Intimate partner violence and community service needs among pregnant and postpartum Latina women

Understanding Intimate Partner Violence Service Delivery for Latinx Survivors in Rural Areas

Using a statewide survey, this exploratory, cross-sectional study examined 78 domestic violence (DV) service organizations' service delivery practices and perceived challenges to serving Latinx survivors in the context of rurality. Findings showed that DV organizations in rural areas perceived more challenges to delivering culturally appropriate services for Latinx survivors compared to those in other geographic settings even after accounting for client characteristics, service provision characteristics, and community resources. The study finding offers critical insights to ensure and enhance the provision of linguistically and culturally accessible services for rural Latinx survivors of intimate partner violence.

Mothers’ Resilience: Experiences of Intimate Partner Violence Survivors at Work

Mothers who experience intimate partner violence can be resilient in maintaining employment during periods of abuse. The current qualitative study examines mothers’ experiences of abusive workplace disruptions as well as helpful responses from workplaces. Two main research questions are addressed: 1. What ways do abusive partners use issues related to children to disrupt mothers’ employment? 2. How do workplaces respond to mothers experiencing IPV? How do mothers show resilience? Mothers (n = 18) receiving services for abuse explained that abusive partners disrupted their work through compromising or withholding childcare, manipulating them through children, and jeopardizing child safety during work hours. However, mothers showed resilience when coworkers extend housing, childcare, and genuine concern for their situations. Implications for researchers, practitioners, and employers of survivors are discussed.

When Abused Women Decide to Seek Help From a Victims Assistance Program: Their Perceived Needs and Self-Reported Mental Health Symptoms

This study examines the nature of perceived needs of women victims of intimate partner violence (IPV) and their association with social demographic characteristics and self-reported mental health symptoms. The study uses data from case records of women victims of IPV (n = 154) seeking help from a victim assistance program housed within city police station located in the southwest, United States. The majority of the women in this study reported needs related to counseling, protection orders, Crime Victims' Compensation Rights, legal services, and Temporary Aid for Needy Families. Findings also indicate that perceived needs of women were significantly associated with self-reported mental health symptoms. Some needs had a stronger relationship to women's mental health symptoms than others. Overall these findings suggest that it is imperative to emphasize responses that can address all the needs of women (in addition to stopping IPV) to reduce mental health symptoms.

Willing but Not Able: Patient and Provider Receptiveness to Addressing Intimate Partner Violence in Johannesburg Antenatal Clinics

Intimate partner violence (IPV) during pregnancy is associated with maternal and infant health. However, in South Africa, where 20% to 35% of pregnant women report experiencing IPV, antenatal care rarely addresses violence. Little research has explored how clinic staff, community members, or pregnant women themselves view IPV. We conducted formative, qualitative research with 48 participants in urban Johannesburg. Focus group discussions with pregnant women ( n = 13) alongside qualitative interviews with health providers ( n = 10), managers and researchers ( n = 10), non-governmental organizations ( n = 6), community leaders ( n = 4), and pregnant abused women ( n = 5) explored the context of IPV and health care response. Data were analyzed using a team approach to thematic coding in NVivo 10. We found that pregnant women in the urban Johannesburg setting experience multiple forms of IPV, but tend not to disclose violence to antenatal care providers. Providers are alert to physical injuries or severe outcomes from IPV, but miss subtler cues, such as emotional distress or signs of poor mental health. Providers are uncertain how to respond to IPV, and noted few existing tools, training, or referral systems. Nevertheless, providers were supportive of addressing IPV, as they noted this as a common condition in this setting. Providers and managers considered the safety and well-being of mother and infant to be a strong rationale for the identification of IPV. Pregnant women were receptive to being asked about violence in a kind and confidential way. Understaffing, insufficient training, and poorly developed referral systems were noted as important health system problems to address in future interventions. South African patients and providers are receptive to the identification of and response to IPV in antenatal care, but require tools and training to be able to safely address violence in the health care setting. Future interventions should consider the urban South African antenatal clinic a supportive, if under-resourced, entry point for improving the health of pregnant women experiencing violence.

Alcohol Drinking by Husbands/Partners is Associated with Higher Intimate Partner Violence against Women in Angola

Intimate partner violence (IPV), as the most prevalent form of violence against women, is a commonly encountered phenomenon across sub-Saharan African countries, including Angola. As a fast-growing economy, Angola is experiencing a booming alcohol industry and persistent IPV and women’s rights issues, along with weak prohibition and enforcement against this practice. However, so far, there is no systematic research investigating the predictors of IPV in Angola and whether spousal alcohol drinking has any relationship with women’s experience of IPV. Therefore, in this study, we aimed to assess the predictors of IPV (defined as physical, emotional, and sexual violence) among Angolan women with a special focus on their partners’ alcohol drinking habit. Cross-sectional data on 7669 women aged 15–49 years from the Angola Demographic and Health Survey were used for this study. Data were analyzed using descriptive and logistic regression methods. Results indicated that physical IPV (32.3%, 95% Confidence Interval = 30.3 to 34.5) was most prevalent, followed by emotional (27.3%, 95% CI = 25.3 to 29.4) and sexual IPV (7.4%, 95% CI = 6.6 to 8.4). In the multivariate analysis, higher education and household wealth status showed protective effects against certain forms of IPV. Alcohol drinking by husbands/partners was associated with significantly higher odds of experiencing physical [OR = 2.950; 95% CI = 2.632, 3.306], emotional [OR = 2.470; 95% CI = 2.187,2.789], and sexual IPV [OR = 2.729; 95% CI = 2.220, 3.354] among women. Women who reported experiencing physical IPV had increased odds of drinking alcohol [OR = 1.474; 95% CI = 1.290, 1.684] compared with those who did not. These findings reflect the widespread prevalence of IPV in sub-Saharan African countries. Special focus should be given to married men with alcohol drinking habits to reduce women’s vulnerability to IPV and dependence on alcohol use.

Addressing Intimate Partner Violence With Latina Women: A Call for Research

Latina women, especially those who are immigrants, have an increased vulnerability to intimate partner violence, yet they also have a low rate of using formal services (i.e. health care and legal services). Existing research focused on Latina women's help seeking for intimate partner violence has identified multiple factors, such as the presence of children, cultural values, and type of victimization, that influence women's formal help seeking. Immigrant Latina women in particular commonly report many barriers to formal services; however, heterogeneity and nuanced patterns of help seeking exist across Latina survivors. While research has focused mainly on understanding factors that are barriers to help seeking by Latina women, there is an overwhelming dearth of research about interventions and factors that facilitate effective help-seeking experiences for Latina IPV survivors. In an effort to improve Latina IPV survivors' access to services, we examine the gaps in research across dimensions of access to care (i.e. availability, affordability, accessibility, accommodation, and acceptability of services). Research within each of these facets of access to services for Latina survivors is lacking. This brief commentary illustrates the sparse data to inform evidence based interventions for Latina IPV survivors and is a call for research in order to determine best practices and to move the knowledge base from the vast descriptive base to evidence-based, culturally appropriate and acceptable interventions.

"El Silencio": Conceptualizations of Latina Immigrant Survivors of Intimate Partner Violence in the Midwest of the United States

This critical ethnography explored the experiences of battered, immigrant, Spanish-speaking Latinas in the Midwest of the United States. It relied on Chicana and Mujerista frameworks for understanding help-seeking. Although there has been progress in documenting intimate partner violence in the United States, there is less knowledge concerning this issue with undocumented Latinas. The methodology implemented two stages: (a) observations and informal interviews and (b) formal interviews. The findings reveal multiple sides of "el silencio." Maintaining the silence, or breaking it, is surrounded by exchanges with the internal voice parallel to personal experiences with violence at different points in life. It is also affected by cultural expectations in home and host country.

Design of the Violence and Stress Assessment (ViStA) study: a randomized controlled trial of care management for PTSD among predominantly Latino patients in safety net health centers

Posttraumatic stress disorder (PTSD) is a common problem in primary care. Although effective treatments are available, little is known about whether such treatments are effective within the context of Federally Qualified Health Centers (FQHCs) that serve as national "safety nets" for providing primary care for low income and underinsured patients. The Violence and Stress Assessment (ViStA) study is the first randomized controlled trial (RCT) to test the impact of a care management intervention for treating PTSD in FQHCs. To develop a PTSD management intervention appropriate for lower resource FQHCs and the predominantly Latino patients they serve, formative work was conducted through a collaborative effort between researchers and an FQHC practice-based research network. This article describes how FQHC stakeholders were convened to review, assess, and prioritize evidence-based strategies for addressing patient, clinician, and system-level barriers to care. This multi-component care management intervention incorporates diagnosis with feedback, patient education and activation; navigation and linkage to community resources; clinician education and medication guidance; and structured cross-disciplinary communication and continuity of care, all facilitated by care managers with FQHC experience. We also describe the evaluation design of this five-year RCT and the characteristics of the 404 English or Spanish speaking patients enrolled in the study and randomized to either the intervention or to usual care. Patients are assessed at baseline, six months, and 12 months to examine intervention effectiveness on PTSD, other mental health symptoms, health-related quality-of-life, health care service use; and perceived barriers to care and satisfaction with care.

Troubled times, troubled relationships: how economic resources, gender beliefs, and neighborhood disadvantage influence intimate partner violence

We evaluate race/ethnicity and nativity-based disparities in three different types of intimate partner violence (IPV) and examine how economic hardship, maternal economic dependency, maternal gender beliefs, and neighborhood disadvantage influence these disparities. Using nationally representative data from urban mothers of young children who are living with their intimate partners (N = 1,886), we estimate a series of unadjusted and adjusted logit models on mothers' reports of physical assault, emotional abuse, and coercion. When their children were age 3, more than one in five mothers were living with a partner who abused them. The prevalence of any IPV was highest among Hispanic (26%) and foreign-born (35%) mothers. Economic hardship, economic dependency on a romantic partner, and traditional gender beliefs each increased women's risk for exposure to one or more types of IPV, whereas neighborhood conditions were not significantly related to IPV in adjusted models. These factors also explained most of the racial/ethnic and nativity disparities in IPV. Policies and programs that reduce economic hardship among women with young children, promote women's economic independence, and foster gender equity in romantic partnerships can potentially reduce multiple forms of IPV.

Examining the relationship between Latinas' perceptions about what constitutes domestic violence and domestic violence victimization

Domestic violence is a serious issue for U.S. Latinas. Better understanding of the potential risk or protection that cultural perceptions about what constitutes domestic violence may convey can help strengthen interventions. Therefore, a convenience sample of 93 Latinas was surveyed about their current levels of domestic violence victimization, acculturation, and demographics, as well as about whether 5 behavioral scenarios constituted domestic violence. Hierarchical multiple regressions were performed to examine the relationships between the 5 perception items and domestic violence victimization. After adjusting for established risk factors, only viewing male partner stalking and female verbal aggression as domestic violence were significantly associated with decreased domestic violence victimization. Findings can be integrated into the development and implementation of culturally competent interventions targeting Latinas.