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2.
Interv. psicosoc. (Internet) ; 30(1): 47-55, ene. 2021. tab, graf
Artigo em Inglês | IBECS | ID: ibc-197952

RESUMO

Spanish police makes an extensive use of intimate partner violence (IPV) risk assessment on a daily basis. Improved prediction procedures have encouraged the search for greater refinement of IPV predictors by adjusting to specific targets, such as lethal outcomes or potential victimization of children. This paper describes the evolution of the VPR5.0 tool (VioGén System Police Risk Assessment) as an algorithm aimed at improving predictability of intimate partner homicides (IPH). A sample of 2,159 records was used, 159 of whom were IPH victims. The sample was divided into two comparable groups of cases (IPH) and controls (N-IPH) to validate the results. The results showed that 13 out of 35 risk factors were significantly related to IPH with an effect size different to that of general N-IPH (with OR values ranging between 1.507 and 8.087). Binary logistic regression showed six significant factors that correctly classified 86.3% of the IPH. The new H-Scale performance parameters were comparable to those obtained in studies with the same objective (sensitivity 84%, specificity 60%, OR = 8.130, AUC = .80, PPV = .19 and NPV = .97)


La policía española hace un uso diario y extenso de la evaluación del riesgo de violencia en casos de violencia de género (VCP). El perfeccionamiento de los sistemas de predicción de VCP ha impulsado la búsqueda de procedimientos ajustados a objetivos concretos, como puede ser el resultado letal o la inclusión de menores como posibles víctimas. En el presente trabajo se describe la evolución de la herramienta VPR5.0 (Valoración Policial del Riesgo del Sistema VioGén) a un algoritmo diferenciado cuyo objetivo es predecir mejor los homicidios de mujeres por su pareja (HCP). Se analizaron 2,159 registros, 159 de los cuales correspondían a HCP, dividiendo la muestra en dos grupos comparables con casos (HCP) y controles (N-HCP) para validar los análisis. Los resultados pusieron de manifiesto que de los 35 factores de la herramienta 13 estaban asociados significativamente con el HCP, con un tamaño del efecto diferente al de N-HCP (con valores OR entre 1.507 y 8.087). La regresión logística binaria mostró seis factores significativos que clasificaban correctamente el 86.3% de los HCP. Los parámetros de rendimiento de esta escala-H resultaron comparables a los obtenidos en estudios con el mismo objetivo (sensibilidad 84%, especificidad 60%, OR = 8.130, AUC = .80, VPP = .19 y VPN = .97)


Assuntos
Humanos , Feminino , Adulto , Homicídio/psicologia , Relações Interpessoais , Medição de Risco , Violência de Gênero/psicologia , Maus-Tratos Conjugais/psicologia , Violência de Gênero/estatística & dados numéricos , Algoritmos , Maus-Tratos Conjugais/estatística & dados numéricos , Modelos Logísticos , Fatores de Risco
3.
Rev Saude Publica ; 54: 97, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33146302

RESUMO

OBJECTIVE: To identify the prevalence of violence during pregnancy and the association with the socioeconomic, behavioral and clinical characteristics of pregnant women. METHODS: Cross-sectional study in a low-risk maternity hospital in the municipality of Cariacica, Espírito Santo. A total of 330 puerperal women were interviewed from August to October 2017. Information on socioeconomic, behavioral, reproductive and clinical characteristics, as well as life experiences, was collected through a questionnaire. To identify the types of violence, the proper World Health Organization instrument was used. Gross bivariate and multivariate analysis was performed and adjusted for Poisson regression with robust variance. RESULTS: Prevalence was 16.1% (95%CI 2.5-20.4) for psychological violence, 7.6% (95%CI 5.1-11.0) for physical violence and 2.7% (95%CI 1.4-5.2) for sexual violence. Psychological violence remained associated with age, family income, beginning of sexual life, disease in pregnancy, desire to interrupt pregnancy and number of partners. Physical violence was associated with schooling, beginning of sexual life and disease in pregnancy. Sexual violence remained associated with marital status and desire to interrupt pregnancy (p < 0.05). CONCLUSIONS: Psychological violence by an intimate partner was the most prevalent among pregnant women. Women that were younger, had lower income and less schooling, who started their sexual life before the age of 14 and who wished to interrupt pregnancy, experienced violence more frequently during pregnancy.


Assuntos
Violência por Parceiro Íntimo/estatística & dados numéricos , Saúde Mental/estatística & dados numéricos , Abuso Físico/estatística & dados numéricos , Delitos Sexuais/estatística & dados numéricos , Parceiros Sexuais/psicologia , Maus-Tratos Conjugais/estatística & dados numéricos , Adulto , Brasil/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Abuso Físico/psicologia , Gravidez , Prevalência , Fatores de Risco , Delitos Sexuais/psicologia , Fatores Socioeconômicos , Maus-Tratos Conjugais/psicologia
4.
J Womens Health (Larchmt) ; 29(10): 1239-1242, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33006492

RESUMO

Intimate partner violence (IPV)-defined as physical, psychological, sexual, and/or economic violence typically experienced by women at home and perpetrated by their partners or expartners-is a pervasive form of violence that destroys women's feelings of love, trust, and self-esteem, with important negative consequences on physical and psychological health. Many reports from several countries have underlined a remarkable increase in the cases of IPV during the COVID-19 emergency. In this opinion article, we discussed the hypothesis that such an increase may be related to the restrictive measures enacted to contain the pandemic, including women's forced cohabitation with the abusive partner, as well as the exacerbation of partners' pre-existing psychological disorders during the lockdown. In addition, we retrospectively analyzed some data derived from our practice in a public Italian referral center for sexual and domestic violence (Service for Sexual and Domestic Violence [SVSeD]). These data interestingly revealed an opposite trend, that is, a decrease in the number of women who sought assistance since the beginning of the COVID-19 outbreak. Such a reduction should be interpreted as a negative consequence of the pandemic-related restrictive measures. Although necessary, these measures reduced women's possibilities of seeking help from antiviolence centers and/or emergency services. Owing to the COVID-19 outbreak, there is an urgent need for developing and implementing alternative treatment options for IPV victims (such as online and phone counseling and telemedicine), as well as training programs for health care professionals, especially those employed in emergency departments, to facilitate early detection of IPV.


Assuntos
Infecções por Coronavirus/prevenção & controle , Violência por Parceiro Íntimo/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena/psicologia , Parceiros Sexuais/psicologia , Maus-Tratos Conjugais/estatística & dados numéricos , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/tendências , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Estudos Retrospectivos , Autoimagem , Delitos Sexuais/psicologia , Delitos Sexuais/tendências , Maus-Tratos Conjugais/psicologia , Maus-Tratos Conjugais/tendências
5.
PLoS One ; 15(9): e0239722, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32976544

RESUMO

BACKGROUND: Pakistan and other developing countries need to address disparities in maternal health care and factors associated with it. This justifies tracking the progress on two important indicators 'spousal violence' and 'maternal health care utilization' to improve maternal health and achieve Sustainable Development Goals (SDGs) for these nations. OBJECTIVE: The objective of this study is to compare the data from the latest two Demographic Health Surveys of Pakistan to identify trends in prevalence of various forms of spousal violence and maternal healthcare utilization and to determine the predictive role of spousal violence in poor maternal health. METHODS: We conducted a retrospective analysis of nationally representative data from the 2012-13 and 2017-18 PDHS. The data used in this analysis is from the domestic violence module and core women's questionnaire. Spousal violence and sociodemographic background were predictor variables. Terminated pregnancy, number of pregnancy losses, number of antenatal visits for last birth and institutional delivery for last birth were taken as indicators of maternal health. Logistic regression analysis was conducted to test for association between maternal health indicators and various forms of spousal violence after controlling for sociodemographic variables. RESULTS: Almost one quarter of women experienced physical and emotional violence as revealed by both surveys. Binary analysis revealed that all forms of spousal violence significantly associate with maternal health variables in both surveys. The comparison of results on logistic regression analysis showed that odd ratios were relatively higher for 2012-13 as compared to 2017-18 PDHS. Logistic regression analysis from 2017-18 data showed that experience of less severe physical violence (OR = 1.26; 95% CI, 1.08-1.47), severe physical violence (OR = 1.41; 95% CI, 1.09-1.83), sexual violence (OR = 1.39; 95% CI, 1.02-1.89), physical violence during pregnancy (OR = 1.37; 95% CI, 1.07-1.76) augment the risk of terminated pregnancy. Emotional violence decreases the likelihood for institutional delivery (OR = 0.64; 95% CI, 0.45-0.93) and above than four antenatal visits (OR = 0.54; 95% CI, 0.37-0.79). CONCLUSIONS: Strategies to prevent spousal violence should be at the core of maternal health programs because health sector provides a platform to challenge social norms and promote attitudes that disapprove spousal violence which are essential for promoting gender equality, women empowerment (SDG 3) and improve maternal health (SDG 5).


Assuntos
Utilização de Instalações e Serviços/tendências , Serviços de Saúde Materna/estatística & dados numéricos , Maus-Tratos Conjugais/estatística & dados numéricos , Adolescente , Adulto , Demografia/estatística & dados numéricos , Feminino , Humanos , Pessoa de Meia-Idade , Paquistão , Fatores Socioeconômicos
6.
Cien Saude Colet ; 25(9): 3475-3480, 2020 Sep.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32876252

RESUMO

The study aims to identify marital violence precipitating/intensifying elements during the COVID-19 pandemic. This is a narrative review of the literature, and the search was carried out in May 2020. We employed the PubCovid-19 platform, which is indexed in the United States National Library of Medicine (PubMed) and the Excerpta Medica (EMBASE) database. English descriptors "Domestic violence", "COVID-19", and "Intimate Partner Violence" were used in the search, and nine papers were selected for full-text reading. Three empirical categories were elaborated from the exploration of the selected material: Economic instability, Alcohol and other drugs use/abuse, and Weaker women's support network. Support networks for women in situations of marital violence should be expanded in this pandemic context, with emphasis on the use of digital technologies as possible tools for screening pandemic-related violence cases.


Assuntos
Infecções por Coronavirus/epidemiologia , Programas de Rastreamento/métodos , Pneumonia Viral/epidemiologia , Maus-Tratos Conjugais/estatística & dados numéricos , Consumo de Bebidas Alcoólicas/epidemiologia , Feminino , Humanos , Masculino , Pandemias , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
7.
PLoS One ; 15(7): e0236733, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32722707

RESUMO

Studies on wife abuse in Bangladesh predominantly include the mainstream Bengali population, although there are at least 27 ethnic minority communities including a few 'female-centered' matrilineal groups living in the country. This study explored ethnic differences in the attitudinal acceptance of wife abuse among matrilineal ethnic minority Garo, patrilineal ethnic minority Santal, and mainstream patriarchal Bengali communities in rural Bangladesh. Adopting a cross-sectional design, the study included 1,929 women and men randomly selected from 24 Garo, Santal, and Bengali villages. Multivariate Poisson regression was performed to predict the number of contextual events, where the respondents attitudinally endorsed wife abuse. Of the sample, 33.2% were from Garo, 33.2% from Santal, and 33.6% from the Bengali communities. The acceptance of wife abuse was high in the sample; specifically, 34.1% of the respondents accepted physical wife abuse, 67.5% accepted emotional abuse, and 71.6% accepted any abuse (either physical or emotional) at least on one contextual reason provided in a 10-item scale. The mean for accepting any abuse was 3.0 (SD = 2.8), emotional abuse 2.3 (SD = 2.2), and physical abuse 0.8 (SD = 1.4). The study showed that the rates of accepting any abuse and physical abuse were respectively 16% and 56% lower among Garo as well as 14% and 33% lower among Santal than that of the Bengali community. Data also revealed that individual level factors like younger age, higher education, prestigious occupation as well as family level factors such as higher income, female mobility, and female family authority were inversely associated with the acceptance of wife abuse in the sample. It appears that the gender regime of a society has a great influence on the attitudes toward wife abuse. We argue that a comprehensive socio-cultural transformation of the patriarchal societies into a gender equal order is imperative for the prevention of widespread wife abuse in the country.


Assuntos
Mulheres Maltratadas/estatística & dados numéricos , Grupos Étnicos/psicologia , Grupos Minoritários/estatística & dados numéricos , Maus-Tratos Conjugais/estatística & dados numéricos , Adolescente , Adulto , Bangladesh , Mulheres Maltratadas/psicologia , Estudos Transversais , Características Culturais , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , População Rural , Fatores Socioeconômicos , Maus-Tratos Conjugais/psicologia , Inquéritos e Questionários , Adulto Jovem
8.
PLoS One ; 15(7): e0235761, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32628738

RESUMO

The Women's Experience with Battering (WEB) scale is a self-report instrument that uses a 10-item Likert-type scale to measure IPV victims' cognitive and affective experience of battering. This study aimed to validate the Chinese version of the WEB scale using gender-neutral questions, Experience of Battering Scale (Chinese) (EBS-C), to assess the psychological vulnerability of victims of intimate partner violence (IPV). The study adopted a range of methods, including translation and back translation, expert reviews, cognitive debriefing, and test-retest reliability assessment. The EBS-C was validated in a purposive convenience sample of 718 Chinese-speaking participants (male = 362; female = 356) aged 18-24 (mean age = 21.4) in Hong Kong. The results of CFA showed a good model fit: CFI = .97, TLI = .96, RMSEA = .05, SRMR = .03. The EBS-C was also found to be significantly associated with the Revised Conflict Tactics Scales (CTS2; r = .13-.17, p < .01), depression (BDI-II: r = .15, p < .01), anxiety (GAD-7: r = .17, p < .01), interpersonal support (ISEL-12: r = -.27, p < .01), relationship satisfaction (RAS: r = -.36, p < .01), and self-esteem (RSES: r = -.22, p < .01). The study demonstrated the EBS-C to be a reliable and valid measure for assessing the psychological vulnerability of IPV victims. It is thus useful for identifying the risks such individuals face by assessing their experience of fear, danger, and disempowerment in the intimate relationship relative to abusive incident-based measures alone. The EBS-C will also be useful for developing effective treatments to address the psychological vulnerability resulting from IPV and will facilitate cross-cultural comparative research aimed at enriching our knowledge of IPV victimization.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Mulheres Maltratadas/psicologia , Vítimas de Crime/psicologia , Violência por Parceiro Íntimo/psicologia , Autorrelato , Parceiros Sexuais/psicologia , Maus-Tratos Conjugais/psicologia , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Mulheres Maltratadas/estatística & dados numéricos , Feminino , Nível de Saúde , Humanos , Violência por Parceiro Íntimo/estatística & dados numéricos , Masculino , Maus-Tratos Conjugais/estatística & dados numéricos , Adulto Jovem
9.
BMC Public Health ; 20(1): 1008, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32586297

RESUMO

BACKGROUND: In Uganda, just like in many sub-Saharan countries, studies on Intimate Partner Violence (IPV) among married women are limited. The aim of this paper was to determine the correlates of emotional, sexual, physical IPV and any form of IPV among married women in Uganda. METHODS: The 2016 Uganda Demographic and Health Survey (UDHS) data was used, and a weighted sample of 6879 married women were selected from the Domestic Violence module. Frequency distributions were used to describe the characteristics of respondents. Chi-square tests were used to establish the association between IPV and the explanatory variables. Binary logistic regressions were used to establish the factors that were associated with IPV among married women in Uganda. RESULTS: More than half (56%) of the married women experienced some form of IPV. Sexual IPV was the least prevalent (23%) and 4 in 10 women (41 and 40%) experienced physical and emotional IPV, respectively. Factors associated with all the different forms of IPV included, age, region, witnessing parental violence, partner's controlling behaviors, duration of the relationship, and frequency of intoxication of the male partner. CONCLUSION: IPV among Ugandan married women is far too common. This calls for collective efforts to reduce IPV in Uganda by addressing excessive alcohol consumption, controlling behaviors, and lack of awareness of the issue. Interventions aimed at preventing perpetration and tolerance of violence in the home settings should be promoted.


Assuntos
Violência por Parceiro Íntimo/estatística & dados numéricos , Casamento/estatística & dados numéricos , Maus-Tratos Conjugais/estatística & dados numéricos , Adolescente , Adulto , Distribuição de Qui-Quadrado , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Violência por Parceiro Íntimo/psicologia , Masculino , Casamento/psicologia , Pessoa de Meia-Idade , Prevalência , Comportamento Sexual/estatística & dados numéricos , Parceiros Sexuais/psicologia , Maus-Tratos Conjugais/psicologia , Uganda , Adulto Jovem
10.
PLoS One ; 15(4): e0232454, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32353037

RESUMO

OBJECTIVE: This study attempts to investigate the association between maternal exposure to intimate partner violence (IPV) and morbidity and mortality of children. STUDY DESIGN: A cross-sectional study was carried out using the most recent nationally representative data of the National Family Health Survey (NFHS-4) in India. RESULTS: The prevalence of morbidity and mortality was higher among the children whose mothers faced physical, emotional, or sexual violence perpetrated by the partner than those who did not encounter any violence. Multivariate analysis revealed that maternal exposure to physical and sexual violence significantly increased the risks of childhood diarrhea and fever; and emotional violence was associated with an increased likelihood of diarrhea, fever, and acute respiratory infection (ARI) in the past 2 weeks among under-five children. Moreover, women's experience of physical and emotional violence were associated with increased odds of infant mortality (<1 year) and under-five mortality (<5 years) in crude analysis. However, these associations were insignificant in the adjusted analysis. Similarly, we did not find any significant association between maternal exposure to IPV and child mortality (1 to < 5 years). CONCLUSION: Maternal experience of domestic violence was associated with an increased risk of childhood morbidity (diarrhea, fever and ARI). However, no significant association was found between violence against women and mortality of children. Prevention of domestic violence may help to reduce childhood illnesses. Additional efforts are needed for maternal and child healthcare programs to improve health status of women and children.


Assuntos
Saúde da Criança/estatística & dados numéricos , Mortalidade da Criança , Exposição Materna/efeitos adversos , Maus-Tratos Conjugais/estatística & dados numéricos , Adolescente , Adulto , Pré-Escolar , Estudos Transversais , Diarreia/epidemiologia , Feminino , Febre/epidemiologia , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Índia/epidemiologia , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Prevalência , Infecções Respiratórias/epidemiologia , Fatores de Risco , Adulto Jovem
11.
PLoS One ; 15(5): e0232256, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32427999

RESUMO

BACKGROUND: We developed, and pilot tested a family focused intervention Sammanit Jeevan "Living with Dignity" to reduce gender-based violence by husbands, change harmful social and gender norms and improve the economic conditions of women through young married women-led income generating activities (IGAs). METHODS: We conducted a modified interrupted time series study and qualitative research to evaluate the intervention in two migrant communities in Baglung district, Nepal. We enrolled young married women, their husbands and in-laws from 100 families. 200 women and 157 men completed questionnaires before the programme, and 6, 12 and 18 months afterwards. 18 in-depth interviews were conducted before the programme and 6 and 12 months later. We analysed the data for trends. RESULTS: The intervention positively impacted young married women's economic conditions, exposure to violence and changed inequitable gender attitudes. Some positive outcomes were observed among older women and men. Young women's past month earnings (35.0% - 81.3%, ß = 0.11, p-value<0.001) and savings (29.0% - 80.2%, ß = 0.14, p-value<0.001) more than doubled over time. Young women experienced much less past year physical IPV over time (10% - 4.4%, ß = -0.08, p-value = 0.077). They also perceived that their mothers-in-law were less cruel (mean 9.0-8.6, ß = -0.03, p-value = 0.035). Improvements were observed in young women's individual (mean 44.4-43.3, ß = -0.04, p-value = 0.297) and perceived community gender attitudes (mean 54.4-51.4, ß = -0.19, p-value<0.001) and they reported that their husbands were less controlling (mean 17.5-16.1, ß = -007, p-value<0.001). These changes were supported by qualitative findings. CONCLUSIONS: Whilst caution is needed in attributing the effect due to lack of control arm, the results suggest that with adequate time and seed funding, Sammanit Jeevan enabled considerable income generation, a strengthened the position of young women in the households and it reduced their exposure to violence in this community. It warrants further research to optimise its impact.


Assuntos
Coragem , Família , Renda , Maus-Tratos Conjugais/economia , Maus-Tratos Conjugais/estatística & dados numéricos , Adolescente , Adulto , Feminino , Abastecimento de Alimentos/estatística & dados numéricos , Identidade de Gênero , Humanos , Masculino , Pessoa de Meia-Idade , Nepal , Projetos Piloto , Maus-Tratos Conjugais/psicologia , Inquéritos e Questionários , Adulto Jovem
12.
PLoS One ; 15(4): e0232217, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32330193

RESUMO

Intimate partner violence (IPV) continues to be a major public health problem globally. Although Ethiopia has a high prevalence of IPV, previous studies in this country have only investigated individual-level determinants of IPV within small geographic areas. The current study aimed to identify the individual-, relationship-, community-, and societal-level determinants of IPV directed against women in Ethiopia since women are predominantly affected. A retrospective analysis of nationally representative data from the 2016 Ethiopian Demographic and Health Survey (EDHS) was conducted. A sample of 3,897 married women of reproductive age (15-49 years) who participated in the domestic violence module of the survey were included in the analysis. Three-level mixed-effects multilevel logistic regression models were used to estimate the individual-, relationship-, community-, and societal-level determinants of IPV. Variability at the community- and societal-level were also assessed. About 1,328 (34.1%) of 3,897 participants reported experiencing IPV (a composite measure of physical, sexual and emotional abuse). In adjusted models, the odds of lifetime IPV experience were higher among women who were older, were married before the age of 18 years, witnessed inter-parental violence during their childhood, had a partner who drank alcohol, and lived in a community with high IPV accepting norms. Alternatively, the odds of IPV were lower among women who had decision-making autonomy in the household, had the same or lower educational attainment as their partner, and lived in a community with low proportions of educated women. These findings reveal that although individual-level factors were significant determinants of IPV, higher level factors, including female education and IPV acceptance in the community, were also important influences on this major public health issue in Ethiopia. These findings suggest combined interventions at different levels may reduce IPV in this country.


Assuntos
Violência por Parceiro Íntimo/estatística & dados numéricos , Adolescente , Adulto , Violência Doméstica/estatística & dados numéricos , Etiópia , Características da Família , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Parceiros Sexuais , Maus-Tratos Conjugais/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Adulto Jovem
13.
J Glob Health ; 10(1): 010406, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32257154

RESUMO

Background: There is considerable interest in community organising and activism as a strategy to shift patriarchal gender norms, attitudes and beliefs and thus reduce intimate partner violence (IPV). Yet there is limited insight into how activism actually translates into reduced violence, including how aspects of programme implementation or cultural context may affect impact. This study evaluates the community activism/mobilisation portion of Indashyikirwa, a multi-component, IPV prevention programme implemented in rural Rwanda. The activism part of Indashyikirwa was based on SASA!, a promising program model from Uganda with demonstrated effectiveness. Methods: We implemented two separate cross-sectional surveys as part of a larger community randomised controlled trial to assess the impact of the community portion of Indashyikirwa on preventing physical and/or sexual IPV and other secondary outcomes at a community level. The survey consisted of a random household-based sample of 1400 women and 1400 men at both waves. Surveys were conducted before community-level activities commenced and were repeated 24 months later with a new cross-sectional sample. Longitudinal, qualitative data were collected as part of an embedded process evaluation. Results: There was no evidence of an intervention effect at a community level on any of the trial's primary or secondary outcomes, most notably women's experience of physical and/or sexual IPV from a current male partner in the past 12 months (adjusted odds ratio (aOR) = 1.25; 95% confidence interval (CI) = 0.92-1.70, P = 0.16), or men's perpetration of male-to-female physical and/or sexual IPV (aOR = 1.02; 95% CI = 0.72-1.45, P = 0.89). Process evaluation data suggest that delays due to challenges in adapting and implementing SASA!-style activites in rural Rwanda may account for the trial's failure to measure an effect. Additionally, the intervention strategy of informal activism was not well suited to the Rwandan context and required considerable modification. Conclusions: Failure to reduce violence when implementing an adaptation of SASA! in rural Rwanda highlights the importance of allowing sufficient time for adapting evidence-based programming (EBP) to ensure cultural appropriateness and fidelity. This evaluation held little chance of demonstrating impact since the project timeline forced endline evaluation only months after certain elements of the programme became operational. Donors must anticipate longer time horizons (5 to 7 years) when contemplating evaluations of novel or newly-adapted programmess for reducing IPV at a population level. These findings also reinforce the value of including embedded process evaluations when investing in rigorous trials of complex phenomena such as community activism. Trial registration: ClinicalTrials.gov, NCT03477877.


Assuntos
Participação da Comunidade , Violência por Parceiro Íntimo/prevenção & controle , População Rural , Parceiros Sexuais , Adolescente , Adulto , Serviços de Saúde Comunitária , Estudos Transversais , Características da Família , Feminino , Humanos , Violência por Parceiro Íntimo/etnologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Ruanda , Maus-Tratos Conjugais/etnologia , Maus-Tratos Conjugais/prevenção & controle , Maus-Tratos Conjugais/estatística & dados numéricos
14.
J Glob Health ; 10(1): 010707, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32257164

RESUMO

Background: Intimate partner violence (IPV) is a multi-national problem with many health consequences. Some research suggests that reducing rates of child marriage can improve gender norms and health outcomes related to IPV. Here, we examine whether changes in national child marriage laws can improve attitudes about domestic violence and reduce intimate partner violence at scale. Methods: Data on attitudes towards violence and violence experienced were obtained from the Demographic and Health Surveys (DHS) and longitudinal data on child marriage policy from WORLD and MACHEquity databases (1995-2012). Treatment countries were included if they improved their national child marriage policies from harmful (under 18) to more protective and control countries were included if they had a constant child-marriage policy that allowed girls to marry under the age of 18. Our final data set included 5 treatment and 14 control countries for women's outcomes, 2 treatment and 9 control countries for men's outcomes and 2 treatment and 7 control countries for IPV outcomes (for which fewer countries collect data). We combined individual level responses to five questions on attitudes about domestic violence to create a scale from 0 (always unacceptable) to 5 (always acceptable). All analyses employed a difference-in-differences approach adjusting for individual and country level predictors. Results: Data were available for 532 255 women, of which 96 414 also completed the domestic violence modules, and 104 704 men. National changes to a protective child marriage policy were associated with improved attitudes towards violence among women (-0.21 points, 95% confidence interval (CI) = -0.28, -0.14) and men (-0.98 points, 95% CI = -1.13, -0.83). Additionally, the risk of women experiencing physical and sexual abuse reduced by a greater proportion in treatment compared to control countries (odds ratio OR = 0.65, 95% CI = 0.50, 0.84; OR = 0.63, 95% CI = 0.45, 0.88, respectively). Conclusions: Our large multi-national study is the first of its kind to critically evaluate the role of national policy on attitudes towards and experiences of IPV among both men and women, and finds that these laws have protective outcomes. Our results are consistent with the hypothesis that gender egalitarian laws positively influence norms and health at the national level.


Assuntos
Violência por Parceiro Íntimo/estatística & dados numéricos , Casamento/estatística & dados numéricos , Parceiros Sexuais/psicologia , Maus-Tratos Conjugais/estatística & dados numéricos , Violência/estatística & dados numéricos , Adolescente , Adulto , Atitude , Criança , Comparação Transcultural , Estudos Transversais , Demografia , Feminino , Humanos , Violência por Parceiro Íntimo/etnologia , Masculino , Casamento/etnologia , Normas Sociais , Maus-Tratos Conjugais/etnologia , Adulto Jovem
15.
An. psicol ; 36(1): 173-180, ene. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-192053

RESUMO

El trabajo analiza la relación entre el padecimiento de sucesos vitales estresantes y el consumo excesivo de alcohol y drogas en 136 mujeres víctimas de violencia de género de Nicaragua. Los datos se btuvieron a partir de una entrevista estructurada diseñada para este fin que recoge sucesos vitales estresantes padecidos por las víctimas a lo largo de su vida. Los resultados muestran que quienes padecieron distintos episodios de violencia en la infancia consumieron alcohol y drogas en exceso. Además, el mayor predictor para el consumo de alcohol y drogas se encuentra entre quienes padecieron abuso sexual antes de los 18 años. Por otra parte, los análisis Odds Ratio indican un aumento del riesgo para el consumo de sustancias cuando el abuso se produjo a edades tempranas. Pese a la relevancia para la salud de las víctimas, existen pocos dispositivos en Nicaragua con los que atender a las víctimas de violencia de género hacia procesos de recuperación, sobre todo para quienes han desarrollado estrategias de afrontamiento relacionados con el consumo excesivo de sustancias


The work analyzes the relationship between the suffering of stressful life events and the excessive consumption of alcohol and drugs in 136 women victims of gender violence in Nicaragua. The data was obtained from a heteroapplied structured interview designed for this purpose, which collects stressful life events suffered by the victims through-out their lives. The results show that those who suffered different episodes of violence since childhood consumed alcohol and drugs in excess. In addition, the greatest predictor for alcohol and drug use is among those who suffered sexual abuse before age 18. On the other hand, the Odds Ratio analyzes indicate an increased risk for the consumption of substances when the abuse occurred at an early age. Despite the relevance for the health of the victims, there are few devices in Nicaragua with which to assist victims of gender violence towards recovery processes, especially for those who have developed coping strategies related to excessive substance use


Assuntos
Humanos , Feminino , Adulto , Transtornos Relacionados ao Uso de Substâncias/psicologia , Pobreza , Maus-Tratos Conjugais/estatística & dados numéricos , Fatores de Risco , Inquéritos e Questionários , Transtornos Relacionados ao Uso de Substâncias/complicações , Análise de Dados , Abuso Físico/psicologia , Delitos Sexuais/psicologia
16.
Glob Public Health ; 15(1): 121-136, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31392927

RESUMO

In Bangladesh, one in five currently married women (CMW) presently experience male intimate partner physical violence (MIPPV). While previous studies analysed women's individual-level multiple locations-younger age, lower education, income, and poverty in an additive manner, we took an intersectional approach to look at the effects of their multiple intersectional locations on MIPPV. Using McCall's intercategorical intersectional approach, we examine how women's intersectional locations are associated with their odds of experiencing MIPPV. Our sample from a 2015 nationally representative survey comprised 14,557 CMW living with their spouses. Thirty-four percent of CMW are young, 49% below primary educated, 19% income earning, 23% poor, and 25% experience MIPPV. We found that CMW in their dual disadvantaged younger age-lower education and single disadvantaged higher education-poor locations have 13.57% (95% CI, 9.25, 17.89) and 12.02% (95% CI, 6.87, 17.17) (respectively) higher probabilities of experiencing MIPPV than their counterparts in the corresponding dual privileged older age-higher education and higher education-nonpoor locations. Consistent with intersectionality theory, instead of prioritising a few groups over others (i.e. Oppression Olympics), we recommend building intersectional solidarity with women, men and communities to disrupt the underlying socio-economic-educational-legal-political structures and processes that have sustained these marginalised locations.


Assuntos
Escolaridade , Renda/estatística & dados numéricos , Violência por Parceiro Íntimo/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Cônjuges , Adolescente , Adulto , Fatores Etários , Bangladesh , Feminino , Humanos , Masculino , Fatores de Risco , Maus-Tratos Conjugais/estatística & dados numéricos , Inquéritos e Questionários , Populações Vulneráveis/estatística & dados numéricos , Adulto Jovem
17.
Women Health ; 60(5): 502-516, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31587625

RESUMO

African American women are at higher risk for sexual assault than other racial/ethnic groups and have an overall high prevalence of lifetime sexual assault. Despite elevated risk and prevalence, African American survivors are often reluctant to use services in the aftermath of sexual assault. Yet, little research has focused exclusively on African American women's sexual assault experiences including their experiences of medical care seeking. A mail survey study was conducted in Chicago (2010-2011) to understand better African American women's sexual assault experiences in relationship to post-assault medical care seeking in a large community sample (N = 836). Multivariable regression analyses examined whether demographics, assault characteristics, trauma history, and post-assault psychosocial factors were related to medical care seeking. Results revealed unique correlates of immediate and long-term help-seeking from a variety of medical/health sources. Being of older age and lower income, perceived life threat, and delayed disclosure were related to less medical care seeking. Survivors who were assaulted by strangers, experienced interpersonal and contextual traumas, and who received tangible aid and mixed social reactions were related to medical care seeking. Implications for research and clinical practice with this population are provided.


Assuntos
Afro-Americanos/psicologia , Vítimas de Crime/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Delitos Sexuais/etnologia , Maus-Tratos Conjugais/etnologia , Sobreviventes/estatística & dados numéricos , Saúde da Mulher/etnologia , Adaptação Psicológica , Adolescente , Adulto , Afro-Americanos/estatística & dados numéricos , Fatores Etários , Idoso , Chicago/epidemiologia , Vítimas de Crime/estatística & dados numéricos , Feminino , Comportamentos Relacionados com a Saúde/etnologia , Humanos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Delitos Sexuais/psicologia , Delitos Sexuais/estatística & dados numéricos , Apoio Social , Fatores Socioeconômicos , Maus-Tratos Conjugais/psicologia , Maus-Tratos Conjugais/estatística & dados numéricos , Inquéritos e Questionários , Sobreviventes/psicologia , Adulto Jovem
18.
Women Health ; 60(5): 570-584, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31665985

RESUMO

Screening rates for trauma are low in health care settings. We examined the association between health care providers' (HCPs) experience of physical or sexual trauma and their screening of female patients for trauma. HCPs at an urban academic medical institution were surveyed from September through November 2016. The Brief Trauma (BTQ) and Sexual and Physical Abuse History Questionnaires (SPAHQ) assessed their own experiences of trauma. The Screening Practices Questionnaire (SPQ) assessed HCPs trauma screening. Multiple regression analyses were performed. Among 212 respondents aged 22-67 years, most were female (78.3%) and white (76.1%). Nurses (41.0%) were the largest occupational group. Overall, 85.8% reported having experienced trauma. No significant difference was observed in median SPQ scores between HCPs who had experienced trauma (3.88 [Interquartile Range (IQR) 3.44-4.31]) and those who had not (4.00 [IQR 3.47-4.33], p = .645). In an adjusted model, screening policy awareness and having an obstetrics & gynecology or psychiatry specialty were associated with higher SPQ scores (p < .001). The prevalence of trauma experience in this sample was high, but not associated with screening. Screening policy awareness and practice specialty were associated with screening. HCP factors associated with greater trauma screening should be explored.


Assuntos
Pessoal de Saúde/psicologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Programas de Rastreamento/métodos , Delitos Sexuais/estatística & dados numéricos , Maus-Tratos Conjugais/estatística & dados numéricos , Adolescente , Adulto , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Violência por Parceiro Íntimo/psicologia , Masculino , Pessoa de Meia-Idade , Prevalência , Delitos Sexuais/psicologia , Maus-Tratos Conjugais/psicologia , Inquéritos e Questionários , Adulto Jovem
19.
Ciênc. Saúde Colet ; 25(9): 3475-3480, Mar. 2020. tab
Artigo em Português | LILACS, Coleciona SUS, Sec. Est. Saúde SP | ID: biblio-1133145

RESUMO

Resumo O estudo tem por objetivo identificar elementos precipitadores/intensificadores da violência conjugal em tempos de pandemia da Covid-19. Trata-se de uma revisão narrativa da literatura, tendo a busca sido realizada no mês de maio de 2020. Utilizou-se a plataforma PubCovid-19, a qual está indexada na Biblioteca Nacional de Medicina dos Estados Unidos (PubMed) e no Banco de dados Excerpta Medica (EMBASE). Para a realização da busca foram utilizados os seguintes descritores em inglês: "Domestic violente"; "Covid-19" e "Intimate Partner Violence". Foram selecionados nove artigos para leitura na íntegra. A partir da exploração do material selecionado, foram elaboradas três categorias empíricas a saber: Instabilidade econômica, Uso/abuso de álcool e outras drogas e Enfraquecimento da rede de apoio da mulher. É importante que nesse contexto de pandemia, sejam ampliadas as redes de apoio à mulher em situação de violência conjugal, com destaque para o uso de tecnologias digitais como possíveis ferramentas para a triagem de casos de violência em tempos de pandemia.


Abstract The study aims to identify marital violence precipitating/intensifying elements during the COVID-19 pandemic. This is a narrative review of the literature, and the search was carried out in May 2020. We employed the PubCovid-19 platform, which is indexed in the United States National Library of Medicine (PubMed) and the Excerpta Medica (EMBASE) database. English descriptors "Domestic violence", "COVID-19", and "Intimate Partner Violence" were used in the search, and nine papers were selected for full-text reading. Three empirical categories were elaborated from the exploration of the selected material: Economic instability, Alcohol and other drugs use/abuse, and Weaker women's support network. Support networks for women in situations of marital violence should be expanded in this pandemic context, with emphasis on the use of digital technologies as possible tools for screening pandemic-related violence cases.


Assuntos
Humanos , Masculino , Feminino , Pneumonia Viral/epidemiologia , Maus-Tratos Conjugais/estatística & dados numéricos , Programas de Rastreamento/métodos , Infecções por Coronavirus/epidemiologia , Consumo de Bebidas Alcoólicas/epidemiologia , Fatores de Risco , Infecções por Coronavirus , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Pandemias
20.
Artigo em Espanhol | IBECS | ID: ibc-192393

RESUMO

Las crisis, las emergencias y las épocas de disturbios se han relacionado con un aumento de la violencia interpersonal, incluida la violencia hacia las mujeres. A raíz de la declaración de estado de alarma y confinamiento se han puesto en marcha nuevas medidas encaminadas a paliar el posible impacto de la violencia de género (Plan de Contingencia contra la violencia de género ante la crisis del coronavirus o Real Decreto-Ley de medidas urgentes). Se revisan en este documento las medidas de contención adoptadas hasta el momento por el gobierno de España y las comunidades autónomas, y las iniciativas formuladas en diferentes países. Ante la ausencia de medidas económicas concretas planteadas hasta la fecha y el escenario de incertidumbre económica concluimos que no es posible prevenir la violencia de género de manera integral sin considerar el aumento del desempleo, la temporalidad y la inestabilidad laboral, la dependencia económica o la sobrecarga de tareas reproductivas, entre otros elementos que la facilitan


Crises, emergencies and times of unrest have been linked to increased interpersonal violence, including violence against women. Following the declaration of alarm status and quarantine, different measures have been implemented to mitigate the possible effect of gender violence (Contingency Plan against Gender-Based Violence in Coronavirus Crisis or Royal Decree Law on Emergency Measures). This document reviews the measures adopted so far by the government of Spain, the autonomous governments and the initiatives formulated in different countries. In the absence of concrete economic measures to date, and the scenario of economic uncertainty, we conclude that it is not possible to prevent gender-based violence in a comprehensive way, without considering the increase in unemployment, temporary and instability employment, economic dependency or the overload of household chores and reproductive tasks, among other elements that facilitate it


Assuntos
Humanos , Violência de Gênero/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Maus-Tratos Conjugais/estatística & dados numéricos , Violência Doméstica/prevenção & controle , Pandemias/estatística & dados numéricos , Quarentena/estatística & dados numéricos , Medidas em Epidemiologia
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