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Novitzky P, Janssen J, Kokkeler B. A systematic review of ethical challenges and opportunities of addressing domestic violence with AI-technologies and online tools. Heliyon 2023; 9:e17140. [PMID: 37342580 PMCID: PMC10277589 DOI: 10.1016/j.heliyon.2023.e17140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/01/2023] [Accepted: 06/08/2023] [Indexed: 06/23/2023] Open
Abstract
Domestic violence remains a pressing complex social problem of people of any gender, age, socio-economic status, and ethno-cultural background, an issue that worsened worldwide during the COVID-19 pandemic. Digital, online, or artificial intelligence-based smart technological services, applications, and tools provide novel approaches in addressing domestic violence, including intimate partner violence. This systematic literature review analyses the ethical challenges and opportunities these (protective) digital and smart technologies provide to the stakeholders involved. Our results highlight that the public health and societal issue are the leading narratives of domestic violence, which is predominantly interpreted as gender-based violence. The review highlights an emerging trend of the role of machine learning- and artificial intelligence-based approaches in identifying and preventing domestic violence. However, we argue that little recommendation is available to professionals about how to use these approaches in a responsible way, and that the smartness of high-tech technologies is often challenged by basic-level technologies from perpetrators, creating an imbalance that also limits an impactful development of a comprehensive socio-technical regime that serves the safety and resilience of families in their communal setting.
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Affiliation(s)
- Peter Novitzky
- Department of Engineering – STEaPP, PETRAS National Centre of Excellence for IoT Systems Cybersecurity, University College London, United Kingdom
- Avans University of Applied Sciences, Breda, the Netherlands
| | - Janine Janssen
- Avans University of Applied Sciences, Breda, the Netherlands
- Open University of the Netherlands, Heerlen, the Netherlands
- Police Academy of the Netherlands, Apeldoorn, the Netherlands
| | - Ben Kokkeler
- Avans University of Applied Sciences, Breda, the Netherlands
- University of Twente, Department of Science, Technology and Policy Studies, the Netherlands
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Philbrick W, Milnor J, Deshmukh M, Mechael P. Information and communications technology use to prevent and respond to sexual and gender-based violence in low- and middle-income countries: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1277. [PMID: 36908839 PMCID: PMC9595343 DOI: 10.1002/cl2.1277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND The use of information and communications technologies (ICT) in low- and middle-income countries (LMIC) has increased significantly in the last several years, particularly in health, including related areas such as preventing and responding to sexual and gender-based violence (SGBV) against women and children. While the evidence for ICT effectiveness has grown significantly in the past 5 years in other aspects of health, it has not for effectiveness of using ICT for the prevention and response to SGBV against women and children in LMIC. OBJECTIVES The primary goal of this evidence and gap map (EGM) is to establish a baseline for the state of the evidence connected with the use of ICT for preventing and responding to SGBV against women and children in LMIC. Objectives that contribute to the achievement of this goal are: (1)identifying evidence of effectiveness for the use of ICT targeting the prevention of, and response to, SGBV against women and children in LMIC;(2)identifying key gaps in the available ICT for SGBV prevention and/or response evidence;(3)identifying research methodology issues reflected in the current evidence;(4)identifying any clusters of evidence in one or more ICT interventions suitable for systematic review;(5)identifying enabling factors associated with effective interventions using ICT for the prevention of, and response to, SGBV against women and children in LMIC; and(6)providing a structured and accessible guide to stakeholders for future investment into interventions and research using ICT for SGBV prevention and response in LMIC. SEARCH METHODS The date of the last search from which records were evaluated, and any studies identified were incorporated into the EGM was July 11, 2021. Twenty (20) databases were searched, and identified under "Methods." SELECTION CRITERIA We conducted systematic searches of multiple academic databases using search terms and criteria related to the use of ICT for prevention and/or response to SGBV against women and children. Although excluded, we did consider studies conducted in higher-income countries (HIC) only to provide context and contrast for the EGM discussion of the eligible studies from LMIC. DATA COLLECTION AND ANALYSIS The EGM search process included five phases: (1) initial search of academic databases conducted by two researchers simultaneously; (2) comparison of search results, and abstract screening by two researchers collaboratively; (3) second screening by reviewing full articles of the studies identified in the first screening by two reviewers independently; (4) comparison of results of second screening; resolution of discrepancies of screening results; and (5) data extraction and analysis. MAIN RESULTS The EGM includes 10 studies published in English of which 4 were systematic, literature or scoping reviews directly addressing some aspect of the use of ICT for SGBV prevention and/or response in women and girls. The six individual studies were, or are being, conducted in LMIC (a condition for eligibility). No eligible studies addressed children as a target group, although a number of the ineligible studies reported on the use of ICT for intermediate outcomes connected with violence against children (e.g., digital parenting). Yet, such studies did not explicitly attach those intermediate outcomes to SGBV prevention or response outcomes. Countries represented among the eligible individual studies include Cambodia, Kenya, Nepal Democratic Republic of Congo (DRC), and Lebanon. Of the 10 eligible studies (individual and reviews), most focused on intimate partner violence against women (IPV). Intervention areas among the eligible studies include safety planning using decision algorithms, educational and empowerment messaging regarding norms and attitudes towards gender-based violence (GBV), multi-media radio drama for social behavior change, the collection of survivor experience to inform SGBV/GBV services, and the collection of forensic evidence connected to the perpetration of SGBV. Thirty-one studies which otherwise would have been eligible for the evidence and gap map (EGM) were conducted in HIC (identified under "Excluded Reviews"). None of the eligible studies reported results related to effectiveness of using ICT in a control setting, for the primary prevention of SGBV as an outcome, but rather reported on outcomes such as usability, secondary and tertiary prevention, feasibility, access to services and other outcomes primarily relating to the development of the interventions. Two studies identified IPV prevention as a measurable outcome within their protocols, but one of these had not yet formally published results regarding primary prevention as an outcome. The other study, while reporting on the protocol (and steps to adapt the ICT application, previously reported as effective in HIC contexts to a specific LMIC context), has not yet as of the date of writing this EGM, published outcome results related to the reduction of IPV. Of the four reviews identified as eligible, two are better characterized as either a literature review or case study rather than as traditional systematic reviews reporting on impact outcomes with methodologically rigorous protocols. AUTHORS' CONCLUSIONS The evidence baseline for using ICT to prevent and/or respond to SGBV against women and children in LMIC is nascent. Promising areas for future study include: (1) how ICT can contribute changing gender and social norms related to SGBV and primary prevention; (2) mobile phone applications that promote safety and security; (3) mobile technology for the collection and analysis of survivors' experience with SGBV response services; and (4) digital tools that support the collection of forensic evidence for SGBV response and secondary prevention. Most striking is the paucity of eligible studies examining the use of ICT in connection with preventing or responding to SGBV against children. In light of the exponential increase in the use of ICT by children and adolescents, even in LMIC, greater attention should be given to examining how ICT can be used during adolescence to address gender norms that lead to SGBV. While there appears to be interest in using ICT for SGBV prevention and/or response in LMIC, other than several ad hoc studies, there is little evidence of if, and how effective these interventions are. Further inquiry should be made regarding if and how interventions proven effective in HIC can be adapted to LMIC contexts.
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Affiliation(s)
- William Philbrick
- Sitara InternationalAtlantaGeorgiaUSA
- Health, Equity and Rights, CAREAtlantaGeorgiaUSA
| | - Jacob Milnor
- Oswaldo Cruz FoundationOswaldo Cruz InstituteRio de JaneiroBrazil
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Taccini F, Rossi AA, Mannarini S. Women's EmotionS, Trauma and EmpowErMent (W-ES.T.EEM) study protocol: a psychoeducational support intervention for victims of domestic violence - a randomised controlled trial. BMJ Open 2022; 12:e060672. [PMID: 36008062 PMCID: PMC9422860 DOI: 10.1136/bmjopen-2021-060672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Intimate partner violence (IPV) is a widespread phenomenon that affects the physical and mental well-being of victims. Several barriers prevented sufferers from receiving face-to-face interventions. These obstacles increased with the advent of the COVID-19 pandemic, and online psychological intervention can represent a valid solution to increase the well-being of IPV victims. This manuscript describes the study protocol for a single blind randomised controlled trial that examines the efficacy of a web-based psychoeducational intervention for IPV victims that integrates dialectical behavioural therapy and the empowerment approach. METHODS AND ANALYSIS Eighty-six women who were victims of IPV during the COVID-19 outbreak will be recruited by the Interdepartmental Center for Family Research (CIRF) staff from the several antiviolence centres located in Italy. Participants will be randomly allocated to the Women's EmotionS, Trauma and EmpowErMent experimental group or the treatment as usual control condition. Both interventions will be administered individually to each woman. ETHICS AND DISSEMINATION The study protocol was approved by the Ethics Committee of the University of Padua (protocol no 4300). Written informed consent will be obtained from all research participants before study entry. Study results will be published as peer-reviewed articles. Any relevant protocol changes will be reported in the published articles. The results will be reported anonymously. TRIAL REGISTRATION NUMBER ISRCTN12880309.
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Affiliation(s)
- Federica Taccini
- Interdepartmental Center for Family Research, University of Padua, Padova, Italy
| | - Alessandro Alberto Rossi
- Interdepartmental Center for Family Research, University of Padua, Padova, Italy
- Department of Philosophy, Sociology, Education and Applied Psychology, Section of Applied Psychology, University of Padua, Padua, Italy
| | - Stefania Mannarini
- Interdepartmental Center for Family Research, University of Padua, Padova, Italy
- Department of Philosophy, Sociology, Education and Applied Psychology, Section of Applied Psychology, University of Padua, Padua, Italy
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Garcia-Vergara E, Almeda N, Martín Ríos B, Becerra-Alonso D, Fernández-Navarro F. A Comprehensive Analysis of Factors Associated with Intimate Partner Femicide: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127336. [PMID: 35742583 PMCID: PMC9223751 DOI: 10.3390/ijerph19127336] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/10/2022] [Accepted: 06/11/2022] [Indexed: 02/04/2023]
Abstract
There has been a growing concern about violence against women by intimate partners due to its incidence and severity. This type of violence is a severe problem that has taken the lives of thousands of women worldwide and is expected to continue in the future. A limited amount of research exclusively considers factors related only to these women's deaths. Most focus on deaths of both men and women in an intimate partnership and do not provide precise results on the phenomenon under study. The necessity for an actual synthesis of factors linked solely to women's deaths in heterosexual relationships is key to a comprehensive knowledge of that case. This could assist in identifying high-risk cases by professionals involving an interdisciplinary approach. The study's objective is to systematically review the factors associated with these deaths. Twenty-four studies found inclusion criteria extracted from seven databases (Dialnet, Web of Science, Pubmed, Criminal Justice, Psychology and Behavioral Science Collection, Academic Search Ultimate, and APA Psyarticles). The review was carried out under the PRISMA guidelines' standards. The studies' quality assessment complies with the MMAT guidelines. Findings revealed that there are specific factors of the aggressor, victim, partner's relationship, and environment associated with women's deaths. The results have implications for predicting and preventing women's deaths, providing scientific knowledge applied to develop public action programs, guidelines, and reforms.
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Affiliation(s)
- Esperanza Garcia-Vergara
- Departament of Quantitative Methods, Universidad Loyola Andalucia, Avenida de las Universidades s/n, 41704 Seville, Spain; (D.B.-A.); (F.F.-N.)
- Correspondence:
| | - Nerea Almeda
- Departament of Psychology, Universidad Loyola Andalucia, Avenida de las Universidades s/n, 41704 Seville, Spain;
| | - Blanca Martín Ríos
- Departament of Legal and Political Sciences, Universidad Loyola Andalucia, Avenida de las Universidades s/n, 41704 Seville, Spain;
| | - David Becerra-Alonso
- Departament of Quantitative Methods, Universidad Loyola Andalucia, Avenida de las Universidades s/n, 41704 Seville, Spain; (D.B.-A.); (F.F.-N.)
| | - Francisco Fernández-Navarro
- Departament of Quantitative Methods, Universidad Loyola Andalucia, Avenida de las Universidades s/n, 41704 Seville, Spain; (D.B.-A.); (F.F.-N.)
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O'Campo P, Velonis A, Buhariwala P, Kamalanathan J, Hassan MA, Metheny N. Design and Development of a Suite of Intimate Partner Violence Screening and Safety Planning Web Apps: User-Centered Approach. J Med Internet Res 2021; 23:e24114. [PMID: 34931998 PMCID: PMC8734925 DOI: 10.2196/24114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/12/2020] [Accepted: 08/10/2021] [Indexed: 01/19/2023] Open
Abstract
Background The popularity of mobile health (mHealth) technology has resulted in the development of numerous apps for almost every condition and disease management. mHealth and eHealth solutions for increasing awareness about, and safety around, intimate partner violence are no exception. These apps allow women to control access to these resources and provide unlimited, and with the right design features, safe access when these resources are needed. Few apps, however, have been designed in close collaboration with intended users to ensure relevance and effectiveness. Objective The objective of this paper is to discuss the design of a suite of evidence-based mHealth and eHealth apps to facilitate early identification of unsafe relationship behaviors and tailored safety planning to reduce harm from violence including the methods by which we collaborated with and sought input from a population of intended users. Methods A user-centered approach with aspects of human-centered design was followed to design a suite of 3 app-based safety planning interventions. Results This review of the design suite of app-based interventions revealed challenges faced and lessons learned that may inform future efforts to design evidence-based mHealth and eHealth interventions. Conclusions Following a user-centered approach can be helpful in designing mHealth and eHealth interventions for marginalized and vulnerable populations, and led to novel insights that improved the design of our interventions.
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Affiliation(s)
- Patricia O'Campo
- MAP Center for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | - Alisa Velonis
- MAP Center for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada.,Division of Community Health Sciences, University of Illinois at Chicago School of Public Health, Chicago, IL, United States
| | - Pearl Buhariwala
- MAP Center for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | - Janisha Kamalanathan
- MAP Center for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | - Maha Awaiz Hassan
- MAP Center for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | - Nicholas Metheny
- MAP Center for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada.,School of Nursing and Health Studies, University of Miami, Coral Gables, FL, United States
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Anderson EJ, Krause KC, Meyer Krause C, Welter A, McClelland DJ, Garcia DO, Ernst K, Lopez EC, Koss MP. Web-Based and mHealth Interventions for Intimate Partner Violence Victimization Prevention: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2021; 22:870-884. [PMID: 31742475 DOI: 10.1177/1524838019888889] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Mobile health (mHealth) technologies are increasingly used across health programming including intimate partner violence (IPV) prevention to optimize screening, educational outreach, and linkages to care via telehealth. We systematically evaluated current web-based and mHealth interventions, which include web- or mobile-based delivery methods for primary, secondary, and tertiary IPV victimization prevention. We searched MEDLINE/PubMed, Embase, CINAHL, PsycINFO, Open Grey, and Google Scholar for empirical studies published 1998-2019. Studies were included if they considered empirical data, participants in adult romantic relationships, IPV as a primary or secondary outcome, and an mHealth component. The Mixed Methods Appraisal Tool was used to record critical ratings of quality among studies selected for inclusion. We assessed variation in targeted populations, types of IPV addressed, and mHealth approaches used. Of 133 studies identified for full-text review, 31 were included. Computer-based screening with or without integrated education was the most common mHealth approach (n = 8, 26%), followed by safety decision aids (n = 7, 23%). Feasibility and acceptability were found to be generally high where assessed (23% of studies, n = 7). There was limited evidence around whether mHealth interventions better addressed population needs compared to conventional interventions. mHealth tools for IPV prevention are especially acceptable in health-care settings, on mobile phone platforms, or when connecting victims to health care. Despite enthusiasm in pilot projects, evidence for efficacy compared to conventional IPV prevention approaches is limited. A major strength of mHealth IPV prevention programming is the ability to tailor interventions to individual victim needs without extensive human resource expenditure by providers.
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Affiliation(s)
- Elizabeth J Anderson
- Mel & Enid Zuckerman College of Public Health, 8041University of Arizona, Tucson, AZ, USA
| | - Keegan C Krause
- Mel & Enid Zuckerman College of Public Health, 8041University of Arizona, Tucson, AZ, USA
| | - Caitlin Meyer Krause
- Mel & Enid Zuckerman College of Public Health, 8041University of Arizona, Tucson, AZ, USA
| | - Abby Welter
- Mel & Enid Zuckerman College of Public Health, 8041University of Arizona, Tucson, AZ, USA
| | - D Jean McClelland
- Arizona Health Sciences Center, 8041University of Arizona, Tucson, Arizona, USA
| | - David O Garcia
- Mel & Enid Zuckerman College of Public Health, 8041University of Arizona, Tucson, AZ, USA
| | - Kacey Ernst
- Mel & Enid Zuckerman College of Public Health, 8041University of Arizona, Tucson, AZ, USA
| | - Elise C Lopez
- Mel & Enid Zuckerman College of Public Health, 8041University of Arizona, Tucson, AZ, USA
| | - Mary P Koss
- Mel & Enid Zuckerman College of Public Health, 8041University of Arizona, Tucson, AZ, USA
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Hunt X, Tomlinson M, Sikander S, Skeen S, Marlow M, du Toit S, Eisner M. Artificial Intelligence, Big Data, and mHealth: The Frontiers of the Prevention of Violence Against Children. Front Artif Intell 2020; 3:543305. [PMID: 33733202 PMCID: PMC7861328 DOI: 10.3389/frai.2020.543305] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 09/08/2020] [Indexed: 11/20/2022] Open
Abstract
Violence against children is a global public health threat of considerable concern. At least half of all children worldwide experience violence every year; globally, the total number of children between the ages of 2 and 17 years who have experienced violence in any given year is one billion. Based on a review of the literature, we argue that there is substantial potential for AI (and associated machine learning and big data), and mHealth approaches to be utilized to prevent and address violence at a large scale. This potential is particularly marked in low- and middle-income countries (LMIC), although whether it could translate into effective solutions at scale remains unclear. We discuss possible entry points for Artificial Intelligence (AI), big data, and mHealth approaches to violence prevention, linking these to the World Health Organization's seven INSPIRE strategies. However, such work should be approached with caution. We highlight clear directions for future work in technology-based and technology-enabled violence prevention. We argue that there is a need for good agent-based models at the level of entire cities where and when violence can occur, where local response systems are. Yet, there is a need to develop common, reliable, and valid population- and individual/family-level data on predictors of violence. These indicators could be integrated into routine health or other information systems and become the basis of Al algorithms for violence prevention and response systems. Further, data on individual help-seeking behavior, risk factors for child maltreatment, and other information which could help us to identify the parameters required to understand what happens to cause, and in response to violence, are needed. To respond to ethical issues engendered by these kinds of interventions, there must be concerted, meaningful efforts to develop participatory and user-led work in the AI space, to ensure that the privacy and profiling concerns outlined above are addressed explicitly going forward. Finally, we make the case that developing AI and other technological infrastructure will require substantial investment, particularly in LMIC.
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Affiliation(s)
- Xanthe Hunt
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Mark Tomlinson
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
- School of Nursing and Midwifery, Queens University Belfast, Belfast, United Kingdom
| | - Siham Sikander
- Global Health Department, Health Services Academy, Islamabad, Pakistan
| | - Sarah Skeen
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Marguerite Marlow
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Stefani du Toit
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Manuel Eisner
- Institute of Criminology, University of Cambridge, Cambridge, United Kingdom
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Bromberg DJ, Mayer KH, Altice FL. Identifying and managing infectious disease syndemics in patients with HIV. Curr Opin HIV AIDS 2020; 15:232-242. [PMID: 32487816 PMCID: PMC7376494 DOI: 10.1097/coh.0000000000000631] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW We will present recent articles focusing on HIV synergistic interactions with other sexually transmitted infections, tuberculosis, and hepatitis, as well as recent advances in the study of social and behavioral determinants that facilitate this clustering of infectious disease. For each synergistic interaction, we highlight evidence-based interventions that clinicians and policymakers should consider to tackle HIV and infectious disease syndemics. RECENT FINDINGS Significant advances in understanding the behavioral and structural determinants of HIV and other infectious disease synergisms have been made in the past years. Intervention strategies based on these new models have also been developed. It is now well understood that treating infectious disease syndemics will require a multidisciplinary and multipronged approach. SUMMARY HIV is synergistic with multiple other infectious diseases because the risk behaviors that lead to HIV acquisition may be similar to the other infections. The influence of HIV on the other infection may be due to immunosuppression associated with disease progression resulting in increased susceptibility (e.g., HIV and tuberculosis), especially when patients are not virologically suppressed using antiretroviral therapy. In reverse, another infectious disease may, when not treated, influence HIV disease progression. Social/structural determinants like homelessness, mass incarceration, and structural discrimination precipitate psychiatric comorbidity, substance use, and risky sex behavior which lead to the spread and co-occurrence of infectious disease.
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Affiliation(s)
- Daniel J Bromberg
- Department of Social and Behavioral Sciences, Yale University School of Public Health
- Yale Center for Interdisciplinary Research on AIDS, Yale University, New Haven, Connecticut
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Frederick L Altice
- Yale Center for Interdisciplinary Research on AIDS, Yale University, New Haven, Connecticut
- Section of Infectious Diseases, Department of Medicine, Yale University School of Medicine
- Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, Connecticut, USA
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Winter SC, Obara LM, McMahon S. Intimate partner violence: A key correlate of women's physical and mental health in informal settlements in Nairobi, Kenya. PLoS One 2020; 15:e0230894. [PMID: 32240207 PMCID: PMC7117691 DOI: 10.1371/journal.pone.0230894] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 02/08/2020] [Indexed: 01/09/2023] Open
Abstract
Globally, one billion people live in informal settlements, and that number is expected to triple by 2050. Studies suggests that health in informal settlements is a serious and growing concern, yet there is a paucity of research focused on health outcomes and the correlates of health in these settlements. Studies cite individual, environmental and social correlates to health in informal settlements, but they often lack empirical evidence. In particular, research suggests that high rates of violence against women (VAW) in informal settlements may be associated with detrimental effects on women's health, but few studies have investigated this link. The purpose of this study was to fill this gap by empirically exploring associations between women's experiences of intimate partner violence (IPV) and their physical and mental health. Data for this study were collected in August 2018 in Mathare Valley Informal Settlement in Nairobi, Kenya. A total of 550 randomly-selected women participated in surveys; however, analyses for this study were run on a subpopulation of the women (n = 361). Multivariate logistic regressions were used to investigate the link between psychological, sexual, and emotional IPV and women's mental and physical health. Results suggest that while some socioeconomic, demographic, and environmental variables were significantly associated with women's mental and physical health outcomes, all types of IPV emerged key correlates in this context. In particular, women's experiences of IPV were associated with lower odds of normal-high physical health component scores (based on SF-36); higher odds of gynecological and reproductive health issues, psychological distress (based on K-10), depression, suicidality, and substance use. Findings from this study suggest that policies and interventions focused on prevention and response to VAW in informal settlements may make critical contributions to improving health for women in these rapidly growing settlements.
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Affiliation(s)
- Samantha C. Winter
- Columbia School of Social Work, Columbia University, New York, New York, United States of America
- * E-mail:
| | - Lena Moraa Obara
- Department of Sociology and Social Work, University of Nairobi, Nairobi, Kenya
| | - Sarah McMahon
- Center on Violence Against Women and Children, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, United States of America
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