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Marcos-Marcos J, Nardini K, Briones-Vozmediano E, Vives-Cases C. Listening to stakeholders in the prevention of gender-based violence among young people in Spain: a qualitative study from the positivMasc project. BMC Womens Health 2023; 23:393. [PMID: 37496067 PMCID: PMC10373224 DOI: 10.1186/s12905-023-02545-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 07/13/2023] [Indexed: 07/28/2023] Open
Abstract
OBJECTIVE This study seeks to deepen current knowledge of the phenomenon of gender-based violence (GVB) among young people in Spain, identifying the main challenges in terms of prevention from the perspective of key stakeholders in the field. METHODS 23 semi-structured qualitative interviews were performed with professionals whose work involves youth and comes from different areas: social work, policy making, youth education, feminist and LGBTQ activism and anti-violence masculinities engagement (13 women and 10 men). RESULTS Among the main challenges identified by stakeholders in relation to GBV preventive strategies in young populations there is a need to focus on transformative programmes within educational settings. The findings indicate that specific programs and interventions in this area may not be yielding the expected effectiveness. This outcome could be attributed less to a lack of resources and more to a failure to address the core issues and challenges adequately. Thus, the results underline that intervention programmes should emphasise equitable gender norms and gender relations and incorporate content on anti-violence masculinities. Finally, a pivotal aspect seen by professionals to facilitate GBV prevention is the design and development of interventions based on participatory and active approaches, close to young people's everyday situations. The results also draw attention to the need to analyse the impact of new forms of violence in greater depth, especially those that occur through information and communication technologies. CONCLUSION Among other implications for policy and practice, the study points to the need to articulate interventions designed to work simultaneously at different levels of influence acting on people.
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Affiliation(s)
| | - Krizia Nardini
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain
| | | | - Carmen Vives-Cases
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain
- Center for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Aventin Á, Robinson M, Hanratty J, Keenan C, Hamilton J, McAteer ER, Tomlinson M, Clarke M, Okonofua F, Bonell C, Lohan M. Involving men and boys in family planning: A systematic review of the effective components and characteristics of complex interventions in low- and middle-income countries. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1296. [PMID: 36911859 PMCID: PMC9837728 DOI: 10.1002/cl2.1296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Indexed: 06/18/2023]
Abstract
Background Involving men and boys as both users and supporters of Family Planning (FP) is now considered essential for optimising maternal and child health outcomes. Evidence on how to engage men and boys to meet FP needs is therefore important. Objectives The main objective of this review was to assess the strength of evidence in the area and uncover the effective components and critical process- and system-level characteristics of successful interventions. Search Methods We searched nine electronic databases, seven grey literature databases, organisational websites, and the reference lists of systematic reviews relating to FP. To identify process evaluations and qualitative papers associated with the included experimental studies, we used Connected Papers and hand searches of reference lists. Selection Criteria Experimental and quasi-experimental studies of behavioural and service-level interventions involving males aged 10 years or over in low- and middle-income countries to increase uptake of FP methods were included in this review. Data Collection and Analysis Methodology was a causal chain analysis involving the development and testing of a logic model of intervention components based on stakeholder consultation and prior research. Qualitative and quantitative data relating to the evaluation studies and interventions were extracted based on the principles of 'effectiveness-plus' reviews. Quantitative analysis was undertaken using r with robust variance estimation (RVE), meta-analysis and meta-regression. Qualitative analysis involved 'best fit' framework synthesis. Results We identified 8885 potentially relevant records and included 127 in the review. Fifty-nine (46%) of these were randomised trials, the remainder were quasi-experimental studies with a comparison group. Fifty-four percent of the included studies were assessed as having a high risk of bias. A meta-analysis of 72 studies (k = 265) showed that the included group of interventions had statistically significantly higher odds of improving contraceptive use when compared to comparison groups (odds ratio = 1.38, confidence interval = 1.21 to 1.57, prediction interval = 0.36 to 5.31, p < 0.0001), but there were substantial variations in the effect sizes of the studies (Q = 40,647, df = 264, p < 0.0001; I 2 = 98%) and 73% was within cluster/study. Multi-variate meta-regression revealed several significant intervention delivery characteristics that moderate contraceptive use. These included community-based educational FP interventions, interventions delivered to women as well as men and interventions delivered by trained facilitators, professionals, or peers in community, home and community, or school settings. None of the eight identified intervention components or 33 combinations of components were significant moderators of effects on contraceptive use. Qualitative analysis highlighted some of the barriers and facilitators of effective models of FP that should be considered in future practice and research. Authors' Conclusions FP interventions that involve men and boys alongside women and girls are effective in improving uptake and use of contraceptives. The evidence suggests that policy should continue to promote the involvement of men and boys in FP in ways that also promote gender equality. Recommendations for research include the need for evaluations during conflict and disease outbreaks, and evaluation of gender transformative interventions which engage men and boys as contraceptive users and supporters in helping to achieve desired family size, fertility promotion, safe conception, as well as promoting equitable family planning decision-making for women and girls.
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Affiliation(s)
- Áine Aventin
- Queen's University BelfastBelfastNorthern Ireland
| | | | | | - Ciara Keenan
- Queen's University BelfastBelfastNorthern Ireland
| | | | | | - Mark Tomlinson
- Queen's University BelfastBelfastNorthern Ireland
- Stellenbosch UniversityStellenboschSouth Africa
| | - Mike Clarke
- Queen's University BelfastBelfastNorthern Ireland
| | | | - Chris Bonell
- London School of Hygiene and Tropical MedicineLondonUK
| | - Maria Lohan
- Queen's University BelfastBelfastNorthern Ireland
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Pakpour AH, Fazeli S, Zeidi IM, Alimoradi Z, Georgsson M, Brostrom A, Potenza MN. Effectiveness of a mobile app-based educational intervention to treat internet gaming disorder among Iranian adolescents: study protocol for a randomized controlled trial. Trials 2022; 23:229. [PMID: 35313935 PMCID: PMC8935262 DOI: 10.1186/s13063-022-06131-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 02/26/2022] [Indexed: 11/10/2022] Open
Abstract
Background The use of video games, a hobby for many teenagers in their leisure time, has brought with it a new potential for concerns. Internet gaming disorder (IGD) is a mental condition classified as a disorder due to addictive behaviors. It may include use of video games, both online and offline. Consequences of IGD may include introversion, social anxiety, mood swings, loneliness, sleep problems, behavioral problems, depression, low self-esteem, and increased violence. In order to design an app-based intervention for adolescents, a transtheoretical model (TTM) has been used. This widely used model in the field of behavioral change is also practical for health education programs. In addition, cognitive-behavioral therapy (CBT) has been used to make people more aware of their behaviors, feelings and thoughts and how to achieve behavioral change. The present study seeks to determine the effectiveness of this app-based intervention in in the treatment of IGD among adolescents. Method In this single-blinded, randomized, controlled trial, 206 high-school adolescents aged 13 to 18 years in Qazvin city will be recruited. Eligible adolescents will be randomly assigned into intervention and control groups. Eight consecutive sessions delivered over 2 months and based on the TTM and CBT will be delivered through the `app (named HAPPYTEEN) to the intervention group. The control group will receive a sleep hygiene intervention (8 consecutive sessions for 2 months) via the app. Data collection tools include the Internet Gaming Disorder Scale, Insomnia Severity Index, Depression, Anxiety, and Stress Scales, Stages of Change Questionnaire, Decision Balance, and Self-Efficacy. The study measures will be completed at baseline, post intervention, and 1 month and 3 months after the intervention. Discussion The results of this intervention could be used as adjunct therapy for adolescents with IGD. Trial registration Clinical Trial Registration Center of Iran (IRCT) IRCT20181226042140N1. Registered on June 9, 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06131-0.
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Raj A, Ghule M, Johns NE, Battala M, Begum S, Dixit A, Vaida F, Saggurti N, Silverman JG, Averbach S. Evaluation of a gender synchronized family planning intervention for married couples in rural India: The CHARM2 cluster randomized control trial. EClinicalMedicine 2022; 45:101334. [PMID: 35274093 PMCID: PMC8902598 DOI: 10.1016/j.eclinm.2022.101334] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/27/2022] [Accepted: 02/16/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Despite calls for gender transformative family planning interventions to increase male engagement and female reproductive agency, there is limited research involving rigorous evaluation of the integration of these approaches. CHARM2 (counseling Husbands and wives to Achieve Reproductive Health and Marital Equity) builds upon a prior three-session male engagement intervention by integrating female-focused sessions emphasizing women's choice and agency (i.e., gender synchronization). We hypothesized that CHARM2 participants will be more likely to report marital contraceptive use and communication and women's contraceptive agency, and less likely to report unintended pregnancy, relative to participants in the control condition. METHODS We conducted a two-armed cluster randomized controlled trial evaluating the effects of CHARM2 on marital contraceptive use, communication, decision-making; women's contraceptive agency, and pregnancy among young married couples in rural Maharashtra, India (ClinicalTrials.gov #NCT03514914, complete). 40 geographic clusters, defined based on the catchment areas of subcenter health facilities (the most proximal level of community health care within India's public health system) were randomized to control (n = 20) and intervention (n = 20). We assigned all participants within that geographic cluster to the corresponding cluster treatment condition; participants, investigators, and study staff were not masked to treatment assignment. Eligibility criteria included wife aged 18-29, couple residing together for at least six months with no plan for migration, and neither spouse sterilized or infertile. The CHARM2 intervention included five provider-delivered sessions on gender equity and family planning, two delivered in parallel to husbands and wives separately by gender-matched providers, and one final joint session, delivered within the four months subsequent to baseline survey. We conducted surveys and pregnancy testing at baseline and 9-month and 18-month follow-up. We used difference-in-differences multilevel mixed effects logistic regressions to assess CHARM2 effects on marital contraceptive use and communication, and women's contraceptive agency; we used single time point mixed effects logistic regressions for pregnancy outcomes. All analyses used an intention-to-treat approach. FINDINGS 1201 couples were recruited between September 2018 and June 2019; 600 intervention and 601 control. All couples were included in outcome analyses. Full couple retention was 90·2% (n = 1083) at 9-month follow-up and 90·5% (n = 1087) at 18-month follow-up. Modern contraceptive use was higher among intervention participants at 9-month but not 18-month follow-up (9-month adjusted ratio of odds ratio [AROR] 1·5, 95% CI 1·03-2·3; 18-month AROR 0·8, 95% CI 0·4-1·4). Communication (9-month AROR 1·9, 95% CI 1·0-3·6; 18-month AROR 2·7, 95% CI 1·5-4·8) and agency (9-month AROR 5·1, 95% CI 1·2-22·4; 18-month AROR 8·1, 95% CI 1·4-48·2) both improved at both time points. There was no significant difference in pregnancy between groups over the 18-month period (AOR 0·8, 95% CI 0·7-1.1) However, for women who expressed fertility ambivalence at baseline, unintended pregnancy was marginally less likely among intervention participants (47% vs 19%) (p = 0·07). There were no reported adverse events. INTERPRETATION The CHARM2 intervention offers a scalable model to improve contraceptive use, communication, and agency and possibly decrease unplanned pregnancies for couples in rural India.
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Affiliation(s)
- Anita Raj
- Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093, United States
- Department of Education Studies, University of California, 3350 La Jolla Village Dr, San Diego, CA 92161, United States
- Corresponding author at: Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093, United States.
| | - Mohan Ghule
- Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093, United States
| | - Nicole E. Johns
- Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093, United States
| | - Madhusudana Battala
- Population Council, Zone 5A, Ground Floor, India Habitat Center, Lodi Road, New Delhi 110003, India
| | - Shahina Begum
- Department of Biostatistics, ICMR-National Institute for Research in Reproductive Health, J.M Street, Parel, Mumbai 400012, India
| | - Anvita Dixit
- Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093, United States
- Joint Doctoral Program in Public Health (Global Health Track), University of California San Diego/San Diego State University, UC San Diego 9500 Gilman Dr., La Jolla, CA 92093-0725, USA
| | - Florin Vaida
- Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093, United States
- Division of Biostatistics and Bioinformatics, Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States
| | - Niranjan Saggurti
- Population Council, Zone 5A, Ground Floor, India Habitat Center, Lodi Road, New Delhi 110003, India
| | - Jay G. Silverman
- Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093, United States
| | - Sarah Averbach
- Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093, United States
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego School of Medicine, 9300 Campus Point Drive #7433, La Jolla, CA 92037, USA
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Aventin Á, Robinson M, Hanratty J, Ruane‐McAteer E, Tomlinson M, Clarke M, Okonofua F, Bonell C, Lohan M. PROTOCOL: Involving men and boys in family planning: A systematic review of the effective components and characteristics of complex interventions in low- and middle-income countries. CAMPBELL SYSTEMATIC REVIEWS 2021; 17:e1140. [PMID: 37050964 PMCID: PMC8356317 DOI: 10.1002/cl2.1140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
| | | | | | | | - Mark Tomlinson
- Queen's University BelfastBelfastUK
- Stellenbosch UniversityStellenboschSouth Africa
| | | | | | - Chris Bonell
- London School of Hygiene and Tropical MedicineLondonUK
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