Kirk Lucy, Terry Samantha, Lokuge Kamalini, Watterson Jessica L
Research School of Population Health, The Australian National University, Building 62, Mills Road, Canberra, ACT, 2601, Australia.
School of Public Health, University of California, Berkeley, University Hall, Berkeley, CA, 94720, USA.
BMC Public Health. 2017 Jul 4;17(1):622. doi: 10.1186/s12889-017-4502-6.
Violence against women (VAW) is a major problem worldwide, with one in three women experiencing violence in their lifetime. While interventions to prevent violence (primary prevention) are extremely important, they can take many years. This review focuses on secondary and tertiary prevention interventions that address the needs of survivors of violence and aim to prevent recurrence. This review also focuses on studies taking place in low and low-middle income countries, where rates of VAW are highest.
Searches of peer-reviewed and grey literature took place from March-June 2016 through databases (Embase, CINAHL, WHO Global Index Medicus, Medline, PsychINFO, Web of Science, Cochrane Library, Applied Social Sciences Index and Abstracts and Sociological Abstracts) and by consulting experts in the field. Only primary research was eligible for inclusion and studies had to focus on secondary or tertiary prevention for survivors of VAW in low or low-middle income countries. All study designs were eligible, as long as the study examined client-related outcome measures (e.g., incidence of violence, health outcomes or client satisfaction). Data were extracted and quality of the studies was assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies and a qualitative quality assessment tool developed by Mays and Pope. Due to the low number of results and heterogeneity of the study populations and outcomes, a narrative synthesis was conducted and evidence was summarized.
One thousand two hundred fifteen studies were identified through the search strategy and 22 of these met the eligibility criteria. Overall, the evidence for interventions is weak and study limitations prevent definitive conclusions on what works. There is some evidence that interventions targeting alcohol use, both among perpetrators and survivors, may be effective at reducing VAW through secondary prevention, and that psychotherapy might be effective for survivors of non-partner sexual violence through tertiary prevention. Finally, some evidence exists for crisis centres increasing survivors' access to services (through both secondary and tertiary prevention), however, assessment of their impact on future VAW are needed.
Though some interventions for survivors of VAW have shown evidence of effectiveness, further research is needed, especially high-quality studies with quantitative outcome data.
暴力侵害妇女行为（VAW）是一个全球性的重大问题，三分之一的女性在其一生中会遭受暴力。虽然预防暴力的干预措施（一级预防）极为重要，但可能需要数年时间。本综述聚焦于二级和三级预防干预措施，这些措施旨在满足暴力幸存者的需求并防止暴力行为再次发生。本综述还聚焦于在低收入和中低收入国家开展的研究，这些国家的暴力侵害妇女行为发生率最高。
2016年3月至6月，通过数据库（Embase、CINAHL、世界卫生组织全球医学索引、Medline、PsychINFO、科学引文索引、考克兰图书馆、应用社会科学索引与摘要以及社会学摘要）并咨询该领域专家，对同行评审文献和灰色文献进行检索。仅纳入原始研究，且研究必须聚焦于低收入或中低收入国家暴力侵害妇女行为幸存者的二级或三级预防。只要研究考察了与服务对象相关的结果指标（如暴力发生率、健康结果或服务对象满意度），所有研究设计均符合要求。使用有效公共卫生实践项目定量研究质量评估工具以及由梅斯和波普开发的定性质量评估工具提取数据并评估研究质量。由于结果数量较少以及研究人群和结果的异质性，进行了叙述性综合分析并总结了证据。
通过检索策略共识别出1215项研究，其中22项符合纳入标准。总体而言，干预措施的证据薄弱，且研究局限性使得无法就何种措施有效得出明确结论。有一些证据表明，针对施暴者和幸存者饮酒行为的干预措施，可能通过二级预防有效减少暴力侵害妇女行为，心理治疗可能通过三级预防对非伴侣性暴力幸存者有效。最后，有一些证据表明危机中心增加了幸存者获得服务的机会（通过二级和三级预防），然而，需要评估其对未来暴力侵害妇女行为的影响。
虽然一些针对暴力侵害妇女行为幸存者的干预措施已显示出有效性证据，但仍需要进一步研究，尤其是高质量的具有定量结果数据的研究。
