Development and Evaluation of a Community Advisory Board for Family Violence.

Although intimate partner violence (IPV) is an important risk factor for child physical abuse, most IPV-exposed children are not evaluated for abusive injuries. A Community Advisory Board (CAB) was formed to (a) optimize a program to evaluate IPV-exposed children for abusive injuries and (b) inform research methods to engage IPV victims and their children. The objectives of this study were to implement and to evaluate the family violence CAB. Following best practices on CAB formation, we recruited local stakeholders with key roles as service providers, community leaders, and knowledge experts in IPV, child abuse, and emergency care. Fourteen members met bimonthly to develop a family-centered intervention and to inform research and advocacy activities. A shared memorandum of understanding outlined goals and objectives. One year after the CAB's implementation, a research assistant interviewed CAB members to understand their experiences, perceived benefits of participation, and desired improvements. Eleven CAB members, including an IPV survivor, participated. Emerging categories included (a) motivations to join the CAB (victim advocacy), (b) benefits of participation (development of relationships among members and increased acceptability of research methods), (c) facilitators of sustainability (program adaptability and development of trust), and (d) desired improvements (case-based follow-up). The CAB was successfully implemented and facilitated the development of collaborative relationships among stakeholders with key roles in IPV and child abuse. The CAB led to community member-proposed changes in research activities and clinical care for victims of IPV.

Protective factors for the risk of suffering intimate partner violence in help-seeking women survivors from a social organization in Chile.

Objective: Intimate partner violence (IPV) is a major public health problem in Latin America. The present study investigates the protective factors that contribute to minimizing the risk of exposure to IPV analyzing different variables in a sample of Chilean women victims of IPV. Methods: We used data from the Cicatrices Foundation, a nonprofit Chilean organization providing psychological support to IPV victims. Relevant variables for IPV prevention were identified analyzing a database containing all the information reported by victims during a structured interview. A final sample of 444 women suffering IPV was used in the present study. Results: Logistic regression analysis was calculated in order to make predictions related to IPV protective factors, showing that having a support network (OR = 2.85), treatment compliance (OR = 2.05) and being younger (OR = 0.95) increased the probability of not living with the aggressor. Another logistic regression analysis was calculated in order to predict IPV victims´ health taking medication intake as an indicator. A significant association was observed between this variable and working outside (p = 0.002) and between mediation intake and age (p < 0.001), with an OR of 1.987 and 0.93, respectively. Working outside and being younger were identified as protective factors against consuming medication. Conclusion: To the best of our knowledge, this is one of the first studies conducted in Chile on the prevention of IPV in a sample of victims seeking for help. Our results will contribute to guide policy makers, researchers and other women in the prevention of potential risks for IPV.

Femicide Circumstances and Harmfulness: Case Report and Focusing Review.

(1) Background: Femicide is an increasing phenomenon consisting of the murder of a woman for gender-related reasons. Despite the enactment of new laws aimed at controlling the phenomenon by toughening the penalties and introducing aggravating circumstances, there is an increasing trend that testifies to the persistence of a flaw in the actual measures. (2) Case Presentation. We report the case of the murder of a 32-year-old woman-perpetrated by an ex-husband who refused to accept the end of the marriage-the analysis of which allowed us to frame the case as femicide. (3) Discussion. Despite global awareness of this phenomenon, the identification of risk factors to predict and prevent femicide is of utmost importance. This can be achieved by a multidisciplinary approach involving police officers, legal professionals, hospitals, governmental and nongovernmental organizations, and medico-legal departments aimed at promoting standardized methodologies. (4) Conclusions. We evaluate the contribution of forensic investigations to the identification of key elements that can help frame the murder of a woman as a femicide. Considering the devastating consequences for children who witness this kind of violence within the domestic setting, the planning of more impactful preventive actions is, thus, mandatory to minimize effects on public health.

Supporting Youth Exposed to Violence in the Post-Pandemic: Prevention and Intervention Strategies.

The coronavirus disease 2019 pandemic was a public health emergency that impacted adolescents across the United States and disproportionately affected youth experiencing marginalization due to less access to resources and supports. This study reviews the increases in intimate partner and youth violence during the pandemic, mechanisms contributing to these increases, and the overarching health impacts on adolescents. Pediatric health professionals have a vital role to play in implementing healing-centered practices and prevention efforts that mitigate impacts of trauma and violence and that support youth and families in pathways to healing and recovery.

Kinship, lineage resources (wealth flow transfers), and intimate partner violence among women in Ghana.

Previous research has established relationships between lineage and intimate partner violence (IPV). The findings suggest matrilineal women experience less IPV than patrilineal women. However, the IPV outcomes of bilateral women are unknown because of the limited operationalization of lineage with ethnicity. In our study, we used self-reported and multidimensional measures of lineage to explore its relationship with IPV, focusing particularly on the mechanisms linking the two. We hypothesized that wielding resources would be negatively associated with IPV. Furthermore, matrilineal women's access to lineage resources would reduce their vulnerability to IPV relative to patrilineal women. To examine these hypotheses, we collected data from 1700 ever-married Ghanaian women residing in three ecological zones (coastal, middle, northern). Path analysis was used to explore resources as mechanisms linking lineage and IPV. Our findings indicated resources were patterned by lineage. Matrilineal women benefitted more from maternal family members than patrilineal women and vice versa. Consistent with the standard resource theory, women's access to resources protected against IPV, and the effects were stronger for matrilineal than patrilineal women. Irrespective of how lineage was measured, matrilineal women experienced lower levels of IPV than patrilineal women. The IPV outcomes for bilateral women were mixed. Part of matrilineal women's reduced IPV risk was explained through access to maternal resources. While patrilineal women experienced higher levels of IPV, this was reversed with resources from paternal kin members. Our findings suggest that as resources are fundamental to reducing IPV, lineage can serve as a conduit for resource exchange and wealth transfer.

Domestic violence against women with infertility attending gynaecological clinics in Northern Nigeria: A multi-centre study.

Background: Due to the high premium placed on childbearing, infertility puts a lot of stress on the family which may result in aggressive and irrational behaviour if not properly managed. Domestic violence (DV) against infertile women is a public health issue but under-reported especially in northern Nigeria. Objectives: This study sought to identify the prevalence, pattern, and response to DV. Materials and Methods: This was a descriptive cross-sectional study carried out at three tertiary health facilities; one in each of the geopolitical zones in northern Nigeria. Using a pretested interviewer-administered questionnaire; the prevalence, pattern, and response to DV were determined among 422 respondents who were attending the gynaecological clinics of the three health facilities. The data obtained was entered into SPSS version 22.0 and analysed. Results: The prevalence of DV among women with infertility in the previous year was 39.8% (167/422). Among the survivors, 92.8% (155/167), 35.3% (59/167), and 10.7% (18/167) had experienced psychological aggression, physical assault, and sexual violence, respectively. A significant number of respondents who reported DV were Christians (P = 0.01). Of them, 77 (46.1%) never discussed the issue with anyone, 72 (43.1%) informed their family, and 30 (18.0%) sought help from the husband's family. Conclusion: The prevalence of DV among women with infertility is high, psychological aggression is the most typical form of DV experienced while about half have never reported the incidence to anyone. Screening infertile women for DV during their visit to the gynecological clinics would be beneficial; those found to have experienced DV should be counselled and supported appropriately.

A Study on Economic Stressors During the COVID-19 Pandemic Among Intimate Partner and Sexual Violence Survivors in the United States.

Systemic racism and racialized poverty are socially produced structural determinants that shape health outcomes during infectious disease outbreaks. Public health emergencies compound vulnerabilities for survivors of intimate partner violence (IPV) and sexual violence (SV) and those who self-identify as people from racial and ethnic minority groups. We describe findings from an online survey designed to collect data on financial conditions faced by survivors of IPV and SV to understand these conditions during the COVID-19 pandemic. Our analyses were limited to a sample of women in the United States (91.4%, n = 523) who reported IPV or SV to whom we refer as survivors. We characterize the differences of economic stressors across White and aggregated categories of self-identified race, i.e., Black and Brown Latinx women and non-Black or non-Brown Latinx women of color, to highlight disparities between White and non-White populations in our sample. Logistic regressions were used to examine the relationships among racial categories, food insecurity, housing insecurity, and economic insecurity during the COVID-19 pandemic. Black and Brown Latinx women survivors were twice as likely as White women to report housing, financial, and economic insecurity during the COVID-19 pandemic. Approximately one-third of all survivors anticipated taking on more debt than they would want to cover their expenses due to COVID-19. The results of this study have implications for public health responses that involve coordinating economic relief measures among populations disparately affected by public health crises and disasters to ensure that the economic needs of the most impacted are addressed.

Educational training programs on intimate partner violence in pregnancy for midwives/student midwives: A scoping review.

INTRODUCTION: Educational strategies for preventive screening and effective interventions in midwives are needed to improve clinical practice and outcomes for abused women and their families. This scoping review aimed to describe available educational training programs on intimate partner violence (IPV) in pregnancy for midwives/student midwives. METHODS: A scoping review of the literature, which was published in English from January 2010 to March 2023, in PUBMED, EBSCO, and CINAHAL databases, was applied. The following keywords were used in the search: 'evaluation', 'educational training', 'course', 'midwives', 'student midwife', 'intimate partner violence', 'pregnancy', combined with AND and OR Boolean operators. The included studies focused on training programs/courses for midwives/student midwives regarding intimate partner violence. RESULTS: A total of 9 studies were eligible for inclusion, describing six programs for midwives and 3 for student midwives. Educational interventions varied in length (e.g. a few hours to weeks) and educational approaches such as multidisciplinary sessions, lectures, theory, role-playing, practice in screening, group activities, watching videos, and case reports discussion. The programs had similar content, including raising awareness of violence, defining it, discussing gender roles, the impact of IPV on women's health, referral agencies, and the laws regarding violence in each country. CONCLUSIONS: This scoping review highlighted a lack of educational programs on intimate partner violence during pregnancy, suggesting that new programs need to be developed based on contemporary clinical practices and recommendations for midwifery education.

Intimate partner violence survivors' reported experiences of discrimination in mental health treatment settings.

Research indicates that survivors of intimate partner violence (IPV) face substantial stigma and discrimination, with varying impacts based on demographic factors such as race and income. This study explored perceived discrimination among 88 IPV survivors across different racial backgrounds and income levels in mental health settings. Participants completed a mixed-method electronic survey assessing discrimination experiences related to survivor status, income, and race within mental health treatment. Results revealed high levels of perceived discrimination based on survivor status among both racially minoritized and majoritized survivors. However, racially minoritized survivors reported greater racial discrimination and associated stress within mental healthcare settings. Regardless of income level, all survivors reported significant discrimination experiences. Qualitative analysis highlighted factors perceived as helpful or unhelpful within mental health settings. This study underscores the need for further research on socioeconomic influences on stigma experiences among IPV survivors and suggests implications for provider training to better support survivors, especially those from diverse racial backgrounds.

Constructing comparable intimate partner violence indicators across the DHS, MICS, and PMA health surveys.

We construct comparable indicators that measure the prevalence of recent intimate partner violence (IPV) using publicly available, integrated microdata within the IPUMS data collections across many countries. The objective of this work is to increase opportunities for comparative research by leveraging vast quantities of harmonized data. We use consistent and comparable variables that measure domestic violence in international health surveys. The most consistent indicators of domestic violence measure physical, psychological, and sexual IPV in the last 12 months. We imposed a consistent reference period and restricted to a comparable subpopulation where these differed across surveys. Aggregating IPV variables across surveys, without careful attention to question wording and subpopulations, may produce inconsistent measures leading to bias, over- or under-estimation of IPV prevalence, or spurious trends and associations. Using comparable indicators in microdata and studying the level, distribution, and covariates of IPV in multiple settings over time, we can better understand these phenomena and identify effective policy interventions.

Factors Influencing Cervical Cancer Screening Uptake among Reproductive-Aged Filipino Women: Findings from the 2022 Philippines National Demographic and Health Survey.

Background: Cervical cancer (CC) is the fourth leading cause of death among cancer cases and women intimate partner violence (IPV) survivors are more likely to experience CC-related mortality. This study aims to evaluate the factors influencing CC screening uptake among reproductive-aged women, especially among IPV survivors in the Philippines. Method: We used the 2022 Philippines' National Demographic and Health Survey. The outcome variable was undergoing CC screening. The independent variables were different types of IPV, sociodemographic characteristics (age groups, place of residency, education level, wealth quintile, marital status, religion, employment), and other important variables (number of sexual partners, number of children, and access to health care). Descriptive statistics and multivariable logistic regression analyses were performed to examine influencing factors of CC screening. Method: The results revealed that approximately 10% (n = 1,648) of the women who participated in the survey had screened for CC. The results showed that women who experienced at least one type of IPV (adjusted odds ratio [aOR] = 1.32, 95% confidence interval [CI] = 1.08-1.62), aged 45-49 years (aOR = 6.42, 95% CI = 2.60-15.54), higher education (aOR = 14.26, 95% CI = 3.28-61.99), wealthier (aOR = 3.46, 95% CI = 2.54-4.72), having current employment (aOR = 1.30, 95% CI = 1.08-1.57), and having more than five lifetime sexual partners (aOR = 3.16, 95% CI =1.00-9.97), were more likely to undergo CC screening than their counterparts. Conclusion: Future CC screening initiatives should prioritize women with lower educational and socioeconomic backgrounds to effectively bridge the gaps in health disparities.

Mental Health Professionals' Perspectives on Group Intervention for Women Survivors of Intimate Partner Violence: A Qualitative Study.

Background: To examine the perspectives of mental health professionals on providing group intervention for female spouses of men with alcohol dependence who experienced intimate partner violence (IPV). Methods: A qualitative research design was used, and a purposive sample technique was used to select the participants. Nine experts with more than five years of experience in handling partner violence cases provided insights through in-depth interviews. The transcripts were carefully examined several times, coded and re-coded. The codes were subsequently organized into thematic categories. Results: Most of the experts were between the age of 35-45 years (66.7%), females (77.8%) and had more than five years of experience in mental health and IPV (55.6%). Most of the experts (66.7%) were working in teaching institutions related to mental health and IPV. The remaining one-third (33.3%) of the experts were legal and women empowerment practitioners. The thematic analysis generated six main themes and 19 subthemes, with 189 codes. The six mean themes were: psychosocial needs and concerns, psychosocial interventions, enhancing psychological well-being, enhancing the social support systems, challenges, and therapeutic strategies. Conclusion: Experts emphasized the importance of a holistic approach to IPV intervention. Group intervention addresses multiple issues that contribute to violence. Survivors need safe housing, counseling, legal help, and financial assistance.

[Domestic violence among Quebec women during the health crisis: Trends and risk factors]. / La violence conjugale chez les femmes québécoises durant la crise sanitaire : évolution et facteurs de risque.

This article examines the evolution of domestic violence (DV) among Quebec women during the Covid-19 pandemic and the factors associated with this phenomenon. Based on the literature, we observed that DV increased significantly in Quebec during the health crisis. Furthermore, it appears that job loss, which affected more women than men, increased social isolation, deterioration of the mental health of spouses, increased alcohol and cannabis consumption, and difficulties in reconciling work and family life are the factors that contribute most to the increase in DV in Quebec during this period.

Violence against older people and associations with mental health: A national probability sample survey of the general population in England.

BACKGROUND: Official estimates of violence prevalence in England exclude older people. There are few studies of elder abuse and these excluded violence from acquaintances and strangers and lack comparability with younger adults. OBJECTIVES: To estimate prevalence of past-year violence victimisation in older people, identify factors associated with violence in older age, quantify the extent to which experience of violence in older people was associated with common mental disorder (CMD). STUDY DESIGN/METHODS: Analysis of a 2014 general population probability sample survey of 2570 adults aged 60+ and 4484 16-59 year olds. Modified version of the Conflict Tactics Scale measured domestic violence and List of Threatening Experiences captured bullying and serious assault. CMD were assessed using the revised Clinical Interview Schedule. Associations were examined using regression models adjusted for childhood victimisation and other adversities. RESULTS: 2.0 % (n = 52,CI:1.4-2.6) of older people experienced violence in the past year, with intimate partner violence the most prevalent form. Older people of non-white ethnicity, those who were socially isolated or lonely, and the formerly married were more likely to experience violence. Violence was associated with CMD in older people (adjusted odds ratio 2.2, CI:1.0-4.8), controlling for impairments, adversities and other factors. CONCLUSION: Violence, especially from an intimate partner, is evident in later life and strongly associated with poor mental health. Better instruments for the identification of violence and abuse in older people in research and safe enquiry in practice settings are needed, with recognition of and attention to ethnic and other inequalities among older people in exposure.

Intimate partner violence and symptoms of psychological distress and depression in adolescents and young adults in Haiti.

BACKGROUND: Intimate partner violence (IPV) is prevalent in low and middle-income countries, such as Haiti. However, there is little research on its association with mental health problems such as psychological distress and depression. Although there is evidence that men may experience IPV, few studies have investigated mental health difficulties among Haitian men and women. The present study aims to 1) assess the prevalence of depressive symptoms and psychological distress in this population and 2) examine the association between IPV, psychological distress, and depression while considering potential risk and protective factors. METHOD: The sample comprised a representative sample of 3586 adolescents and young adults aged 14 to 24 living in Haiti. Structural equation modeling was used to examine the association between IPV, depressive symptoms, and psychological distress. RESULTS: Almost half of the sample reported depressive symptoms and psychological distress, with high rates among both genders. IPV was found to be an independent predictor of both depressive symptoms and psychological distress after accounting for risk and protective factors. LIMITATION: This study is the first step in understanding the interplay between IPV victimization, risk and protective factors, and psychological difficulties in this population. However, because of the cross-sectional design, causality should not be inferred. Furthermore, this study did not measure community violence, which could have affected participants' mental health. CONCLUSION: This study highlights the importance of considering the occurrence of IPV victimization when evaluating depression and psychological distress among adolescents and young adults.

Using painting to disclose the inner worlds of women subjected to intimate partner violence.

Intimate partner violence has become an increasingly serious social problem in Türkiye in recent years. It causes social, physical, and psychosocial health problems that impact mortality and morbidity in women. This study aimed to determine the inner worlds of female IPV victims who sought safety from their abusers in women's shelters. The sample consisted of ten women staying in a women's shelter affiliated with the Violence Prevention and Monitoring Center in Ankara. The study used a qualitative research design (phenomenology) and the drawing technique. An art therapist and a psychotherapist interpreted the symbols in pictures drawn by participants. Moreover, in-depth interviews were conducted with participants to disclose their repressed feelings and thoughts. Both in-depth interviews and drawings helped us elaborate on participants' inner worlds. The results showed that all types of violence left deep emotional scars. Some participants stated that legal sanctions should also apply to psychological violence. Participants were highly motivated to change their lives around but had financial concerns. Some participants were concerned that legal procedures, such as housing and economic support, were short-termed. The results indicate that all parties, such as governments, civil society organizations, media, and the private sector, should adopt a holistic approach to combating all types of violence.

"It is like a curse". The lived experiences of the intersection of intergenerational violence, pregnancy, and intimate partner violence among urban Wisconsin Indigenous women.

BACKGROUND: Intimate Partner Violence (IPV) is a significant public health concern that disproportionately impacts Indigenous American women more than any other ethnic/racial group in the United States. PURPOSE: This study aims to inform the work of nurses and allied health professionals by providing insight into the lived realities of Indigenous women in urban areas and how IPV manifests in the lives of Indigenous women. METHODS: Postcolonial and Indigenous feminist frameworks informed this qualitative study. Using thematic analysis, we analyzed data from semi-structured individual interviews with 34 Indigenous women in large urban areas in the upper Midwest. FINDINGS: This manuscript discusses one broad theme: experiences of IPV during pregnancy and the devastating impacts on women and their children in the form of intergenerational trauma. Under this broad theme, we identified two sub-themes: impacts of IPV on individual pregnancy experiences and linkages to adverse pregnancy-related outcomes related to physical IPV during the childbearing years. CONCLUSION: This Indigenous-led study informs the development of effective Indigenous-specific interventions to minimize barriers to accessing prenatal care and help-seeking when experiencing IPV to reduce the devastating consequences for Indigenous women and their families.

Responding to the needs of survivors of intimate partner violence in Lithuania: perceptions of mental health and social care professionals.

Around eight-out-of-ten survivors of domestic violence in Lithuania are women, and of those, eight-out-of-ten suffer violence specifically from their intimate partners (IPV). Women who experience IPV are at higher risk of having mental health conditions. This study aims to explore the perspectives of mental health and social care professionals regarding the provision of mental health support to IPV survivors in Lithuania. Four focus groups were conducted among 29 service providers from across the country. Audio-recordings were transcribed verbatim and analyzed thematically using MAXQDA software. The five main themes derived from the analysis reveal: 1) low levels of IPV awareness among IPV survivors who seek support with their mental health; 2) a lack of specialized training among professionals as a barrier to effective support; 3) a low prioritization on the national level; 4) little inter-sectoral collaboration which undermines the complexity of needed responses; 5) broader systemic problems. The provision of mental health support to IPV survivors lacks the recognition that IPV is gender-based violence and a major public (mental) health problem. The complexity of needed services is absent. Further research needs to explore the utilization of mental health services by IPV survivors and their perceptions concerning it.

Effectiveness of the Addressing Reproductive Coercion in Health Settings (ARCHES) intervention among abortion clients in Bangladesh: a cluster-randomized controlled trial.

Background: The Addressing Reproductive Coercion in Health Settings (ARCHES) intervention trains existing providers to address reproductive coercion (RC) and intimate partner violence (IPV) within routine family planning counseling. This study evaluated the effectiveness of a single ARCHES counseling session as adapted for use with abortion clients in Bangladesh. Methods: In this cluster-randomized controlled trial conducted between January 2019 and January 2021, health facilities with an abortion clinic with infrastructure for private counseling and onsite violence support services were eligible. Six facilities in Bangladesh met inclusion criteria, and matched pairs randomization with parallel assignment and a 1:1 allocation ratio was used to randomize three facilities to ARCHES and three facilities to control, which implemented standard counseling. Blinding was not possible as providers in intervention facilities participated in a three-day ARCHES training. Participants were abortion clients aged 18-49 years who could provide safe recontact information and be interviewed privately. The primary outcome was past three-month modern contraceptive use without interruption or interference. The trial was registered on clinicaltrials.gov (NCT03539315) on 29 May 2018. Findings: A total of 1492 intervention participants and 1237 control participants were enrolled. Available data were analyzed at each follow-up period: 1331 intervention and 1069 control participants at the three-month follow-up, and 1269 intervention and 1050 control participants at the twelve-month follow-up. ARCHES was associated with higher likelihood of modern contraceptive use at the three-month follow-up (adjusted RR = 1.08, 95% CI: 1.06-1.10) and the twelve-month follow-up (adjusted RR = 1.06, 95% CI: 1.02-1.10). ARCHES was also associated with decreased incident pregnancy, decreased IPV, and increased knowledge of IPV support services. Interpretation: The ARCHES intervention is effective in increasing post-abortion modern contraceptive use and decreasing incident pregnancy and IPV among abortion clients in Bangladesh. Implementation of ARCHES should be considered in facilities with sufficient privacy for counseling. Funding: Society of Family Planning (#SFPRF11-07) and Ipas.