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评估刚果民主共和国金沙萨和马拉维布兰太尔 10 至 14 岁青少年机构暴力和同伴暴力之间的关系:一项横断面研究。

Assessing the relationship between agency and peer violence among adolescents aged 10 to 14 years in Kinshasa, Democratic Republic of Congo and Blantyre, Malawi: A cross-sectional study.

机构信息

Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.

Faculty of Medicine, Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo.

出版信息

PLoS Med. 2021 Dec 13;18(12):e1003552. doi: 10.1371/journal.pmed.1003552. eCollection 2021 Dec.

Abstract

BACKGROUND

Interpersonal violence has physical, emotional, educational, social, and economic implications. Although there is interest in empowering young people to challenge harmful norms, there is scant research on how individual agency, and, specifically, the "power to" resist or bring about an outcome relates to peer violence perpetration and victimization in early adolescence. This manuscript explores the relationship between individual agency and peer violence perpetration and victimization among very young adolescents (VYAs) living in two urban poor settings in sub-Saharan Africa (Kinshasa, Democratic Republic of Congo (DRC) and Blantyre, Malawi).

METHODS AND FINDINGS

The study draws on two cross-sectional surveys including 2,540 adolescents 10 to 14 years from Kinshasa in 2017 (girls = 49.8% and boys = 50.2%) and 1,213 from Blantyre in 2020 (girls = 50.7% and boys = 49.3%). The sample was school based in Malawi but included in-school and out-of-school participants in Kinshasa due to higher levels of early school dropout. Peer violence in the last 6 months (dependent variable) was defined as a four categorical variable: (1) no victimization or perpetration; (2) victimization only; (3) perpetration only; and (4) both victimization and perpetration. Agency was operationalized using 3 scales: freedom of movement, voice, and decision-making, which were further divided into tertiles. Univariate analysis and multivariable multinomial logistic regressions were conducted to evaluate the relationships between each agency indicator and peer violence. The multivariable regression adjusted for individual, family, peer, and community level covariates. All analyses were stratified by gender and site. In both sites, adolescents had greater voice and decision-making power than freedom of movement, and boys had greater freedom of movement than girls. Boys in both settings were more likely to report peer violence in the last six months than girls (40% to 50% versus 32% to 40%, p < 0.001), mostly due to higher rates of a perpetration-victimization overlap (18% to 23% versus 10% to 15%, p < 0.001). Adolescents reporting the greatest freedom of movement (Tertile 3) (with the exception of girls in Kinshasa) had a greater relative risk ratio (RRR) of reporting a perpetrator-victim overlap (boys Kinshasa: RRR = 1.9 (1.2 to 2.8, p = 0.003); boys Blantyre: RRR = 3.8 (1.7 to 8.3, p = 0.001); and girls Blantyre: RRR = 2.4 (1.1 to 5.1, p = 0.03)). Adolescents with the highest decision-making power in Kinshasa also had greater RRR of reporting a perpetrator-victim overlap (boys: RRR = 3.0 (1.8 to 4.8, p < 0.001). Additionally, girls and boys in Kinshasa with intermediate decision-making power (tertile 2 versus 1) had a lower RRR of being victimized (Girls: RRR = 1.7 (1.02 to 2.7, p = 0.04); Boys: RRR = 0.6 (0.4 to 0.9, p = 0.01)). Higher voice among boys in Kinshasa (Tertile 2: RRR = 1.9 (1.2 to 2.9, p = 0.003) and Tertile 3: 1.8 (1.2 to 2.8, p = 0.009)) and girls in Blantyre (Tertile 2: 2.0 (1.01 to 3.9, p = 0.048)) was associated with a perpetrator-victim overlap, and girls with more voice in Blantyre had a greater RRR of being victimized (Tertile 2: RRR = 1.9 (1.1 to 3.1, p = 0.02)). Generally, associations were stronger for boys than girls, and associations often differed when victimization and perpetration occurred in isolation of each other. A main limitation of this study is that the cross-sectional nature of the data does not allow a causal interpretation of the findings, which need further longitudinal exploration to establish temporality.

CONCLUSIONS

In this study, we observed that peer violence is a gendered experience that is related to young people's agency. This stresses the importance of addressing interpersonal violence in empowerment programs and of including boys who experience the greatest perpetration-victimization overlap.

摘要

背景

人际暴力会对身体、情感、教育、社会和经济产生影响。尽管人们对赋予年轻人权力以挑战有害规范很感兴趣,但对于个体能动性,特别是“抵抗”或带来结果的“力量”与青少年早期的同伴暴力侵害和受害之间的关系,研究甚少。本文探讨了个体能动性与撒哈拉以南非洲两个城市贫困地区(金沙萨,刚果民主共和国和布兰太尔,马拉维)非常年轻的青少年(VYAs)中同伴暴力侵害和受害之间的关系。

方法和发现

这项研究基于两项横断面调查,包括 2017 年金沙萨的 2540 名 10 至 14 岁的青少年(女生占 49.8%,男生占 50.2%)和 2020 年布兰太尔的 1213 名青少年。该样本基于学校,在马拉维,但由于较高的早期辍学率,包括金沙萨的在校内和校外参与者。过去 6 个月的同伴暴力(因变量)被定义为四个分类变量:(1)无受害或侵害;(2)受害;(3)侵害;(4)受害和侵害。能动性通过 3 个指标来操作化:行动自由、发言权和决策权,这些指标进一步分为三分位数。进行单变量分析和多变量多项逻辑回归,以评估每个能动性指标与同伴暴力之间的关系。多变量回归调整了个体、家庭、同伴和社区水平的协变量。所有分析都按性别和地点进行分层。在这两个地点,青少年的发言权和决策权都大于行动自由,而男孩的行动自由大于女孩。两个地点的男孩报告过去六个月中同伴暴力的比例都高于女孩(40%至 50%比 32%至 40%,p<0.001),主要是由于侵害-受害重叠的发生率更高(18%至 23%比 10%至 15%,p<0.001)。报告行动自由最大的青少年(除了金沙萨的女孩)报告侵害-受害重叠的相对风险比(RRR)更高(男孩金沙萨:RRR=1.9(1.2 至 2.8,p=0.003);男孩布兰太尔:RRR=3.8(1.7 至 8.3,p=0.001);女孩布兰太尔:RRR=2.4(1.1 至 5.1,p=0.03))。金沙萨决策能力最高的青少年报告侵害-受害重叠的 RRR 也更高(男孩:RRR=3.0(1.8 至 4.8,p<0.001))。此外,金沙萨的女孩和男孩,处于中等决策能力的(三分位数 2 与 1),受害的 RRR 较低(女孩:RRR=1.7(1.02 至 2.7,p=0.04);男孩:RRR=0.6(0.4 至 0.9,p=0.01))。金沙萨男孩的声音较高(三分位数 2:RRR=1.9(1.2 至 2.9,p=0.003)和三分位数 3:1.8(1.2 至 2.8,p=0.009))和布兰太尔女孩(三分位数 2:2.0(1.01 至 3.9,p=0.048))与侵害-受害重叠有关,布兰太尔的女孩声音越大,受害的 RRR 越高(三分位数 2:RRR=1.9(1.1 至 3.1,p=0.02))。一般来说,与女孩相比,男孩的关联性更强,而且关联性往往因受害和侵害相互孤立而有所不同。这项研究的一个主要局限性是,数据的横断面性质不允许对研究结果进行因果解释,这需要进一步的纵向探索来确定时间性。

结论

在这项研究中,我们观察到同伴暴力是一种性别化的经历,与年轻人的能动性有关。这强调了在赋权计划中解决人际暴力问题的重要性,并包括经历最大侵害-受害重叠的男孩。

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