Violence Prevention Interventions Research Articles

Task-sharing to promote caregiver mental health, positive parenting practices, and violence prevention in vulnerable families in Sierra Leone: a pilot feasibility study

Abstract Background The prevalence of household violence in low- and middle-income countries (LMICs) is high, and exposure to violence has significant adverse effects on both mental health and child development across generations. Evidence-based services to improve parenting practices and reduce household violence in LMICs are scarce, particularly across rural regions of West Africa. This study explored the feasibility, acceptability, and potential benefits of an evidence-based home-visiting intervention to promote early childhood development and reduce household violence—the Family Strengthening Intervention for Early Childhood Development and Violence-Prevention (FSI-ECD + VP)—among vulnerable families in rural regions of Sierra Leone. Methods Eighty dual-caregiver households in the Makeni region of Sierra Leone were included in the study (N = 160 caregivers; 73% female). Eligibility criteria included having at least one child aged 6–36 months and elevated scores (> 62.5) on the Difficulties in Emotion Regulation Scale (DERS). Community Health Workers (CHWs) employed in the Makeni region completed a 3-week FSI-ECD + VP training. Families were randomized to receive either the FSI-ECD + VP or treatment as usual (TAU). Research assistants blinded to treatment assignment assessed caregiver mental health, caregiver-child interactions, and household violence at baseline, post-intervention, and 3-month follow-up time points. Results Triangulation of quantitative and qualitative data showed that caregivers, CHWs, and supervisors generally perceived the intervention as beneficial, feasible, and acceptable. Mixed effects models showed that caregivers who received the FSI-ECD + VP had significantly improved caregiver-child relationship outcomes compared to TAU as assessed by the Home Observation for Measurement of the Environment and the Observation of Caregiver-Child Interactions at post-intervention. Preliminary data also suggests that caregivers receiving the FSI-ECD + VP were less likely to have experienced intimate partner physical violence during the post-intervention period, and had lower symptoms of anxiety and depression at 3-month follow-up. Conclusions FSI-ECD + VP delivery by CHWs in Sierra Leone may be feasible and acceptable; it may also help improve caregiver-child interactions and reduce the likelihood of household violence among vulnerable families with young children. Task-sharing approaches may help increase acceptability and access to evidence-based behavioral interventions that promote early childhood development and violence prevention among families in rural regions of Sierra Leone and other similar settings. Trial registration The study is registered in clinicaltrials.gov (NCT 03045640; 07/22/2020). This study follows the Consort 2010 guidelines for reporting of clinical trials.

Mapping Multilevel Contributions to the Sexual Victimization of Trans Women and Trans Feminine People: A Qualitative Intersectional Stigma Analysis

ABSTRACT We aimed to characterize and conceptually organize multilevel factors associated with the sexual victimization experiences of trans women and trans feminine people to advance violence prevention interventions for health-equity. Between October 2020 and July 2021, we conducted in-depth interviews with 17 expert informants in New York City, which we transcribed, coded, and analyzed. Qualitative insights were derived through an intensive, team-based iterative coding strategy resulting in the development of an exhaustive set of consensus codes which were organized and interpreted in a multi-level structure. Findings revealed a complex constellation of intersecting macro- and micro-structural mechanisms reinforcing sexual violence. Unique characteristics of this violence were characterized hierarchically in terms of: 1) violence forms (e.g. murder, fetishization), 2) perpetrators (e. g. safety-staff; group assault), 3) contexts (e.g. public accommodations), 4) functions (e.g. gender policing), 5) ideological reinforcers (e.g. transphobia, racism), and 6) structural reinforcers (e.g. legislation; linking access to material means of survival to poverty/illness). Results indicate that acute incidents of sexual victimization are “the tip of the iceberg” of the violence impacting trans communities. The community experts we interviewed (e.g. trans women, violence prevention practitioners, social workers) understand chronic functional, ideological, and structural oppression as inextricable from sexual violence. Multi-level determinants of violence therefore constitute essential targets of sexual violence prevention intervention for this population.

Violence Reduction Units: What is a public health approach?

The World Health Organization (WHO) (2017: para 3), illustrate that a public health approach to reducing violence involves ‘improving the health and safety of all individuals by addressing underlying factors that increase the likelihood that an individual will become a victim or perpetrator of violence… programmes for primary prevention of violence… are designed to expose a broad segment of a population to prevention measures to reduce and prevent violence at a population-level’. These approaches to violence reduction are not a new concept, but they are becoming increasingly popular in dealing with the increasing the threat, exposure, and fear of violence in the UK. Serious Violence among all ages groups in England and Wales has significantly increased, increasing by almost 12% since 2022, nearly returning to pre-COVID-19 figures (Violence Research Group, 2023). This paper explores what is meant by adopting a public health approach to violence reduction, demonstrates how violence is a worldwide public health issue, and outlines how this underpins the recent Violence Reduction Unit initiatives in the UK. This paper provides important context for the violence prevention and reduction intervention focused papers in this special edition.

MIDWIFERY SERVICE MANAGERS’ READINESS FOR PREVENTION OF OBSTETRIC VIOLENCE IN NIGERIA: A COMMUNITY READINESS MODEL

Obstetric violence is a public health problem that needs to be prevented at all levels to improve maternal and newborn health outcomes. The midwifery service managers, as custodians of patient care in maternity centres are in a prime position to develop and implement effective obstetric violence prevention interventions. This study explored the midwifery service managers’ level of readiness for the prevention of Obstetric Violence in three maternity centres at three separate hospitals in Oyo State, Nigeria. Data was collected from six midwifery service managers as midwifery community leaders, using the adapted Community Readiness Model as a data collection tool. The Community Readiness Model scoring guide was used to score the six dimensions of community readiness. In addition, a thematic analysis was used to analyze the qualitative data from their views on each of the six dimensions of the Community Readiness Model. The findings revealed an overall level of readiness for the prevention of obstetric violence among midwifery service managers was at level five which is the preparatory level. This means that the community has a modest readiness for Obstetric violence prevention, and it would be easier to develop sustainable prevention interventions for obstetric violence. Understanding the midwifery service managers’ level of readiness for the prevention of obstetric violence is important for governments and other stakeholders intending to develop obstetric violence prevention interventions that are contextually appropriate and acceptable to communities.

A Qualitative Exploratory Case Study of the Safe Doors, Safe Homes Intervention for Intimate Partner Violence Prevention in the Canadian Context: Perspectives from IPV Survivors, Service Providers and Police

A Qualitative Exploratory Case Study of the Safe Doors, Safe Homes Intervention for Intimate Partner Violence Prevention in the Canadian Context: Perspectives from IPV Survivors, Service Providers and Police

School-based prevention of teacher and parental violence against children: Study protocol of a cluster-randomized controlled trial in Tanzania

BackgroundViolence against children at home and at school is particularly prevalent in Africa and is associated with adverse and persistent health effects on children. The violence prevention intervention Interaction Competencies with Children - for Teachers (ICC-T) is an effective tool to reduce violence against children by fostering teachers’ non-violent communication and interaction skills. To enhance these effects, in the present study, ICC-T will be extended to parents (ICC-P) aiming to increase children’s experience of consistent behavior and application of non-violent discipline strategies between teachers and parents.MethodsTo investigate the effectiveness of the school-based combined implementation of ICC-T and ICC-P, a cluster-randomized controlled trial with 16 primary schools in the urban district of Morogoro in Eastern Tanzania will be conducted. Both quantitative (structured interviews) and qualitative (focus group discussions, in-depth interviews, evaluation forms) methods will be used to investigate the effects on teachers’ and parents’ violence against children in home and school settings. The intervention implementation will be accompanied by a comprehensive process evaluation to assess the implementation quality of and participants’ engagement with ICC-T and ICC-P. Potential downstream effects of violence reduction will be investigated by assessing the children’s mental health and well-being.DiscussionThe present study aims to provide evidence for the feasibility, acceptability, and effectiveness of the school-based combined implementation of ICC-T and ICC-P to reduce teacher and parental violence against children and contribute to children’s well-being in home and school settings.Trail registrationThe clinical trial was registered at ClinicalTrials.gov (ClinicalTrials.gov, 2024) under the identifier NCT06369025 (Hecker, Preventing Physical and Emotional Violence by Parents and Teachers in Public Schools in Tanzania (ICC-T/ICC-P_Tanz) (PreVio), 2024) on April 17, 2024.

Violence outcomes in later adolescence with the Good School Toolkit-Primary: a nonrandomized controlled trial in Uganda

BackgroundWe sought to determine whether the Good School Toolkit-Primary violence prevention intervention was associated with reduced victimisation and perpetration of peer and intimate partner violence four years later, and if any associations were moderated by sex and early adolescent: family connectedness, socio-economic status, and experience of violence outside of school.MethodsDrawing on schools involved in a randomised controlled trial of the intervention, we used a quasi-experimental design to compare violence outcomes between those who received the intervention during our trial (n = 1388), and those who did not receive the intervention during or after the trial (n = 522). Data were collected in 2014 (mean age 13.4, SD 1.5 years) from participants in 42 schools in Luwero District, Uganda, and 2018/19 from the same participants both in and out of school (mean age 18, SD: 1.77 years). We compared children who received the Good School Toolkit-Primary, a whole school violence prevention intervention, during a randomised controlled trial, to those who did not receive the intervention during or after the trial. Outcomes were measured using items adapted from the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool-Child Institutional. We used mixed-effect multivariable logistic regression, with school fitted as a random-effect to account for clustering.Results1910 adolescents aged about 16–19 years old were included in our analysis. We found no evidence of an average long-term intervention effect on our primary outcome, peer violence victimization at follow-up (aOR = 0.81, 95%CI = 0.59–1.11); or for any secondary outcome. However, exposure to the intervention was associated with: later reductions in peer violence, for adolescents with high family connectedness (aOR = 0.70, 95% CI 0.49 to 0.99), but not for those with low family connectedness (aOR = 1.07, 95% CI 0.69 to 1.6; p-interaction = 0.06); and reduced later intimate partner violence perpetration among males with high socio-economic status (aOR = 0.32, 95%CI 0.11 to 0.90), but not low socio-economic status (aOR = 1.01 95%CI 0.37 to 2.76, p-interaction = 0.05).ConclusionsYoung adolescents in connected families and with higher socio-economic status may be better equipped to transfer violence prevention skills from primary school to new relationships as they get older.Trial registrationClinicaltrials.gov, NCT01678846, registration date 24 August 2012.Protocol for this paper: https://www.researchprotocols.org/2020/12/e20940.

Associations between childhood violence and mental health in refugee settings in Uganda

BackgroundChildhood violence and mental health remain concerning public health issues globally yet there is limited evidence on the associations between experiences of such violence and mental health in refugee settings. ObjectiveTo assess the association between experiences of childhood violence (sexual, physical, and emotional violence) and mental health (severe mental distress, self-harm, suicidal ideation and/or attempted suicide) in refugee settings in Uganda. Data and methodsData are from the 2022 Uganda Humanitarian Violence against Children and Youth Survey (HVACS) conducted among 1338 females and 927 males aged 13–24 years between March and April 2022. Cross-tabulation with chi-square tests and multivariate logistic regression analysis were used to assess the association between experiencing childhood violence and mental health. ResultsThe results show a high prevalence of experiencing childhood violence (females 40.8% vs males 55.2%) and mental distress (45% for both males and females). Females who experienced childhood sexual violence had significantly higher odds of reporting severe mental distress (aOR = 1.989; CI = 1.216–3.255), suicidal ideation and/or attempted suicide (aOR = 4.119; CI = 2.157–7.864) and self-harm (aOR = 3.734; CI = 1.619–8.609) compared to those who did not experience such violence. Experiencing childhood physical or emotional violence was also significantly associated with increased odds of reporting suicidal ideation and/or attempts and self-harm among females. Among males, childhood emotional violence was significantly associated with increased odds of reporting suicidal ideation and/or attempts (aOR = 9.233; CI = 2.293–37.177) or severe mental distress (aOR = 2.823; CI = 1.115–7.148). ConclusionChildhood exposure to violence was associated with poor mental health, with a higher risk observed among females. The findings of this paper provide critical insights to facilitate the development or strengthening of violence prevention and response interventions on violence against children in refugee settings.

A participatory and comprehensive intervention to improve violence prevention in two high-risk occupations: effect and process evaluation of a stepped wedge cluster randomised trial

BackgroundWork-related violence committed by clients, patients, and customers represents a major occupational health risk for employees that needs to be reduced.MethodsWe tested a comprehensive violence prevention intervention involving active participation of both employees and managers in the Prison and Probation Service (PPS) and on psychiatric wards in Denmark. We used a stepped wedge cluster randomised controlled trial design. We measured the degree of implementation of the intervention by registration of fidelity, reach, and dose and used a mixed-effects regression analysis to estimate the effects of the intervention.ResultsWe recruited 16 work units for the intervention, but three work units dropped out. The average implementation rate was 73%. In the psychiatric wards, the intervention led to statistically significant improvements in the primary outcome (an increase in the degree to which managers and employees continuously work on violence prevention practices based on their registration and experiences), but none statistically significant improvements in any of the secondary outcomes. In the PPS units, the intervention did not lead to a statistically significant improvement in the primary outcome, but to statistically significant improvements in three secondary outcomes.ConclusionMost work units were able to carry out the intervention as planned. The intervention showed mixed results regarding the primary outcome. Nevertheless, the results indicate improvements also in the sector where a change in the primary outcome was not achieved. The results point at that a participatory and comprehensive approach could be a viable way of working with violence prevention in high-risk workplaces.Trial registrationISRCTN86993466: 20/12/2017

Childhood Violence, High School Academic Environment, and Adult Alcohol Use Among Latinas and Black Women: A Structural Equation Modeling Study.

Young Latinas and Black women drink less than women of other racial/ethnic groups but experience more alcohol-related problems in midlife. This study aims to identify modifiable factors to prevent adult onset of alcohol use disorder (AUD) in this population. Data were collected at six time points as part of the Harlem Longitudinal Development Study from 365 Latinas (47%) and Black (53%) women (mean age at time 1 = 14, standard deviation 1.3). Structural equation modeling was used to test hypothesized pathways from childhood physical and sexual abuse to AUD via depressive mood, anxiety disorders, and somatic complaints in the 20s. We also tested the moderation effect of the high school academic environment by including in the structural equation model two latent variable interaction terms between the school environment and each of the abuse variables. Childhood physical and sexual abuse was positively associated with depressive mood, anxiety disorders, and somatic complaints when participants were in the 20s. Depressive mood mediated childhood abuse and AUD when women were in the 30s. The high school academic environment attenuated the effect of physical, but not sexual abuse, on depressive mood (β = -0.59, B = -9.38, 95% CI [-14.00, -4.76]), anxiety symptoms (β = -0.61, B = -14.19, 95% CI [-21.76, -6.61]), appetite loss (β = -0.41, B = -10.52, 95% CI [-15.61, -5.42]), and sleeplessness (β = -0.50, B = -9.56, 95% CI [-13.95, -5.17]) in the early 20s. Our findings underscore the need to invest in early violence prevention interventions and in education to ensure equitable access to quality, academically oriented, and safe schools.

Co-design of a digital violence prevention and management tool for psychiatric inpatient care: focus on supporting integration into electronic health record system

IntroductionViolence in psychiatric inpatient settings is a global challenge. Several methods have been developed and tested to help staff prevent the occurrence of violence on the wards. One novel and effective method is eDASA+APP, originating from Australian forensic psychiatric settings (Maguire et al. Int J Ment Health Nurs 2019; 281186-1197, Griffith et al. Psychiatr Serv 2021; 72 885-890). This electronic method contains an instrument (DASA) to assess the risk for imminent violence and includes evidence-based violence risk management methods for risk levels. It is important to ensure that this electronic intervention is integrated into daily clinical practice. This can be done in co-design between all that are involved e.g., staff and experts by experience, and by encouraging them to achieve a common goal and gain benefits by working together.ObjectivesThis prevention gives an overview of how the Finnish version of eDASA+APP was co-designed with healthcare staff and experts by experience, focusing on integration into the electronic patient health record system. The presentation is part of a larger research project testing eDASA+APP in Finnish psychiatric inpatient care.MethodsCo-design workshops focusing on three major themes: 1) identifying current practices and how eDASA+APP would fit in those, 2) producing a linguistically and culturally appropriate version of eDASA+APP, and 3) preferred use of eDASA+APP in an electronic patient health record system. Notes were kept during the workshops by researchers. Qualitative material were analysed with deductive content analysis. Results from the third theme are shared in this presentation.ResultsStaff and experts by experience described that integration of eDASA+APP in electronic patient health record system is supported if it 1) brings clear and fast information to the staff about the violence risk of a patient, 2) is a visible measure that is concretely in sight in electronic patient health record system, 3) provides information about which violence prevention and management interventions have worked with a patient, 4) involves patient preferences, and 5) consist of joint decisions that have been agreed multi-professionally.ConclusionsIntegration of eDASA+APP in the electronic patient health record system has the potential to succeed if it is realized in cooperation with staff and experts by experience, is technically easy to use, and the users have an understanding of its benefits to everyone involved.Disclosure of InterestNone Declared

Workplace Violence in the Pediatric Emergency Department: A National Survey of Physicians in the United States.

Previous work shows that health care workers, and particularly emergency department (ED) staff, are at an above average risk of workplace violence (WPV), defined as verbal threats or physical violence in the workplace. Previous data suggest that staff of a single pediatric ED frequently feel unsafe. The objective of this study was to conduct the first national survey study to assess the prevalence and incidence of WPV in the pediatric ED. In this cross-sectional survey study, a representative sample of US pediatric emergency medicine physicians were invited to participate in a national survey adapted from the previously validated Workplace Violence in the Health Sector questionnaire from the World Health Organization. The primary outcome measure was the proportion of physicians who have been exposed to WPV. Rates of exposure to violence, reporting habits, and physician perception of various violence prevention strategies were studied secondarily. Surveys were completed by 207 (45%) invited participants, representing 31 US children's hospitals. The prevalence of WPV exposure was 96%. Physical violence with a weapon was witnessed by 20% of participants. Injuries requiring medical attention or time off work were experienced by 10% of participants. Half of participants never reported violent events. Security guards were welcome by 99%, armed law enforcement officers by 70%, and metal detectors by 81% of physicians. Self-arming was opposed by 85% of respondents. Exposure to WPV is frequent among pediatric emergency medicine physicians with a prevalence similar to that of general emergency departments. Workplace violence remains underreported. This national survey contributes to the objective evaluation of individual- and systems-level violence prevention interventions.

Experiences of teachers and students on school closures and its consequences during the COVID-19 pandemic in Nyarugusu refugee camp, Tanzania.

Tanzania has experienced several waves of COVID-19 since it was first detected in the country. During the first wave, Tanzania took several measures to prevent wider virus transmission with school closures being one of them. All areas and institutions were targeted, including the refugee camps in Kigoma region. Despite the abundant evidence generated in relation to the effects of the pandemic and associated school closures globally, there has been a paucity of literature exploring the experiences of teachers and students in humanitarian settings. We conducted a qualitative study to explore COVID-19 related school closures in Nyarugusu refugee camp. We aimed to describe teachers' and students' experiences and perceived consequences of school closures. In-depth interviews with teachers and students were conducted in September 2020 in Burundian and Congolese schools in the context of a cluster randomised trial of EmpaTeach, a school-based violence prevention intervention. A total of 44 individuals (29 teachers and 15 students) were interviewed. A phenomenological theoretical framework was used to guide the content analysis. Findings indicated that the COVID-19 pandemic was generally seen as frightening by refugees. Study participants understood the importance of school closures to prevent transmission of the virus, but various negative consequences were reported by both teachers and students. These included perceived mental health difficulties such as stress, depression and anxiety associated with the worry of infection, idleness, and disruption of education. Participants also perceived an increase in occurrences of early marriages and unplanned pregnancies, which they thought contributed to increased school dropout. Participants identified the main causes of such outcomes as a lack of parental supervision, children's lack of restraint and poor character, and a lack of alternative teaching practices (such as online or remote learning) to keep the students busy while at home. Children were held accountable for their faults with little support from the adults. Our findings suggest that there is an urgent need to strengthen child protection programming to support children and their communities during emergencies and provides protective environments such as school and education. There is a critical need to develop preparedness plans for future pandemics to support child safety, academic development and wellbeing.

Adapting a complex violence prevention intervention: a case study of the Good School Toolkit in Uganda

BackgroundAdaptation is a key strategy to extend the reach of evidence-based interventions to prevent violence in new populations, but there is a dearth of practical case examples. The Good School Toolkit was developed by Ugandan NGO Raising Voices for use in primary schools (GST-P). We describe our systematic approach to adapting the GST-P for use in secondary schools in Uganda, and reflect on the utility of the process as well as limitations of existing adaptation frameworks.MethodsWe adapted the GST-P in four phases, which included: I) clarifying the logic model and core intervention components using a streamlined process; II) conducting formative research (cross-sectional survey, focus groups, etc.) to understand the new population; III) selecting and preparing new intervention components and modifying existing intervention components; and IV) pretesting new intervention components with teachers and students in Uganda.ResultsWe identified core components using a logic model. Formative research showed results largely in line with our apriori hypotheses. Teacher violence remained highly prevalent in secondary versus primary schools (> 65% of secondary students reported past year exposure), while peer violence significantly increased (secondary = 52% vs. primary girls = 40%, P < 0.001; secondary = 54% vs. primary boys = 44%, P = 0.009) in secondary versus primary schools. Significantly more secondary girls (51%) than secondary boys (45%) reported past year dating/intimate partner violence (P = 0.03). Inequitable, gendered educational practices emerged as a salient theme, perceived to heighten female students’ vulnerability to violence. In light of these findings, we made several adjustments to the adapted intervention. We strengthened existing teacher and peer violence intervention components. We also developed, pretested and revised new program components to prevent dating violence and promote ‘gender fairness in schools’. Finally, original activities were modified to support engagement with school administration and promote increased student agency in secondary schools.ConclusionsBased on our experience, it was difficult to apply mechanistic models to clarify the intervention logic of the GST-P, a complex multicomponent intervention, and simpler methods may be sufficient. Our team had high levels of contextual knowledge before the adaptation, and formative research to understand the new target population provided only limited additional insight. In similar situations, a simplified approach to mapping the core intervention components, qualitative research to understand the new target population, and pre-testing of new intervention components may be the most informative elements of systematic adaptation processes.

Conceptualisation of violence and discipline among students, teachers, and parents in Nyarugusu Refugee Camp, Tanzania

BackgroundLittle academic research has been conducted on how people conceptualise ‘violence’ and ‘discipline’, especially in humanitarian settings. This may limit the transferability of violence prevention interventions. This paper examines the understanding of violence and discipline concepts among students, teachers, and parents in the Nyarugusu Refugee Camp in Tanzania. MethodsA qualitative study was undertaken as part of the larger trial testing the effectiveness of the EmpaTeach intervention to prevent physical violence from teachers to students implemented in 27 schools in Nyarugusu Refugee Camp. Data from baseline and midline surveys in control schools that did not receive the intervention informed this paper where a total of 14 in-depth interviews (eight with students and six teachers) and six focus group discussions (two with teachers and four with parents from the Parent Teacher Association) were analyzed. Both audio recordings from in-depth interviews and focus group discussions were transcribed verbatim, and translated from Kiswahili to English (Congolese) and Kirundi to English (Burundian). Translated data were verified and coded using thematic analysis based on the views of students, teachers, and parents. ResultsParticipants revealed that the same behavioural acts could be differentially classified as violence or discipline. Violence was understood in relation to the consequences of acts, which could include physical or psychological harm, or other harms which were seen as detrimental to children's futures and life chances, particularly adolescent pregnancy. Sexual acts without consent were also seen as violence. In contrast, discipline was understood according to intent, and perceived acts done towards students to correct bad behaviour. ConclusionResults imply that education about the harmful consequences of behavioural acts intended as discipline, may be important for violence prevention interventions and that framing interventions in terms of positive child development could help change discipline strategies in schools.

Effectiveness of a family violence prevention program on mental health outcomes for adult men and women in North Kivu, Democratic Republic of Congo: Insights from a pilot trial.

The eastern Democratic Republic of Congo (DRC) has faced dual burdens of poor mental health and heightened levels of violence against women and children within the home. Interventions addressing family violence prevention may offer a path to mitigate mental distress within the eastern DRC. This exploratory analysis uses data from a pilot cluster randomized controlled trial conducted in North Kivu, DRC, assessing the impact of Safe at Home, a violence prevention intervention. Mental health was assessed at endline using the Patient Health Questionnaire-4. Statistical analyses employed multilevel linear regression. Assuming successful randomization, impact of the Safe at Home intervention on mental health differed by participant gender. Women enrolled in the Safe at Home intervention reported statistically significant decreases in mental distress symptoms [β (95%CI)=-1.01 (-1.85, -0.17)], whereas men enrolled in Safe at Home had similar scores in mental distress to the control group [β (95%CI)=-0.12 (-1.32, 1.06)]. Ultimately, this exploratory analysis provides evidence of the potential for a family violence prevention model to improve women's mental health in a low-resource, conflict-affected setting, although further research is needed to understand the impact on men's mental health.

Evaluating the function and psychometric properties of a violence risk screening tool in a community sample of adolescents.

Youth violence continues to be widespread. Despite numerous evidence-based programs that reduce youth violence, objective ways to identify youth in need of services is lacking. Few screening tools are available that enables practitioners or community organizations to predict who may perpetrate serious violence. The Violence Injury Protection and Risk Screen (VIPRS) is a previously validated screening tool providing a framework to address youth violence. The purpose of this study is to evaluate the psychometric properties of the VIPRS in a community sample for use in multiple settings. Youth participating in a community-focused youth violence prevention intervention served as the study subjects. Households with youth ages 10-17 were eligible to participate. Study personnel verbally asked youth survey questions and recorded answers on a laptop. Multiple measures-including risk factors for violent behavior as well as, violence and delinquency scales, were asked. Eleven hundred youth participated. Mean age was 13.3; 53% female, 26% Black, 58% Hispanic, 11% more than 1 race. Twenty percent screened positive on the VIPRS-28% male versus 13% female (p = .000). Violence-related behaviors were common: 33% were in a physical fight, 27% experienced cyberbullying victimization, and 9% perpetrated a minor assault. The VIPRS demonstrated robust criterion validity with significant correlation to multiple violence measures (0.3-0.6). Scoring positive on the VIPRS conveyed increased odds of reporting other violent behaviors, such as perpetrating physical aggression (OR: 7 [95% CI: 5.1-11.5]). Overall, the VIPRS performed well in a community sample of youth further validating its psychometric functioning while demonstrating the potential for use in settings beyond healthcare.

Pop-up Digital for Disability Tunagrahita Pencegahan Pelecahan Seksual pada Anak Tuna Grahita Di SLB Samudra Lavender

Background: Children with disabilities, especially mentally retarded, have difficulty distinguishing between appropriate and inappropriate touches, which will make it difficult for disabled children to identify actions that lead to sexual harassment directed at them. Intellectual disability or mental disability is a condition where a person's intelligence development experiences obstacles so that they do not reach the optimal stage of development. Digital pop up books are very easy to understand in the learning process and are an effective medium in providing sexual education for mentally retarded children. Purpose: The aim of this community service is to increase awareness of mentally retarded teenagers about preventing sexual violence through digital pop up book media. Method: The stages include planning and preparation, implementation of service activities with workshops, Popi Dita fungame, barcode story corner hut and evaluation. The activity was held on Wednesday 7 June 2023 at SLB Samudra Lavender Bangkalan. Measuring the success of this digital pop up book media uses a pre-test and post-test with a questionnaire containing 16 short questions. Result: The results showed an increase in student knowledge scores from 4.95 to 7.36. The paired t-test obtained a p- value of 0.019 which shows that sexual violence prevention interventions can increase the knowledge or awareness of mentally retarded children regarding the prevention of sexual violence. Conclusion: This activity was successfully carried out with high participation and enthusiasm from students in taking part in this activity. It is hoped that this pop up book can be a useful educational tool for schools in an effort to minimize the number of victims of sexual violence.

Interventions to prevent or manage workplace violence against student nurses during clinical placement: a systematic review protocol.

The objective of this review is to investigate the effectiveness of workplace violence management or prevention interventions, including strategies, protocols, and policies, to address violence against, and provide support to, registered nursing students (RNS) following incidents of violence during clinical placement. Workplace violence is a global issue that affects victims' physical and mental health. RNS are especially vulnerable to workplace violence because of their limited work experience and confidence. These students often feel shocked and unprepared when experiencing workplace violence due to limited education and support provided by educational institutions or clinical sites. Workplace violence can lead to anxiety, decreased confidence, and professional attrition. There is a need to systematically synthesize the evidence on workplace violence management and prevention to support nursing students during clinical placement. The review will consider studies assessing the effectiveness of interventions to address workplace violence or improve support for RNS. Studies that report on educational interventions or pre-clinical placement strategies and measure the preparedness of students will also be considered. Study designs will be limited to quantitative methods that evaluate intervention effectiveness. Databases to be searched include MEDLINE (Ovid), CINAHL (EBSCOhost), Web of Science Core Collection, Scopus, Embase (Ovid), Cochrane Central, ERIC (ProQuest), ProQuest Central, ProQuest Social Science Premium Collection, and ProQuest Dissertations and Theses Global. Two independent reviewers will screen, review, appraise, and extract data from eligible articles. For data synthesis, studies will be pooled using JBI SUMARI. The GRADE approach for grading the certainty of evidence will be followed and a Summary of Findings will be created. PROSPERO CRD42022377318.

Development, feasibility, and acceptability of SPoRT: a dating violence and sexual risk prevention intervention for college student-athletes

BackgroundStudent-athletes are one subgroup of college students in the USA at risk for dating violence and sexual risk behaviors. Despite this, research on student-athletes’ dating behaviors is limited; existing research pertains primarily to the National Collegiate Athletic Association (NCAA) Division I athletes and focuses on male student-athletes as perpetrators of dating and sexual violence. While some existing programs aim to reduce dating violence and promote healthy relationships, these programs are education based, and not tailored to the specific strengths and challenges of student-athletes. We therefore designed Supporting Prevention in Relationships for Teams (SPoRT), a novel, four-session prevention intervention for Division III student-athletes of all genders to reduce dating violence and sexual risk behavior by targeting knowledge and skills identified in pilot research, incorporating psychoeducation with techniques from cognitive-behavioral therapy, mindfulness, bystander intervention, and normative feedback.MethodsThis study represents stage 1 of the National Institutes of Health (NIH) Stage Model for Behavioral Intervention Development, evaluating the feasibility and acceptability of SPoRT. We describe the development, content, and proposed delivery methods for SPoRT and evaluated the feasibility and acceptability of the program using a mixed-methods approach. Thirty college student-athletes (12 men, 18 women) completed questionnaires and participated in focus groups to provide feedback on the program’s length, timing, group size and dynamics, content, and suggestions for making the SPoRT prevention intervention more feasible and acceptable.ResultsOur recruitment procedures were successful, and participants rated the program as feasible in terms of delivery methods and logistics. Participants liked that SPoRT was developed based on pilot data collected from student-athletes, brief, and skills based and tailored to athletic team needs. SPoRT was perceived as appropriate and relevant to student-athlete needs in terms of dating violence and sexual risk prevention knowledge and skills. Most participants (63%) rated the program as “excellent” and said they would recommend it to others.ConclusionsWe found SPoRT to be both feasible and acceptable in terms of content and delivery. Suggested modifications will be incorporated into the SPoRT healthy relationships prevention intervention to be tested in an NIH Stage 1 efficacy trial.