7 results
Two-year treatment effects of the common elements treatment approach (CETA) for reducing intimate partner violence and unhealthy alcohol use in Zambia
- Jeremy C. Kane, Nancy Glass, Paul A. Bolton, John Mayeya, Ravi Paul, Mwamba Mwenge, Laura K. Murray
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- Journal:
- Global Mental Health / Volume 8 / 2021
- Published online by Cambridge University Press:
- 19 February 2021, e4
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Background
Intimate partner violence (IPV) and unhealthy alcohol use are common yet often unaddressed public health problems in low- and middle-income countries. In a randomized trial, we found that the common elements treatment approach (CETA), a multi-problem, flexible, transdiagnostic intervention, was effective in reducing IPV and unhealthy alcohol use among couples in Zambia at a 12-month post-baseline assessment. In this follow-up study, we investigated whether treatment effects were sustained among CETA participants at 24-months post-baseline.
MethodsParticipants were heterosexual couples in Zambia in which the woman reported IPV perpetrated by the male partner and in which the male had hazardous alcohol use. Couples were randomized to CETA or treatment as usual plus safety checks. Measures were the Severity of Violence Against Women Scale (SVAWS) and the Alcohol Use Disorders Identification Test (AUDIT). The trial was stopped early upon recommendation by the trial's DSMB due to CETA's effectiveness following the 12-month assessment. Control participants exited the study and were offered CETA. This brief report presents data from an additional follow-up assessment conducted among original CETA participants at a 24-month visit.
ResultsThere were no meaningful changes in SVAWS or AUDIT scores between 12- and 24-months. The within-group treatment effect for SVAWS from baseline to 24-months was d = 1.37 (p < 0.0001) and AUDIT was d = 0.85 (p < 0.0001).
ConclusionsThe lack of change in levels of IPV and unhealthy alcohol use between the 12- and 24-month post-baseline timepoints suggests that treatment gains were sustained among participants who received CETA for at least two years from intervention commencement.
Acceptability and feasibility of using actigraphy to assess habitual physical activity and sleep parameters in men and women living in rural communities in conflict-affected Eastern Democratic Republic of Congo
- Lisa J. Wood, Mervyn Christian, Nancy Perrin, Alfred Backikenge Mirindi, Jean Heri Banywesize, Clovis Murhula Mitima, Arsene Kajabika Binkurhorwa, Eric Mitima Ntqali, Gisele Ntakwinja Mushengezi, Mitima Mpanano Remy, Nancy Glass
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- Journal:
- Global Mental Health / Volume 7 / 2020
- Published online by Cambridge University Press:
- 20 November 2020, e33
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Background
The goals of this study were to (1) determine the feasibility and acceptability of using actigraphy to objectively measure sleep quality and habitual physical activity in rural Democratic Republic of Congo (DRC) and (2) examine the relationship between sleep parameters, self-report symptoms, daytime physical activity, and physical function, including the ability to work.
MethodThirty individuals were asked to wear a wrist-worn accelerometer for 5 nights and 4 days. Nighttime sleep parameters derived were average and intra-individual variability (IIV) in total sleep time (TST), sleep onset latency (SOL), sleep efficiency (SE), and wake after sleep onset (WASO). Daytime habitual physical data derived were average and peak activity and daytime napping.
ResultsNinety-three percent (n = 28) of participants completed the study. All participants who wore the device marked sleep and wake cycles and periods of non-wear using the marker. Trauma-related symptoms were not associated with mean or IIV in TST, SE, SOL, or WASO (p > 0.01). Those with higher levels of bodily pain slept longer (β = 0.633, p = 0.003, adjusted R2 = 0.279), were more likely to report that their physical health limited their physical activities (β = 0.71, p < 0.001, adjusted R2 = 0.679) and had greater difficulty doing daily work (β = 0.84, p = 0.001, adjusted R2 = 0.665).
ConclusionThe use of actigraphy to collect objective measures of activity and sleep quality in rural post-conflict settings is feasible and acceptable. Our preliminary findings suggest that bodily pain and not trauma-related symptoms have a significant impact on sleep and functional outcomes in men and women survivors of prolonged conflict in the DRC.
3453 The Spectrum of Homelessness and Its Association with Maternal Morbidity
- Kelley N. Robinson, Kelly Bower, Jennifer Stewart, Nancy Perrin, Nancy Glass, Keshia Pollack-Porter, Phyllis Sharps
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- Journal:
- Journal of Clinical and Translational Science / Volume 3 / Issue s1 / March 2019
- Published online by Cambridge University Press:
- 26 March 2019, pp. 96-97
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OBJECTIVES/SPECIFIC AIMS: To examine maternal morbidity and its related social determinants among women experiencing homelessness during pregnancy. METHODS/STUDY POPULATION: This study will use an exploratory sequential mixed method design to explore and examine the structural, interpersonal and individual factors contributing to maternal morbidity among a convenience sample of 150 English speaking women experiencing homelessness during a pregnancy within the last 3 years in Baltimore. In the qualitative phase of the study, we will conduct semi-structured interviews with 15 women purposively sampled to refine the relationships between resilience, social determinants of health and multilevel factors that impact maternal morbidities. Factors of interest include prenatal care received, barriers and facilitators to receiving prenatal care, maternal morbidities, social support, and strategies used to manage their condition during this time. Using the findings from the qualitative phase, a quantitative survey will be developed to gather data on topics that emerged in the interviews. In addition, the Housing Instability Index will be used to measure the degree of homelessness as defined by the degree of housing instability in a 6-month period. Using the 25-item Connor-Davidson Resilience Scale, resilience levels among women in the sample will be assessed as a moderating factor in the examination of the relationship between a pregnant woman’s homeless status and maternal morbidity. Descriptive statistics and logistical regression tests will be used to analyze these relationships while controlling for other structural, interpersonal, and individual factors that may be associated with maternal morbidity. RESULTS/ANTICIPATED RESULTS: Qualitatively we expect to gain insight into the relationship between the extrinsic and intrinsic factors impacting maternal morbidities and the health behaviors and practices used by women to manage their pregnancy while homeless. These findings will inform the quantitative survey development and help generalize the quantitative findings. We expect to identify the common morbidities in this population we anticipate that there will be differences in maternal morbidity among the different types of homelessness. Maternal morbidity will be higher among women with a greater degree of homelessness. Resilience will have a moderating effect on the relationship between homelessness and maternal morbidity. DISCUSSION/SIGNIFICANCE OF IMPACT: This study, to our knowledge, is the first to look at maternal morbidity in this population. Additionally, this study seeks to move current research from examining infant outcomes at birth among mothers experiencing homelessness to understanding the maternal morbidities during this period. Long term, good maternal health has significant implications for the health of a mother’s future pregnancies and a risk reduction of adverse chronic conditions. Study results will provide the preliminary knowledge needed to guide further research leading to clinical approaches that promote better maternal health in this population. Lastly, the study findings will inform policy by characterizing the quality and strength of evidence of the adverse maternal health effects associated with the experience of homelessness.
The relationship between parent mental health and intimate partner violence on adolescent behavior, stigma and school attendance in families in rural Democratic Republic of Congo
- Nancy Glass, Anjalee Kohli, Pamela J. Surkan, Mitma Mpanano Remy, Nancy Perrin
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- Journal:
- Global Mental Health / Volume 5 / 2018
- Published online by Cambridge University Press:
- 21 May 2018, e20
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Background.
Prolonged conflict and economic instability challenge the existing support networks in families and society places significant stress on both adults and adolescents. Exploring individual, family and social factors that increase the likelihood of or protect adolescents from negative outcomes are important to the development of evidence-based prevention and response programing in global settings.
Objective.Examine the relationship between parent mental health and experience/perpetration of intimate partner violence (IPV) and adolescent behaviors, stigma, and school attendance. The relationship is further examined for differences by gender.
Methods.Secondary analysis of data from an ongoing comparative effectiveness trial of a productive asset transfer program in eastern Democratic Republic of Congo (DRC).
Results.Three hundred and eighty-eight adolescent and parent dyads were included in the analysis. The analysis demonstrated that parent mental health and IPV can have a negative impact their children's well-being and the impact is different for boys and girls, likely linked to gender roles and responsibilities in the home and community. Social relationships of adolescents, as reported through experienced stigma, were negatively impacted for both boys and girls. Parent report of symptoms of PTSD and depression had a stronger negative effect on girls’ outcomes, including experienced stigma, externalizing behaviors, and missed days of school than boys. For adolescent boys, their parent's report of IPV victimization/perpetration was associated with more negative behaviors at the 8-month follow-up assessment.
Conclusion.The findings reinforce the critical importance of interventions that engage parents and their children in activities that advance health and improve relationships within the family.
Five - Gender-based Violence Assessment in the Health Sector and Beyond
- Edited by Claire M. Renzetti, University of Kentucky, Diane R. Follingstad, University of Kentucky, Ann L. Coker, University of Kentucky
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- Book:
- Preventing Intimate Partner Violence
- Published by:
- Bristol University Press
- Published online:
- 05 April 2022
- Print publication:
- 12 July 2017, pp 101-128
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Summary
Introduction
Over the past three decades, gender-based violence (GBV) has emerged as a primary threat to health and human rights globally. GBV is defined as types of violence that primarily women and girls experience, including physical violence (for example, being hit, punched, kicked, slapped, choked, hurt with a weapon, or otherwise physically hurt), sexual violence (for example, unprotected forced sex and coercive behaviors, which include sexual slavery and coerced abortion), and psychological harm (for example, controlling behaviors, stalking, threats of violence). Intimate partners, members of the woman or girl's family, acquaintances, and/or strangers perpetrate these acts of violence, in the home, community, and/or during armed conflict.
Globally, an estimated 35% of women experience physical and/or sexual violence in their lifetime, including partner and non-partner violence (Bott et al., 2012; World Health Organization, 2013a). GBV confers profound health consequences, including physical, sexual, and mental health issues and homicide (Campbell, 2002; Decker et al., 2005; Ellsberg et al., 2008; Hathaway et al., 2000; Jewkes et al., 2010; Seth et al., 2010; Silverman et al., 2008; Stockl et al., 2013). Refugees fleeing conflicts and natural disasters are vulnerable to sexual violence; in humanitarian emergencies, refugee and displaced women and girls experience GBV within the context of war or conflict, during transit and displacement, and in the camp/settlement setting. Loss of secure housing, limited economic opportunities, lack of security, and family disruption among conflict-affected populations enable opportunistic violence as well as intimate partner violence (IPV) (Wirtz et al., 2016). A recent systematic review and meta-analysis of GBV among female refugees in complex humanitarian emergencies generated a pooled estimate of 21.4% (95%CI: 14.9–29.7%) sexual violence prevalence (Vu et al., 2013). There is substantial evidence indicating underreporting of GBV globally (Palermo et al., 2013) as well as in diverse humanitarian settings, where women and girls can be particularly vulnerable (Palermo & Peterman, 2011; Wirtz et al., 2013).
Global efforts often focus on a range of GBV perpetrators. Within the US, as elsewhere, intimate partners are the dominant perpetrators of GBV (Black et al., 2011), hence the domestic focus on IPV. In the US, an estimated one in three women experience IPV—that is, physical or sexual violence by a current or former spouse or boyfriend—with youth and young adult women at highest risk (Black et al., 2011). Gender differences persist in the nature and impact of IPV.
Contributors
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- By Nalini Vadivelu, Christian J. Whitney, Raymond S. Sinatra, M. Khurram Ghori, Yu-Fan (Robert) Zhang, Raymond S. Sinatra, Joshua Wellington, Yuan-Yi Chia, Francis J. Keefe, Jon McCormack, Ian Power, John Butterworth, P. M. Lavand’homme, M. F. De Kock, Bradley Urie, Oscar A. de Leon-Casasola, Frederick M. Perkins, Larry F. Chu, David Clark, Martin S. Angst, Cynthia M. Welchek, Lisa Mastrangelo, Raymond S. Sinatra, Richard Martinez, Scott S. Reuben, Asokumar Buvanendran, Raymond S. Sinatra, Pamela E Macintyre, Julia Coldrey, Daniel B. Maalouf, Spencer S. Liu, Susan Dabu-Bondoc, Samantha A. Franco, Raymond S. Sinatra, James Benonis, Jennifer Fortney, David Hardman, Gavin Martin, Holly Evans, Karen C. Nielsen, Marcy S. Tucker, Stephen M. Klein, Benjamin Sherman, Ikay Enu, Raymond S. Sinatra, James W. Heitz, Eugene R. Viscusi, Jonathan S. Jahr, Kofi N. Donkor, Raymond S. Sinatra, Manzo Suzuki, Johan Raeder, Vegard Dahl, Stefan Erceg, Keun Sam Chung, Kok-Yuen Ho, Tong J. Gan, Dermot R. Fitzgibbon, Paul Willoughby, Brian E. Harrington, Joseph Marino, Tariq M. Malik, Raymond S. Sinatra, Giorgio Ivani, Valeria Mossetti, Simona Italiano, Thomas M. Halaszynski, Nousheh Saidi, Javier Lopez, Kate Miller, Ferne Braveman, Jaya L. Varadarajan, Steven J. Weisman, Sukanya Mitra, Raymond S. Sinatra, Theodore J. Saclarides, Knox H. Todd, James R. Miner, Chris Pasero, Nancy Eksterowicz, Margo McCaffery, Leslie N. Schechter, Amr E. Abouleish, Govindaraj Ranganathan, Tee Yong Tan, Stephan A. Schug, Marie N. Hanna, Spencer S. Liu, Christopher L. Wu, Craig T. Hartrick, Garen Manvelian, Christine Miaskowski, Brian Durkin, Peter S. A. Glass
- Edited by Raymond S. Sinatra, Oscar A. de Leon-Cassasola, University of Rochester Medical Center, New York, Eugene R. Viscusi, Brian Ginsberg
- Foreword by Henry McQuay
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- Book:
- Acute Pain Management
- Published online:
- 26 October 2009
- Print publication:
- 27 April 2009, pp vii-xii
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8 - Risk Assessment for Intimate Partner Homicide
- Edited by Georges-Franck Pinard, Université de Montréal, Linda Pagani, Université de Montréal
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- Book:
- Clinical Assessment of Dangerousness
- Published online:
- 03 July 2009
- Print publication:
- 13 November 2000, pp 136-157
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Summary
Intimate partner homicide represents a serious health and social problem throughout the world. The majority of research on the topic has been conducted in the United States, Canada, and Australia, with only limited cross-national investigations disaggregating intimate partner homicide from other forms of homicide (Gartner, 1990; LaFree, 1998). Even with the limitations in worldwide databases, it is clear that men are universally most often the perpetrators in intimate partner homicide as with homicide in general. When women kill a husband, boyfriend, or estranged partner, they are far more likely to be acting in self-defense than are men (Wolfgang, 1958; Easteal, 1993; Browne, Williams, & Dutton, 1998). In intimate partner homicide overall, estrangement, jealousy, and prior beating of the female partner represent major risk factors (Browne et al., 1998; Smith, Moracco, & Butts, 1998). Daly and Wilson (1998) conclude that the underlying dynamics of intimate partner homicide are basically “male sexual proprietariness and female attempts to escape male control” with the actual homicide only representing the extreme of the coercive control that characterizes battering. Most data from individual countries′ sources such as Africa, Australia, England, United States, and Canada support that general contention (Crawford & Gartner, 1992; Edwards, 1985; Mushanga, 1978; Easteal, 1993; Campbell, 1992).
Determination of risk of intimate partner homicide needs to be based on this underlying theoretical premise of male coercive control of females.