一项关于移民后对女性生殖器切割态度的计划中的随机对照试验的基线数据：干预措施何时合理？
Baseline data from a planned RCT on attitudes to female genital cutting after migration: when are interventions justified?
作者信息
Wahlberg Anna, Johnsdotter Sara, Selling Katarina Ekholm, Källestål Carina, Essén Birgitta
机构信息
Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden.
Faculty of Health and Society, Malmö University, Malmö, Sweden.
出版信息
BMJ Open. 2017 Aug 11;7(8):e017506. doi: 10.1136/bmjopen-2017-017506.
OBJECTIVES
To present the primary outcomes from a baseline study on attitudes towards female genital cutting (FGC) after migration.
DESIGN
Baseline data from a planned cluster randomised, controlled trial. Face-to-face interviews were used to collect questionnaire data in 2015. Based on our hypothesis that established Somalis could be used as facilitators of change among those newly arrived, data were stratified into years of residency in Sweden.
SETTING
Sweden.
PARTICIPANTS
372 Somali men and women, 206 newly arrived (0-4 years), 166 established (>4 years).
PRIMARY OUTCOME MEASURES
Whether FGC is acceptable, preferred for daughter and should continue, specified on anatomical extent.
RESULTS
The support for anatomical change of girls and women's genitals ranged from 0% to 2% among established and from 4% to 8% among newly arrived. Among those supporting no anatomical change, 75%-83% among established and 53%-67% among newly arrived opposed all forms of FGC, with the remaining supporting pricking of the skin with no removal of tissue. Among newly arrived, 37% stated that pricking was acceptable, 39% said they wanted their daughter to be pricked and 26% reported they wanted pricking to continue being practised. Those who had lived in Sweden ≤ 2 years had highest odds of supporting FGC; thereafter, the opposition towards FGC increased over time after migration.
CONCLUSION
A majority of Somali immigrants, including those newly arrived, opposed all forms of FGC with increased opposition over time after migration. The majority of proponents of FGC supported pricking. We argue that it would have been unethical to proceed with the intervention as it, with this baseline, would have been difficult to detect a change in attitudes given that a majority opposed all forms of FGC together with the evidence that a strong attitude change is already happening. Therefore, we decided not to implement the planned intervention.
TRIAL REGISTRATION NUMBER
Trial registration number NCT02335697;Pre-results.
目的
呈现一项关于移民后对女性生殖器切割（FGC）态度的基线研究的主要结果。
设计
来自一项计划中的整群随机对照试验的基线数据。2015年通过面对面访谈收集问卷数据。基于我们的假设，即已定居的索马里人可作为新移民中变革的推动者，数据按在瑞典的居住年限进行分层。
地点
瑞典。
参与者
372名索马里男性和女性，206名新移民（0 - 4年），166名已定居者（>4年）。
主要观察指标
FGC是否可接受、是否希望女儿接受以及是否应继续进行，并具体说明解剖范围。
结果
已定居者中支持女孩和女性生殖器解剖结构改变的比例为0%至2%，新移民中为4%至8%。在支持不进行解剖结构改变的人中，已定居者中有75% - 83%、新移民中有53% - 67%反对所有形式的FGC，其余支持仅刺破皮肤而不切除组织。在新移民中，37%表示刺破是可以接受的，39%表示希望女儿接受刺破，26%表示希望继续实行刺破。在瑞典居住≤2年的人支持FGC的几率最高；此后，移民后随着时间推移对FGC的反对有所增加。
结论
大多数索马里移民，包括新移民，反对所有形式的FGC，且移民后随着时间推移反对态度有所增强。FGC的大多数支持者支持刺破。我们认为，鉴于大多数人反对所有形式的FGC以及已有证据表明态度正在发生强烈变化，在此基线情况下继续进行干预是不道德的，因为很难检测到态度的变化。因此，我们决定不实施计划中的干预措施。
试验注册号
试验注册号NCT02335697；预结果。
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