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Mzilangwe ES, Chande Mallya R, Lindkvist M, Kaaya S, Nkulu Kalengayi FK. Sexual violence victimisation and response among university students in sub-Saharan Africa: a scoping review protocol. BMJ Open 2024; 14:e076015. [PMID: 38233058 PMCID: PMC10806683 DOI: 10.1136/bmjopen-2023-076015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 01/04/2024] [Indexed: 01/19/2024] Open
Abstract
INTRODUCTION Sexual violence (SV) is highly prevalent among university campuses across the globe, despite of several initiatives implemented to address it. Several studies have been published focusing on various aspects of SV on campuses. However, no review has been retrieved from the Joanna Briggs Institute (JBI) Database, Cochrane Library or Ovid examining evidence synthesis on prevalence, risk factors, victims and perpetrators, policies, laws and universities responses to SV in sub-Saharan Africa (SSA). This review aims to map the existing literature on SV victimisation among university students in SSA, related response strategies, and identify gaps in the evidence. METHODS AND ANALYSIS This review will follow JBI guidelines and will be conducted from 1 July 2023 to 31 December 2023. A team of five reviewers will screen eligible documents and articles for relevance from various data sources including electronic databases such as MEDLINE, EMBASE, PsycINFO, CINAHL, Google Scholar, PubMed and websites for government and agencies. Standard information for each study will be collected and a common analytical framework for all the primary documents will be conducted. ETHICS AND DISSEMINATION This review will involve analysis of published data only and therefore does not require ethics approval. The results will be published in a peer-reviewed journal. REGISTRATION This review has been registered with the Open Science Framework.
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Affiliation(s)
- Ester Steven Mzilangwe
- Department of Epidemiology and Global Health, Umea University, Umea, Sweden
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
| | - Rehema Chande Mallya
- Directorate of Library Services, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
| | - Marie Lindkvist
- Department of Epidemiology and Global Health, Umea University, Umea, Sweden
| | - Sylvia Kaaya
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
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Chemhaka GB, Moyo S, Simelane MS, Odimegwu C. Women's socioeconomic status and attitudes toward intimate partner violence in Eswatini: A multilevel analysis. PLoS One 2023; 18:e0294160. [PMID: 37956118 PMCID: PMC10642784 DOI: 10.1371/journal.pone.0294160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
INTRODUCTION Attitudes supportive of spousal violence retards developmental efforts worldwide, and in particular in patriarchal African settings. It is important to curb this behavior by designing preventative evidence-based policies. This study examines the acceptance of intimate partner violence among women residing in Eswatini and determines whether attitudes supportive of intimate partner violence are associated with women's low socioeconomic status both at the individual- and community-level. METHODS Cross-sectional secondary data from two Eswatini Multiple Indicator Cluster Surveys (MICS) conducted in 2010 and 2014 with representative samples of 4,686 and 4,761 women, respectively were analyzed using descriptive statistics and multilevel (random effect) logistic regressions. RESULTS Overall, the prevalence of acceptance of intimate partner violence declined significantly between 2010 and 2014 in Eswatini (29.0% vs. 19.8%, p<0.001). In both surveys, socioeconomic factors associated with women's supportive attitudes toward intimate partner violence were educational level, marital structure, and community socioeconomic disadvantage. Overall, primary or lower educational attainment, single/unmarried relationships, and women living in a community with a high socioeconomic disadvantage were key factors associated with supportive attitudes toward intimate partner violence. CONCLUSIONS Secondary or higher education for individual women and a high proportion of women in the community with low socioeconomic disadvantage are important socioeconomic predictors of reducing women's supportive attitudes toward intimate partner violence. Therefore, further gains in non-supportive attitudes toward acceptance of intimate partner violence could be achieved through efforts and intervention in the education of individual women and improving women's socioeconomic status in the community.
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Affiliation(s)
- Garikayi B. Chemhaka
- Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Kwaluseni, Manzini, Eswatini
| | - Stanzia Moyo
- Department of Demography Settlement and Development, Faculty of Social and Behavioural Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Maswati S. Simelane
- Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Kwaluseni, Manzini, Eswatini
| | - Clifford Odimegwu
- Demography and Population Studies Programme, Schools of Social Sciences and Public Health, University of the Witwatersrand, Braamfontein, Johannesburg, South Africa
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Steele B, Martin M, Sciarra A, Melendez-Torres GJ, Degli Esposti M, Humphreys DK. The Prevalence of Sexual Assault Among Higher Education Students: A Systematic Review With Meta-Analyses. Trauma Violence Abuse 2023:15248380231196119. [PMID: 37728132 DOI: 10.1177/15248380231196119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Sexual assault among higher education students has detrimental impacts on the health and educational outcomes of survivors. This systematic review aims to describe and synthesize the available quantitative evidence on sexual assault prevalence among this population. We searched Medline, EMBASE, Global Health, PsycINFO, Web of Science, ERIC, and CINAHL for studies published in English, French, Italian, and Spanish from database inception to August 2020 (updated May 2022). We screened studies using prespecified inclusion criteria for the population and context (registered higher education students), condition (self-reported sexual assault), and study design (quantitative survey). The Joanna Briggs Institute Critical Appraisal Checklist was used to assess study quality. Prevalence estimates disaggregated by type of sexual assault, gender identity, and world region were meta-analyzed using a random-effects model and reported following PRISMA guidance. We identified 131 articles, from 21 different countries. The meta-analyzed prevalence of sexual assault was 17.5% for women, 7.8% for men, and 18.1% for transgender and gender diverse people. Four types of sexual assault were identified: rape, attempted rape, forced sexual touching, and coercive sex. Forced sexual touching was the most common act experienced. The African Region had the highest prevalence estimates for women's sexual assault, and the Western Pacific region had the highest prevalence estimates for men's sexual assault. Higher education institutions, especially those outside of the United States, should commit to the implementation of surveys to monitor sexual assault prevalence and dedicate increased resources to supporting student survivors of sexual assault.
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Machisa MT, Mahlangu P, Chirwa E, Nunze N, Sikweyiya Y, Dartnall E, Pillay M, Jewkes R. Ntombi Vimbela! Sexual violence risk reduction intervention: pre and one-year post assessments from a single arm pilot feasibility study among female students in South Africa. BMC Public Health 2023; 23:1242. [PMID: 37370055 DOI: 10.1186/s12889-023-16149-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/19/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The extremely high prevalence of sexual violence victimisation reported among female students in South African public higher education demands urgent action to develop, rigorously evaluate and scale effective prevention interventions. This article details findings from a pilot feasibility study of Ntombi Vimbela! a campus sexual violence risk reduction intervention developed to tackle the high burden of sexual violence in higher education institutions in South Africa. METHODS Ntombi Vimbela! (NV!) is a sexual violence risk reduction intervention that comprises sexuality empowerment, gender and social norm change, early-risk identification, self-defence, resistance and mental wellbeing components. NV! is comprised of ten workshop sessions running for 3.5 h each. Workshops are co-delivered by two trained peer facilitators per group of at most 20 first-year female students. One-year post-intervention quantitative outcome assessments were remotely completed by 98 participants who participated in the NV! pilot workshops. Qualitative assessments were conducted with 35 participants through in-depth telephone interviews (IDTIs). FINDINGS One year after attending NV! workshops, most participants reported improved awareness of sexual rights, assertive communication, shifts in gender equitable beliefs, reductions in rape myth acceptance, improved expressed sexual relationship power sexual decision-making, and improved negotiation within their intimate relationships. Participants' depressive symptoms also significantly decreased. Many participants improved awareness of sexual assault risk and vigilance, including using self-protection strategies such as removing themselves from environments where alcohol intoxication posed sexual assault risks. Some participants used assertive communication to withstand peer pressure to engage in risky sexual behaviours. Most participants scored highly on the self-defence efficacy scale. Some participants were exposed to and successful in using verbal and physical resistance strategies in potential sexual assault risky situations. CONCLUSION These findings indicate the potential beneficial effects of NV! as a campus sexual violence risk reduction intervention at one-year post-intervention, which must be evaluated in a future rigorous randomised control trial. PILOT TRIAL REGISTERED AT ClinicalTrials.gov NCT04607564 on 29/10/2020.
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Affiliation(s)
- Mercilene Tanyaradzwa Machisa
- South African Medical Research Council Gender and Health Research Unit, Pretoria, South Africa.
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
| | - Pinky Mahlangu
- South African Medical Research Council Gender and Health Research Unit, Pretoria, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Esnat Chirwa
- South African Medical Research Council Gender and Health Research Unit, Pretoria, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Ncediswa Nunze
- South African Medical Research Council Gender and Health Research Unit, Pretoria, South Africa
| | - Yandisa Sikweyiya
- South African Medical Research Council Gender and Health Research Unit, Pretoria, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | | | - Managa Pillay
- Department of Basic Education, Pretoria, South Africa
| | - Rachel Jewkes
- South African Medical Research Council Gender and Health Research Unit, Pretoria, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
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Yount KM, Anderson KM, Trang QT, Bergenfeld I. Preventing sexual violence in Vietnam: qualitative findings from high school, university, and civil society key informants across regions. BMC Public Health 2023; 23:1114. [PMID: 37301883 PMCID: PMC10256971 DOI: 10.1186/s12889-023-15973-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Sexual violence by young men against women is common, but efficacious primary prevention interventions tailored to men are limited in low- and middle-income settings like Vietnam. GlobalConsent, a web-based sexual violence prevention intervention tailored to university men in Hanoi, is efficacious. Implementation research is needed to understand facilitators and barriers to scaling GlobalConsent and prevention programs generally. We conducted qualitative research with key informants from three youth-focused organizational settings to understand the context of implementation in Vietnam. METHODS Interviews with university (n = 15), high-school (n = 15) and non-governmental (n = 15) key informants focused on perceptions about sexual violence among young people and prevention programming. Four focus group discussions with 22 interviewed informants, following the Consolidated Framework for Implementation Research, asked about facilitators and barriers to implementing GlobalConsent. Narratives were transcribed, translated, and coded inductively and deductively to identify salient themes. RESULTS Outer-setting influences included greater expectations for sex among young people alongside norms favoring men's sexual privilege, ostensibly ambiguous and lax laws on sexual violence, government ministries as bureaucratic but potential allies, external subject-matter experts, and the media. Inner-setting influences included variable cultures regarding openness to discuss sexual violence and equitable gender norms, variable departmental coordination, limited funding and 'red tape' especially in public institutions, inconsistent student access to technologies, and limited time and competing priorities among students and teachers. Several actors were considered influential, including institutional leaders, human-resource staff, the Youth Union, and student-facing staff. Important characteristics of individuals for implementation included subject-matter expertise, science or social science training, younger age, engagement in social justice related activities, and more open attitudes about sex. Regarding characteristics of sexual violence prevention programming, some participants preferred online formats for busy students while others suggested hybrid or in-person formats, peer education, and incentives. Participants generally accepted the content of GlobalConsent and suggested adding more content for women, ancillary support services, and adapted content for high-school students. CONCLUSIONS Implementation of sexual violence prevention programs in youth-focused organizations in Vietnam requires multilevel strategies that connect outer-setting subject-matter experts with supportive inner-setting leaders and student-facing staff to overcome normative and organizational constraints, and thereby, to deliver institution-wide programming.
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Affiliation(s)
- Kathryn M Yount
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA.
- Department of Sociology, Emory University, Atlanta, GA, USA.
| | - Katherine M Anderson
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Quach Thu Trang
- Center for Creative Initiatives in Health and Population, Hanoi, Vietnam
| | - Irina Bergenfeld
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
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Wamoyi J, Ranganathan M, Mugunga S, Stöckl H. Male and Female Conceptualizations of Sexual Harassment in Tanzania: The Role of Consent, Male Power, and Social Norms. J Interpers Violence 2022; 37:NP17492-NP17516. [PMID: 34182809 DOI: 10.1177/08862605211028309] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Sexual harassment is pervasive worldwide, yet there is a lack of clarity on its conceptualization in many settings, especially in low-income countries. Context-specific conceptualization of sexual harassment is vital to develop effective measurement tools, estimate its magnitude, and the design of interventions to address it. We explored how different population groups in Mwanza, Tanzania, understood, conceptualized, and experienced sexual harassment. This study employed a qualitative research design involving 74 in-depth interviews and 13 focus group discussions with participants from educational, workplace, and public settings in Mwanza, Tanzania. Participants were adolescent girls and boys, adult women and men. We explored individual-level perceptions and experiences of sexual harassment, and community norms and expectations around sexual harassment. We analyzed the data using a thematic approach. Participants' perceptions of sexual harassment emphasized the critical role of consent, the expression of male power, and social norms with regard to sexual harassment. Sexual harassment was understood to be a result of men being in positions of power and in charge of material resources, school grades, or employment opportunities. These in turn enabled them to take advantage of girls and women. Social norms around male and female interactions, courtship and seduction, expressions of sexual interest were crucial in delineating what was and what was not considered sexual harassment. Sexual harassment is a fluid concept, and its definition is highly dependent on contextual factors. Consent underpins the conceptualization of sexual harassment and is a fundamental feature in the definition and measurement of sexual harassment in Tanzania. Consent is largely determined by sexual norms around male and female interactions and gendered power. There is a need for consensus in schools, workplaces, and communities about what constitutes sexual harassment in order to measure and address it appropriately.
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Affiliation(s)
- Joyce Wamoyi
- National Institute for Medical Research, Mwanza, Tanzania
| | | | - Samuel Mugunga
- National Institute for Medical Research, Mwanza, Tanzania
| | - Heidi Stöckl
- London School of Hygiene and Tropical Medicine, London, United Kingdom
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Machisa MT, Chirwa ED, Mahlangu P, Sikweyiya Y, Nunze N, Dartnall E, Pillay M, Jewkes R. Factors associated with female students' past year experience of sexual violence in South African public higher education settings: A cross-sectional study. PLoS One 2021; 16:e0260886. [PMID: 34855900 PMCID: PMC8639100 DOI: 10.1371/journal.pone.0260886] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 11/18/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Intimate partner sexual violence and non-partner rape experiences are widely reported by female students in South African higher education institutions, as they are globally. However, limited research has focused on investigating vulnerability factors, which is vital for informing interventions. OBJECTIVE To describe the factors and inter-relationships associated with female students' increased vulnerability to past year experience of partner sexual violence and non-partner rape in South African higher education settings. METHODS We interviewed 1293 female students, i.e., 519 students in six Technical Vocational Education and Training (TVET) college campuses and 774 students at three university campuses. Participants were volunteers aged 18-30. The measured vulnerability factors included childhood sexual abuse, other trauma, mental ill-health, risky sexual behaviours, food insecurity, partner violence, and controlling behaviours. We used bivariate analysis, logistic regression, and structural equation modelling methods. RESULTS Twenty percent of participants experienced past-year sexual violence (17% partner sexual violence and 7.5% non-partner rape). Childhood sexual abuse had direct effects on experiencing past year sexual violence and physical, emotional partner violence or controlling behaviours. Risky sexual behaviours mediated the relationships of childhood sexual abuse or harmful alcohol use and past-year sexual violence experience. Mental ill-health mediated the relationships between childhood sexual abuse, other traumatic exposures, food insecurity, physical, emotional partner violence or controlling behaviours, and past-year partner sexual violence or non-partner rape experience. CONCLUSIONS Risky sexual behaviours, gender inequitable relationship dynamics, mental ill-health, and food insecurity are related and amenable vulnerability factors associated with female students' sexual violence experiences. Therefore, addressing these through comprehensive campus interventions, which are implemented when students first enrol in higher education and are most vulnerable to sexual violence, is critical. Society-wide sexual violence prevention is also imperative.
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Affiliation(s)
- Mercilene T. Machisa
- South African Medical Research Council Gender and Health Research Unit, Pretoria, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Esnat D. Chirwa
- South African Medical Research Council Gender and Health Research Unit, Pretoria, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Pinky Mahlangu
- South African Medical Research Council Gender and Health Research Unit, Pretoria, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Yandisa Sikweyiya
- South African Medical Research Council Gender and Health Research Unit, Pretoria, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Ncediswa Nunze
- South African Medical Research Council Gender and Health Research Unit, Pretoria, South Africa
| | | | - Managa Pillay
- Department of Basic Education, Pretoria, South Africa
| | - Rachel Jewkes
- South African Medical Research Council Gender and Health Research Unit, Pretoria, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
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Chemhaka GB, Simelane MS, Moyo S, Shongwe MC. Prevalence and sociodemographic determinants of alcohol consumption among adults living with HIV in Eswatini. Afr J AIDS Res 2021; 20:132-140. [PMID: 33985423 DOI: 10.2989/16085906.2021.1895236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Aim: Alcohol consumption contributes to a significant burden of illnesses, health conditions and premature deaths globally. There is limited knowledge of alcohol consumption among people living with HIV (PLWH) in Eswatini. This study sought to determine the prevalence, and examine the sociodemographic determinants of alcohol consumption among adult people living with HIV in Eswatini.Methods: Using the Swaziland HIV Incidence Measurement Survey 2, a recent national representative cross-sectional survey conducted in Eswatini between August 2016 and March 2017, a subsample of 2 832 adults (aged 18 and older) living with HIV was extracted. Multinomial logistic regression was used to assess the sociodemographic factors associated with alcohol consumption (i.e. use or misuse).Results: The prevalence of alcohol misuse (hazardous drinking) was 10.9% (23% male v 4.5% female), whereas alcohol use (moderate drinking) was estimated at 8.5% (14.7% male v 5.2% female). Men were more likely to engage in alcohol use (adjusted relative risk ratio [aRRR] = 3.46 [95% CI 3.46-6.62]) and misuse (aRRR = 6.12 [95% CI 6.12-11.47]) than females. Those who reported HIV stigma had a higher likelihood of alcohol misuse compared to those who did not report HIV stigma (aRRR = 1.43 [95% CI 1.04-1.98]).Conclusion: Our findings highlight a notable prevalence of alcohol use or misuse among PLWH in Eswatini. Males, those with no education, never married and those who reported HIV stigma were more likely to report alcohol misuse. The study thus recommends innovative policies and strategies to curb alcohol-related harm in the Eswatini population, specifically among PLWH.
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Affiliation(s)
- Garikayi B Chemhaka
- Department of Statistics and Demography, University of Eswatini, Kwaluseni, Eswatini
| | - Maswati S Simelane
- Department of Statistics and Demography, University of Eswatini, Kwaluseni, Eswatini
| | - Stanzia Moyo
- Demography Settlement and Development, University of Zimbabwe, Mount Pleasant, Harare, Zimbabwe
| | - Mduduzi C Shongwe
- Department of Midwifery Science, University of Eswatini, Mbabane, Eswatini
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Niemeyer Hultstrand J, Engström E, Målqvist M, Tydén T, Maseko N, Jonsson M. Evaluating the implementation of the Reproductive Life Plan in disadvantaged communities: A mixed-methods study using the i-PARIHS framework. PLoS One 2020; 15:e0236712. [PMID: 32915798 PMCID: PMC7485818 DOI: 10.1371/journal.pone.0236712] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 07/12/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction The Reproductive Life Plan (RLP) is a clinical tool to help clients find strategies to achieve their reproductive goals. Despite much research on the RLP from high-income countries, it has never been studied in low- or middle income countries. Together with health workers called Mentor Mothers (MMs), we used a context-adapted RLP in disadvantaged areas in Eswatini. Our aim was to evaluate the implementation of the RLP in this setting. Methodology MMs participated in focus group discussions (FGDs, n = 3 MMs n = 29) in January 2018 and at follow-up in May 2018 (n = 4, MMs n = 24). FGDs covered challenges in using the RLP, how to adapt it, and later experiences from using it. We used a deductive qualitative thematic analysis with the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework, creating themes guided by its four constructs: facilitation, innovation, recipients and context. The MMs also answered a questionnaire to assess the implementation process inspired by normalization process theory. Results The RLP intervention was feasible and acceptable among MMs and fit well with existing practices. The RLP questions were perceived as advantageous since they opened up discussions with clients and enabled reflection. All except one MM (n = 23) agreed or strongly agreed that they valued the effect the RLP has had on their work. Using the RLP, the MMs observed progress in pregnancy planning among their clients and thought it improved the quality of contraceptive counselling. The clients’ ability to form and achieve their reproductive goals was hampered by contextual factors such as intimate partner violence and women’s limited reproductive health and rights. Discussion The RLP was easily implemented in these disadvantaged communities and the MMs were key persons in this intervention. The RLP should be further evaluated among clients and suitable approaches to include partners are required.
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Affiliation(s)
| | - Ellinor Engström
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Mats Målqvist
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Tanja Tydén
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Maria Jonsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Yount KM, Minh TH, Trang QT, Cheong YF, Bergenfeld I, Sales JM. Preventing sexual violence in college men: a randomized-controlled trial of GlobalConsent. BMC Public Health 2020; 20:1331. [PMID: 32873262 PMCID: PMC7466489 DOI: 10.1186/s12889-020-09454-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 08/26/2020] [Indexed: 11/21/2022] Open
Abstract
Background Sexual violence—any sexual act committed against a person without freely given consent—disproportionately affects women. Women’s first experiences of sexual violence often occur in adolescence. In Asia and the Pacific, 14% of sexually experienced adolescent girls report forced sexual debut. Early prevention with men that integrates a bystander framework is one way to address attitudes and behavior while reducing potential resistance to participation. Methods This paper describes a study protocol to adapt RealConsent for use in Vietnam and to test the impact of the adapted program—GlobalConsent—on cognitive/attitudinal/affective mediators, and in turn, on sexual violence perpetration and prosocial bystander behavior. RealConsent is a six-session, web-based educational entertainment program designed to prevent sexual violence perpetration and to enhance prosocial bystander behavior in young men. The program has reduced the incidence of sexual violence among men attending an urban, public university in the Southeastern United States. We used formative qualitative research and the Centers for Disease Control and Prevention’s Map of the Adaptation Process to adapt RealConsent. We conducted semi-structured interviews with college men (n = 12) and women (n = 9) to understand the social context of sexual violence. We conducted focus group discussions with university men and stakeholders (n = 14) to elicit feedback on the original program. From these data, we created scripts in storyboard format of the adapted program. We worked closely with a small group of university men to elicit feedback on the storyboards and to refine them for acceptability and production. We are testing the final program—GlobalConsent—in a randomized controlled trial in heterosexual or bisexual freshmen men 18–24 years attending two universities in Hanoi. We are testing the impact of GlobalConsent (n = 400 planned), relative to a health-education attention control condition we developed (n = 400 planned), on cognitive/attitudinal/affective mediators, prosocial bystander behavior, and sexual violence perpetration. Discussion This project is the first to test the impact of an adapted, theoretically grounded, web-based educational entertainment program to prevent sexual violence perpetration and to promote prosocial bystander behavior among young men in a middle-income country. If effective, GlobalConsent will have exceptional potential to prevent men’s sexual violence against women globally. Trial registration U.S. National Library of Medicine Clinicaltrials.govNCT04147455 on November 1, 2019 (Version 1). Retrospectively registered. Protocol amendments will be submitted to clinicaltrials.gov.
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Affiliation(s)
- Kathryn M Yount
- Hubert Department of Global Health and Department of Sociology, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA.
| | - Tran Hung Minh
- Center for Creative Initiatives in Health and Population, 48, 251/8 Nguyen Khang str, Cau Giay, Hanoi, Vietnam
| | - Quach Thu Trang
- Center for Creative Initiatives in Health and Population, 48, 251/8 Nguyen Khang str, Cau Giay, Hanoi, Vietnam
| | - Yuk Fai Cheong
- Department of Psychology, Emory University, 36 Eagle Row, Atlanta, GA, 30322, USA
| | - Irina Bergenfeld
- Hubert Department of Global Health and Department of Sociology, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
| | - Jessica M Sales
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
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