Duluth versus cognitive behavioral therapy: A natural field experiment on intimate partner violence diversion programs.

We used data from a 3-year natural field experiment to study rates of recidivism in 2 types of diversion programs designed to reduce intimate partner violence (IPV) among heterosexual partners. In one program (Duluth), efforts are focused on protecting women from male aggression through a psychoeducational program, regardless of the offender's sex. In the other program (cognitive behavioral therapy [CBT]), efforts are focused on improving intrahousehold behaviors and communication skills through counseling. Our experimental results found that the IPV recidivism rate, measured as reconvictions for IPV, was 11 percentage points higher for offenders randomly assigned to a Duluth treatment program (14 percentage points higher among males). This outcome is statistically and practically significant, suggesting that the Duluth approach corresponds to meaningfully higher recidivism rates compared with CBT. In an attempt to explain the observed difference of IPV recidivism between these programs, we discuss theories for plausible psychological, sociological, psychophysiological, and neurological mechanisms responsible for this outcome. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

"Keeping family matters behind closed doors": healthcare providers' perceptions and experiences of identifying and managing domestic violence during and after pregnancy.

BACKGROUND: Violence against women is an international public health concern and a violation of women's rights. Domestic violence can first occur, and increase in frequency and severity, during and after pregnancy. Healthcare providers have the potential to identify and support women who experience domestic violence. We sought to investigate the knowledge and perceptions of domestic violence among doctors who provide routine antenatal and postnatal care at healthcare facilities in Pakistan. In addition, we explored possible management options from policy makers, and enabling factors of and barriers to the routine screening of domestic violence. METHODS: Semi-structured key informant interviews were conducted with doctors (n = 25) working in public and private hospitals and with officials involved in domestic violence policy development (n = 5) in Islamabad, Pakistan. Transcribed interviews were coded and codes grouped into categories. Thematic framework analysis was undertaken to identify emerging themes. RESULTS: Most doctors have a good awareness of domestic violence and a desire to help women who report domestic violence during and after pregnancy. Enabling factors included doctors' ability to build rapport and trust with women and their suggestion that further education of both healthcare providers and women would be beneficial. However, domestic violence is often perceived as a "family issue" that is not routinely discussed by healthcare providers. Lack of resources, lack of consultation time and lack of effective referral pathways or support were identified as the main barriers to the provision of quality care. CONCLUSIONS: Doctors and policy advisors are aware of the problem and open to screening for domestic violence during and after pregnancy. It is suggested that the provision of a speciality trained family liaison officer or healthcare provider would be beneficial. Clear referral pathways need to be established to provide quality care for these vulnerable women in Pakistan.

Feasibility of an online safety planning intervention for rural and urban pregnant abused women.

BACKGROUND: Intimate partner violence (IPV) in pregnancy is common and harmful to maternal-child health. Safety planning is the gold standard for intervention, but most abused women never access safety planning. Pregnant women may face increased barriers to safety planning and risk of severe IPV, particularly if they are also rural residents. Internet-based safety planning interventions may be useful, but no such interventions specific to the needs of pregnant women have been developed. OBJECTIVES: The aim was to evaluate feasibility (usability, safety, and acceptability) of Internet-based safety planning for rural and urban abused pregnant women and practicality of recruitment procedures for future trials. METHODS: An existing Internet-based safety decision aid for pregnant and postpartum women was adapted; initial content validity was established with survivors of IPV, advocates, and national IPV experts; and a convenience sample of community-dwelling abused pregnant women was recruited and randomized into two groups to test the decision aid. RESULTS: Fifty-nine participants were enrolled; 46 completed the baseline session, 41% of whom (n = 19) resided in nonmetropolitan counties. Participants' average gestational age was 20.2 weeks, and 28.3% resided with the abusive partner. Participants reported severe IPV at baseline (mean Danger Assessment score of 16.1), but all were able to identify a safe computer, and 73.9% completed the baseline session in less than 1 week, with no adverse events reported. DISCUSSION: These findings provide preliminary evidence for the feasibility, acceptability, and safety of an Internet-based safety decision aid for urban and rural abused pregnant women.

A Canadian model for building university and community partnerships: centre for research & education on violence against women and children.

The importance of Canadian research on violence against women became a national focus after the 1989 murder of 14 women at École Polytechnique in Montreal. This tragedy led to several federal government studies that identified a need to develop centers for applied research and community-university alliances on violence against women. One such center is the Centre for Research & Education on Violence against Women and Children. The Centre was founded in London, Canada in 1992 out of a partnership of a university, a community college, and community services. The centre's history and current activities are summarized as a model for the development and sustainability of similar centers.

University of Illinois at Chicago's interdisciplinary center for research on violence: changing systems to prevent violence in Chicago and beyond.

This article describes an interdisciplinary center at the University of Illinois at Chicago focused on collaborative research on violence. Our center is unique in its emphasis on developing infrastructure and distinctive processes for overcoming obstacles to interdisciplinary research; the involvement of outside policy makers, advocates, and service providers in jointly discussing and developing research proposals; the breadth of commitments from leading violence researchers and administrators across five colleges; and the innovativeness of proposed research projects that support interdisciplinary activity and show promise for funding. The center has developed an infrastructure to address violence-related issues in both research and teaching. This article discusses the challenges of implementation and boundary spanning in a university context and makes recommendations for sustainability.

Building community partnerships to end interpersonal violence: a collaboration of the schools of social work, law, and nursing.

The article discusses the University of Texas at Austin's (UT Austin) Institute on Domestic Violence and Sexual Assault (IDVSA), an institution that was established in 2001. IDVSA is a collaboration of the Schools of Social Work, Law, and Nursing, and 150 community affiliates. Recognizing that interpersonal violence does not occur in a vacuum, the IDVSA operates within an ecological framework in which explanations for interpersonal violence acknowledge that individuals and families are nested in larger mezzo and macro systems, and factors such as gender, poverty, ethnicity, religion, disability, sexual orientation, and immigration status play influential roles in our understanding of these issues. The overarching goal is to advance knowledge and meaningful practice in the field through partnerships with survivors and community practitioners. Specifically, the mission is to advance the knowledge related to domestic violence and sexual assault in order to end interpersonal violence. IDVSA seeks to achieve its mission by focusing on three key areas: (1) rigorous research and scholarship on domestic violence and sexual assault; (2) comprehensive training, technical assistance, and information dissemination to the practitioner community and the community at large; and (3) substantial collaboration with our community partners. This article summarizes the authors' pursuit.

The Minnesota Center Against Violence and Abuse (MINCAVA): providing research, education, and access to information on violence against women and children.

The Minnesota Center Against Violence and Abuse (MINCAVA) was established in 1994 through an appropriation of the Minnesota Legislature. Located at the University of Minnesota, MINCAVA conducts original research, develops extensive collections of translational materials, provides higher education training on family violence prevention, and disseminates information globally. Over a dozen professional and student staff work on projects funded by federal, state, and private sources and collaborate closely with national and global advisory boards and partner agencies as well as local community-based and national advocacy organizations. The Center operates multiple project-specific and general websites that receive millions of unique visits each year from dozens of countries.

Experiences of emergency care by the women exposed to acute physical intimate partner violence from the Finnish perspective.

BACKGROUND: In the acute trauma caused by intimate partner violence (IPV), the emergency department (ED) and its staff are often the first contact for women. The failure to intervene in IPV situations may contribute to further injury and health problems for women, as well as to frequent visits to the ED. AIMS: The aims of this study is to describe the history of IPV with its health consequences for women when seeking care for their acute injuries and what kinds of care experiences had the women had when visiting EDs. METHODS: Data were collected via questionnaires from 35 women and after that seven semi-structured interviews were conducted. The data were analyzed using quantitative and qualitative methods. RESULTS: Among the women the lifetime prevalence of physical IPV was 94%. Ninety-seven percent of past and 56% of acute cases of physical violence were accompanied by psychological violence. The surveyed women highlighted individual needs for care, including appropriate medical care of injuries, and psychological and tangible support. The women worried about their children and partners and regarded supporting the whole family as important. CONCLUSION: There is a need for ED professionals to develop family-oriented services, and a need for further training and research on how to deal with women exposed to IPV.

Depression among women experiencing intimate partner violence in a Chinese community.

BACKGROUND: Depression is one of the significant mental health impacts of intimate partner violence. However, there is a lack of empirical evidence on the factors associated with depression among abused Chinese women. OBJECTIVE: The purpose of this study was to identify the factors associated with a higher level of depression among abused Chinese women. METHODS: This was a cross-sectional study with participation of 200 abused Chinese women in a local community center in Hong Kong. The measurement tools used are the Chinese Abuse Assessment Screen, the Chinese Beck Depression Inventory Version II, the Revised Conflict Tactics Scale, the Interpersonal Support Evaluation List 12, and the demographic data. Structured multiphase regression analysis was used for data analysis. RESULTS: Factors significantly associated with a higher level of depression in Chinese abused women were low educational level (estimate = -2.49, p = .038), immigration (estimate = 4.99, p = .025), financial support from friends and relatives (estimate = 4.72, p = .006), and chronic psychological abuse (estimate = 0.09, p < .001). A protective factor against depression is the perception of social support (estimate = -1.11, p < .001). DISCUSSION: An overwhelming number of abused Chinese women have moderate or severe levels of depression. There is a need for more awareness of the detrimental mental health impact of abuse on women, screening for depression when women are found to be abused, and provision of social support at an earlier stage to minimize depression.

How domestic abuse affects the wellbeing of older women.

AIM: The aim of this study was to explore older women's experience of domestic abuse and its effect on their health and lives. METHOD: A qualitative research design was used and data were collected using in-depth interviews with 16 participants. FINDINGS: The consequences of domestic abuse for older women have a significant effect on their long-term health and emotional wellbeing. CONCLUSION: There are little available data about older women and domestic abuse. This is increasingly being recognised as a significant deficit in awareness and understanding in society as a whole, and more particularly for those responsible for support and care provision.

What causes domestic abuse and how can nurses effectively support abused women?

Domestic abuse is a significant public health problem in the UK, primarily perpetrated against women. Nurses can play a vital role in identifying patients who have experienced abuse, and in offering them emotional, psychological and practical support. This article explores the causes of domestic abuse, and nurses' role in caring for those affected. It emphasises the need for enhanced nurse education and awareness to enable nurses to provide holistic care for women.

Intimate partner violence in older women: what home healthcare clinicians should know.

Older women can be victims of intimate partner violence (IPV), and home healthcare clinicians should know what they can do. Although there is no instrument specific to screening for IPV in older women within the home environment, home healthcare clinicians can use currently available resources and lobby for better resources to screen for and serve older women who may be victims of IPV. Forensic nursing education can provide additional skills to identify possible victims of violence, gather evidence, document findings, and provide treatment and referrals.

A multilevel analysis of individual, household, and neighborhood correlates of intimate partner violence among low-income pregnant women in Jefferson county, Alabama.

OBJECTIVES: We examined individual, household, and neighborhood correlates of intimate partner violence (IPV) before and during pregnancy. METHODS: We used multilevel modeling to investigate IPV among 2887 pregnant women in 112 census tracts who sought prenatal care in 8 public clinics in Jefferson County, Alabama, from 1997 through 2001. Data were collected from the Perinatal Emphasis Research Center project, the 2000 Census, and the local Sheriff and Police Departments Uniform Crime Reports for 1997 through 2001. RESULTS: Participants were predominantly young, African American, on Medicaid, and residents of low-income neighborhoods. The prevalence of past-year male partner-perpetrated physical or sexual violence was 7.4%. Neighborhood residential stability, women performing most of the housework (lack of involvement among partners), being unmarried (being in an uncommitted relationship), and alcohol use were positively associated with elevated IPV risk. Significant protective factors for IPV included older age at first vaginal intercourse and a greater sense of mastery (e.g., the perception of oneself as an effective person). CONCLUSIONS: Both neighborhood contextual and individual and household compositional effects are associated with IPV among low-income pregnant women. The results imply that combined interventions to improve neighborhood conditions and strengthen families may effectively reduce IPV.

Prevalence of violence during pregnancy: findings from a Jordanian survey.

BACKGROUND: Violence during pregnancy is a significant health and social problem. In the last few years several factors have contributed to the emergence of family violence as a high priority social and health issue in Jordan, and the acknowledgement that abuse during pregnancy is a harmful act to the mother and the fetus. The purposes of this study were to investigate the prevalence of physical, emotional, verbal, and sexual violence on pregnant women, and to describe the relationships between violence and selected study variables. METHODS: A descriptive study was conducted using a self-administered questionnaire. A convenience sample of 316 pregnant women was recruited from five Maternal and Child Health Centers, located in Irbid City in the North of Jordan. RESULTS: The prevalence of physical, emotional, verbal and sexual violence by husbands during pregnancy was 10.4%, 23.4%, 23.7%, and 5.7%, respectively. Prevalence of physical, emotional and verbal violence by a family member other than the husband was 1.9%, 11.1% and 13.9%, respectively, and most perpetrators were the mother in-law. Data also showed that there was a significant association between prevalence of violence and unplanned pregnancy, the pregnant women's perception of their husband's violent attributes and the women's low self-esteem. Pre- and post-natal visits should include assessment for family violence and intervention when violence or abuse is identified. The findings support continued public awareness of family violence to bring about social and political changes that increase reporting and reduce incidence of violence in Jordan.

Factors influencing disclosure of abuse by women of Mexican descent.

PURPOSE: The purpose of this study was to describe the factors that influence disclosure of abuse by women of Mexican descent. Few published studies describe the experiences of women of Mexican descent with a history of intimate partner abuse, specifically in terms of their process of disclosure of abuse. METHODS: A qualitative research design was used to conduct this study in south Texas adjacent to the United States-Mexico border. Twenty-six key informants were recruited from two different sites. An open-ended approach with a semistructured interview guide was used to collect the narrative information from the 26 participants. RESULTS: The findings illuminated that many factors hindered disclosure. Some of these factors included protecting their partners, avoidance of worrying their mothers, and fear of losing their children. CONCLUSIONS: The study may help healthcare providers to understand the complexity of disclosure by women with a history of intimate partner abuse and may help explain why women do not readily disclose their abusive situations. CLINICAL RELEVANCE: This study on the disclosure decision process of abuse by women of Mexican descent provides some understanding on the cultural or situational factors that hindered or encouraged disclosure; ultimately this knowledge can help healthcare providers and others to provide for the woman's health, welfare, and safety.

Why do Jordanian women stay in an abusive relationship: implications for health and social well-being.

PURPOSE: The purpose of this study was to explore why Jordanian women stay with an abusive husband. DESIGN: The study used a qualitative approach to collect data from 28 abused women who were recruited through their community during the summer and fall of 2007. METHODS: Data were collected using an open-ended question through one-on-one in-depth interviews. FINDINGS: Results from analysis of the qualitative data revealed that abused Jordanian women identified five main reasons for staying with an abusive husband: the inherited social background, financial dependency, lack of family support, sacrificing self for the sake of the children, and the adverse social consequences of divorce. CONCLUSIONS: The results indicate that Jordanian women are strongly bound by traditions and cultural rules and lack all means of empowerment. Results of the study have implications for healthcare providers, social workers, policy makers, and educators to enhance the health and social well-being of Arab Muslim women in Jordan. The findings may also apply to Arab families immigrating to the United States, Canada, and Europe who tend to bring their cultural beliefs, values, and norms, and may help healthcare professionals dealing with violence against women in these countries. CLINICAL RELEVANCE: Healthcare professionals worldwide need to play an instrumental role in providing culture-specific and evidence-based care to empower women staying in abusive relationships, taking into consideration the influence of Arab Muslim culture.

Prevalence estimate of intimate partner violence in Jordan.

This study examined the prevalence of intimate partner violence in Jordan among a sample of 517 reproductive health clinic attendees. Intimate partner violence was measured using the World Health Organization's domestic violence questionnaire which was modified by the results of focus group discussions conducted in Amman. The percentages of women experiencing at least 1 form of control or violence since marriage were: control, 97.2%; psychological violence, 73.4%; physical violence, 31.2%; and sexual violence, 18.8%. Modifications of the WHO questionnaire were needed to measure control and psychological violence in Jordan. Similar modifications might be required when conducting research in the Region.

Development of an evidence-based domestic violence guideline: supporting perinatal women-centred care in Japan.

OBJECTIVE: to develop an evidenced-based, women-centred care clinical guideline designed to assist midwives and other health-care providers in Japanese hospitals, clinics and midwifery offices, in identifying and supporting potential or actual perinatal victims of domestic violence. DESIGN: systematic review and critical appraisal of extant research; structured assessment of clinical guideline development. METHOD: systematic and comprehensive literature search. Appraisal of Guidelines for Research and Evaluation (AGREE) was used to assess the guideline development for purposes of assuring methodological quality. FINDINGS: electronic searches of medical and nursing databases between February and December 2003 retrieved 2392 articles. Selected as evidence were 157 articles yielding 28 recommendations aligned to clinical assessment questions. KEY CONCLUSIONS: using expert consensus and external reviews, recommendations were generated that provided the at-risk perinatal group with the best possible practice available to prevent further harm. IMPLICATIONS FOR PRACTICE: the evidenced-based clinical guideline fosters a supportive environment for educating health-care providers on domestic violence, and to improve clinic access for at-risk perinatal women. Information on domestic violence and a negotiated midwife-client safety plan can be initiated for potential or actual victims of domestic violence, and is achieved through understanding the risks of the woman and her fetus or baby, while respecting the woman's intention.

Prediction of women's utilization of resistance strategies in a sexual assault situation: a prospective study.

The present study prospectively explored the predictors of resistance strategies to a sexual assault situation. Participants were assessed at the beginning of an academic quarter on a number of variables, including past history of sexual victimization, perceived risk of sexual victimization, and intentions to use specific types of resistance strategies. Only women who reported being victimized over the interim (N=68) were included in the analyses, which suggested that women's Time 1 intentions to utilize assertive resistance strategies (e.g., physically fight, run away) and offender aggression predicted women's use of assertive resistance strategies in response to the assault that occurred over the follow-up. Women's utilization of nonforceful verbal resistance (e.g., reason, plead, quarrel) was predicted by perpetrator aggression and previous sexual victimization. Women's immobility (e.g., turn cold, freeze) during the assault that took place over the interim was predicted by experiences of childhood sexual victimization and previous sexual victimization.