The Importance of Culture in Addressing Domestic Violence for First Nation's Women

Global Indigenous gender concepts, gender-based violence and resilience: A scoping review

BACKGROUND & OBJECTIVE

The legacy of colonialism includes ongoing trauma and disruption of traditional teachings on relationality, which has contributed to Indigenous populations being disproportionately exposed to gender-based violence (GBV). GBV in Indigenous populations is explored to consider gender-specific findings and points of resilience in relational networks.

PARTICIPANTS & SETTING

Included articles sampled Indigenous groups in Canada, US, Mexico, Guatemala, and Israel. All participants self-identified as Indigenous, and were either GBV survivors or service providers working in GBV contexts.

METHODS

A scoping review was conducted in OVID Medline, Embase, APA Psycinfo, and Informit Indigenous Collection, using keywords for Indigenous peoples, gender concepts, and GBV. Articles were screened and extracted by two reviewers; a third reviewer resolved conflicts.

RESULTS

Our search yielded one mixed-method study and seven qualitative studies, all published since 2016. North American studies identified colonial, patriarchal disruptions (e.g. residential schools) to positive pre-contact gender norms (e.g. non-hierarchical roles) that contribute to emerging GBV. Studies conducted in Guatemala and Israel also described local patriarchal cultures contributing to GBV. Lack of understanding of the Two-Spirit identity (i.e. supra-binary gender identity used by Indigenous persons) led to harmful attitudes and stigma. Interpersonal support and return to traditional matriarchal practices were identified as key resilience processes.

CONCLUSIONS

There is limited literature on Indigenous gender concepts and GBV, particularly regarding GBV against males and Two-Spirit persons. Colonization-related violence and/or patriarchal gender norms were identified as precursors for GBV. Decolonization processes should be further explored to address GBV in Indigenous populations.

Reduction in contraceptive use during the COVID-19 pandemic among women in an indigenous Mexican community: a retrospective crossover study

Background

Being indigenous, being a woman, and living in poverty are social determinants that contribute to reduced access to healthcare, including reproductive health services. The COVID-19 pandemic might have exacerbated this lag.

Objective

This study explored how the COVID-19 pandemic affected the contraceptive use of a group of indigenous Mexican women and adolescents in their community.

Methods

Between June and December of 2021, 158 indigenous Mexican women who had experienced recurrent pregnancies were interviewed at two health centers in San Cristóbal de las Casas, Chiapas. Participants were either pregnant when they completed the questionnaire or had been pregnant during the COVID-19 pandemic. Women were asked about their contraceptive practices before and during the pandemic. The change in contraceptive practice was estimated using a logistic model.

Results

The COVID-19 pandemic reduced contraceptive use by 50%. Among women who wanted contraception, 58% did not receive it. During the pandemic, 77% of previous contraceptive users reported difficulty obtaining contraception, and only 23% sought family planning assistance.

Conclusion

During the COVID-19 pandemic, indigenous women in the studied community used fewer contraceptive methods and did not use intrauterine devices. Additionally, there was a decline in the percentage of women using contraceptives. These results highlight the impact on indigenous populations and the difficulties they could face in accessing reproductive health services during health emergencies.

Barriers Faced by American Indian Women in Urban Wisconsin in Seeking Help Following an Experience of Intimate Partner Violence

American Indian1 (AI) women experience high rates of intimate partner violence (IPV) and face many barriers when help-seeking. This study aims to understand better the context of IPV and help-seeking behaviors for urban AI women after experiences with IPV. Postcolonial and Indigenous feminist frameworks framed this critical ethnography study. Semistructured interviews with 34 AI IPV survivors2 living in Wisconsin urban areas were conducted. Our findings highlight context-specific structural barriers to help-seeking after experiences of IPV heightened by the COVID-19 pandemic. Context-specific and survivor-led interventions are necessary to address and reduce barriers that urban AI women face.

A Systematic Review of Culturally Competent Family Violence Responses to Women in Primary Care

Existing culturally competent models of care and guidelines are directing the responses of healthcare providers to culturally diverse populations. However, there is a lack of research into how or if these models and guidelines can be translated into the primary care context of family violence. This systematic review aimed to synthesise published evidence to explore the components of culturally competent primary care response for women experiencing family violence. We define family violence as any form of abuse perpetrated against a woman either by her intimate partner or the partner's family member. We included English language peer-reviewed articles and grey literature items that explored interactions between culturally diverse women experiencing family violence and their primary care clinicians. We refer women of migrant and refugee backgrounds, Indigenous women and women of ethnic minorities collectively as culturally diverse women. We searched eight electronic databases and websites of Australia-based relevant organisations. Following a critical interpretive synthesis of 28 eligible peer-reviewed articles and 16 grey literature items, we generated 11 components of culturally competent family violence related primary care. In the discussion section, we interpreted our findings using an ecological framework to develop a model of care that provides insights into how components at the primary care practice level should coordinate with components at the primary care provider level to enable efficient support to these women experiencing family violence. The review findings are applicable beyond the family violence primary care context.

Influences and patterns of intimate partner violence among married Akha and Lahu women in northern Thailand

BACKGROUND

Intimate partner violence (IPV) is a major global public health problem. Women are the principal victims of IPV, and some special populations have been particularly impacted. The Akha and Lahu women are vulnerable populations for IPV due to the modernization and changes of their culture and norms. This study aimed to understand premarriage factors related to IPV, including associated factors, influencers, patterns and impacts, in Akha and Lahu women in Thailand.

METHODS

A qualitative method was used to gather information among Akha and Lahu women who had experienced IPV in the previous year and were fluent in Thai. Women who had experienced IPV in the previous year and lived in the border area of Thailand and Myanmar were invited to provide information. A thematic analysis was used to extract information from the participants and develop findings.

RESULTS

A total of fifty-two married women were recruited into the study: 46.2% were Akha and 53.8% were Lahu. Those married Akha and Lahu women younger than 39 years found their partner through social media, had conditions before getting married, had high self-confidence, and tended to marry people from different tribes. While those aged 40 years and over met their husbands in village activities, were highly compliant with the norms of their culture, and married men from the same tribe. Three factors were detected as associated factors of IPV: cultural differences between partners from different tribes, substance use, and personality. Differences in age between partners, living in poor family economic status, and poor education were also detected as influencers of IPV. Four patterns of IPV were observed among Akha and Lahu married women: neglect, emotional abuse, verbal abuse, and physical abuse. Several patterns of the impacts were presented: children were neglected, especially in the preparation of daily food, having stress, having poor family relationships, and having children with unsuccessful lives in terms of education and getting a good job. Almost all married Akha and Lahu women had no particular expectations in their lives.

CONCLUSION

Akha and Lahu women face IPV problems with several key influences and impacts. Effective implementations are required to monitor and reduce the problem in the Akha and Lahu families, especially where the women are younger than 40 years old and married to men from different tribes.

Indigenous Cultural Safety in Recognizing and Responding to Family Violence: A Systematic Scoping Review

This systematic scoping review synthesizes the recommended approaches for providing culturally safe family violence interventions to Indigenous peoples in health care and social service settings. A total of 3783 sources were identified through our electronic database searches, hand-searching of Indigenous-focused journals, and backward and forward citation chaining. After screening those sources in duplicate, 28 papers were included for synthesis in June 2020. Forward citation chaining of these 28 included articles in June 2022 identified an additional 304 possible articles for inclusion; following the screening of those 304 articles, an additional 6 were retained in the review. Thus, a total of 34 articles were included for data extraction and narrative synthesis. Initial results were presented to members of the Six Nations of the Grand River Youth Mental Wellness Committee, and their feedback was incorporated into our inductive organization of findings. Our findings represent three thematic areas that reflect key recommendations for health care and social service provision to Indigenous families for whom family violence is a concern: (1) creating the conditions for cultural safety; (2) healing at the individual and community level; and (3) system-level change. These findings demonstrate the need to center Indigenous peoples and perspectives in the development and implementation of cultural safety approaches, to acknowledge and address historically contingent causes of past and present family violence including colonization and related state policies, and to transform knowledge and power relationships at the provider, organization, and government level.

Peace and health: exploring the nexus in the Americas

The relationship between peace and health is complex, multifactorial and fraught with challenges of definitions, measurements and outcomes. This exploratory commentary on this nexus within a focus on the Americas posits this challenge clearly and calls for more scholarship and empirical work on this issue from an interdisciplinary perspective. The overall goal of this paper is to try and explore the elements that impact the relationship between peace and health with a focus on the Americas (defined as countries spanning from Canada to Argentina) in the post-Cold war period. Focusing on the 1990s and onwards, we seek to underscore why violence continues to permeate these societies despite a third and lasting wave of democratisation in the hemisphere. We hope this will allow a more robust dialogue on peace and health in the regional and global health literature.

Evaluation of the ways of coping with stress and the personality traits in women exposed to violence: A comparative study

PURPOSE

To determine the stress-coping methods and personality traits of the women who were exposed to violence.

DESIGN AND METHODS

This cross-sectional study was conducted by using a web-based online survey with 1242 women in Turkey.

FINDINGS

Women who were exposed to violence used mostly emotional strategies in coping with stress. The women's personality traits did not affect whether they were victims of the violence.

PRACTICE IMPLICATIONS

It is necessary to take initiatives to encourage the use of effective methods in coping with stress. Other studies should be conducted to determine the personality traits of women exposed to violence.

Social determinants of violence against women in Panama: results from population-based cross-sectional studies and a femicide registry

BACKGROUND

We aimed to investigate the prevalence of violence against women (VAW) in Panama and its association with social determinants of health (SDH) and to estimate the femicide rates from 2014 to 2017.

METHODS

Data were derived from three cross-sectional population-based studies. Logistic regression models were used to estimate the association between SDH and VAW, expressed as odds ratios (ORs) and 95% confidence intervals (CIs). Age-standardized femicide rates were estimated using data from the Public Ministry.

RESULTS

Compared to the reference categories, women in the lowest quintile (Q) of income distribution (Q1: OR 4.0 [95% CI 1.4-11.7], Q2: OR 3.0 [95% CI 1.1-7.9]), divorced/separated women (OR 1.5 [95% CI 1.0-2.1]) and those in the age categories 25-33 y and 34-49 y (OR 1.9 [95% CI 1.2-3.1]) were more likely to have experienced violence in the past year. Indigenous ethnicity (OR 2.3 [95% CI 1.3-4.1]), age 15-19 y (OR 1.8 [95% CI 1.1-2.9]) and lowest education levels (very low: OR 4.7 [95% CI 1.4-15.5]; low: OR 4.5 [95% CI 1.4-14.6]) were associated with permissive attitudes towards violence. Indigenous (OR 2.7 [95% CI 1.3-6.1]), Afro-Panamanians (OR 3.1 [95% CI 1.3-7.6]) and education level (low: OR 2.5 [95% CI 1.2-4.9]; medium: OR 3.0 [95% CI 1.4-6.6]) were associated with physical/sexual intimate partner violence. Standardized adjusted femicide rates (×100 000) from 2015 to 2017 were 1.5, 0.9 and 0.8, respectively.

CONCLUSIONS

Our findings highlight the importance of prevention programmes.

Interpersonal violence and other social-structural barriers associated with needing HIV treatment support for women living with HIV

Women living with HIV (WLWH), experience disproportionate rates of violence, along with suboptimal HIV health outcomes, despite recent advancements in HIV treatment, known as antiretroviral therapy (ART). The objectives of this study were to: (a) describe different types of support needed to take ART and (b) investigate the social and structural correlates associated with needing support for ART adherence among WLWH. Data are drawn from Sexual health and HIV/AIDS: Women's Longitudinal Needs Assessment, a community-based open research cohort with cisgender and transgender WLWH, aged 14+ who live or access HIV services in Metro Vancouver, Canada (2014-present). Baseline and semi-annual questionnaires are administered by community interviewers alongside a clinical visit with a sexual health research nurse. Bivariate and multivariable logistic regression using generalized estimating equations and an exchangeable working correlation matrix was used to model factors associated with needing supports for ART adherence. Among 276 WLWH, 51% (n = 142) reported needing support for ART adherence; 95% of participants reported lifetime gender-based violence and identified many interpersonal, structural, community, and clinical supports that would facilitate and support ART adherence. In multivariable logistic regression, participants who were Indigenous (adjusted odds ratio [AOR]: 1.70, 95% confidence intervals [CI]: 1.07-2.72), or otherwise racialized (AOR: 2.36, 95% CI : 1.09-5.12) versus white, experienced recent gender-based physical violence (AOR : 1.54, 95% CI : 1.03-2.31), lifetime post-traumatic stress disorder (AOR : 1.97, 95% CI : 1.22-3.18), and recent illicit drug use (AOR : 2.15, 95% CI : 1.43-3.22), had increased odds of needing support for ART adherence. This research suggests a need for trauma-informed, culturally safe and culturally responsive practice and services for WLWH along the HIV care continuum to support ART adherence. All services should be developed by, with, and for WLWH and tailored according to gender identity, taking into account history, culture, and trauma, including the negative impacts of settler colonialism for Indigenous people.

Psicología y Pueblos Indígenas

La pregunta sobre la existencia de características comunes inherentes a la psicología de los pueblos Indígenas de todo el mundo ha sido objeto de mucho debate. Nosotros argumentamos que los pueblos Indígenas comparten la experiencia de la colonización, así como sus consecuencias sociales y psicológicas. Desarrollamos este argumento en cuatro secciones: ( a) La historia global de la colonización y las desigualdades sociales; ( b) aspectos relativos a la identidad y los procesos grupales, incluidas la transmisión intergeneracional de valores compartidos, la conexión con la naturaleza y la promoción del cambio social; ( c) el prejuicio y la discriminación hacia los pueblos Indígenas y el rol que juegan los procesos psicológicos para promover relaciones positivas entre los pueblos Indígenas y no-Indígenas; y ( d) el impacto del trauma histórico y del colonialismo en la cognición, la salud mental y el bienestar de los pueblos Indígenas, así como la base para el desarrollo de intervenciones exitosas que integran los conocimientos Indígenas. Por último, abordamos los desafíos futuros de la investigación sobre estos temas.

"No Man Is an Island": Perspectives of CHamorus in Guam on COVID-19

OBJECTIVES

Guam is a United States territory situated in the western Pacific Ocean with a multiethnic population numbering approximately 168,000. The CHamorus, who are the Indigenous people of Guam, make up 37%. In this study, we sought to explore CHamorus' perspectives on and experiences of COVID-19.

DESIGN

Interviews were conducted with 10 CHamoru adults in June-July 2020 via telephone for a larger study on understanding how the collective history of the CHamoru people is perceived relative to contemporary health beliefs and practices. This study is a secondary data analysis of questions that focused on COVID-19. We used thematic analysis techniques to analyze the data.

RESULTS

Three themes were identified: self and other, or "no man is an island"; trust in government; and focusing on the positives. A cross-cutting theme was commitment to the common welfare of the community through interconnectedness and inafa'maolek (doing good for others).

CONCLUSION

Results indicated that CHamorus recognized a balance between community and individual, the need to protect the vulnerable while also considering personal choice, and the implications of enforced social distancing on community and economic stability.

Psychology and Indigenous People

Whether there are common features inherent to the psychology of Indigenous peoples around the globe has been the subject of much debate. We argue that Indigenous peoples share the experience of colonization and its social and psychological consequences. We develop this argument across four sections: (a) the global history of colonization and social inequalities; (b) aspects concerning identity and group processes, including the intergenerational transmission of shared values, the connection with nature, and the promotion of social change; (c) prejudice and discrimination toward Indigenous peoples and the role of psychological processes to improve relations between Indigenous and non-Indigenous peoples; and (d) the impact of historical trauma and colonialism on dimensions including cognition, mental health, and the well-being of Indigenous peoples as well as the basis for successful interventions that integrate Indigenous knowledge. Finally, we address future challenges for research on these topics. Expected final online publication date for the Annual Review of Psychology, Volume 73 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Help-Seeking to Cope With Experiences of Violence Among Women Living With HIV in Canada

Using baseline data from a community-collaborative cohort of women living with HIV in Canada, we assessed the prevalence and correlates of help-seeking among 1,057 women who reported experiencing violence in adulthood (≥16 years). After violence, 447 (42%) sought help, while 610 (58%) did not. Frequently accessed supports included health care providers (n = 313, 70%), family/friends (n = 244, 55%), and non-HIV community organizations (n = 235, 53%). All accessed supports were perceived as helpful. Independent correlates of help-seeking included reporting a previous mental health diagnosis, a history of injection drug use, experiencing childhood violence, and experiencing sexism. We discuss considerations for better supporting women who experience violence.

Finding opportunity in the COVID-19 crisis: prioritizing gender in the design of social protection policies

The COVID-19 pandemic is highlighting the harm perpetuated by gender-blind programs for marginalized citizens, including sexual and gender minorities (SGMs) and cisgender women. Gender-blind programs are known to augment harms associated with violence and structural stigmatization by reinforcing rather than challenging unequal systems of power. The intersecting marginalization of these populations with systems of class, race, and settler-colonialism is exacerbating the impact that policies such as physical distancing, school closures, and a realignment of healthcare priorities are having on the wellbeing of these populations. The overarching reasons why women and SGM are marginalized are well known and stem from a hegemonic, patriarchal system that fails to fully integrate these groups into planning and decision making regarding public health programming-including the response to COVID-19. In this perspective, we aim to highlight how the exclusion of cisgender women and SGM, and failure to use a gender redistributive/transformative approach, has (i) hampered the recovery from the pandemic and (ii) further entrenched the existing power structures that lead to the marginalization of these groups. We also argue that COVID-19 represents a once-in-a-century opportunity to realign priorities regarding health promotion for cisgender women and SGM by using gender redistributive/transformative approaches to the recovery from the pandemic. We apply this framework, which aims to challenge the existing power structures and distribution of resources, to exemplars from programs in health, housing, employment, and incarceration to envision how a gender redistributive/transformative approach could harness the COVID-19 recovery to advance health equity for cisgender women and SGM.

Domestic violence and its relationship with depression, anxiety and quality of life: A hidden dilemma of Pakistani women

Objectives:

To find out the relationship of domestic violence with depression, anxiety and quality of life in married women in hospitals of Rawalpindi and Islamabad.

Methods:

This co-relational study was conducted in Rawalpindi Institute of Health Sciences from January 2019 to December 2019. All the females’ patients who were the victim of domestic violence were the population of the study. Consecutive non-probability sampling technique was used for selection of sampling from the target population. The inclusion criterion for this study was diagnosed case of domestic violence. DASS 21 (The Depression, Anxiety and Stress Scale) and Quality of life (WHO) scales were administered to 116 patients.

Results:

The study’s key results were that domestic abuse has positive relationship with depression, anxiety, and stress. It was also found that domestic abuse has a negative relationship with quality of life of those who have been subjected to domestic violence of this sort.

Conclusion:

It was concluded that domestic violence whether verbal, physical, emotional or sexual has strongly effects the mental health and quality of life of abused women.

Improving the response of primary care providers to rural First Nation women who experience intimate partner violence: a qualitative study

BACKGROUND

Some legacies of colonialism are that Indigenous women living in Canada experience higher rates of intimate partner violence (IPV) and that violence is often more severe relative to non-Indigenous women. This results in avoidable physical, psychological, emotional, financial, sexual and spiritual harm in the lives of Indigenous women, families, and communities. Trusted primary care providers are well positioned to provide brief interventions and referrals to treatment and services, but little is known about the providers' preparedness to support Indigenous women. Information on what enables or prevents providers to respond to Indigenous patients who experience IPV is needed in order to ensure this potential lifeline for support is realized.

METHODS

The purpose of this community-based participatory study was to elucidate the barriers and facilitators to care for rural Indigenous women who experience IPV from the perspectives of primary care providers and to recommend strategies to improve their preparedness. Using a Grounded Theory approach, we conducted qualitative research with 31 providers to discuss their experiences with patients affected by IPV.

RESULTS

The results showed providers often feel a degree of unpreparedness to deal with IPV in a clinical setting. Underlying the feelings of unpreparedness were: Recognition of patients' under disclosure of IPV due to stigma, shame and fear Lack of formal provider training on appropriate approaches to IPV Lack of referral network due to fragmented, scarce services for IPV Lack of understanding of jurisdictional complexity of First Nations and non-First Nations specific services for IPV Uncertainty how to negotiate cultural safety around IPV Multiple-role relationship & confidentiality dilemmas characteristic of small communities Risk of jeopardizing patient-provider relationship CONCLUSIONS: Our recommendations to improve provider preparedness to address IPV include reducing the stigma of IPV; creating effective referral pathways; improving cultural safety within the referral network; developing services for perpetrators; engaging natural helpers in the community, and; developing policies, procedures and continuing education related to patients who experience IPV in the clinical and community setting. We suggest that increasing providers' comfort to respond to IPV for rural and Indigenous women will ultimately lead to improved safety and health outcomes.

Effectiveness of ICT-based intimate partner violence interventions: a systematic review

BACKGROUND

Intimate Partner Violence is a "global pandemic". Meanwhile, information and communication technologies (ICT), such as the internet, mobile phones, and smartphones, are spreading worldwide, including in low- and middle-income countries. We reviewed the available evidence on the use of ICT-based interventions to address intimate partner violence (IPV), evaluating the effectiveness, acceptability, and suitability of ICT for addressing different aspects of the problem (e.g., awareness, screening, prevention, treatment, mental health).

METHODS

We conducted a systematic review, following PRISMA guidelines, using the following databases: PubMed, PsycINFO, and Web of Science. Key search terms included women, violence, domestic violence, intimate partner violence, information, communication technology, ICT, technology, email, mobile, phone, digital, ehealth, web, computer, online, and computerized. Only articles written in English were included.

RESULTS

Twenty-five studies addressing screening and disclosure, IPV prevention, ICT suitability, support and women's mental health were identified. The evidence reviewed suggests that ICT-based interventions were effective mainly in screening, disclosure, and prevention. However, there is a lack of homogeneity among the studies' outcome measurements and the sample sizes, the control groups used (if any), the type of interventions, and the study recruitment space. Questions addressing safety, equity, and the unintended consequences of the use of ICT in IPV programming are virtually non-existent.

CONCLUSIONS

There is a clear need to develop women-centered ICT design when programming for IPV. Our study showed only one study that formally addressed software usability. The need for more research to address safety, equity, and the unintended consequences of the use of ICT in IPV programming is paramount. Studies addressing long term effects are also needed.

Contemporary Indigenous Women's Roles: Traditional Teachings or Internalized Colonialism?

Prior to the colonization of Turtle Island, Indigenous women held leadership roles within their communities. Colonization brought patriarchy and racism which attacked women's identities. Violence toward Indigenous women and girls continues to be a tool of the colonial state while many Indigenous peoples have internalized patriarchal beliefs which manifests in the way they view women's identities. This article argues that patriarchy may have infiltrated so-called "traditional teachings" that dictate rules about women's participation in spiritual and cultural practices. It highlights the voices of Indigenous women who discuss this exclusion and how they are taking back their power.