Violence Outcomes Research Articles

Effects of Intimate Partner Violence Prevention Programming on Social Support, Coparenting, and Parenting Among Teen Parents: A Pilot Study

Understanding mechanisms and secondary outcomes of intimate partner violence (IPV) prevention programs for teen parents can help to improve relationships. This study used data from a randomized pilot trial of the Safe Dates for Teen Mothers IPV prevention program compared to the original Safe Dates program with 32 teen mothers recruited from four community-based sites. We examined effect sizes of cross-sectional associations between IPV, social support, coparenting, and parenting, and of differences between the adapted program and the original on social support, coparenting, and parenting over 6 months. Effect sizes of associations were medium on average. Effect sizes on social support, coparenting, and parenting favored the adapted program over the original program and were medium to large. IPV prevention programs adapted for teen parents have the potential to support positive dynamics in their social relationships. These preliminary estimates can inform the design of larger research and intervention studies.

Abstract Strengths and difficulties Lithuania

Abstract Background Most mental health disorders begin before the age of 18, peaking at 14.5 years (Solmi, 2022) and manifest as emotional and behavioural difficulties that are more frequent in institutional social care (ISC): former foster care recipients have higher rates of depression and PTSD than the general population (Pecora, 2009). The rate of children living in residential care facilities in Europe and Central Asia is double the global average (UNICEF, 2024). This study aims to assess and compare the mental health of children in ISC centers and regular high schools. Methods A cross-sectional study was conducted in ISC centres and high schools in 2022-2023. The sample size consisted of children aged 11-17 living in ISC (n = 49) or in families (n = 193). Online anonymous survey was applied to assess the prevalence of endured violence, substance use and measure mental health outcomes using the Strengths and Difficulties Questionnaire (SDQ-25). Results A total of 242 respondents (age mean 14.6, SD = 2.12) in ISC and families showed similar poor mental health rates (42% and 44%, respectively). Prosocial behaviour problems were exhibited more by boys (p < 0.05), whereas emotional symptoms were more common in families (p < 0.001): 90% normal SDQ-25 scores in ISC vs 60% in families. Enduring psychological (38% vs 60.2%) violence was more prevalent among children in families (p < 0.05); smoking - in ISC, alcohol use - in families (p < 0.05). In both groups enduring physical violence was associated with smoking and alcohol use (p < 0.05), and overall poor SDQ-25 results strongly correlated (p < 0.001, r = 0.815, r = 0.610, respectively) with hyperactivity. Conclusions A significant part of study participants reported poor mental health outcomes with most problems in relationships with peers. Mental health risk factors such as violence or substance abuse are associated with poor emotional wellbeing while being more common among children living with families. Key messages • Children living in ISC and in families demonstrate similar level of mental health problems. • Varying prevalence of substance abuse among children living in different settings highlights the importance of environmental factors when addressing the issue.

The Associations Between Intimate Partner Violence and Mental Health Outcomes Among Sexual Minority Men: A Systematic Review and Meta-Analysis.

Sexual minority men (SMM) experience intimate partner violence (IPV) at a substantially high rate and also bear high burdens of adverse mental health outcomes. This systematic review and meta-analysis aimed to consolidate existing evidence on the associations between experiencing IPV and adverse mental health outcomes (depressive symptoms, anxiety, stress, etc.) among SMM. Following the Preferred Reporting Items For Systematic Reviews and Meta-Analyses guideline, we identified 22 published studies encompassing data from 18,454 individuals, all of which were cross-sectional in design and half of which were conducted in the U.S. We found that experiencing IPV was associated with an increased risk of depressive symptoms and anxiety with a pooled Adjusted Odds Ratios (AORs) of 1.71 (95% CI [1.43, 2.05]) and 1.89 (95% CI [1.46, 2.43]), respective. Studies also found that IPV was positively associated with suicide-related risk (AOR = 2.71, 95% CI [2.21, 3.32] and perceived loneliness. Studies varied in their IPV measures and recall periods and used diverse mental health measurement tools like PHQ-9/GAD-7, Perceived Stress Scale, and the Suicide Behaviors Questionnaire-Revised. This systematic review and meta-analysis revealed an urgent need to examine the effects of IPV on SMM's mental well-being in low- and middle-income countries using standardized IPV measurement tools. Future research should employ a longitudinal design to track the long-term effects of IPV on the mental well-being of SMM and explore potential interventions for mitigating these impacts over time. These insights are crucial for enhancing IPV screening within healthcare settings and identifying key intervention targets aimed at improving the mental health of SMM.

The Role of Shame in Associations with PTSD and Depression Symptoms and Hazardous Drinking Among Bisexual Women Who Experienced Sexual Violence

ABSTRACT Bisexual (i.e. those with attraction to multiple genders) women experience disparities in sexual violence and mental health outcomes, including PTSD, depression, and hazardous drinking, compared to lesbian and heterosexual women. Unique stigma due to bisexual identity (antibisexual stigma), negative reactions to sexual violence (SV) disclosure (e.g. victim blaming), and prior child sexual abuse (CSA) may all contribute to shame. We tested whether shame explained the associations of antibisexual stigma, negative reactions to SV disclosure, and CSA severity with PTSD symptoms, depression, and hazardous drinking among young bisexual women. Participants who self-identified as bisexual women, between the ages of 18–35, residing in the US were recruited via Amazon’s Mechanical Turk (MTurk) and completed online questionnaires. Women who reported SV since age 18 that they disclosed to someone were included in the current study, yielding a sample of 156 bisexual women (Mage = 25.7; 98.1% cisgender, 86.5% White). Path analysis with bias-corrected bootstrapping was conducted. There were significant direct effects of negative reactions on hazardous drinking and CSA on PTSD, and direct effects of shame on PTSD and depression symptoms. Shame explained the associations of antibisexual stigma, negative reactions, and CSA with PTSD symptoms, depression symptoms, and hazardous drinking. Shame may explain why stigmatizing experiences related to bisexual identity, sexual violence, and CSA history relate to distress among bisexual women. Shame is an important treatment target among bisexual survivors of SV.

Women's Participation in the Arab Spring Protests and the Prevalence of Domestic Violence: Evidence From Egypt

During the Arab Spring protests, Egyptian women demonstrated in streets in unprecedented numbers, challenging societal norms about women’s roles and rights. Using a triple difference approach and nationally representative DHS data, this study exploits regional variation in protest intensity and women’s participation in the protests from 2011 to 2014 to examine the changes in women’s risk of experiencing domestic violence. Results show that women experienced a significant decline in their probability of experiencing physical, sexual, and psychological violence from their intimate partners in regions more exposed to women’s political participation in Arab Spring protests. Exploring potential channels, the study finds a significant increase in women’s decision-making power in more affected regions, without significant changes in attitudes toward domestic violence or labor market outcomes. These effects underscore the role of increased visibility of women in public spaces in empowering women and reducing their experience of intimate partner violence. HIGHLIGHTS Egyptian women protested in unprecedented numbers during Arab Spring demonstrations. Exposure to these events changed women’s risk of experiencing intimate partner violence. Women experienced a significant decline in intimate partner violence in more affected regions. Women also experienced an increase in decision-making power within the household.

Exploratory analysis of the potential impact of violence on HIV among female sex workers in Mombasa, Kenya: a mathematical modelling study

BackgroundUnderstanding the frequency of violence experienced by female sex workers (FSWs) and how violence contributes to HIV transmission can help improve HIV programs.MethodsUsing recent recommendations for modelling structural factors and associated causal pathways, we developed a HIV transmission dynamic model for FSWs and their clients in Mombasa, Kenya, mechanistically representing three types of violence (sexual violence, SV; physical violence, PV; police assault and arrest, PAA). Each type of violence affects HIV transmission through key mediators (condom non-use, HIV testing). We parameterized the model using data from a cross-sectional study of FSWs aged 15–24 recruited from a systematic geographical mapping sampling frame in Mombasa, Kenya (Cheuk E et al., Frontiers in Reproductive Health 2(7), 2020). Using this model, calibrated (and cross-validated) to HIV epidemiological and violence outcomes, we estimated the incidence of violence episodes, the contribution of violence to the HIV epidemic measured by the transmission population-attributable fraction, and the potential impact of possible violence interventions.ResultsThe median estimated incidence of PAA in 2023 among FSWs who had not previously experienced that type of violence was 0.20 (95% credible interval: 0.17–0.22) per person-year (ppy), about double the incidence of SV and PV (0.10 (0.09–0.11), 0.11 (0.09–0.12), respectively). The incidence of violence was higher among FSWs who had previously experienced violence: the incidence of recurrent PV was 2.65 (1.82–3.37) ppy, while the incidence of recurrent SV and PAA were 1.26 (0.80–1.67) and 1.37 (0.94–1.74 ppy, respectively. In this setting, we estimated that a median of 35.3% (3.4–55.8%) infections in FSWs and clients combined over the next 10 years may be due to all types of violence (and mediators), mainly through reduced condom use in FSWs who have ever experienced SV (34.6% (2.4–55.5%)). Interventions that prevent future violence without mitigating the effects of past violence may only prevent 8.8% (0.8–14.0%) infections over 10 years.ConclusionsFSWs in Mombasa experience violence frequently. In this population, we find that addressing sexual violence, including mitigating the effects of past violence, is potentially important in reducing HIV transmission in this population. However, the wide uncertainty range shows longitudinal studies are needed to strengthen the evidence of the influence of violence on HIV risk behavior. We find that the recommendations for modelling structural factors provide a useful framework for describing the model.

Structural violence and policy outcomes of Lagos State Health Insurance Scheme in selected ministries, Lagos State

The decentralization of the NHIS’s implementation to states intended to hasten progress towards universal health coverage, has not effectively addressed healthcare disparities, particularly in Lagos State. The implementation of the Lagos State Health Insurance Scheme appears to perpetuate structural violence, evident in increased out-of-pocket expenses, discrimination based on insurance type, and substandard healthcare delivery. The study therefore examined how structural violence has affected the policy outcomes of the Lagos State Health Insurance Scheme, with a specific emphasis on junior officers in grade level 01–07 in five selected ministries situated within Lagos State. Both primary and secondary data were collected using questionnaire, interview and literature search. Data gathered were analysed statistically and thematically. The findings of the study indicate that the policy outcome of the scheme has been adversely affected by structural violence, resulting in dissatisfaction, compensation claims for unresolved health issues and a shift in health insurance providers among enrolled junior officers.

Lifetime Violence and Perinatal Sleep Quality: A Scoping Review

Abstract Introduction In-utero experience of violence through maternal experience of intimate partner violence (IPV) is a risk factor for adverse pregnancy outcomes via ‘biological programming,’ whose effect can be mediated by sleep. We conducted a scoping review to synthesize the current evidence of the association between experiences of violence and sleep in women. Methods Between August and October 2023, we conducted a search in four databases (PubMed, APA PsycInfo, Embase, and Web of Science) for peer-reviewed articles, using 11 inclusion and exclusion criteria. Any study published in English in peer-reviewed journals that conducted original research on the association between exposure to violence (lifetime IPV, IPV during the previous year, during and 1 year after pregnancy, as well as adverse childhood experiences) and poor sleep outcomes (sleep disturbances, insomnia, poor sleep quality, and longer time to fall asleep) in the perinatal population were included. Results The synthesis of the 12 included studies revealed a positive association between exposure to violence and poor sleep, and between adverse childhood experiences and sleep disturbances or poor sleep during pregnancy. Moreover, IPV in the postpartum period was associated with poor sleep. Conclusion Most of the evidence synthesized comprises data from high-income countries, resulting in lack of cultural context. However, it is evident that the experience of violence throughout life is a risk for poor perinatal sleep quality. Thus, there is a growing need to study this association, especially in resource-limited settings, where data on sleep health is largely absent, inform pregnancy care and maternal and child health policies.

Sexual Harassment, Sexual Violence, and Mental Health Outcomes: Causal Inference with Ambiguous Exposures.

Social exposures and their impact on mental health has proven hard to capture, partly owing to the complex and multifaceted nature of social reality. Sexual harassment and sexual violence (SHV) are no exceptions. SHV can be conceptualized as a continuum of negative sexual experiences whose severity vary depending on multiple determinants. Further, SHV can be conceptualized as either discrete events or as a generally hostile sexual environment represented by latent variables. With any of these conceptualizations, SHV constitutes a broad construct containing many kinds of negative experiences. This ambiguity poses challenges for determining the mental health consequences, as different forms of SHV may vary in terms of their mental health impact. We discuss different conceptualizations of SHV in relation to mental health outcomes through the lens of the potential outcomes framework, with a focus on the consistency condition. The multiple versions of treatment theory is presented to show how to provide formal interpretations of causal estimates under ambiguous exposures. Lastly, we provide suggestions on how the increase the clarity and interpretability of the effects of SHV on mental health, by increasing the precision of the causal questions and the use of more specific definitions of SHV.

Promotive Factors Within Neighborhood, Family, and School Contexts for Adolescents Living in an Urban, High-Burden Community

Adverse outcomes associated with living in urban, high-burden communities can be reduced by strengthening promotive factors—processes that promote positive development or resilience. Utilizing the social development strategy, we examined promotive factors (perceptions of safety, attachment, rewards and opportunities for prosocial involvement) across neighborhood, family, and school, in relation to mental health and violence outcomes. Participants were 1,744 adolescents (50% female, 91% Black) from an urban, high-burden community in Chicago. Latent profile analyses found four groups of promotive factors. Thirty-seven percent of youth were in a profile with high levels of promotive factors, reporting the lowest levels of mental health symptoms and violence. As youth moved towards average or low levels of promotive factors in one or multiple contexts, they reported worse mental health and violence. These results have important implications, specifically for high-burden communities, highlighting the need to strengthen promotive factors in comprehensive prevention efforts and mental health care.

The meaning of obstetric violence experiences: A qualitative content analysis of the Break the Silence Campaign

BackgroundObstetric violence involves the mistreatment, disrespect, and abuse of birthing people and the problem has been recognized in healthcare systems worldwide. Obstetric violence is a gendered, sex-specific form of violence against women that is a public health problem and a violation of human rights. There are an unknowable number of online posts and social media messages that describe obstetric violence experiences. There are no known studies about self-published experiences of obstetric violence in the US maternity care system. ObjectiveTo understand the meaning of obstetric violence experiences in the US maternity care system from a naturally occurring, purposive sample. DesignA secondary analysis of the textual data from the original Break the Silence social media campaign using qualitative content analysis. The theory of social justice in nursing provided a theoretical framework. A healthcare systems approach was used for a wide-angle view of the multidirectional structure, processes, and outcome of obstetric violence. SettingThe study setting is the public Facebook page where the Break the Silence social media campaign can be seen. Break the Silence was an online activism response to the problem of obstetric violence in the US maternity care system with signboard messages posted from 31 known US states. The setting is bounded by the digital page where the campaign is published. ParticipantsThere were 139 participants, and 11 of them posted more than one signboard message. Most participants were birthing people (n = 125) followed by doulas (n = 10). MethodsKrippendorff's methodology for qualitative content analysis was applied to 156 signboard messages posted on Break the Silence from 2014 to 2016. Qualitative content analysis was supported by Atlas.ti 23. ResultsFour themes illustrated the meaning of obstetric violence in US maternity care: 1) pregnancy and birth as a battle with healthcare providers and the healthcare system, 2) sacrifice of the maternal body normalized and assumed as a gender stereotype, 3) disrupted rites of passage from childbirth, and 4) abuse of fiduciary power by healthcare providers. ConclusionsThis study demonstrated thematic meanings for the experience of obstetric violence in US maternity care with a healthcare systems approach that included structural and organizational considerations to increase understanding. Categories and forms of obstetric violence from the existing literature were expanded and strengthened by findings from this study. Themes were validated in principle with consistency in findings across the international evidence base on obstetric violence.Tweetable abstract: The meaning of #obstetricviolence experiences is interpersonal and structural with thematic consistency across international studies.

A - 146 Psychiatric Drugs Can Precipitate Neuropsychological Predicates of Homicide

Abstract Objective A man inexplicably killed his beloved wife. He had no history of violence, was a prominent member of the community, and gave no indications of the impending horrific act. He had been recently commenced treatment with psychiatric drugs, and his condition deteriorated, culminating in homicide. After his incarceration, he stopped taking psychiatric drugs and his mental health improved. Many practitioners are not aware that psychiatric drugs can create a risk for violence - or precursors of violence - such as anger, hostility, and agitation. This risk is often described on the product label. Method The subject was an intensive care nurse who became exhausted and despondent serving long hours during the Covid epidemic, when many of his patients were put on ventilators and died. He had suffered panic attacks from his difficulty breathing through the respiratory masks. He temporarily left employment and sought psychiatric assistance for his professional “burn-out” condition. After three doses of venlafaxine, he reported side effects including increased anxiety, blood pressure and heart rate. He was then prescribed escitalopram without tapering of the venlafaxine. As his anxiety progressed, he was prescribed escitalopram once daily and buspirone three times daily, yet he continued to deteriorate until the homicide. Results Expert genetic analysis found susceptibility to the psychiatric drugs prescribed. The neuropsychological evaluation, months post-homicide, found excellent neuropsychological function, although psychomotor and processing speed was deficit. Personality testing found no disorders, with a profile inconsistent with violent behavior. Conclusions Prescribers need to monitor patients carefully for potentially adverse and violent outcomes of treatment.

Dispossessed exposures. Housing and regimes of the visible

Literatures and organising show us how, in contemporary racial financial capitalism, housing is formed through dispossessive histories and geographies. Here, we query how these enter into play in the visual regimes through which housing is seen and experienced. For if the visual realm is as much a construct as any other housing matter, finding a grammar to tap into its workings might become handy when its violent outcomes come to the fore. What is reproduced in the visual regimes of housing? What is offered and taken anyway? What might never be seen, and by whom? The article offers a tentative analytical approach to questioning what we call dispossessed exposures: the (en)visioning of homely futures that are deprived, already in the social construct of seeing with the house, the possibility of radical care for and of habitation. These ideas are unpacked through reflection on two films: Ladj Ly’s Les Misérables and Fanny Liatard and Jérémy Trouihl’s Gagarine. We offer these reasonings as a contribution to ongoing conversations in the renewed field of housing justice scholarship.

Migrant survivors of conflict-related sexual violence accessing a specialist health service in Turin, Italy: a qualitative analysis of clinical forensic interview transcripts.

The Sexual Violence Relief center Soccorso Violenza Sessuale (SVS) is a specialist service, situated in Sant'Anna Hospital, an Obstetrics and Gynecology facility in Turin, North-West Italy. The study aimed to qualitatively analyze the transcripts of interviews routinely conducted by gynecologist and midwife in the first part of the medical examination of migrant patients accessing care at SVS after being subjected to conflict-related sexual violence (CRSV) in their home country or during migration and to explore the adverse outcomes of such violence on their health. Interview transcripts were purposely selected to include adult migrant patients (age > 18) subjected to CRSV in the different phases of migration and accessing SVS from January 1st, 2014, to September 4th, 2023. Data was extracted from the SVS archive, anonymized, and thematically analyzed. In total, 43 interview transcripts were eligible for inclusion. All of them were related to cisgender women of Sub-Saharan origin describing different forms of violence as a driver for migration. CRSV was disclosed by 18 survivors as occurring in their home country and by 31 in transit (e.g., Libya), the most reported type being rape. 49% of the patients described adverse physical outcomes of CRSV, while 72% reported psychological sequelae. The findings confirm high levels and different modalities of violence throughout the migratory route. Qualitative analysis of interview transcripts served as a valuable source for understanding how survivors described the CRSV they endured, its consequences, as well as other violence encountered during migration.

The Characteristics of Teacher Training with Social Impact to Overcome School Violence: A Literature Review

Research demonstrates that overcoming school violence is crucial for ensuring a safe environment and quality education for all students. The scientific literature shows that educators can significantly impact school violence, but their effectiveness hinges on the quality of their training. Therefore, identifying the most effective training types is essential. This literature review aims to identify and synthesize the characteristics of teacher-training programs that have effectively reduced school violence. Inclusion criteria were studies focusing on interventions to reduce school violence, with either quantitative or qualitative outcomes. Exclusion criteria were studies not specifically addressing school violence or lacking evaluative measures. Data sources included Web of Science, EBSCO Host, Medline, Scielo, and Scopus, with searches conducted in December 2023. From an initial pool of 2128 articles, 13 studies were included. The results, synthesized through narrative analysis, reveal the key features of teacher-training programs that effectively address school violence, including the nature of the training, the content covered, and the social impact achieved.

Intimate partner violence and childhood health outcomes in 37 sub-Saharan African countries: an analysis of demographic health survey data from 2011 to 2022

Understanding the contribution of intimate partner violence (IPV) to childhood health outcomes (eg, morbidity and mortality) is crucial for improving child survival in sub-Saharan Africa. This comprehensive study aimed to explore the associations between maternal exposure to physical, sexual, or emotional violence and adverse childhood health outcomes in sub-Saharan Africa. We analysed Demographic Health Survey datasets from 37 sub-Saharan African countries from 2011 to 2022. A generalised linear mixed model was used to examine the associations between maternal physical violence, sexual violence, or emotional violence, and early childhood health outcomes (eg, acute respiratory infection, diarrhoea, undernutrition, and child mortality). A random effects meta-analysis was used to calculate pooled odds ratios (ORs) for adverse childhood health outcomes. The odds of undernutrition and mortality were 55% and 58% higher among children younger than 5 years born to mothers who were exposed to physical and sexual violence, respectively. 238 060 children younger than 5 years were included. Children whose mothers experienced physical violence (adjusted OR 1·33, 95% CI 1·29-1·42), sexual violence (1·47, 1·34-1·62), emotional violence (1·39, 1·32-1·47), or a combination of emotional and sexual violence (1·64, 1·20-2·22), or a combination of all the three forms of violence (1·88, 1·62-2·18) were associated with an increased odds of developing diarrhoeal disease. Similarly, children whose mothers experienced physical violence (1·43, 1·28-1·59), sexual violence (1·47, 1·34-1·62), emotional violence (1·39, 1·32-1·47), or a combination of emotional and sexual violence (1·48, 1·16-1·89), or a combination of all three forms of violence (1·66, 1·47-1·88) were positively associated with symptoms of acute respiratory infection. We found a strong link between maternal exposure to IPV and health outcomes for children younger than 5 years in sub-Saharan Africa, with minor variations across countries. To address childhood morbidity and mortality attributed to IPV, interventions need to be tailored for specific countries. Burkina Faso, Burundi, Chad, Comoros, Gabon, Liberia, Nigeria, Sierra Leone, South Africa, and Uganda should be priority nations. None.

Maternal intimate partner violence and child health outcomes

Maternal intimate partner violence and child health outcomes

Association Between Domestic Violence and Mental Health Among Nepalese Women: Results from a Nationally Representative Sample.

This study aims to examine the association between exposure to domestic violence and mental health outcomes, such as symptoms of depression and anxiety among married women in Nepal. The 2022 Nepal Demographic and Health Survey was used. Descriptive, bivariate, and multivariate logistic regression analyses were employed. A complex sampling frame was used to ensure the accuracy of the sample. A total of 4,211 women aged 14 to 49 years were analyzed. Among women between the ages of 15 and 49, 22.8% experience anxiety, and 22.5% experience depressive symptoms. Nearly 50% of women who had experienced domestic violence had symptoms of anxiety and depression. At the multivariate level, in Model 1, the study found that wealthy women were less likely to have anxiety (OR = 0.75; 95% CI [0.58, 0.96] and depression (OR = 0.70; 95% CI [0.54, 0.91]) than poor women. Similarly, women of the former untouchable caste were more likely to have anxiety (OR = 1.51; 95% CI [1.14, 2.00]) and depression (OR = 1.20; 95% CI [0.91, 1.58]) than high-caste women. In Model 2, the odds of anxiety and depressive symptoms were 1.70 (95% CI [1.29, 2.24]) and 1.99 (95% CI [1.48, 2.67]), respectively, for those women who had experienced severe physical violence. The odds of experiencing anxiety and depression were 2.88 (95% CI [2.28, 3.64]) and 3.04 (95% CI [2.32, 3.98]) times, respectively, for those women who had experienced emotional abuse. Similarly, women who had been sexually assaulted had 2.34 (95% CI [1.72, 3.20]) and 1.67 times (95% CI [1.23, 2.26]) more likely to experience anxiety and depression than women who had never been sexually assaulted. We found a strong association between mental health problems and women's experience of domestic violence. To address the mental health of Nepalese women, it is critical to strengthen domestic violence prevention programs, especially those targeting the lowest social strata of the population.

Intimate Partner Violence and Breastfeeding Outcomes Among Canadian Women: An Exploratory Correlational Study.

Human breastmilk is the optimal nutrition for infants; however, preliminary research suggests that women who experience intimate partner violence (IPV) are less likely to initiate and continue breastfeeding. Self-efficacy is a known facilitator to achieve positive breastfeeding outcomes. This study aimed to explore the relationship between experiencing IPV and breastfeeding duration, exclusivity, and self-efficacy for Canadian mothers, and to identify potential variables that influence breastfeeding decision-making among women with experiences of IPV. This was a cross-sectional secondary analysis of surveys completed by 129 mothers with children under the age of 2 years from Ontario, Canada. Data were stratified according to those who had experienced IPV and those who had not. Breastfeeding outcomes assessed included breastfeeding self-efficacy and breastfeeding duration and exclusivity. Non-parametric tests and correlations were used to determine if relationships existed between IPV and breastfeeding outcomes. 72.3% (n = 94) of women in this sample breastfed their child(ren). Experiencing IPV was associated with lower breastfeeding self-efficacy scores (W = 768, p = 0.055) with a moderate effect size (r = 0.32 [95% 0.06,0.55]). This relationship was significant in the context of psychological abuse (W = 816.5, p = 0.015) with a small effect size (r = 0.22 [95% 0.03,0.41]). This study provides novel preliminary evidence suggesting that experiencing IPV of any type can negatively impact breastfeeding self-efficacy, with psychological abuse potentially being the most detrimental. Future research is required to build upon these findings.

The Insidiousness of Institutional Betrayal: An Ecological Systematic Review of Campus Sexual Violence Response Literature.

Recently, post-secondary institutions have been under increased public and academic scrutiny regarding their ability to prevent and respond to instances of campus sexual violence. Emerging research has explored institutional betrayal (IB), which is a theoretical framework that states that actions and inactions on the part of the institution can cause further harm to survivors of violence. The goals of this review were, using an ecological systems lens, to identify what specific behaviors, policies, responses, and other factors constitute IB or institutional support (IS) as defined by the existing literature. A search of 16 databases across 8 disciplines led to the identification of 100 articles that mentioned either IB or IS verbatim. Factors that can be categorized as IB and IS were identified across nine levels: (1) the individual level, (2) the interpersonal level, (3) within institutional spaces, (4) within institutional procedures, (5) within institutional policies, (6) at the institutional structural level, (7) at the institutional culture level, (8) at a government and public policy level, and (9) within greater societal cultural values and established social norms. IB itself manifests across all levels of the institution and is, in fact, quite insidious-it is largely invisible and deeply rooted in systemic oppression, woven into the structure of institutions of higher education. IB remains a looming, almost inevitable outcome of the structural violence that occurs in post-secondary settings. Yet, IS and the related concept of institutional courage are emerging fields of study that pose important implications for institutional change.