) data extraction and analysis. MAIN RESULTS The EGM includes 10 studies published in English of which 4 were systematic, literature or scoping reviews directly addressing some aspect of the use of ICT for SGBV prevention and/or response in women and girls. The six individual studies were, or are being, conducted in LMIC (a condition for eligibility). No eligible studies addressed children as a target group, although a number of the ineligible studies reported on the use of ICT for intermediate outcomes connected with violence against children (e.g., digital parenting). Yet, such studies did not explicitly attach those intermediate outcomes to SGBV prevention or response outcomes. Countries represented among the eligible individual studies include Cambodia, Kenya, Nepal Democratic Republic of Congo (DRC), and Lebanon. Of the 10 eligible studies (individual and reviews), most focused on intimate partner violence against women (IPV). Intervention areas among the eligible studies include safety planning using decision algorithms, educational and empowerment messaging regarding norms and attitudes towards gender-based violence (GBV), multi-media radio drama for social behavior change, the collection of survivor experience to inform SGBV/GBV services, and the collection of forensic evidence connected to the perpetration of SGBV. Thirty-one studies which otherwise would have been eligible for the evidence and gap map (EGM) were conducted in HIC (identified under "Excluded Reviews"). None of the eligible studies reported results related to effectiveness of using ICT in a control setting, for the primary prevention of SGBV as an outcome, but rather reported on outcomes such as usability, secondary and tertiary prevention, feasibility, access to services and other outcomes primarily relating to the development of the interventions. Two studies identified IPV prevention as a measurable outcome within their protocols, but one of these had not yet formally published results regarding primary prevention as an outcome. The other study, while reporting on the protocol (and steps to adapt the ICT application, previously reported as effective in HIC contexts to a specific LMIC context), has not yet as of the date of writing this EGM, published outcome results related to the reduction of IPV. Of the four reviews identified as eligible, two are better characterized as either a literature review or case study rather than as traditional systematic reviews reporting on impact outcomes with methodologically rigorous protocols. AUTHORS' CONCLUSIONS The evidence baseline for using ICT to prevent and/or respond to SGBV against women and children in LMIC is nascent. Promising areas for future study include: (1) how ICT can contribute changing gender and social norms related to SGBV and primary prevention; (2) mobile phone applications that promote safety and security; (3) mobile technology for the collection and analysis of survivors' experience with SGBV response services; and (4) digital tools that support the collection of forensic evidence for SGBV response and secondary prevention. Most striking is the paucity of eligible studies examining the use of ICT in connection with preventing or responding to SGBV against children. In light of the exponential increase in the use of ICT by children and adolescents, even in LMIC, greater attention should be given to examining how ICT can be used during adolescence to address gender norms that lead to SGBV. While there appears to be interest in using ICT for SGBV prevention and/or response in LMIC, other than several ad hoc studies, there is little evidence of if, and how effective these interventions are. Further inquiry should be made regarding if and how interventions proven effective in HIC can be adapted to LMIC contexts.
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Affiliation(s)
- William Philbrick
- Sitara InternationalAtlantaGeorgiaUSA
- Health, Equity and Rights, CAREAtlantaGeorgiaUSA
| | - Jacob Milnor
- Oswaldo Cruz FoundationOswaldo Cruz InstituteRio de JaneiroBrazil
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Jock BW, Dana-Sacco G, Arscott J, Bagwell-Gray ME, Loerzel E, Brockie T, Packard G, O’Keefe VM, McKinley CE, Campbell J. "We've Already Endured the Trauma, Who is Going to Either End that Cycle or Continue to Feed It?": The Influence of Family and Legal Systems on Native American Women's Intimate Partner Violence Experiences. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP20602-NP20629. [PMID: 35114840 PMCID: PMC9346087 DOI: 10.1177/08862605211063200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Native American (NA) women experience higher rates of intimate partner violence (IPV) compared to other U.S. racial/ethnic groups, yet previous research has not sufficiently examined the complex determinants shaping their IPV experiences. This research explores the interplay of family networks and legal systems influencing NA women's IPV experiences. Data were collected through in-depth individual and group interviews with 42 NA survivors and 41 health/social service providers from July 2016 to June 2017 in NA communities from three different U.S. regions. We used Grounded Theory to develop emergent themes from the data, focusing on system-level risk and protective factors of women's of IPV experiences. In terms of family systems, participants indicated that NA communities were comprised of highly influential and interwoven family systems, making them powerful sources of support for both survivors and their partners who use violence. Participants described how intergenerational violence exposures contributed to the normalization of violence. In terms of legal systems, participants described inconsistent consequences for abusers of NA women, insufficient protection from legal systems, and manipulation of jurisdictional complexities. Interactions between family and legal systems influenced decision-making and outcomes. Family and community-based approaches, and the incorporation of traditional language and cultures, are needed to promote healing. Our findings reflect the complex ways that family and legal systems shape NA women's IPV experiences. Results provide insight into how NA women interact with and navigate these systems when experiencing IPV and how these systems impact decision-making and the ability to be safe from IPV. Research is needed to advance understanding of the inter-relationships between intergenerational trauma, family systems, and legal systems on IPV survivors' mental health and wellness. To make meaningful change, further research examining IPV from an interdisciplinary perspective that explores the interplay of social determinants of health inequities is needed.
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Affiliation(s)
- Brittany Wenniserí:iostha Jock
- McGill University, School of Human Nutrition, Centre of Indigenous Peoples’ Nutrition and Environment (CINE), Montreal, QC, Canada
| | - Gail Dana-Sacco
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joyell Arscott
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Emily Loerzel
- University of Washington School of Social Work, Seattle, WA, USA
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10
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Wathen CN, Mantler T. Trauma- and Violence-Informed Care: Orienting Intimate Partner Violence Interventions to Equity. CURR EPIDEMIOL REP 2022; 9:233-244. [PMID: 36212738 PMCID: PMC9527731 DOI: 10.1007/s40471-022-00307-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2022] [Indexed: 12/01/2022]
Abstract
Purposeof Review Intimate partner violence (IPV) is a complex traumatic experience that often co-occurs, or is causally linked, with other forms of structural violence and oppression. However, few IPV interventions integrate this social-ecological perspective. We examine trauma- and violence-informed care (TVIC) in the context of existing IPV interventions as an explicitly equity-oriented approach to IPV prevention and response. Recent Findings Systematic reviews of IPV interventions along the public health prevention spectrum show mixed findings, with those with a theoretically grounded, structural approach that integrates a trauma lens more likely to show benefit. Summary TVIC, embedded in survivor-centered protocols with an explicit theory of change, is emerging as an equity-promoting approach underpinning IPV intervention. Explicit attention to structural violence and the complexity of IPV, systems and sites of intervention, and survivors’ diverse and intersectional lived experiences has significant potential to transform policy and practice.
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Affiliation(s)
- C. Nadine Wathen
- Arthur Labatt Family School of Nursing, Western University, FIMS & Nursing Building, Room 2307, London, ON N6A 5B9 Canada
| | - Tara Mantler
- School of Health Studies, Western University, London, Canada
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11
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Elbelassy AE, van Gelder NE, Ligthart SA, Oertelt-Prigione S. Optimization of eHealth interventions for intimate partner violence and abuse: A qualitative study amongst Arabic-speaking migrant women. J Adv Nurs 2022; 79:1414-1425. [PMID: 36097434 DOI: 10.1111/jan.15437] [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: 02/07/2022] [Revised: 07/28/2022] [Accepted: 08/20/2022] [Indexed: 11/29/2022]
Abstract
AIMS This interview study focuses on the needs and wishes of Arabic-speaking migrant women in the Netherlands to culturally adapt and optimize the digital support platform SAFE (safewomen.nl) for intimate partner violence and abuse (IPVA) for their use. DESIGN This is a qualitative interview-based study. METHODS We conducted the study between March 2020 and 2021. The study entailed 16 semi-structured interviews with Arabic-speaking women in the Netherlands with a migration background. RESULTS Findings suggest that a cultural gap, a lack of knowledge of the Dutch law, and the prevalence of restrictive gender roles amongst the participants and their spouses affected their acknowledgement of the different forms of IPVA. Furthermore, mental health consequences of IPVA were also strongly stigmatized. Clear information in their native language, summarizing infographics and potential interactive features should be main components of any eHealth intervention for this target group. CONCLUSION The participants in our study deemed e-help a potentially valuable support option for women experiencing IPVA in their community. The impact of IPVA on mental health is currently overlooked within this target group and should be emphasized in future interventions. IMPACT Cultural sensitivity proved crucial in understanding the concepts of IPVA amongst women with migrant backgrounds. To ensure effective eHealth interventions for migrant women, they should be involved in the design and delivery of these interventions.
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Affiliation(s)
- Allaa E Elbelassy
- Gender Unit, Department of Primary and Transmural Care, Radboud University Medical Center, Nijmegen, Netherlands
| | - Nicole E van Gelder
- Gender Unit, Department of Primary and Transmural Care, Radboud University Medical Center, Nijmegen, Netherlands
| | - Suzanne A Ligthart
- Gender Unit, Department of Primary and Transmural Care, Radboud University Medical Center, Nijmegen, Netherlands
| | - Sabine Oertelt-Prigione
- Gender Unit, Department of Primary and Transmural Care, Radboud University Medical Center, Nijmegen, Netherlands
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Emezue C, Chase JD, Udmuangpia T, Bloom TL. Technology-based and digital interventions for intimate partner violence: A systematic review and meta-analysis. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1271. [PMID: 36909881 PMCID: PMC9419475 DOI: 10.1002/cl2.1271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND A growing body of research shows the promise and efficacy of technology-based or digital interventions in improving the health and well-being of survivors of intimate partner violence (IPV). In addition, mental health comorbidities such as anxiety, post-traumatic stress disorder (PTSD), and depression occur three to five times more frequently in survivors of IPV than non-survivors, making these comorbidities prominent targets of technology-based interventions. Still, research on the long-term effectiveness of these interventions in reducing IPV victimization and adverse mental health effects is emergent. The significant increase in the number of trials studying technology-based therapies on IPV-related outcomes has allowed us to quantify the effectiveness of such interventions for mental health and victimization outcomes in survivors. This meta-analysis and systematic review provide critical insight from several randomized controlled trials (RCTs) on the overall short and long-term impact of technology-based interventions on the health and well-being of female IPV survivors. OBJECTIVES To synthesize current evidence on the effects of technology-based or digital interventions on mental health outcomes (depression, anxiety, and PTSD) and victimization outcomes (physical, psychological, and sexual abuse) among IPV survivors. SEARCH METHODS We examined multiple traditional and grey databases for studies published from 2007 to 2021. Traditional databases (such as PubMed Central, Web of Science, CINAHL Plus, and PsychINFO) and grey databases were searched between April 2019 and February 2021. In addition, we searched clinical trial registries, government repositories, and reference lists. Authors were contacted where additional data was needed. We identified 3210 studies in traditional databases and 1257 from grey literature. Over 2198 studies were determined to be duplicates and eliminated, leaving 64 studies after screening titles and abstracts. Finally, 17 RCTs were retained for meta-analysis. A pre-registered protocol was developed and published before conducting this meta-analysis. SELECTION CRITERIA We included RCTs targeting depression, anxiety, PTSD outcomes, and victimization outcomes (physical, sexual, and psychological violence) among IPV survivors using a technology-based intervention. Eligible RCTs featured a well-defined control group. There were no study restrictions based on participant gender, study setting, or follow-up duration. Included studies additionally supplied outcome data for calculating effect sizes for our desired outcome. Studies were available in full text and published between 2007 and 2021 in English. DATA COLLECTION AND ANALYSIS We extracted relevant data and coded eligible studies. Using Cochrane's RevMan software, summary effect sizes (Outcome by Time) were assessed using an independent fixed-effects model. Standardized mean difference (SMD) effect sizes (or Cohen's d) were evaluated using a Type I error rate and an alpha of 0.05. The overall intervention effects were analyzed using the Z-statistic with a p-value of 0.05. Cochran's Q test and Higgins' I 2 statistics were utilized to evaluate and confirm the heterogeneity of each cumulative effect size. The Cochrane risk of bias assessment for randomized trials (RoB 2) was used to assess the quality of the studies. Campbell Systematic Reviews registered and published this study's protocol in January 2021. No exploratory moderator analysis was conducted; however, we report our findings with and without outlier studies in each meta-analysis. MAIN RESULTS Pooled results from 17 RCTs yielded 18 individual effect size comparisons among 4590 survivors (all females). Survivors included college students, married couples, substance-using women in community prisons, pregnant women, and non-English speakers, and sample sizes ranged from 15 to 672. Survivors' ages ranged from 19 to 41.5 years. Twelve RCTs were conducted in the United States and one in Canada, New Zealand, China (People's Republic of), Kenya, and Australia. The results of this meta-analysis found that technology-based interventions significantly reduced depression among female IPV survivors at 0-3 months only (SMD = -0.08, 95% confidence interval [CI] = -0.17 to -0.00), anxiety among IPV survivors at 0-3 months (SMD = -0.27, 95% CI = -0.42 to -0.13, p = 0.00, I 2 = 25%), and physical violence victimization among IPV survivors at 0-6 months (SMD = -0.22, 95% CI = -0.38 to -0.05). We found significant reductions in psychological violence victimization at 0-6 months (SMD = -0.34, 95% CI = -0.47 to -0.20) and at >6 months (SMD = -0.29, 95% CI = -0.39 to -0.18); however, at both time points, there were outlier studies. At no time point did digital interventions significantly reduce PTSD (SMD = -0.04, 95% CI = -0.14 to 0.06, p = .46, I 2 = 0%), or sexual violence victimization (SMD = -0.02, 95% CI = -0.14 to 0.11, I 2 = 21%) among female IPV survivors for all. With outlier studies removed from our analysis, all summary effect sizes were small, and this small number of comparisons prevented moderator analyses. AUTHORS' CONCLUSIONS The results of this meta-analysis are promising. Our findings highlight the effectiveness of IPV-mitigating digital intervention as an add-on (not a replacement) to traditional modalities using a coordinated response strategy. Our findings contribute to the current understanding of "what works" to promote survivors' mental health, safety, and well-being. Future research could advance the science by identifying active intervention ingredients, mapping out intervention principles/mechanisms of action, best modes of delivery, adequate dosage levels using the treatment intensity matching process, and guidelines to increase feasibility and acceptability.
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Affiliation(s)
- Chuka Emezue
- Department of Women, Children and Family NursingRush University College of NursingChicagoIllinoisUSA
| | - Jo‐Ana D. Chase
- Sinclair School of NursingUniversity of MissouriColumbiaMissouriUSA
| | - Tipparat Udmuangpia
- Department of Maternal‐Child Health and MidwiferyBoromarajonani College of NursingKhon KaenThailand
| | - Tina L. Bloom
- School of NursingNotre Dame of Maryland UniversityBaltimoreMarylandUSA
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Saboury Yazdy N, Talaei A, Ebrahimi M, Ghofrani Ivari A, Pouriran MA, Faridhosseini F, Mohaddes Ardabili H. "Be my Voice" to break social stigma against domestic violence: The underestimated role of smartphone applications in protecting victims in developing countries. Front Psychiatry 2022; 13:954602. [PMID: 35990047 PMCID: PMC9386513 DOI: 10.3389/fpsyt.2022.954602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/14/2022] [Indexed: 12/04/2022] Open
Affiliation(s)
- Niloofar Saboury Yazdy
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Talaei
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Ebrahimi
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Aida Ghofrani Ivari
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Amin Pouriran
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farhad Faridhosseini
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Mohaddes Ardabili
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Signorelli MC, Costa da Silva VL, Evans DP, Prado SM, Glass N. Feasibility of an Online-Based Safety Decision Aid for Brazilian Women Living with Intimate Partner Violence: Findings from Participatory-Action Research in a One Stop Center. JOURNAL OF FAMILY VIOLENCE 2022; 38:433-446. [PMID: 35601758 PMCID: PMC9113623 DOI: 10.1007/s10896-022-00409-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/02/2022] [Indexed: 06/15/2023]
Abstract
Intimate partner violence (IPV) is a challenge in Brazil; the country is ranked 6th globally for femicide and one in four women experience physical and/or sexual IPV in their lifetimes. Safety decision aids (SDA) are tools for women experiencing IPV. Building upon previously developed and tested online SDA tools, we intend to adapt an SDA tool for use in Brazil. The purpose of this study was to examine the feasibility of a technology-based SDA to support Brazilian women living with IPV, tailored for the Brazilian context. Our participatory-action research approach built upon research between 2018 and 2019 at the House of the Brazilian Woman (HBW) of Curitiba, Brazil, a cross-sectoral one-stop center (OSC) providing comprehensive care for IPV survivors. Field research included observation, field notes, and in-depth interviews with twenty-eight (n = 28) participants (HBW staff and survivors). The results were grouped into four main thematic categories: advantages; uncertainties; barriers; and suggestions. The triangulated results showed that the majority of participants considered the SDA feasible, highlighting flexibility and confidentiality; information about IPV; and access to resources for formal help-seeking as advantages of the tool. Participants also expressed uncertainties about SDA's ability to increase women's safety and its accessibility for the most vulnerable. They made suggestions for improvement to meet the unique needs of Brazilian women. This study provided evidence on the potential of an SDA tailored for use within a comprehensive program of women survivors in Brazil. This step was crucial to inform the future implementation and evaluation.
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Affiliation(s)
- Marcos Claudio Signorelli
- Chamber of Public Health, Federal University of Paraná, Rua Jaguariaíva, 512, Matinhos, PR 83260-000 Brazil
| | - Vera Lucia Costa da Silva
- Post-Graduation in Sustainable Territorial Development, Federal University of Paraná, Rua Jaguariaíva, 512, Matinhos, PR 83260-000 Brazil
| | - Dabney P. Evans
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322 USA
| | - Sandra Marques Prado
- House of the Brazilian Woman of Curitiba, Av. Paraná, 870, Curitiba, PR 80035-130 Brazil
| | - Nancy Glass
- Johns Hopkins Center for Global Health, Johns Hopkins University, 415 N Washington St, Baltimore, MD 21205 USA
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Draughon Moret J, Todd A, Rose L, Pollitt E, Anderson J. Mobile Phone Apps for Intimate Partner and Sexual Violence Prevention and Response: Systematic Search on App Stores. JMIR Form Res 2022; 6:e28959. [PMID: 35133285 PMCID: PMC8864520 DOI: 10.2196/28959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 10/06/2021] [Accepted: 11/30/2021] [Indexed: 01/17/2023] Open
Abstract
Background Since the 2008 advent of the smartphone, more than 180 billion copies of apps have been downloaded from Apple App Store, with more than 2.6 million apps available for Android and 2.2 million apps available for iOS. Many violence prevention and response apps have been developed as part of this app proliferation. Objective This study aims to evaluate the prevalence and quality of freely available mobile phone apps targeting intimate partner violence (IPV) and sexual violence (SV) prevention and response. Methods We conducted a systematic search of violence prevention and response mobile phone apps freely available in Apple App Store (iOS; March 2016) and Google Play Store (Android; July 2016). Search terms included violence prevention, sexual assault, domestic violence, intimate partner violence, sexual violence, forensic nursing, wife abuse, and rape. Apps were included for review if they were freely available, were available in English, and had a primary purpose of prevention of or response to SV or IPV regardless of app target end users. Results Using the Mobile Application Rating Scale (MARS), we evaluated a total of 132 unique apps. The majority of included apps had a primary purpose of sharing information or resources. Included apps were of low-to-moderate quality, with the overall subjective quality mean for the reviewed apps being 2.65 (95% CI 2.58-2.72). Quality scores for each of the 5 MARS categories ranged from 2.80 (engagement) to 4.75 (functionality). An incidental but important finding of our review was the difficulty in searching for apps and the plethora of nonrelated apps that appear when searching for keywords such as “rape” and “domestic violence” that may be harmful to people seeking help. Conclusions Although there are a variety of mobile apps available designed to provide information or other services related to SV and IPV, they range greatly in quality. They are also challenging to find, given the current infrastructure of app store searches, keyword prioritization, and highlighting based on user rating. It is important for providers to be aware of these resources and be knowledgeable about how to review and recommend mobile phone apps to patients, when appropriate.
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Affiliation(s)
- Jessica Draughon Moret
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, United States
| | - Angela Todd
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, United States
| | - Lauren Rose
- College of Nursing, Pennsylvania State University, University Park, PA, United States
| | - Erin Pollitt
- District of Columbia Forensic Nurse Examiners, Washington, DC, United States
| | - Jocelyn Anderson
- College of Nursing, Pennsylvania State University, University Park, PA, United States
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Sabri B, Glass N, Murray S, Perrin N, Case JR, Campbell JC. A technology-based intervention to improve safety, mental health and empowerment outcomes for immigrant women with intimate partner violence experiences: it's weWomen plus sequential multiple assignment randomized trial (SMART) protocol. BMC Public Health 2021; 21:1956. [PMID: 34711182 PMCID: PMC8554998 DOI: 10.1186/s12889-021-11930-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 10/06/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) disproportionately affects immigrant women, an understudied and underserved population in need for evidence-based rigorously evaluated culturally competent interventions that can effectively address their health and safety needs. METHODS This study uses a sequential, multiple assignment, randomized trial (SMART) design to rigorously evaluate an adaptive, trauma-informed, culturally tailored technology-delivered intervention tailored to the needs of immigrant women who have experienced IPV. In the first stage randomization, participants are randomly assigned to an online safety decision and planning or a usual care control arm and safety, mental health and empowerment outcomes are assessed at 3-, 6- and 12-months post-baseline. For the second stage randomization, women who do not report significant improvements in safety (i.e., reduction in IPV) and empowerment from baseline to 3 months follow up (i.e., non-responders) are re- randomized to safety and empowerment strategies delivered via text only or a combination of text and phone calls with trained advocates. Data on outcomes (safety, mental health, and empowerment) for early non-responders is assessed at 6 and 12 months post re-randomization. DISCUSSION The study's SMART design provides an opportunity to implement and evaluate an individualized intervention protocol for immigrant women based on their response to type or intensity of intervention. The findings will be useful for identifying what works for whom and characteristics of participants needing a particular type or intensity level of intervention for improved outcomes. If found to be effective, the study will result in an evidence-based trauma-informed culturally tailored technology-based safety decision and planning intervention for immigrant survivors of IPV that can be implemented by practitioners serving immigrant women in diverse settings. TRIAL REGISTRATION This trial was registered with ClinicalTrials.gov as NCT04098276 on September 13, 2019.
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Affiliation(s)
- Bushra Sabri
- School of Nursing, Johns Hopkins University, 525 North Wolfe Street, Room S408, Baltimore, MD 21205 USA
| | - Nancy Glass
- Nancy Glass, Johns Hopkins University School of Nursing, Baltimore, MD 21205 USA
| | - Sarah Murray
- Sarah Murray, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205 USA
| | - Nancy Perrin
- Nancy Perrin, Johns Hopkins University School of Nursing, Baltimore, MD 21205 USA
| | - James R. Case
- James R. Case, Johns Hopkins University School of Nursing, Baltimore, MD 21205 USA
| | - Jacquelyn C. Campbell
- Jacquelyn C. Campbell, Johns Hopkins University School of Nursing, Baltimore, MD 21205 USA
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Emezue CN, Enriquez M, Dougherty DS, Bullock LFC, Bloom TL. Rural young males' acceptance & receptiveness to technology-based interventions for dating violence prevention: A qualitative descriptive study. J Adolesc 2021; 92:137-151. [PMID: 34530185 DOI: 10.1016/j.adolescence.2021.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/19/2021] [Accepted: 08/24/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Rural youth are twice as likely as urban youth to experience some forms of teen dating violence (TDV), and significant barriers to accessing support services for physical, psychological, sexual violence. However, rural youth remain understudied and undersampled. Rural young men, in particular, are at risk for experiencing or perpetrating dating violence influenced by regional and sociocultural risk factors that promote male supremacy ideals while also impeding male help-seeking. Technology-based interventions circumvent some of these risk factors by offering confidential and reliable support. This study investigates rural young males' acceptability of technology-based interventions for fostering healthy relationships and preventing dating abuse, including their preferences for intervention content and features. METHODS Three online focus groups (n = 14) and phone interviews (n = 13) were conducted with rural young males. Participants were stratified by age (15-17 and 18-24 year-olds). Most were White (81%) from the United States Midwest (65%). Semi-structured interview data were analyzed using Qualitative Description (QD), guided by the Unified Theory of Acceptance and Use of Technology (UTAUT). RESULTS Three themes identified were (1) Scarcity of Useful Resources, (2) Socio-Structural Challenges for Intervention Uptake, with two subthemes (2a) Rural-Specific Structural Barriers and (2b) Rural Masculinity Disrupting Help-seeking; (3) Finally, participants discussed Functionality and Design Needs, itemizing their intervention "must-have" in terms of content, resources, and features. CONCLUSION This qualitative study identified obstacles and facilitators to using technology-based interventions for dating violence prevention among young rural males and offers pragmatic "ready-to-use" recommendations for the development of technology-based anti-dating violence interventions for rural youth.
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Affiliation(s)
- Chuka N Emezue
- Rush University College of Nursing, Department of Women, Children and Family Nursing Chicago, IL, USA.
| | - Maithe Enriquez
- Sinclair School of Nursing, University of Missouri-Columbia, Missouri, USA.
| | - Debbie S Dougherty
- College of Arts and Science Communication, University of Missouri-Columbia, Missouri, USA.
| | - Linda F C Bullock
- Sinclair School of Nursing, University of Missouri-Columbia, Missouri, USA.
| | - Tina L Bloom
- School of Nursing, Notre Dame of Maryland University, Baltimore, MD, USA.
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Longitudinal Curricular Assessment of Knowledge and Awareness of Intimate Partner Violence among First-Year Dental Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116039. [PMID: 34199709 PMCID: PMC8200024 DOI: 10.3390/ijerph18116039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 05/30/2021] [Accepted: 06/01/2021] [Indexed: 02/08/2023]
Abstract
Background: Intimate partner violence (IPV) has previously been recognized as a major public health issue. Oral healthcare providers, such as dentists, are crucial to the screening and identifying of individuals experiencing IPV, since most injuries occur in the head and neck region. A lack of knowledge and awareness regarding teaching and learning about IPV in dental school curricula has been identified. Based upon the overall lack of knowledge, the objective of this study was to conduct a longitudinal assessment of knowledge, awareness, and beliefs regarding IPV among dental students in their first year of education. Methods: All students (n = 245) from three consecutive, first-year dental student cohorts (n = 81, n = 82, n = 82) were provided a brief and voluntary in-class survey in conjunction with an instructional workshop. The survey included questions designed to ascertain knowledge, awareness, and beliefs regarding IPV as a healthcare and dental issue before and after the instructional session. Differences in responses to the questions before and after the IPV educational workshop were measured using paired t-tests. Results: A total of n = 232 completed pre- and post-responses were received from all three first-year dental student cohorts (n = 76, n = 80, n = 76), representing an overall 94.6% response rate. Analysis of these data showed that the student population was predominantly male and white (non-minority), aged in their mid- to late twenties, with most students reporting no previous IPV education. The few students reporting previous IPV education were mainly younger (<25 years), which may represent more recent endeavors to increase awareness of IPV among students currently attending colleges and universities. Conclusions: The results of this study may suggest that information-specific seminars within the curriculum might be adequate to provide dental students with awareness and knowledge of IPV and specific information regarding local resources and referrals for any patients experiencing IPV.
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Holliday CN, Bevilacqua K, Grace KT, Denhard L, Kaur A, Miller J, Decker MR. Examining the Neighborhood Attributes of Recently Housed Partner Violence Survivors in Rapid Rehousing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084177. [PMID: 33920892 PMCID: PMC8071223 DOI: 10.3390/ijerph18084177] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/01/2021] [Accepted: 04/07/2021] [Indexed: 11/25/2022]
Abstract
Survivors’ considerations for re-housing following intimate partner violence (IPV) are understudied despite likely neighborhood-level influences on women’s safety. We assess housing priorities and predictors of re-housing location among recent IPV survivors (n = 54) in Rapid Re-housing (RRH) in the Baltimore-Washington Metropolitan Area. Choropleth maps depict residential location relative to census tract characteristics (neighborhood deprivation index (NDI) and residential segregation) derived from American Community Survey data (2013–2017). Linear regression measured associations between women’s individual, economic, and social factors and NDI and segregation. In-depth interviews (n = 16) contextualize quantitative findings. Overall, survivors re-housed in significantly more deprived and racially segregated census tracts within their respective regions. In adjusted models, trouble securing housing (B = 0.74, 95% CI: 0.13, 1.34), comfortability with proximity to loved ones (B = 0.75, 95% CI: 0.02, 1.48), and being unsure (vs unlikely) about IPV risk (B = −0.76, 95% CI: −1.39, −0.14) were significantly associated with NDI. Economic dependence on an abusive partner (B = −0.31, 95% CI: −0.56, −0.06) predicted re-housing in segregated census tracts; occasional stress about housing affordability (B = 0.39, 95% CI: 0.04, 0.75) predicted re-housing in less segregated census tracts. Qualitative results contextualize economic (affordability), safety, and social (familiarity) re-housing considerations and process impacts (inspection delays). Structural racism, including discriminatory housing practices, intersect with gender, exacerbating challenges among survivors of severe IPV. This mixed-methods study further highlights the significant economic tradeoffs for safety and stability, where the prioritization of safety may exacerbate economic devastation for IPV survivors. Findings will inform programmatic policies for RRH practices among survivors.
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Affiliation(s)
- Charvonne N. Holliday
- Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA; (K.B.); (K.T.G.); (A.K.); (M.R.D.)
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Correspondence:
| | - Kristin Bevilacqua
- Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA; (K.B.); (K.T.G.); (A.K.); (M.R.D.)
| | - Karen Trister Grace
- Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA; (K.B.); (K.T.G.); (A.K.); (M.R.D.)
- Department of Advanced Nursing Practice, School of Nursing & Health Studies, Georgetown University, Washington, DC 20057, USA
| | - Langan Denhard
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Arshdeep Kaur
- Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA; (K.B.); (K.T.G.); (A.K.); (M.R.D.)
| | | | - Michele R. Decker
- Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA; (K.B.); (K.T.G.); (A.K.); (M.R.D.)
- Center for Public Health & Human Rights, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
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