Domestic violence (DV) is associated with serious consequences for victims, children, and families, and even national economies. An emerging literature demonstrates that DV also has a negative impact on workers and workplaces. Less is known about the extent to which people are aware of coworkers' experiences of DV. Using data from a pan-Canadian sample of 8,429 men and women, we examine: (1) awareness of coworker DV victimization and perpetration; (2) the warning signs of DV victimization and perpetration recognized by workers; (3) whether DV victims are more likely than nonvictims to recognize DV and its warning signs in the workplace; and (4) the impacts of DV that workers perceive on victims'/perpetrators' ability to work. Nearly 40% of participants believed they had recognized a DV victim and/or perpetrator in the workplace and many reported recognizing more than one warning sign. DV victims were significantly more likely to report recognizing victims and perpetrators in the workplace, and recognized more DV warning signs. Among participants who believed they knew a coworker who had experienced DV, 49.5% thought the DV had affected their coworker's ability to work. For those who knew a coworker perpetrating DV, 37.9% thought their coworker's ability to work was affected by the abusive behavior. Our findings have implications for a coordinated workplace response to DV. Further research is urgently needed to examine how best to address DV in the workplace and improve outcomes for victims, perpetrators, and their coworkers.
Intimate partner violence (IPV) threatens the safety and health of women worldwide. Safety planning is a widely recommended, evidence-based intervention for women experiencing IPV, yet fewer than 1 in 5 Canadian women access safety planning through domestic violence services. Rural, Indigenous, racialized, and immigrant women, those who prioritize their privacy, and/or women who have partners other than men, face unique safety risks and access barriers. Online IPV interventions tailored to the unique features of women's lives, and to maximize choice and control, have potential to reduce access barriers, and improve fit and inclusiveness, maximizing effectiveness of these interventions for diverse groups. In this double blind randomized controlled trial, 450 Canadian women who have experienced IPV in the previous 6 months will be randomized to either a tailored, interactive online safety and health intervention (iCAN Plan 4 Safety) or general online safety information (usual care). iCAN engages women in activities designed to increase their awareness of safety risks, reflect on their plans for their relationships and priorities, and create a personalize action plan of strategies and resources for addressing their safety and health concerns. Self-reported outcome measures will be collected at baseline and 3, 6, and 12 months post-baseline. Primary outcomes are depressive symptoms (Center for Epidemiological Studies Depression Scale, Revised) and PTSD Symptoms (PTSD Checklist, Civilian Version). Secondary outcomes include helpful safety actions, safety planning self-efficacy, mastery, and decisional conflict. In-depth qualitative interviews with approximately 60 women who have completed the trial and website utilization data will be used to explore women's engagement with the intervention and processes of change. This trial will contribute timely evidence about the effectiveness of online safety and health interventions appropriate for diverse life contexts. If effective, iCAN could be readily adopted by health and social services and/or accessed by women to work through options independently. This study will produce contextualized knowledge about how women engage with the intervention; its strengths and weaknesses; whether specific groups benefit more than others; and the processes explaining any positive outcomes. Such information is critical for effective scale up of any complex intervention. Clinicaltrials.gov ID NCT02258841 (Registered on Oct 2, 2014).
Abstract Introduction In Rwanda, maternal community health workers play a critical role to improving maternal, newborn and child health, but little is known about their specific experiences with adolescent mothers, who face unique challenges, including trauma, ongoing violence, stigma, ostracism, mental health issues, barriers within the healthcare system, and lack of access to the social determinants of health. This study explored the experiences of maternal community health workers when caring for adolescent mothers in Rwanda to inform the delivery of trauma- and violence-informed care in community maternal services. Methods Interpretive Description methodology was used to understand the experiences of 12 community health workers purposively recruited for interviews due to their management roles. To gain additional insights about the context, seven key informants were also interviewed. Findings Maternal community health workers provided personalized support to adolescent mothers through the provision of continuity of care, acting as a liaison, engaging relationally and tailoring home visits. They reported feeling passionate about their work, supporting each other, and receiving support from their leaders as facilitators in caring for adolescent mothers. Challenges in their work included handling disclosures of violence, dealing with adolescent mothers’ financial constraints, difficulties accessing these young mothers, and transportation issues. Adolescent mothers’ circumstances are generally difficult, leading to self-reports of vicarious trauma among this sample of workers. Conclusion Maternal community health workers play a key role in addressing the complex needs of adolescent mothers in Rwanda. However, they face individual and structural challenges highlighting the complexities of their work. To sustain and enhance their roles, it is imperative for government and other stakeholders to invest in resources, mentorship, and support. Additionally, training in equity-oriented approaches, particularly trauma- and violence-informed care, is essential to ensure safe and effective care for adolescent mothers and to mitigate vicarious trauma among maternal community health workers.
Babcock JC, Green CE, Robie C. Does batterers’ treatment work? A meta-analytic review of domestic violence treatment. Clin Psychol Rev 2004;23:1023–53.[OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] Q Does treatment of men committing domestic acts of violence prevent recurrence and, if so, what types of treatment work best? ### ![Graphic][5]Design: Systematic review with meta-analysis. ### ![Graphic][6]Data sources: PsycINFO searched plus hand search of bibliographies and reference sections of five reviews. Additional information was obtained from study authors. ### ![Graphic][7]Study selection and analysis: Inclusion criteria: experimental or quasi-experimental studies with a comparison group (randomised control groups or treatment dropouts); victim reports or police records (criminal reports) used to measure recidivism. Effect sizes using Cohen’s d were calculated. A hierarchical fixed effects model was used to assess the impacts of report type, study design, and treatment type. ### ![Graphic][8]Outcomes: Recidivism rates, treatment types. Twenty two experimental (five studies) and quasi-experimental … [1]: {openurl}?query=rft.jtitle%253DClinical%2Bpsychology%2Breview%26rft.stitle%253DClin%2BPsychol%2BRev%26rft.aulast%253DBabcock%26rft.auinit1%253DJ.%2BC.%26rft.volume%253D23%26rft.issue%253D8%26rft.spage%253D1023%26rft.epage%253D1053%26rft.atitle%253DDoes%2Bbatterers%2527%2Btreatment%2Bwork%253F%2BA%2Bmeta-analytic%2Breview%2Bof%2Bdomestic%2Bviolence%2Btreatment.%26rft_id%253Dinfo%253Adoi%252F10.1016%252Fj.cpr.2002.07.001%26rft_id%253Dinfo%253Apmid%252F14729422%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1016/j.cpr.2002.07.001&link_type=DOI [3]: /lookup/external-ref?access_num=14729422&link_type=MED&atom=%2Febmental%2F7%2F3%2F79.atom [4]: /lookup/external-ref?access_num=000188607200002&link_type=ISI [5]: /embed/inline-graphic-1.gif [6]: /embed/inline-graphic-2.gif [7]: /embed/inline-graphic-3.gif [8]: /embed/inline-graphic-4.gif
Intimate partner violence (IPV) is at epidemic levels across low-, middle-, and high-income countries, including Canada, where recent lifetime prevalence indicated that over 40% of women had IPV experiences. In response to this, Canada’s federal government has made investments toward IPV prevention and response. We conducted a scoping review of English and French literature identified through searches of multiple databases and specific journals to assess the current state of IPV research in Canada. A total of 267 articles met inclusion criteria of being peer-reviewed research primarily about IPV in either French or English published from 2020 to 2022 with at least one Canadian-affiliated author. Almost a third of studies described services for survivors but did not evaluate service effectiveness. We noted a significant gap in research on the IPV experiences of gender and/or sexual minorities. Canada’s federal social science research funding agency was the most common funder, with the two federal government departments with specific IPV funding initiatives in place cited as funding less than 6% of included studies. In general, there remains an overfocus on IPV epidemiology and on descriptions of service use, and not enough research examining the effectiveness and implementation of interventions, especially grounded in theoretical, gendered, and trauma- and violence-informed frameworks. Funders and researchers are encouraged to consider moving resources from ongoing description of well-established factors to assessment and implementation of evidence-informed interventions, and, crucially, primary prevention of IPV and all forms of gender-based violence.
People who are structurally disadvantaged and marginalized often report poor health care experiences, such as inequitable treatment, due to intersecting forms of stigma and discrimination. There are many measures of patient experiences of care, however, few are designed to measure equity-oriented health care. In alignment with ongoing calls to integrate actions in support of health equity, we report on the development and testing of patient-reported experience measures that explicitly use a health equity and intersectional lens. Our analysis focuses on two different scales: the Equity-Oriented Health Care Scale—Ongoing , which was evaluated in primary health care settings where patients have an ongoing relationship with providers over time, and the Equity-Oriented Health Care Scale—Episodic , which was tested in an emergency department where care is provided on an episodic basis. Item Response Theory was used to develop and refine the scales. The psychometric properties of each scale were also evaluated. The Equity-Oriented Health Care Scale—Ongoing was first tested with a cohort of 567 patients. The Equity-Oriented Health Care Scale—Episodic was subsequently tested in an emergency department setting with 284 patients. Results of the Item Response Theory analysis for each scale yielded a brief index that captured the level of equity-oriented care when care is ongoing (12 items) or episodic (9 items). Both scales showed evidence of internal consistency and concurrent validity, based on a high correlation with quality of care. They are brief, easy-to-administer patient-reported experience measures that can support organizations to monitor quality of care. Their availability enhances the possibility of measuring equity-oriented health care in diverse contexts and can provide nuanced understandings of quality of care through an intersectional and equity lens.
This paper presents one model for building and sustaining a research partnership between researchers and professional staff in child protection (CPS) agencies. The Maltreatment and Adolescent Pathways (MAP) study was designed to assess the health and well-being of the population of adolescents involved in the child welfare system of a major urban area. The study involved the collaboration between university based researchers and a range of child welfare staff, from administration to front-line workers. A key factor supporting collaboration was reciprocity with expertise, with CPS practitioner knowledge yielding intervention-relevant study queries and constructs, and researcher knowledge on health content and best practices yielding tailored training opportunities and increased climate for knowledge uptake. The MAP study combined a Participatory Action Research (PAR) model with a traditional, scientific positivist model, including the scientific elements of standardized measures, explicit evaluation of the participatory process, and research impact on the community members. This study: 1) provides information on the process of creating effective researcher-CPC agency partnerships, 2) considers key ethics issues, such as the participant’s reactivity to research of child welfare- involved clients, and 3) examines the implications of implanting a PAR approach in research with Aboriginal CPS agencies, as per the required use of the Canadian Institutes of Health Research (CIHR) Guidelines for Health Research Involving Aboriginal People for future community- university partnerships.
P H Chen
Dr P H Chen, University of Medicine and Dentistry of New Jersey–New Jersey Medical School. Newark, NJ, USA; chenpi@umdnj.edu
What is the relative effectiveness of self-report, medical staff interview, and physician interview for screening for domestic violence (DV) in women?
### Design:
randomised controlled trial.
### Allocation:
{concealed}.*
### Blinding:
{unblinded}.*
### Follow-up period:
end of healthcare visit.
### Setting:
4 family practices {in the US}.*
### Patients:
523 women ⩾18 years of age (mean age 36 y, 71% black) who were currently living with a partner.
### Intervention:
self-report (n = 173), medical staff {included nurses and medical assistants}* interview (n = 169), or physician interview (n = 181) for administering 2 questionnaires to screen for DV: Woman Abuse Screening Tool (WAST)-Short and Hurt-Insult-Threaten-Scream (HITS). WAST-Short had 2 questions (“In general, how would you describe your relationship? A …
