University of California, San Diego- Herbert Wertheim School of Public Health and Human Longevity Science, CA, USA.
University of California, San Diego- Herbert Wertheim School of Public Health and Human Longevity Science, CA, USA; Joint Doctoral Program in Public Health-Global Health, San Diego State University, San Diego, CA, USA.
Soc Sci Med. 2024 Sep;357:117175. doi: 10.1016/j.socscimed.2024.117175. Epub 2024 Aug 2.
Gender-based violence (GBV) research in public health has historically paid close attention to gender as a system of oppression, with less attention paid to the intersections between gender and other oppressive systems such as colonialism, white supremacy, and capitalism. In 2019, we adapted and pilot-tested an individual-level evidence-based sexual violence resistance intervention for university-attending women in Eswatini. We conducted a qualitative assessment of our adapted intervention's acceptability and feasibility using a critical pedagogy lens to explore how power operated in delivering an empowerment intervention, using in-depth interviews with intervention participants and facilitators. We analyzed interview transcripts thematically guided by a critical pedagogy framework and organized emergent themes into a concept map with two primary axes: participant-researcher-driven power and proximal-distal determinants. We located participant experiences with the intervention within three quadrants defined by these axes: 1) "Prescriptive," in which the researcher or facilitator primarily controls the content and delivery, with a principal focus on proximal risk reduction strategies; 2) "Solidarity," which emphasizes fostering critical consciousness among facilitators and intervention participants through dialogue, building collective power through participant-driven discussions of individual experiences; and 3) "Liberation," in which participants critically examined the power structures that underpinned their lived experiences, and expressed a desire to transform these in ways the intervention was not designed to address. These three quadrants suggest the existence of a fourth quadrant, "paternalistic," - in which the interventionist seeks to didactically educate participants about structural drivers of their own experience. Our analysis highlights a fundamental tension in the epistemology of GBV research: While there is a clear consensus that 'empowerment' is a necessary component of successful GBV interventions, "liberatory" approaches that cede power to participants are inherently antithetical to the scripted approach typically required for consistent replication in randomized control trials or other 'gold-standard' approaches for post-positivist evidence generation.
基于性别的暴力（GBV）研究在公共卫生领域历史上一直密切关注性别作为一种压迫制度，而较少关注性别与殖民主义、白人至上和资本主义等其他压迫制度的交叉。2019 年，我们在斯威士兰为在校女大学生改编并试点了一项基于个体层面证据的性暴力预防干预措施。我们采用批判教育学视角，对我们改编的干预措施的可接受性和可行性进行了定性评估，以探讨权力在实施赋权干预措施时是如何运作的，方法是对干预措施的参与者和促进者进行深入访谈。我们根据批判教育学框架对访谈记录进行了主题分析，并根据两条主要轴线将新出现的主题组织到一个概念图中：参与者-研究人员驱动的权力和近端-远端决定因素。我们根据这两条轴线将参与者的干预经历定位在三个象限内：1）“指令性”，其中研究人员或促进者主要控制内容和交付，主要关注近端风险降低策略；2）“团结”，通过对话强调在促进者和干预参与者之间培养批判意识，通过参与者对个人经历的讨论集体构建权力；3）“解放”，其中参与者批判性地审视了支撑其生活经历的权力结构，并表示希望以干预措施未设计解决的方式来改变这些。这三个象限表明存在第四个象限，“家长式”——在这个象限中，干预者试图通过说教向参与者传授他们自身经历的结构性驱动因素。我们的分析突显了基于性别的暴力研究认识论中的一个基本紧张关系：虽然人们清楚地认识到“赋权”是成功的基于性别的暴力干预措施的必要组成部分，但将权力让渡给参与者的“解放”方法从根本上与通常需要在随机对照试验或其他后实证主义证据生成的“黄金标准”方法中进行一致复制的脚本方法背道而驰。
