Schwab-Reese Laura M, Renner Lynette M
1 Department of Health & Kinesiology, Purdue University, West Lafayette, IN, USA.
2 Department of Pediatrics, School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA.
Womens Health (Lond). 2018 Jan-Dec;14:1745506518766709. doi: 10.1177/1745506518766709.
The prevention of intimate partner violence continues to be a high priority for health practitioners and researchers around the world. Screening practices and intervention efforts utilized within high- and/or middle-income areas may not translate effectively to low-resource areas due to differences in financial, social, and physical context. However, little is known about the evidence-base of intervention efforts in such areas. Using the Arksey and O'Malley framework for scoping reviews, the purpose of this review was to synthesize what is known about intimate partner violence screening, management, and treatment in low-resource areas. A total of 31 programs reported across 34 articles were included in this scoping review. The programs incorporated a range of intervention activities, including group-based education and skill-development combined with microfinance to screening and referral to community resources. Slightly less than half of the studies (n = 14) were randomized controlled trials or clustered randomized controlled trials. Many barriers were common across the programs, including limited financial support, lack of community support, and lack of coordination across programs. Despite considerable barriers related to the limited available resources, the literature base had many strengths, such as strong evaluation methodologies, inclusion of a theoretical or conceptual framework to guide the intervention, and community engagement before and during the intervention implementation. However, insufficient statistical power and barriers related to cultural differences or inadequate cultural sensitivity were also common. With a variety of barriers to program implementation noted within the articles, it is important for researchers and practitioners to consider the geographic, social, cultural, and economic contexts when implementing intimate partner violence programs in low-resource areas. Given the significant differences in context across low-resource areas, additional research to establish effective protocols for tailoring and implementing evidence-based programs using a community-engaged framework would be beneficial to future research and practice.
预防亲密伴侣暴力仍然是全球卫生从业人员和研究人员的一项高度优先事项。由于高收入和/或中等收入地区与资源匮乏地区在经济、社会和实际情况方面存在差异,这些地区所采用的筛查方法和干预措施可能无法有效地应用于资源匮乏地区。然而,对于此类地区干预措施的证据基础,我们知之甚少。本综述采用阿克斯和奥马利的范围综述框架,旨在综合资源匮乏地区亲密伴侣暴力筛查、管理和治疗方面的已知信息。本范围综述纳入了34篇文章中报道的31个项目。这些项目包含了一系列干预活动,包括基于小组的教育和技能发展,并结合小额信贷,以及筛查和转介社区资源。略少于一半的研究(n = 14)为随机对照试验或整群随机对照试验。这些项目存在许多共同障碍,包括财政支持有限、缺乏社区支持以及各项目之间缺乏协调。尽管与可用资源有限相关的障碍相当多,但文献基础也有许多优点,例如强大的评估方法、纳入指导干预的理论或概念框架,以及在干预实施之前和期间的社区参与。然而,统计效力不足以及与文化差异或文化敏感性不足相关的障碍也很常见。鉴于文章中指出了项目实施存在的各种障碍,研究人员和从业人员在资源匮乏地区实施亲密伴侣暴力项目时,考虑地理、社会、文化和经济背景非常重要。鉴于资源匮乏地区的情况存在显著差异,开展更多研究以建立使用社区参与框架定制和实施循证项目的有效方案,将有助于未来的研究和实践。