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潜在干预措施对改变乌干达亲密伴侣暴力发生率的性别社会规范的有效性:因果推理方法。

Effectiveness of Potential Interventions to Change Gendered Social Norms on Prevalence of Intimate Partner Violence in Uganda: a Causal Inference Approach.

机构信息

African Population and Health Research Center, APHRC Campus, Manga Close, Off Kirawa Road, P.O. Box 10787-00100, Nairobi, Kenya.

Department of Statistics, University of Ghana, P.O. Box LG 115, Legon, Accra, Ghana.

出版信息

Prev Sci. 2019 Oct;20(7):1043-1053. doi: 10.1007/s11121-019-01010-8.

Abstract

Evidence of the effectiveness of programs to change gendered social norms related to intimate partner violence (IPV) is growing, but their potential to significantly impact actual occurrence of IPV at population level is lacking. We study whether modest changes in gendered social norms related to wife-beating can result in significant changes in the incidence of emotional, physical, and sexual IPV among ever married women in Uganda. We employ an imputation-based causal inference approach, based on nationally representative Demographic Health Survey data. The steps are (1) model the association between adjusted neighborhood norms and experiences of IPV using a random effects logistic regression model, (2) impute unobserved counterfactual probabilities of experiencing IPV for each woman while manipulating her neighborhood norms by setting it to different values, (3) average the probabilities across the population, and (4) bootstrap confidence intervals. Results show that statistically significant inverse associations between more prohibitive neighborhood IPV norms and women's experiences of different forms of IPV at the population level exist. The effect is however small, that even if an entire community disapproves of wife-beating, incidence of IPV falls by about 10 percentage points to 48.5% (95% CI 46.0%-50.9%) from the observed value of 57.6% (95% CI 55.2%-59.9%). Furthermore, changes in neighborhood social norms are found to have no statistical significant effect on the incidence of sexual violence. In conclusion, changing gendered social norms related to wife-beating will not result in significant reductions in different forms for IPV at the population level.

摘要

有关亲密伴侣暴力(IPV)的性别社会规范改变项目的有效性证据正在增加,但这些项目在人口层面上对实际发生的 IPV 产生重大影响的潜力却缺乏。我们研究了与打妻子相关的性别社会规范的适度改变是否会导致乌干达已婚妇女中情绪、身体和性 IPV 的发生率发生重大变化。我们采用基于推断的因果推理方法,基于全国代表性的人口健康调查数据。步骤如下:(1)使用随机效应逻辑回归模型,对调整后的邻里规范与 IPV 经历之间的关联进行建模;(2)通过将邻里规范设置为不同的值来操纵每个妇女的未观察到的反事实经历 IPV 的概率进行推断;(3)在人群中平均概率;(4)进行自举置信区间。结果表明,在人口层面上,邻里 IPV 规范越严格,与妇女经历不同形式的 IPV 之间存在统计学上显著的反比关系。然而,这种影响很小,即使整个社区都不赞成打妻子,IPV 的发生率也只会从观察到的 57.6%(95%CI 55.2%-59.9%)下降到 48.5%(95%CI 46.0%-50.9%),从观察值下降约 10 个百分点。此外,邻里社会规范的变化对性暴力的发生率没有统计学上的显著影响。总之,改变与打妻子相关的性别社会规范不会导致人口层面上不同形式的 IPV 显著减少。

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