The Uptake and Measurement of Alternative Approaches to Domestic Violence Intervention Programs: A Scoping Review.

This scoping review explores the breadth and depth to which Domestic Violence Intervention Programs (DVIPs) in the United States and globally: (a) incorporate components that address the relationship between intimate partner violence (IPV) and social injustice, racism, economic inequality, and adverse childhood experiences (ACEs); (b) use restorative (RJ)/transformative justice (TJ) practices, individualized case management, partnerships with social justice actors, and strengths-based parenting training in current programming; and (c) measure effectiveness. In 2021, we searched 12 academic databases using a combination of search terms and Medical Subject Headings. In all, 27 articles that discussed at least one key concept relative to DVIP curricula were included in the final review. Findings suggest that very few DVIPs address ACEs and/or the relationship between structural violence, social inequality, and IPV perpetration. Even fewer programs use restorative practices including RJ or TJ. Furthermore, DVIPs use inconsistent methods and measures to evaluate effectiveness. To respond to IPV perpetration more effectively and create lasting change, DVIPs must adopt evidence-informed approaches that prioritize social and structural determinants of violence, trauma-informed care, and restoration.

Web-Based Delivery of a Family-Based Dating Abuse Prevention Program for Adolescents Exposed to Interparental Violence: Feasibility and Acceptability Study.

BACKGROUND: Numerous studies have demonstrated that exposure to caregiver intimate partner violence (IPV) can have cascading negative impacts on children that elevate the risk of involvement in dating abuse. This cascade may be prevented by programs that support the development of healthy relationships in children exposed to IPV. This paper describes the results of a study of the web-based adaptation of an evidence-based dating abuse prevention program for IPV-exposed youth and their maternal caregivers. Core information and activities from an evidence-based program, Moms and Teens for Safe Dates, were adapted to create the web-based program (e-MTSD), which comprises 1 module for mothers only and 5 modules for mother-adolescent dyads to complete together. OBJECTIVE: The primary objective of this study was to evaluate the feasibility and acceptability of the e-MTSD program and the associated research processes. We also examined the practicability of randomizing mothers to receive SMS text message reminders and an action planning worksheet, which were intended to support engagement in the program. METHODS: Mothers were recruited through community organizations and social media advertising and were eligible to participate if they had at least one adolescent aged 12 to 16 years of any gender identity who was willing to participate in the program with them, had experienced IPV after their adolescent was born, and were not currently living with an abusive partner. All mothers were asked to complete the program with their adolescent over a 6- to 8-week period. Participants were randomized to receive SMS text message reminders, action planning, or both using a 2×2 factorial design. Research feasibility was assessed by tracking recruitment, randomization, enrollment, and attrition rates. Program feasibility was assessed by tracking program uptake, completion, duration, and technical problems, and acceptability was assessed using web-based surveys. RESULTS: Over a 6-month recruitment period, 101 eligible mother-adolescent dyads were enrolled in the study and were eligible for follow-up. The median age of the adolescent participants was 14 years; 57.4% (58/101) identified as female, 32.7% (33/101) identified as male, and 9.9% (10/101) identified as gender diverse. All but one mother accessed the program website at least once; 87.1% (88/101) completed at least one mother-adolescent program module, and 74.3% (75/101) completed all 6 program modules. Both mothers and adolescents found the program to be highly acceptable; across all program modules, over 90% of mothers and over 80% of adolescents reported that the modules kept their attention, were enjoyable, were easy to do, and provided useful information. CONCLUSIONS: Findings suggest the feasibility of web-based delivery and evaluation of the e-MTSD program. Furthermore, average ratings of program acceptability were high. Future research is needed to assess program efficacy and identify the predictors and outcomes of program engagement.

TikToks Lead to Higher Knowledge and Perceived Severity of Sexual Violence among Adolescent Men.

Social media communication is a promising way to deliver important health messages about sexual violence to a key population of adolescent men. The researchers conducted an online, between-participants experiment to examine the impact of personal narrative TikToks about sexual violence on adolescent men. Participants were adolescent men (n = 580) aged 15 to 19 (M = 17.3, SD = 1.43). Participants were randomly assigned to treatment (personal narrative TikToks about sexual violence) or control (hair braiding TikTok tutorials) conditions. Adolescent men who viewed personal narrative TikToks about sexual violence had higher knowledge of consequences and higher perceived severity of sexual violence. Additionally, adolescent men found personal narrative TikToks more attention-grabbing (vs. control) and did not have negative reactions. Findings that short (approximately one-minute) TikTok videos led to differences in knowledge and beliefs among, and were interesting and not aversive to, adolescent men are important for sexual violence prevention research. Health messages on TikTok can help shift adolescent perceptions of sexual violence, which is a key starting point towards changing norms.

Researcher-Practitioner Partnerships to Implement and Evaluate Sexual and Relationship Violence Prevention Programs for Boys and Men.

Although male-focused sexual and relationship violence (SRV) prevention programs are widely promulgated, limited guidance concerning how programs should be implemented for rigorous evaluation exists. To help develop evidence for such guidance, this paper reports on 20 interviews with leaders at youth-serving community-based organizations (CBOs) and educational institutions, which are sites for male-focused SRV prevention programs. This study examined: (1) how programs can be designed to engage male participants; and (2) how youth-serving CBOs and educational institutions can partner with researchers for evaluations. Findings underscore the importance of attending to the unique needs of program participants, their parents/guardians, and host organizations.

Intimate Partner Violence Circumstances for Fatal Violence in the US.

This cross-sectional study investigates intimate partner violence circumstances associated with violent deaths in the US from 2015 to 2019.

Detecting intimate partner violence circumstance for suicide: development and validation of a tool using natural language processing and supervised machine learning in the National Violent Death Reporting System.

BACKGROUND: Intimate partner violence (IPV) victims and perpetrators often report suicidal ideation, yet there is no comprehensive national dataset that allows for an assessment of the connection between IPV and suicide. The National Violent Death Reporting System (NVDRS) captures IPV circumstances for homicide-suicides (<2% of suicides), but not single suicides (suicide unconnected to other violent deaths; >98% of suicides). OBJECTIVE: To facilitate a more comprehensive understanding of the co-occurrence of IPV and suicide, we developed and validated a tool that detects mentions of IPV circumstances (yes/no) for single suicides in NVDRS death narratives. METHODS: We used 10 000 hand-labelled single suicide cases from NVDRS (2010-2018) to train (n=8500) and validate (n=1500) a classification model using supervised machine learning. We used natural language processing to extract relevant information from the death narratives within a concept normalisation framework. We tested numerous models and present performance metrics for the best approach. RESULTS: Our final model had robust sensitivity (0.70), specificity (0.98), precision (0.72) and kappa values (0.69). False positives mostly described other family violence. False negatives used vague and heterogeneous language to describe IPV, and often included abusive suicide threats. IMPLICATIONS: It is possible to detect IPV circumstances among singles suicides in NVDRS, although vague language in death narratives limited our tool's sensitivity. More attention to the role of IPV in suicide is merited both during the initial death investigation processes and subsequent NVDRS reporting. This tool can support future research to inform targeted prevention.

"He Will Not Leave Us Alone and I Need the Courts to Help": Defendants' Use of Nonphysical Violence in Domestic Violence Protective Order Cases.

District court judges who make final determinations in domestic violence protective order (DVPO) cases in North Carolina indicate often using heuristics, such as the presence of visible injury, to guide their assessment of violence severity. This approach is concerning as it minimizes nonphysical intimate partner violence. We conducted a thematic analysis of DVPO plaintiff complaints to identify the types of nonphysical vioence described and its effects on plaintiff health outcomes. Most case files included descriptions of nonphysical violence and plaintiffs described fear as a significant mental health outcome. Findings highlight the potentially deleterious impact of nonphysical violence on the well-being of DVPO plaintiffs.

Web-Based Delivery of a Family-Based Dating Violence Prevention Program for Youth Who Have Been Exposed to Intimate Partner Violence: Protocol for an Acceptability and Feasibility Study.

BACKGROUND: Children exposed to intimate partner violence (IPV) between caregivers are at an increased risk of becoming involved in dating violence during adolescence. However, to date, few adolescent dating violence (ADV) prevention programs have been developed for and evaluated with youth exposed to IPV. An exception is Moms and Teens for Safe Dates (MTSD), an evidence-based ADV prevention program for mothers or maternal caregivers (mothers) exposed to IPV and their teenagers. The MTSD program comprises a series of booklets that families complete together in a home that includes activities to promote positive family communication and healthy teenager relationships. We developed a web-adapted version of the MTSD program-entitled eMoms and Teens for Safe Dates (eMTSD)-to provide a delivery format that may increase program appeal for digitally oriented teenagers, lower dissemination costs, lower reading burden for low-literacy participants, and incorporate built-in cues and reminders to boost program adherence. OBJECTIVE: This protocol is for a research study that has the following three main objectives: to assess the acceptability of eMTSD; to identify the feasibility of the research process, including program adherence and participant recruitment and assessment; and to explore the acceptability, feasibility, and preliminary efficacy of 2 features-text reminders and the creation of an action plan for engaging with the program-that may increase program uptake and completion. METHODS: Approximately 100 mothers and their teenagers will be invited to complete eMTSD, which includes six 30-minute web-based modules over a 6-week period. Mothers will be recruited through community organizations and social media advertising and will be eligible to participate if they have at least 1 teenager aged 12 to 16 years living with them, have experienced IPV after the teenager was born, are not currently living with an abusive partner, and have access to an internet-enabled device. Using a factorial design, enrolled dyads will be randomized to the following four adherence support groups (n=25 dyads per group): text reminders and action planning, text reminders only, action planning only, and no adherence supports. All participants will complete brief web-based assessments at enrollment after each module is completed, after the full program is completed, and 90 days after enrollment. Program adherence will be tracked using website use metrics. RESULTS: The data collected will be synthesized to assess the acceptability of the program and the feasibility of the study procedures. An exploratory analysis will examine the impact of adherence support on program completion levels. In November 2021, ethical approval was received and recruitment was initiated. Data collection is expected to continue until December 2022. CONCLUSIONS: The web-based delivery of a family-based healthy relationship program for teenagers exposed to IPV may offer a convenient, low-cost, and engaging approach to preventing ADV. The findings from this study are expected to guide future research. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/35487.

Developing and validating a new scale to measure the acceptability of health apps among adolescents.

BACKGROUND: The acceptability of health interventions is centrally important to achieving their desired health outcomes. The construct of acceptability of mobile health interventions among adolescents is neither well-defined nor consistently operationalized. OBJECTIVES: Building on the theoretical framework of acceptability, these two studies developed and assessed the reliability and validity of a new scale to measure the acceptability of mobile health applications ("apps") among adolescents. METHODS: We followed a structured scale development process including exploratory factor analyses (EFAs), confirmatory factor analyses (CFAs), and employed structural equation modeling (SEM) to assess the relationship between the scale and app usage. Adolescent participants used the Fooducate healthy eating app and completed the acceptability scale at baseline and one-week follow-up. RESULTS: EFA (n = 182) determined that the acceptability of health apps was a multidimensional construct with six latent factors: affective attitude, burden, ethicality, intervention coherence, perceived effectiveness, and self-efficacy. CFA (n = 161) from the second sample affirmed the six-factor structure and the unidimensional structures for each of the six subscales. However, CFA did not confirm the higher-order latent factor model suggesting that the six subscales reflect unique aspects of acceptability. SEM indicated that two of the subscales-ethicality and self-efficacy-were predictive of health app usage at one-week follow-up. CONCLUSIONS: These results highlight the importance of ethicality and self-efficacy for health app acceptability. Future research testing and adapting this new acceptability scale will enhance measurement tools in the fields of mobile health and adolescent health.

Intimate Partner Violence-Related Fatalities Among U.S. Youth Aged 0-24 Years, 2014-2018.

INTRODUCTION: Little is known about intimate partner violence-related fatalities among young people. This study comprehensively identifies and describes intimate partner violence-related homicides, homicide-suicides, legal intervention deaths, and suicides among young people. METHODS: Data from the 2014-2018 National Violent Death Reporting System were analyzed for all decedents aged 0-24 years in 38 states, the District of Columbia, and Puerto Rico with known circumstances of death (n=29,702). Intimate partner violence-related deaths were identified using National Violent Death Reporting System variables across all manners of death and supplementary narrative review for suicides. This article reports the proportion of intimate partner violence versus non-intimate partner violence-related deaths by manner of death, descriptive statistics, and rate of intimate partner violence-related death per 100,000 person years. To examine disparities in intimate partner violence-related deaths, generalized estimating equations were used with robust standard errors to account for clustering of deaths within states and fixed effects for years. Statistical analyses were conducted May and August 2021. RESULTS: A total of 1,927 intimate partner violence-related deaths were identified, which represents 6.5% of violent deaths with known circumstances, at a rate of 0.35 per 100,000 person years. Supplementary narrative review identified 44.7% of all intimate partner violence-related deaths. There were significant differences by race/ethnicity and whether a firearm inflicted the fatal injury for male and female decedents by manner of death. CONCLUSIONS: If the National Violent Death Reporting System does not assess whether intimate partner violence was a precipitating factor across all death manners, the true magnitude of intimate partner violence's contribution to violent death will be underestimated. Future research that identifies factors associated with all manners of intimate partner violence-related deaths among young people will help inform intervention and prevention strategies to save young lives.

From "Homegrown" to Research-Ready: Converting an Existing Practitioner-Developed Violence Prevention Intervention Into an Evaluable Intervention.

There is an increased call for research on promising prevention programs already embedded in communities ("homegrown interventions"). Unfortunately, there is limited guidance to help researchers prepare these types of interventions for rigorous evaluation. To address this need, this article presents our team's process for revising a promising community-based sexual violence prevention intervention for rigorous research. Our extensive and iterative process of reviewing and revising the intervention was guided by evaluability assessment (EA) approaches, implementation science, and a close collaboration with our community partners. Our EA process allowed us to specify the intervention's core components and develop a "research ready" standardized curriculum with implementation fidelity assessments. We offer four lessons learned from our process: (1) even with existing materials and an extensive history of community-based delivery, community-developed programs are not necessarily research-ready; (2) close collaboration and a trusting relationship between researchers and community partners throughout the revision process ensures the integrity of core program components are maintained and implementation in diverse community settings is feasible; (3) observations of program implementation are a crucial part of the revision process; and (4) it is important to budget adequate time and resources for such revisions.

Individual and Relationship-Level Correlates of Transactional Sex Among Adolescent Girls and Young Women in Malawi: A Multilevel Analysis.

Transactional sex increases HIV risk among adolescent girls and young women (AGYW). Understanding the individual and dyadic nature of transactional sex may provide evidence for risk reduction interventions. Multilevel logistic regression was used to cross-sectionally examine correlates of transactional sex among AGYW in Lilongwe, Malawi. Participants (N = 920) reported 1227 relationships. Individual-level associations were found between being divorced/widowed (AOR 5.07, 95% CI 1.93, 13.25), married (AOR 0.26, 95% CI 0.09, 0.72), or unstably housed (AOR 7.11, 95% CI 2.74, 18.47) and transactional sex. At the relationship-level, transactional sex occurred in relationships with: non-primary primary partners (AOR 4.06, 95% CI 2.37, 6.94), perceived partner concurrency (AOR 1.85, 95% CI 1.11, 3.08), and feared violence with couples HIV testing (AOR 2.81, 95% CI 1.26, 6.29), and less likely to occur in relationships with children (AOR 0.15, 95% CI 0.06, 0.38). Multiple co-occurring social and structural vulnerabilities increase transactional sex engagement warranting the need for social protection and gender transformative approaches.

Love in the Time of War: Identifying Neighborhood-level Predictors of Intimate Partner Violence from a Longitudinal Study in Refugee-hosting Communities.

A high prevalence of intimate partner violence (IPV) has been documented among women living in conflict-affected and refugee-hosting areas, but why this occurs is not well understood. Conflict and displacement deteriorate communities' social cohesion and community connectedness; these neighborhood social environments may influence individual IPV outcomes. We explored neighborhood-level social disorganization and cohesion as predictors of recent IPV in refugee-hosting communities in northern Ecuador by conducting multi-level logistic regression on a longitudinal sample of 1,312 women. Neighborhood social disorganization was marginally positively associated with emotional IPV (AOR: 1.17, 95% CI: .99, 1.38) and physical and/or sexual IPV (AOR: 1.20, 95% CI: .96, 1.51). This was partially mediated by neighborhood-level civic engagement in the case of emotional IPV. At the household level, perceived discrimination and experience of psychosocial stressors were risk factors for both types of IPV, whereas social support was protective. To our knowledge, this is one of the first studies to examine how neighborhood social factors influence IPV outcomes in refugee-hosting communities or in South America. As the world grapples with the largest number of displaced people in history, this research can inform prevention and response programming and reinforces the critical importance of promoting acceptance of refugees and immigrants and positively engaging all community members in civic life in refugee-hosting settings.

What is the role of firearms in nonfatal intimate partner violence? Findings from civil protective order case data.

BACKGROUND: Perpetrators of intimate partner violence (IPV) use firearms to injure, scare, and manipulate their partners. Abusers who have a firearm in their homes are more likely to threaten and/or kill their partner. To date, however, limited research documents the nature of IPV perpetrator firearm access or the prevalence of nonfatal firearm abuse behaviors. METHODS: Federal law restricts firearm access for IPV perpetrators in qualifying domestic violence protective order (DVPO) cases and information about firearms should be disclosed during the DVPO process. We used secondary data from civil DVPO cases (n = 406) in North Carolina that were collected using a representative sampling strategy. Data were from DVPO case files and structured DVPO hearing observations. We conducted a content analysis to record IPV perpetrator access to guns and reported firearm abuse behaviors. We used a linear regression analysis to determine whether IPV perpetrator gun access was associated with higher levels of reported abuse. We also examined factors associated with perpetration of nonfatal firearm abuse. RESULTS: We found evidence of perpetrator firearm access in nearly half of all cases (46%, n = 108). Controlling for covariates, gun access was significantly associated with higher levels of reported IPV (b = 0.5, p < .001). Firearm abuse was reported in nearly one out of four cases (23.1%, n = 101), and often entailed spoken threats, displaying a gun, or holding a partner at gun point. The only factors associated with firearm abuse in the multivariate models were related to English language speaking/fluency. CONCLUSIONS: Gun access should be considered an indicator for severe IPV. We must ensure that existing legal mechanisms to identify and restrict abuser access to firearms are fully implemented and enforced. Firearm abuse often manifests as non-physical coercive control which is traumatic and has the potential to escalate to homicide, even in the absence of past physical violence.

Evaluations of Prevention Programs for Sexual, Dating, and Intimate Partner Violence for Boys and Men: A Systematic Review.

Among violence prevention educators and researchers, there is growing interest in sexual, dating, and intimate partner violence (SV/DV/IPV) prevention programs for males because of evidence showing that boys and men are more likely than girls and women to perpetrate SV as well as more severe forms of DV/IPV. To date, comprehensive guidance on the content, structure, delivery, and effectiveness of such programs is limited. We reviewed randomized controlled studies that evaluated SV/DV/IPV perpetration prevention programs for boys and men. Searches yielded 5,249 potential documents for review of which 10 met inclusion criteria-representing 9 unique studies of 7 distinct programs. Two reviewers independently reviewed and abstracted data from these studies regarding program setting and target audience; type of violence addressed; number and length of program sessions; program duration, topics, activities, and delivery mode; and implementer details. Study characteristics were also examined (sample size, participant characteristics, recruitment, randomization, comparison/control condition, data collection protocols, attrition, measures of violence perpetration, and perpetration findings). The Cochrane Risk of Bias Tool was used to assess study design quality. Results show considerable heterogeneity among program content and delivery strategies, study designs, and outcome measurement. Study sample size ranged widely, and most used cluster-randomized designs, recruited undergraduate college students, and evaluated a multisession program delivered via group sessions. Only one program reduced men's self-reported SV perpetration. Accordingly, critical gaps exist around "what works" for SV/DV/IPV perpetration prevention programs for boys and men.

Fatalities related to intimate partner violence: towards a comprehensive perspective.

BACKGROUND: In 2015, 1350 people in the US were killed by their current or former intimate partner. Intimate partner violence (IPV) can also fatally injure family members or friends, and IPV may be a risk factor for suicide. Without accounting for all these outcomes, policymakers, funders, researchers and public health practitioners may underestimate the role that IPV plays in violent death. OBJECTIVE: We sought to enumerate the total contribution of IPV to violent death. Currently, no data holistically report on this problem. METHODS: We used Violent Death Reporting System (VDRS) data to identify all IPV-related violent deaths in North Carolina, 2010-2017. These included intimate partner homicides, corollary deaths, homicide-suicides, single suicides and legal intervention deaths. We used the existing IPV variable in VDRS, linked deaths from the same incident and manually reviewed 2440 suicide narratives where intimate partner problems or stalking were a factor in the death. RESULTS: IPV contributes to more than 1 in 10 violent deaths (10.3%). This represents an age-adjusted rate of 1.97 per 100 000 persons. Of the IPV-related violent deaths we identified, 39.3% were victims of intimate partner homicide, 17.4% corollary victims, 11.4% suicides in a homicide-suicide event, 29.8% suicides in a suicide-only event and 2.0% legal intervention deaths. IMPLICATIONS: If researchers only include intimate partner homicides, they may miss over 60% of IPV-related deaths. Our novel study shows the importance of taking a comprehensive approach to prevent IPV and decrease violent deaths. IPV is a risk factor for suicide as well as homicide.

Intimate Partner Homicides in North Carolina: 2011-2015.

BACKGROUND Research on intimate partner homicide (IPH), when someone is killed by a current or former intimate partner, in North Carolina is limited, making it difficult to understand the magnitude of IPHs and identify strategies for prevention.METHOD We used North Carolina Violent Death Reporting System (NC-VDRS) data to assess IPHs among North Carolina residents between 2011 and 2015. Homicides were considered IPHs if intimate partner violence was identified and the victim was the suspect's current or former intimate partner. Proportions and rates of demographic characteristics and circumstances were assessed.RESULTS Of the 2,299 homicides that occurred between 2011 and 2015, 350 were IPHs (0.9 per 100,000 person-years). Most (72.3%) IPH victims were female (n = 253). Among all female homicides almost half (48.2%) were IPHs, while only 5.4% of all male homicides were IPHs. The highest rate of IPH occurred among women aged 20-44 (2.1 per 100,000 person-years). Most victims were non-Hispanic (NH) white (54.0%, n = 189), although rates for NH American Indians and NH blacks were 1.8 and 2.0 times those among NH whites respectively. Most victims, 86.6% male and 82.6% female, were the suspect's current partner. Firearms were the most common weapon used (62.6%, n = 219).LIMITATIONS NC-VDRS data are not representative of all IPHs in the United States. Circumstance data were sometimes incomplete and categories of circumstance variables restrictive, limiting available information on IPHs.CONCLUSION Future interventions focused on women aged 20-44, NH American Indian and NH Black communities, and firearm access could be effective in preventing IPHs in North Carolina.

Socioeconomic Predictors of Transactional Sex in a Cohort of Adolescent Girls and Young Women in Malawi: A Longitudinal Analysis.

Transactional sex is associated with incident HIV infection among adolescent girls and young women (AGYW) in sub-Saharan Africa. Evidence on the dimensions of socioeconomic status (SES) which predict transactional sex are mixed and primarily come from cross-sectional studies. This study examined the association between SES and transactional sex in a longitudinal cohort (n = 844) of AGYW ages 15-24 years enrolled in a quasi-experimental study in Lilongwe, Malawi. Prevalence of transactional sex was 22% at baseline, 15% at 6-months and 20% at 12-months. Being divorced or widowed, being food insecure, living in a home without electricity or running water, and having few assets were associated with transactional sex. Higher educational attainment and school enrollment were protective. Having 6-7 socioeconomic risk factors increased odds of transactional sex (AOR = 4.13, 95% CI 2.45, 6.98). Structural interventions which address multiple dimensions of SES may reduce transactional sex and ultimately prevent HIV transmission among AGYW.

Enhancing Community-Based Participatory Research Through Human-Centered Design Strategies.

Introduction. The purpose of this review is to compare and contrast the values, purpose, processes, and outcomes of human-centered design (HCD) and community-based participatory research (CBPR) approaches to address public health issues and to provide recommendations for how HCD can be incorporated into CBPR partnerships and projects. Review Process. By consulting published literature, source materials, and experts on both approaches, a team of researchers completed a three-phased process of synthesizing key similarities and differences between HCD and CBPR and generating recommendations for ways to integrate HCD strategies in CBPR projects. Results. There are five HCD strategies that can be readily incorporated into CBPR projects to improve outcomes: (1) form transdisciplinary teams, (2) center empathy, (3) recruit and work with "extreme users," (4) rapidly prototype, and (5) create tangible products or services. Conclusions. Integrating HCD in CBPR projects may lead to solutions that potentially have greater reach, are more readily adopted, are more effective, and add innovation to public health services, products, and policies.

Judging Domestic Violence From the Bench: A Narrative Analysis of Judicial Anecdotes About Domestic Violence Protective Order Cases.

Interview participants sometimes share anecdotes (stories about past events), to illustrate a point or discuss their perspectives. When sharing these stories, participants may imbue the events with their own personal meaning-making, selective memory, and biases. We conducted a narrative analysis of anecdotes shared by judges ( n = 20) who preside over Domestic Violence Protective Order (DVPO) hearings to examine how biases and misperceptions shape decisions in DVPO cases. We found that judges rely on biases to sort cases as "true domestic violence" compared with "frivolous cases." In the anecdotes they shared, judges often used gendered stereotypes to depict litigants, and many judges felt that DVPOs had limited efficacy in preventing violence. We argue that important cognitive insights are revealed by interview participants during the spontaneous act of storytelling. In the case of judges, their biases could lead to DVPOs being denied in situations when they are warranted.