Primary Prevention of Intimate Partner Violence Among Recently Married Dyads Residing in the Slums of Pune, India: Development and Rationale for a Dyadic Intervention

Prevalence, disparities, and trends in intimate partner violence against women living in urban slums in 34 low-income and middle-income countries: a multi-country cross-sectional study

Background

Intimate partner violence (IPV) is a significant public health issue, closely tied to social and neighborhood environments. The impoverished, overcrowded, and stressful conditions in urban slums may heighten IPV risk, yet evidence remains limited. This study aims to assess the prevalence, disparities, and trends of IPV in urban slums across low- and middle-income countries (LMICs).

Methods

This cross-sectional study used nationally representative Demographic and Health Surveys data from 2006 to 2023, focusing on countries with available domestic violence data for women aged 15-49. The outcomes measured include past-year exposure to any IPV (primary outcome) and physical IPV, sexual IPV, and psychological IPV (secondary outcomes). We examined both absolute and relative disparities between urban slums, non-slum urban, and rural areas using differences and ratios. Additionally, we used Fairlie decomposition analysis based on a multivariable logistic regression model to examine the contributions of IPV risk factors (i.e., poor partner relationships, gender inequality, and poverty) to the disparities. For countries with multiple surveys, we conducted trend analysis by assessing annual changes in IPV prevalence in urban slums and the disparities.

Findings

Among 283,658 women from 34 LMICs, 14,111 (5.0%) lived in urban slums. IPV prevalence in urban slums was notably high, with 18 of the studied countries above 30% for any IPV. Women in urban slums experienced higher IPV rates than those in non-slum urban and rural areas. For example, the prevalence of any IPV in urban slums was 31.4% (95% confidence interval [CI]: 30.7-32.2), which was 5.9 percentage points (95% CI: 5.1-6.7, P < 0.0001) higher than that in non-slum urban areas and 1.2 percentage points (95% CI: 0.4-2.0, P = 0.0022) higher than that in rural areas. Controlling behavior by husbands explained the largest proportion of disparities in all IPV types between urban slums and other areas. For example, 27.2% (95% CI: 25.1-29.3) of the any IPV disparities between urban slums and non-slum urban areas could be explained by this factor. In ten countries with multiple surveys, trend analysis showed rising any IPV prevalence in urban slums of four countries-Sierra Leone, Tanzania, Mali, and Nigeria-with Sierra Leone having the most significant increase (4.6 percentage points, 95% CI: 2.5-6.6, P < 0.0001).

Interpretation

Our findings suggest that IPV is more prevalent in urban slums than other areas, underscoring the need for targeted public health strategies, such as addressing harmful partner's behaviors.

Funding

This research was supported by China National Natural Science Foundation and the Research Fund, Vanke School of Public Health, Tsinghua University.

The Role of Formal Schooling, Literacy, and Health Knowledge in Addressing Domestic Violence Against Women in West Africa

When "education" is cited as a solution for domestic violence, different aspects of knowledge acquisition are often omitted. This study uses 2019 Demographic and Health Surveys from four West African countries (The Gambia, Liberia, Senegal, Sierra Leone) with a combined sample size of 12,480 women and generalized ordered logit regression to examine the effects of types of knowledge (years of schooling, literacy, and health knowledge) on domestic violence (physical abuse, emotional abuse, and control issues). The results suggest that literacy has the most reliable beneficial impact on domestic violence and was consistently associated with decreased odds of abuse. However, greater findings suggest that schooling, literacy, and health knowledge function as separate types of education and that their relationships are complex and context-specific. By neglecting to see these types of knowledge as separate entities that can operate together, it is possible that mitigation strategies for domestic violence are going undiscovered.

Citizen involvement in research on technological innovations for health, care or well-being: a scoping review

Citizen science can be a powerful approach to foster the successful implementation of technological innovations in health, care or well-being. Involving experience experts as co-researchers or co-designers of technological innovations facilitates mutual learning, community building, and empowerment. By utilizing the expert knowledge of the intended users, innovations have a better chance to get adopted and solve complex health-related problems. As citizen science is still a relatively new practice for health and well-being, little is known about effective methods and guidelines for successful collaboration. This scoping review aims to provide insight in (1) the levels of citizen involvement in current research on technological innovations for health, care or well-being, (2) the used participatory methodologies, and (3) lesson's learned by the researchers.A scoping review was conducted and reported in accordance with the PRISMA-ScR guidelines. The search was performed in SCOPUS in January 2021 and included peer-reviewed journal and conference papers published between 2016 and 2020. The final selection (N = 83) was limited to empirical studies that had a clear focus on technological innovations for health, care or well-being and involved citizens at the level of collaboration or higher. Our results show a growing interest in citizens science as an inclusive research approach. Citizens are predominantly involved in the design phase of innovations and less in the preparation, data-analyses or reporting phase. Eight records had citizens in the lead in one of the research phases.Researcher use different terms to describe their methodological approach including participatory design, co-design, community based participatory research, co-creation, public and patient involvement, partcipatory action research, user-centred design and citizen science. Our selection of cases shows that succesful citizen science projects develop a structural and longitudinal partnership with their collaborators, use a situated and adaptive research approach, and have researchers that are willing to abandon traditional power dynamics and engage in a mutual learning experience.

Validity evaluation of the Health Information Preferences Questionnaire among college students

Objective

This study aims to explore the association between health information preferences and specific health behaviors and outcomes, such as preventive measures and chronic disease management among college students. It assesses how different levels of health information preference influence individuals' utilization, perception, and self-efficacy within healthcare and health information contexts. Given the rising prevalence of non-communicable chronic diseases among younger populations in China, this research seeks to understand how tailored health information preferences can support effective health education and behavioral interventions. The development of the Health Information Preference Questionnaire (HIPQ) aims to bridge the existing gap in tools for assessing health information preferences among Chinese college students, with a focus on collecting validity evidence to confirm the HIPQ's applicability in this group.

Methods

The study employed a mixed-methods approach, beginning with an initial item pool derived from a comprehensive review of existing research tools, literature, and expert inputs. An expert review panel conducted item evaluations, leading to item reduction for clarity and relevance. The validation process utilized two independent samples of college students, detailing the sample size (n = 446 for preliminary testing, n = 1,593 for validation) and characteristics (age, major, urban vs. rural background) to enhance the understanding of the study's generalizability.

Results

The HIPQ, comprising 25 items across five dimensions-prevention-oriented approaches, relationship with healthcare providers, self-efficacy in obtaining health information, perception of the importance of health information, and health information behavior-demonstrated excellent content validity (ICVI ranged from 0.72 to 0.86). Factor analysis confirmed significant loadings for each item across the anticipated factors, with fit indices (RMSEA = 0.065, CFI = 0.942) supporting good model fit. The HIPQ's reliability was underscored by Cronbach's alpha coefficients (>0.8) for each subscale, with significant correlations across all subscales, indicating strong internal consistency and construct validity.

Conclusion

The HIPQ proves to be a reliable and valid instrument for assessing health information preferences among Chinese college students, highlighting its potential for broader application in health education and intervention strategies. Recognizing the study's focus on a specific demographic, future research should investigate the HIPQ's adaptability and utility in broader populations and different cultural settings. The study's limitations, including its concentrated demographic and context, invite further exploration into the HIPQ's applicability across diverse groups. Additionally, potential future research directions could include longitudinal studies to assess the impact of tailored health information on actual health outcomes and behaviors.

A Couples-Based Intervention (Ghya Bharari Ekatra) for the Primary Prevention of Intimate Partner Violence in India: Pilot Feasibility and Acceptability Study

Background

The high global prevalence of intimate partner violence (IPV) and its association with poor physical and mental health underscore the need for effective primary prevention. We previously developed Ghya Bharari Ekatra (GBE), a couples-based primary prevention intervention for IPV among newly married couples residing in slum communities in Pune, India.

Objective

Through this pilot study, we aimed to explore the acceptance, safety, feasibility, and preliminary efficacy of GBE.

Methods

Between January and May 2018, we enrolled and assigned 20 couples to receive GBE plus information on IPV support services and 20 control couples to receive information on IPV support services alone. The GBE intervention was delivered over 6 weekly sessions to groups of 3 to 5 couples by lay peer educators in the communities in which the participants resided. Intervention components addressed relationship quality, resilience, communication and conflict negotiation, self-esteem, sexual communication and sexual health knowledge, and norms around IPV. Outcome evaluation included exit interviews with participants and peers to examine acceptance and feasibility challenges and baseline and 3-month follow-up interviews to examine change in IPV reporting and mental health (by women) and alcohol misuse (by men). The process evaluation examined dose delivered, dose received, fidelity, recruitment, participation rate, and context.

Results

Half (40/83) of the eligible couples approached agreed to participate in the GBE intervention. Retention rates were high (17/20, 85% across all 6 sessions), feedback from exit interviews suggested the content and delivery methods were very well received, and the community was highly supportive of the intervention. The principal feasibility challenge involved recruiting men with the lowest income who were dependent on daily wages. No safety concerns were reported by female participants over the course of the intervention or at the 3-month follow-up. There were no reported physical or sexual IPV events in either group, but there were fewer incidents of psychological abuse in GBE participants (3/17, 18%) versus control participants (4/16, 25%) at 3-month follow-up. There was also significant improvement in the overall mental health of female intervention participants and declines in the control participants (change in mean General Health Questionnaire-12 score: –0.13 in intervention vs 0.13 in controls; P=.10).

Conclusions

GBE has high acceptance, feasibility, and preliminary efficacy in preventing IPV and improving mental health among women. Next steps include refining the intervention content based on pilot findings and examining intervention efficacy through a large-scale randomized trial with longer follow-up.

Trial Registration

ClinicalTrials.gov NCT03332134; https://clinicaltrials.gov/ct2/show/NCT03332134. Clinical Trials Registry of India CTRI/2018/01/011596; http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=21443

International Registered Report Identifier (IRRID)

RR2-10.2196/11533

Effectiveness of a Module Based Training on Nurses' Attitude Towards Social Norms and Beliefs That Support Abuse Among women with Mental Illness

Violence against women is a priority public health issue. Women with mental illness are at a double disadvantage. While social norms and beliefs either support or confront violence against women, research is limited on this issue. A randomized controlled design was adopted for the present study. This study was aimed to evaluate the effectiveness of module-based training in changing nurses' attitudes towards norms and beliefs that support violence against women in mental health care settings. In this study, 68 nurses were randomly assigned to either the experimental or control group (34 in each group). After receiving the training program, the mean scores on norms and beliefs and justifiability of abuse scales were significantly higher in the experimental group compared to the control group (p < 0.05). The results confirmed the positive impact of the training program in changing nurses' attitudes. However, further studies are required to draw firm conclusions on the effectiveness of the training intervention.

Addressing the Needs of Abused Chinese Women Through a Community-Based Participatory Approach

PURPOSE

Intimate partner violence against women is a priority global health issue. It has had serious negative consequences on women's health and has led to huge burdens on the community. Numerous interventions have been demonstrated to have positive effects, and the majority of them have been developed using a top-down approach. However, the specific needs of abused Chinese women have not been fully addressed; incorporating women's input seems to be an essential element for the success of any intervention. This article describes the experiences and success in using a community-based participatory approach (CBPA) to develop a culturally appropriate intervention for abused Chinese women in order to address their multifaceted needs.

DESIGN

A CBPA was adopted in this study to develop a culturally appropriate intervention in order to address the multifaceted needs of abused Chinese women.

METHODS

A core group of six participants (three abused Chinese women, one researcher, and two social workers who provided community services for abused Chinese women) was formed in a local community center in Hong Kong. The three Chinese women were recruited from the local community center, and according to the Abuse Assessment Screen they had been in an intimate relationship in the preceding 12 months and had been abused by an intimate partner.

FINDINGS

Three core group meetings were conducted over 6 weeks for intervention development. An integrated multicomponent intervention was developed, comprising a four-part, women-centered program called "Women-centred, we are with you." The program was implemented and completed over 4 months (October 2015 to January 2016). Eighteen abused Chinese women participated in the intervention.

CONCLUSIONS

A CBPA provides actual empowerment spirit for abused Chinese women. This approach was well accepted by the women and enabled them to develop more culturally appropriate interventions in fulfilling their specify needs.

CLINICAL RELEVANCE

Researchers can consider using a CBPA to develop and tailor a culturally appropriate intervention for groups such as abused Chinese women in order to improve their health and eliminate disparities by addressing their specific and multifaceted needs.