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Mercier O, Fu SY, Filler R, Leclerc A, Sampsel K, Fournier K, Walker M, Wen SW, Muldoon K. Interventions for intimate partner violence during the perinatal period: A scoping review: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1423. [PMID: 39010852 PMCID: PMC11247475 DOI: 10.1002/cl2.1423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/17/2024]
Abstract
Background Intimate partner violence (IPV) is a prevalent global health problem. IPV that occurs before pregnancy often continues during the perinatal period, resulting in ongoing violence and many adverse maternal, obstetrical, and neonatal outcomes. Objectives This scoping review is designed to broadly capture all potential interventions for perinatal IPV and describe their core components and measured outcomes. Search Methods We conducted a search for empirical studies describing IPV interventions in the perinatal population in June 2022. The search was conducted in MEDLINE, EMBASE, PsycInfo, CINAHL, Cochrane Central Register of Controlled Trials, Web of Science, Applied Social Sciences Index & Abstracts, ClinicalTrials.gov and MedRxiv. Hand searching of references from select articles was also performed. Selection Criteria Included studies described an intervention for those experiencing IPV during the perinatal period, including 12 months before pregnancy, while pregnant or in the 12 months post-partum. The search encompassed January 2000 to June 2022 and only peer-reviewed studies written in either English or French were included. Included interventions focused on the survivor exposed to IPV, rather than healthcare professionals administering the intervention. Interventions designed to reduce IPV revictimization or any adverse maternal, obstetrical, or neonatal health outcomes as well as social outcomes related to IPV victimization were included. Data Collections and Analysis We used standard methodological procedures expected by The Campbell Collaboration. Main Results In total, 10,079 titles and abstracts were screened and 226 proceeded to full text screening. A total of 67 studies included perinatal IPV interventions and were included in the final sample. These studies included a total of 27,327 participants. Included studies originated from 19 countries, and the majority were randomized controlled trials (n = 43). Most studies were of moderate or low quality. Interventions included home visitation, educational modules, counseling, and cash transfer programs and occurred primarily in community obstetrician and gynecologist clinics, hospitals, or in participants' homes. Most interventions focused on reducing revictimization of IPV (n = 38), improving survivor knowledge or acceptance of violence, knowledge of community resources, and actions to reduce violence (n = 28), and improving maternal mental health outcomes (n = 26). Few studies evaluated the effect of perinatal IPV interventions on obstetrical, neonatal or child health outcomes. Authors' Conclusions The majority of intervention studies for perinatal IPV focus on reducing revictimization and improving mental health outcomes, very few included obstetrical, neonatal, and other physical health outcomes. Future interventions should place a larger emphasis on targeting maternal and neonatal outcomes to have the largest possible impact on the lives and families of IPV survivors and their infants.
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Affiliation(s)
- Olivia Mercier
- Faculty of MedicineUniversity of OttawaOttawaOntarioCanada
- Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
| | - Sarah Yu Fu
- Faculty of MedicineUniversity of OttawaOttawaOntarioCanada
| | - Rachel Filler
- Faculty of MedicineUniversity of OttawaOttawaOntarioCanada
- Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
| | - Alexie Leclerc
- Faculty of MedicineUniversity of OttawaOttawaOntarioCanada
- Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
| | - Kari Sampsel
- Faculty of MedicineUniversity of OttawaOttawaOntarioCanada
- Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
- Department of Emergency MedicineThe Ottawa HospitalOttawaOntarioCanada
| | - Karine Fournier
- Health Sciences LibraryUniversity of OttawaOttawaOntarioCanada
| | - Mark Walker
- Faculty of MedicineUniversity of OttawaOttawaOntarioCanada
- Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
- Department of Global Health and InternationalizationUniversity of OttawaOttawaOntarioCanada
- Department of Obstetrics and GynecologyUniversity of OttawaOttawaOntarioCanada
- Department of Obstetrics, Gynecology and Newborn CareThe Ottawa HospitalOttawaOntarioCanada
| | - Shi Wu Wen
- Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
- Department of Obstetrics and GynecologyUniversity of OttawaOttawaOntarioCanada
- School of Epidemiology and Public HealthUniversity of OttawaOttawaOntarioCanada
| | - Katherine Muldoon
- Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
- Department of Obstetrics and GynecologyUniversity of OttawaOttawaOntarioCanada
- Children's Hospital of Eastern OntarioOttawaOntarioCanada
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Shrestha R, Sapkota D, Sarraf RR, Mehra D, Ekström AM, Deuba K. Perceptions on violence against women and its impacts on mental health and response mechanisms among community-based stakeholders: a qualitative study from Nepal. BMC Womens Health 2024; 24:258. [PMID: 38658963 PMCID: PMC11040903 DOI: 10.1186/s12905-024-03064-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/29/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Violence against women (VAW) is a significant public health problem. With the emergence of the COVID-19 pandemic, the frequency and severity of VAW has escalated globally. Approximately one in four women in Nepal have been exposed to either physical, psychological, and/or sexual violence in their lifetime, with husbands or male partners being the perpetrators in most cases. VAW prevention has been under-researched in low- and middle-income countries, including Nepal. This study aims to explore the perspectives of local stakeholders, including healthcare providers and survivors of violence in Madhesh Province. The overarching goal is to provide insights for designing prevention and support programs that are acceptable to communities and cater to the needs of survivors. METHODS An explorative qualitative study was conducted in Madhesh Province, southern Nepal. A total of 21 interviews, including 15 in-depth interviews (IDIs) with health care providers, three IDIs with women seeking general or maternal and child health services at health care centres, three key informant interviews with the local stakeholders working in the field of VAW, and one focus group discussion with violence survivors, were conducted in Nepali by trained field interviewers. Interviews were recorded, transcribed, translated into English, and analysed using content analysis. RESULTS VAW, particularly physical violence, was a common experience in the study area. Sociocultural traditions such as dowry, child marriages and son preference were identifiable triggers for VAW, causing significant physical injuries and mental health problems, including suicide. Health care providers reported that violence survivors often hide their experiences of violence and do not seek any kind of help. Women feared that violence would increase in frequency and intensity if their perpetrators found out that they had disclosed their experiences of violence to health care providers. Local stakeholders emphasized the importance of engaging community leaders and garnering support from both women and men in interventions designed to reduce VAW and its impacts on mental health. CONCLUSIONS Participants reported that verbal and physical violence is often perceived as a normal part of women's lives. Women should be made aware of available support services and empowered and supported to increase access and uptake of these services. Additionally, more individual-based counselling sessions that encourage women to escape violence and its mental health consequences while maintaining privacy and confidentiality are recommended.
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Affiliation(s)
- Rachana Shrestha
- Public Health and Environment Research Centre (PERC), Lalitpur, Nepal
- Knowledge to Action (K2A), Lalitpur, Nepal
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Diksha Sapkota
- Public Health and Environment Research Centre (PERC), Lalitpur, Nepal
- Griffith Criminology Institute, Queensland, Australia
| | | | - Devika Mehra
- MAMTA Health Institute for Mother and Child, New Delhi, India
- Public Health Consultant, Medeon Science Park, Malmö, Sweden
| | - Anna Mia Ekström
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Infectious Diseases, South General Hospital, Stockholm, Sweden
| | - Keshab Deuba
- Public Health and Environment Research Centre (PERC), Lalitpur, Nepal.
- Knowledge to Action (K2A), Lalitpur, Nepal.
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
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Sapkota D, Baird K, Anderson D, Saito A, Seib C. Self-efficacy and social support as mediators of mental health among abused women. Nurs Health Sci 2022; 24:458-468. [PMID: 35420245 PMCID: PMC9322585 DOI: 10.1111/nhs.12943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 04/06/2022] [Accepted: 04/09/2022] [Indexed: 11/26/2022]
Abstract
Supportive counseling and facilitated referrals to support organizations have shown positive effects on mental health and coping with domestic and family violence. However, the reasons why and how such effects are significant remain unknown. The current paper used data from a randomized controlled trial of a psychosocial intervention implemented in Nepal among 140 abused pregnant women. The hypothesized mediating effects of self-efficacy and social support on mental health and quality of life of abused pregnant women were tested using serial mediation analyses. Significance of parameter estimates and bias-corrected 95% confidence intervals (CIs) for the indirect effects were generated using bootstrapping. The postintervention changes in self-efficacy and social support were found to have significant mediating effects on the relationship between the intervention and changes in both mental health and quality of life of participants post intervention. The positive effects on outcomes were seen at follow-up as well, though to a lesser extent. Further interventions should focus on enhancing abused women's self-efficacy and social support to ensure their positive mental health and better lives.
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Affiliation(s)
- Diksha Sapkota
- Griffith Criminology Institute, Level 4 Social Sciences Building (M10), Griffith University, Mt Gravatt, Queensland, Australia.,School of Nursing and Midwifery, Griffith University, Meadowbrook, Queensland, Australia
| | - Kathleen Baird
- School of Nursing and Midwifery, Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Debra Anderson
- Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Amornrat Saito
- School of Nursing and Midwifery, Griffith University, Meadowbrook, Queensland, Australia
| | - Charrlotte Seib
- School of Nursing and Midwifery, Griffith University, Meadowbrook, Queensland, Australia
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Irene-López L, Kalmakis KA. The experience of IPV among older women in Puerto Rico; a hermeneutic phenomenological study. J Adv Nurs 2022; 79:1342-1352. [PMID: 35301745 DOI: 10.1111/jan.15228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/18/2022] [Accepted: 03/02/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Lourdes Irene-López
- School of Nursing, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico, USA
| | - Karen A Kalmakis
- College of Nursing, University of Massachusetts Amherst, Amherst, Massachusetts, USA
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Sapkota D, Baird K, Saito A, Rijal P, Anderson D. Antenatal-Based Pilot Psychosocial Intervention to Enhance Mental Health of Pregnant Women Experiencing Domestic and Family Violence in Nepal. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP3605-NP3627. [PMID: 32812489 DOI: 10.1177/0886260520948151] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Survivors of domestic and family violence (DFV) report poorer quality of life and worsening mental health. This study evaluated the effect of a counseling and education intervention on the mental health and help-seeking behaviors among pregnant women living with DFV. A parallel pilot randomized controlled trial was performed among 140 pregnant women attending an antenatal clinic of a tertiary hospital of Nepal. Using computer-generated random numbers, participants were randomized to the intervention group (a counseling session, an information booklet about DFV, and contact details of the counselor) or a control group (usual care plus a booklet containing contact details of local DFV support services). Outcome measures included mental health, quality of life (QOL), self-efficacy, social support, and safety planning behaviors. Analyses followed intention-to-treat, using the generalized estimating equation model. Intervention participants showed significant improvements in anxiety (β = -3.24, p < .001) and depression (β = -3.16, p < .001) at postintervention. Such improvements were also sustained at follow-up assessment (p < .001). Significant group and time interaction for QOL, social support, use of safety behaviors, and self-efficacy (p < .05) revealed a greater increase in these outcome measures among intervention participants at both follow-up assessments compared with the control group. This pilot integrated intervention showed promising outcomes in improving the mental health, social support, and the use of safety behaviors among women with DFV. This intervention could be incorporated into regular antenatal care as a strategy to identify and support victims of DFV. Larger controlled trials with longer follow-up are needed to support and expand on the current findings regarding the effectiveness of a psychosocial intervention targeting victims of DFV in resource-constrained settings.
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Affiliation(s)
- Diksha Sapkota
- Griffith University, Meadowbrook, Queensland, Australia
- Menzies Health Institute Queensland, Gold Coast, Australia
| | - Kathleen Baird
- Griffith University, Meadowbrook, Queensland, Australia
- University of Technology Sydney, New South Wales, Australia
| | - Amornrat Saito
- Griffith University, Meadowbrook, Queensland, Australia
- Menzies Health Institute Queensland, Gold Coast, Australia
| | - Pappu Rijal
- B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Debra Anderson
- Menzies Health Institute Queensland, Gold Coast, Australia
- University of Technology Sydney, New South Wales, Australia
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Lewis NV, Munas M, Colombini M, d'Oliveira AF, Pereira S, Shrestha S, Rajapakse T, Shaheen A, Rishal P, Alkaiyat A, Richards A, Garcia-Moreno CM, Feder GS, Bacchus LJ. Interventions in sexual and reproductive health services addressing violence against women in low-income and middle-income countries: a mixed-methods systematic review. BMJ Open 2022; 12:e051924. [PMID: 35193906 PMCID: PMC8867339 DOI: 10.1136/bmjopen-2021-051924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 01/17/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To synthesise evidence on the effectiveness, cost-effectiveness and barriers to responding to violence against women (VAW) in sexual and reproductive health (SRH) services in low/middle-income countries (LMICs). DESIGN Mixed-methods systematic review. DATA SOURCES Medline, Embase, Psycinfo, Cochrane, Cinahl, IMEMR, Web of Science, Popline, Lilacs, WHO RHL, ClinicalTrials.gov, Google, Google Scholar, websites of key organisations through December 2019. ELIGIBILITY CRITERIA Studies of any design that evaluated VAW interventions in SRH services in LMICs. DATA EXTRACTION AND SYNTHESIS Concurrent narrative quantitative and thematic qualitative syntheses, integration through line of argument and mapping onto a logic model. Two reviewers extracted data and appraised quality. RESULTS 26 studies of varied interventions using heterogeneous outcomes. Of ten interventions that strengthened health systems capacity to respond to VAW during routine SRH consultation, three reported no harm and reduction in some types of violence. Of nine interventions that strengthened health systems and communities' capacity to respond to VAW, three reported conflicting effects on re-exposure to some types of VAW and mixed effect on SRH. The interventions increased identification of VAW but had no effect on the provision (75%-100%) and uptake (0.6%-53%) of referrals to VAW services. Of seven psychosocial interventions in addition to SRH consultation that strengthened women's readiness to address VAW, four reduced re-exposure to some types of VAW and improved health. Factors that disrupted the pathway to better outcomes included accepting attitudes towards VAW, fear of consequences and limited readiness of the society, health systems and individuals. No study evaluated cost-effectiveness. CONCLUSIONS Some VAW interventions in SRH services reduced re-exposure to some types of VAW and improved some health outcomes in single studies. Future interventions should strengthen capacity to address VAW across health systems, communities and individual women. First-line support should be better tailored to women's needs and expectations. PROSPERO REGISTRATION NUMBER CRD42019137167.
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Affiliation(s)
- Natalia V Lewis
- Bristol Medical School (PHS), University of Bristol Faculty of Health Sciences, Bristol, UK
| | - Muzrif Munas
- Bristol Medical School (PHS), University of Bristol Faculty of Health Sciences, Bristol, UK
- Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Manuela Colombini
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - A F d'Oliveira
- Faculty of Medicine, University of São Paulo Institute of Biomedical Sciences, Sao Paulo, Brazil
| | - Stephanie Pereira
- Faculty of Medicine, University of São Paulo Institute of Biomedical Sciences, Sao Paulo, Brazil
| | - Satya Shrestha
- Bristol Medical School (PHS), University of Bristol Faculty of Health Sciences, Bristol, UK
- School of Medical Sciences, Kathmandu University, Kathmandu, Nepal
| | - Thilini Rajapakse
- Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Amira Shaheen
- Faculty of Medicine and Health Sciences, An-najah National University, Nablus, State of Palestine
| | - Poonam Rishal
- School of Medical Sciences, Kathmandu University, Kathmandu, Nepal
| | - Abdulsalam Alkaiyat
- Faculty of Medicine and Health Sciences, An-najah National University, Nablus, State of Palestine
| | - Alison Richards
- Bristol Medical School (PHS), University of Bristol Faculty of Health Sciences, Bristol, UK
- NIHR ARC West, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Claudia M Garcia-Moreno
- Department of Reproductive Health and Research, Organisation mondiale de la Sante, Geneve, Switzerland
| | - Gene S Feder
- Bristol Medical School (PHS), University of Bristol Faculty of Health Sciences, Bristol, UK
| | - Loraine J Bacchus
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
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