VHA Primary Care Providers’ Perspectives on Screening Female Veterans for Intimate Partner Violence: A Preliminary Assessment

Female Veterans experience intimate partner violence (IPV) at alarming rates. The Veterans Health Administration (VHA) requires foundational research to guide the development of policy and programs to detect IPV among women Veterans and provide interventions. This pilot study reports findings from in-depth qualitative interviews conducted with 12 VHA primary care providers treating female Veterans in the New England region. Although most providers indicated that they were not currently routinely screening for IPV, they expressed positive attitudes and beliefs about screening in VHA primary care settings. Themes also included the importance of a comprehensive health care response to IPV, such as interdisciplinary coordination of care and team-based approaches to detection and intervention. Barriers to routine screening were identified, as well as recommendations for training programs and clinical tools to inform the successful implementation of a standardized IPV screening and response program in VHA. Although preliminary, these findings represent an initial step in an essential line of research.     

Domestic Violence Against Women: Systematic Review of Prevalence Studies

To systematically review the worldwide evidence on the prevalence of domestic violence against women, to evaluate the quality of studies, and to account for variation in prevalence between studies, using consistent definitions and explicit, rigorous methods. Systematic review of prevalence studies on domestic violence against women. Literature searches of 6 databases were undertaken for the period 1995 to 2006. Medline, Embase, Cinahl, ASSIA, ISI, and International Bibliography of the Social Sciences were searched, supplemented by hand searching of the reference lists from studies retrieved and specialized interdisciplinary journals on violence. A total of 134 studies in English on the prevalence of domestic violence against women, including women aged 18 to 65 years, but excluding women with specific disabilities or diseases, containing primary, empirical research data, were included in the systematic review. Studies were scored on eight pre-determined criteria and stratified according to the total quality score. The majority of the sudies were conducted in North America (41%), followed by Europe (20%). 56% of studies were population-based, and 17% were carried out either in primary or community health care settings. There was considerable heterogeneity both between and within geographical locations, health care settings, and study quality The prevalence of lifetime domestic violence varies from 1.9% in Washington, US, to 70% in Hispanic Latinas in Southeast US. Only 12% scored a maximum of 8 on our quality criteria, with 27% studies scored 7, and 17% scored 6. The mean lifetime prevalence of all types of violence was found to be highest in studies conducted in psychiatric and obstetric/gynecology clinics. Results of this review emphasize that violence against women has reached epidemic proportions in many societies. Accurate measurement of the prevalence of domestic violence remains problematic and further culturally sensitive research is required to develop more effective preventive policies and programs.     

An Innovative Program for Justice-Involved Partner Violence Victims: “No Man is Worth Me Getting Locked Up”

Violence victims who are the primary caregivers for their children sometimes become justice-involved through efforts to protect and defend against intimate partner violence (IPV). Judges often mandate these victims to community-based services, although little is known about these services. Given increasing numbers of such victims, two human service agencies collaborated to create a program for female IPV victims who were their children’s primary caregivers and who were mandated to services for violence against a male partner. Our research team conducted a feasibility study of the program using an exploratory qualitative study design to collect data from program participants (n?=?18) and providers (n?=?7). Analyses determined three key findings: (a) the importance of a welcoming, comfortable environment; (b) the value of certain aspects of the program content; and (c) the importance of support from like others for participant improvement. These findings point to indispensable program elements. Implications for other communities and providers serving justice-involved IPV victims who are also primary caregivers are described.     

Women College Students’ Reasons for Engaging in Psychological Dating Aggression: a Qualitative Examination

Dating violence frequently occurs within women college students’ relationships, but few examinations of their reasons for engaging in psychological aggression have been conducted. Accordingly, the current study investigated psychological aggression initiated by women undergraduates against their male partners using a qualitative methodology. Overall, 72 of the 206 participants responded to an open-ended question examining their reasons for initiating psychological aggression. Six domains of reasons were identified; the two most frequently reported precipitants were negative affect and a partner’s transgression. One domain, “self-soothing,” (i.e., aggressing to help oneself feel better) had not been observed in studies of women’s initiation of physical aggression. These reasons could be targeted in prevention and intervention programs for reducing dating aggression among undergraduates.     

Barriers to Seeking Police Help for Intimate Partner Violence

Intimate partner violence is underreported to police. A study was conducted utilizing focus group methodology to identify women's perceptions of the barriers to seeking police help for intimate partner violence (IPV). Facilitators used a structured format with open-ended questions for five focus group sessions that were recorded and subsequently analyzed using Ethnograph software. Participants were 41 women identified from social service agencies in an urban setting serving IPV women with diverse ethnic and cultural backgrounds. Participants identified many barriers for victims, which fell within the following three themes: (1) Predisposing characteristics — situational and personal factors; (2) fears and negative experiences with police response; and (3) fears of possible repercussions. Participants also described positive experiences with police and generated a wish list for improving police response to IPV. Policies and actions that can be taken by police and social service agencies to address the barriers IPV victims face in seeking police help are discussed.     

Women’s Knowledge of the Domestic Violence Legislation in Erbil,Iraq and their Response to Spousal Violence

This study assessed the knowledge of 82 married women about existing legislations and law enforcement structure in Iraqi Kurdistan region to combat violence against women and women’s response to spousal violence. A female physician interviewed the participants using a specially designed questionnaire. The women possessed good knowledge about the presence of legislation (76.8 %) and related law enforcement structure (70.7 % to 74.4 %) to combat violence against women, but they lacked adequate knowledge about how to contact the law enforcement agencies. Women’s response to spousal violence primarily included self-defense (37.8 %) or keeping silent (26.8 %), rather than seeking justice (4.9 %). Women’s educational status was positively associated with reporting violence to police (52.1 % vs 29.4 %, p = 0.041) and the health staff (62.5 % vs 35.3 %, p = 0.015). Further research is needed to explore the reasons behind women’s poor knowledge of the details of the existing law enforcement structure and women’s reluctance to seek justice.     

Evaluation of a Health Care Provider Training Program to Identify and Help Partner Violence Victims

This study tested four hypotheses about the impact of a 3-h domestic violence training program with 752 health care providers on attitudes and values related to screening and helping partner violence victims. Hypotheses 1, 2, and 3 were that training would be related to: 1) increased self-efficacy to identify and help partner violence victims, 2) increased endorsement of the role of health care providers and settings for helping partner violence victims, and 3) increased comfort making appropriate community referrals to help partner violence victims. Hypothesis 4 was that training effects would be moderated by prior training and by prior experience with helping a victim. Following training, health care providers reported increased self-efficacy, increased comfort making appropriate community referrals, and increased valuation of health care providers and the health care system as having an important role in stopping domestic violence. Hypothesis 4 was also supported. Prior training and/or experience with an abuse victim predicted smaller changes in the dependent variables. These gains held at a 6-month follow-up. Implications for training curriculum design are discussed, in addition to institutional policy implications for determining the benefits versus costs of universal training, including staff who demonstrate prior training or experience with battered victims. Study limitations and future research directions, including the need to measure performance and policy compliance will also be outlined.     

Bruise Documentation,Race and Barriers to Seeking Legal Relief for Intimate Partner Violence Survivors: a Retrospective Qualitative Study

Documentation of physical injuries from intimate partner violence (IPV) is critically important when a victim seeks legal help. Bruising, a common IPV injury, is often less visible on victims of color. This retrospective qualitative study is focused on IPV survivors’ and service providers’ experiences with the complex interrelationship between IPV injury, bruise documentation, race and legal assistance. Focus group results with a racially diverse group of female IPV survivors and legal service providers indicate that all victims struggle with documenting their bruises, but for women of color, even documentation of visible bruising underrepresents the severity of their IPV injuries. Further, there are a number of social, logistic, and systemic barriers to injury documentation that may make legal relief for IPV difficult for all women, but particularly more difficult for women of color. Proposed solutions to address the gap include, improved documentation techniques, and greater education for legal service providers. Implications for the field of family violence generally and potential future research directions are also discussed.     

Post-Separation Abuse of Women and their Children: Boundary-Setting and Family Court Utilization among Victimized Mothers

Continued abuse of themselves and their children is a concern for many mothers leaving intimate partner violence (IPV) perpetrating husbands. This research examines women’s responses to abuse committed by ex-husbands with whom they had undergone custody disputes. In-depth, qualitative interviews were conducted with 19 mothers who had divorced IPV-perpetrating husbands between 1 and 3 years prior. Participants were located through publicly available family court divorce records and interviews were examined using analytic induction. Women’s strategies to protect themselves and their children from abuse involved setting boundaries to govern their interactions with ex-husbands. Mothers often turned to family court for assistance in setting boundaries to keep children safe, but found that family court did not respond in ways they believed protected their children. Conversely, when women turned to the justice system for restraining orders or called the police for help against IPV, they generally found the justice system responsive.     

Protecting Rural Church-Going Immigrant Women from Family Violence

Rural Latino immigrant women at risk of family violence may perceive churches as their only source of help. However, immigrant church leaders may be poorly equipped to address family violence in their congregations. This article describes a project designed to stimulate and support appropriate responses to family violence by rural immigrant churches, including those identified with conservative theological views on women. The primary goal was to provide rural Latino church leaders with culturally sensitive materials and resources they were willing to use with their congregations. We collaborated with local service providers who assisted in recruiting the church leaders for the pastors’ workshops where the resource materials were presented. Survey data indicated most of the pastors were receptive to the content and planned to incorporate it into their church work. Suggestions are made for future research on this culturally sensitive approach to addressing family violence in the immigrant community.     

Domestic Violence and its Relationship with Quality of Life in Iranian Women of Reproductive Age

Violence against women is a major concern for public health. This study was conducted in Tabriz (Iran) to investigate domestic violence and its relationship with quality of life in women of reproductive age. This cross-sectional study was conducted on 558 women selected through a two-stage cluster sampling method. Data were collected by Revised Conflict Tactics Scales (CTS2) and Short Form Health Survey (SF-36) questionnaires. Negotiation-emotional violence had the highest prevalence (93 %) and severe injury (12 %) had the lowest. There was a significant inverse correlation between chronicity of psychological, physical, sexual and injury domains of domestic violence and quality of life and a significant positive correlation between negotiation-emotional domain and quality of life. There is a significant relationship between domestic violence and quality of life. So, regarding the importance of empowering women and improving their quality of life, we must help eliminate violence against women.     

Domestic violence during pregnancy in an eastern city of Turkey: a field study

Violence is an increasing and important community health problem that can be seen in any area of human life. Limited studies were found about domestic violence among pregnant women and its relation with social status of women. The aim of this study was to determine the prevalence and types of domestic violence during pregnancy, factors affecting it, women's thoughts about violence, and relation between social status of women and domestic violence. This cross-sectional study was conducted on 253 pregnant women, using cluster and simple random sampling methods. Chi-square test and logistic regression analysis methods were used to analyze the data. Women who indicated that they have been exposed to violence at some point of their lives were 24.1% and who indicated that violence continued while they were pregnant were 11.1%. Physical violence was the most common type of violence reported (18.2%). It was found that women who had primary school or lower level of education and who made unwanted marriage suffered from more violence during pregnancy. It can be said that violence against pregnant women is still a social problem. In societies where gender roles are dominant, decision makers have to take necessary steps such as supporting education of girls to improve social status of women, increasing awareness among women in regard to personal rights and legal regulations which will contribute to the solution of the issue.     

How the Indashyikirwa Intimate Partner Violence Prevention Programme in Rwanda Influenced Parenting and Violence against Children

There is increasing interest in working at the intersections of intimate partner violence (IPV) and violence against children (VAC), especially in the family, yet few programmatic strategies exist or have been evaluated to assess the combined impact of strategies on both types of violence. This paper addresses this gap by exploring the influence that Indashyikirwa—a programme designed to reduce IPV in Rwanda— had on VAC in the families of couples participating in the programme. Indashyikirwa included a 21-session couples’ curriculum, safe spaces for IPV survivors, and community activism against violence. In addition to reductions in IPV, a randomized control trial found significant reductions in parent’s reports of children witnessing IPV, parents’ attitudes condoning harsh physical punishment of children, and parents’ use of corporal punishment as discipline. This paper uses qualitative data to better understand how and why the couples’ curriculum influenced parenting and VAC. Twenty-eight participants (fourteen male-female couples) were individually interviewed at three time points, once before and twice after the couples’ curriculum implementation. Six men and six women who completed the curriculum and subsequently carried out activism were also interviewed at two time points. The data were analyzed thematically. Pathways motivating couples’ attitude and behavior changes towards children included reflecting on the consequences of IPV for children and appreciating the benefits for children of non-violent, gender equitable households. This analysis suggests that working with co-habiting couples presents a viable strategy for working to prevent IPV, VAC and promote more gender equitable family dynamics.

     

A mixed methods study of participant reaction to domestic violence research in Jordan

Research on domestic violence against women has increased considerably over the past few decades. Most participants in such studies find the exercise worthwhile and of greater benefit than emotional cost; however, systematic examination of participant reaction to research on violence is considerably lacking, especially in the Middle East region. This study begins to fill this gap by examining women's reactions to domestic violence research in Jordan and whether a personal history of violence is associated with unfavorable experiences. This sequential exploratory mixed methods study included 17 focus group discussions (FGD) with women in Amman followed by a survey conducted in reproductive health clinics throughout the country (pilot n = 30; survey n = 517). Open coding was used to identify the theme related to participant reaction in the FGD data. This construct was further examined by the subsequent survey that included dichotomous questions inquiring whether the respondent thought the study questions were important and whether they were angry or felt resentment as a result of the survey. One open-ended question on the survey provided additional qualitative data on the theme that was combined with the FGD data. Themes identified in the qualitative data pertained to expressions of gratitude and comments on the survey's value. Findings of this study indicate that Jordanian women's responses to the research process are similar to women currently represented by the extant literature in that a vast majority of its participants felt that the study was important (95%) and it did not evoke anger or resentment (96%). Many even found the study to be useful to them personally or to society. Among those who had a negative emotional reaction, most still found the research to be important. This study's findings highlight the safety and potential benefits of ethically conducted violence research.     

Microcredit and Marital Violence: Moderating Effects of Husbands’ Gender Ideology

Evidence on the relation between women’s microcredit participation and their exposure to marital violence has been inconsistent across studies. This study examined how women’s various levels of microcredit participation are associated with marital violence against women (MVW), while also taking into account the husbands’ gender ideology. The study included 243 wife-abusive men in rural Bangladesh. Multiple regressions were performed to predict the frequency of MVW in the preceding year. Of the married women, 52.3 % were microcredit participants, 11.1 % of whom were active participants and 41.2 % nominal participants. The study showed that women’s active microcredit participation was negatively associated with MVW, and nominal participation was positively associated with MVW among the husbands who held a more conservative gender ideology. The findings suggest that women-focused microcredit interventions should also take into account men’s gender ideologies.     

The Relation Between Intimate Partner Violence, Parenting Stress, and Child Behavior Problems

Parenting characteristics can have a significant influence on how children are affected by family violence. The purpose of this study was to explore the role women’s parenting stress plays in the relationship between exposure to physical and psychological intimate partner violence (IPV) and children’s externalizing and internalizing behavior problems. Data for this study were taken from three waves of the Illinois Families Study. The final sample included 1,653 children from 805 families. Structural equation modeling analyses were conducted across two developmental stages in order to better understand the unique relationships based on child development. For children ages 6–12 years, parenting stress mediated the relationship between exposure to psychological IPV and internalizing behaviors. No direct or indirect pathways between exposure to IPV and children’s behavior problems were found among adolescents ages 13–17. Implications for social service interventions with children and families exposed to violence are included.     

Racial Minority Women and Criminal Justice Responses to Domestic Violence

Racialized minority women’s experiences with Canadian specialized criminal justice responses to domestic violence have seldom been documented. Informed by an intersectionality framework, this qualitative study presents the struggles of 14 racial minority women from three Canadian cities and their experiences with the police and criminal court’s response to their partner’s acts of domestic violence. The results focus on how well specialized criminal justice responses address the needs of these women and protect them from further violence. Factors that facilitate or deter these women from approaching the criminal justice system for help are highlighted. The implications of these women’s narratives for criminal justice responses to domestic violence are discussed.     

Service providers' reactions to intimate partner violence as a function of victim sexual orientation and type of abuse

In this online vignette study, a national sample of domestic violence shelter service providers (N = 282) completed a 10-item questionnaire about a woman experiencing intimate partner violence (IPV). Scenarios varied in terms of couple sexual orientation (heterosexual or lesbian) and type of abuse (physical or nonphysical). Results indicate that although participants did not overtly discriminate against a woman in a lesbian relationship, they were less likely to perceive her as a victim, and their acceptance of a lesbian as a client was more dependent on their comfort with her than was the case for a woman in a heterosexual relationship. Type of abuse, as expected, had a main effect on many questions, with physical abuse taken more seriously than nonphysical abuse. Scores on the Attitudes Toward Lesbians subscale (Herek) were unrelated to responses. Implications for service providers are discussed.