Kristin VanderEnde

Community-level correlates of intimate partner violence against women globally: A systematic review

Intimate partner violence (IPV) against women is a problem facing women around the world, one that has implications for womens health and well-being. The relationship between communities and the occurrence of IPV is an expanding area of research. Although a large number of community characteristics have been examined in relation to IPV, the research as a whole lacks a coherent theoretical focus or perspective. In this systematic review, we provide a comprehensive synthesis of the evidence regarding the community-level correlates of IPV against women. In our review of peer-reviewed research published between January 1, 1990 and January 31, 2011, we identify key community-level correlates, detect gaps, and offer recommendations for future research. Recognizing a difference in approach between U.S. and non-U.S. based research and an over-reliance on a primarily urban, U.S.-based perspective on communities and IPV, we advocate for a global perspective that better reflects the social and economic fabric of communities around the world. Specifically, future research should focus on the most promising, but currently under-studied, community-level correlates of IPV against women, namely gender inequality, gender norms, and adapted measures of collective efficacy/social cohesion.

Effect of Face-to-Face Interview Versus Computer-Assisted Self-Interview on Disclosure of Intimate Partner Violence Among African American Women in WIC Clinics

African American women in the United States report intimate partner violence (IPV) more often than the general population of women. Overall, women underreport IPV because of shame, embarrassment, fear of retribution, or low expectation of legal support. African American women may be especially unlikely to report IPV because of poverty, low social support, and past experiences of discrimination. The purpose of this article is to determine the context in which low-income African American women disclose IPV. Consenting African American women receiving Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) services in WIC clinics were randomized to complete an IPV screening (Revised Conflict Tactics Scales–Short Form) via computer-assisted self-interview (CASI) or face-to-face interview (FTFI). Women (n = 368) reported high rates of lifetime and prior-year verbal (48%, 34%), physical (12%, 7%), sexual (10%, 7%), and any (49%, 36%) IPV, as well as IPV-related injury (13%, 7%). Mode of screening, but not interviewer race, affected disclosure. Women screened via FTFI reported significantly more lifetime and prior-year negotiation (adjusted odds ratio [aOR] = 10.54, 3.97) and more prior-year verbal (aOR = 2.10), sexual (aOR = 4.31), and any (aOR = 2.02) IPV than CASI-screened women. African American women in a WIC setting disclosed IPV more often in face-to-face than computer screening, and race-matching of client and interviewer did not affect disclosure. Findings highlight the potential value of face-to-face screening to identify women at risk of IPV. Programs should weigh the costs and benefits of training staff versus using computer-based technologies to screen for IPV in WIC settings.

Women's empowerment and generalized anxiety in Minya, Egypt

Gender disparities in mental health are global, with women experiencing higher rates than men of anxiety disorders, mood disorders, and attempted suicide. Womens low social status may partly explain these disparities, yet evidence from Arab and Middle Eastern settings is limited. We assessed whether womens empowerment - or acquisition of enabling resources, and in turn, enhanced agency - was associated with their lower generalized anxiety. For 539 ever-married women 22-65 years who participated in the 2005 Egypt Demographic Health Survey (EDHS) and a 2012 follow-up survey in rural Minya, we estimated linear reduced-form and mediation regression models to assess the associations of womens premarital enabling resources with their generalized anxiety in 2012, overall and through measures of their marital agency in 2005. Womens higher schooling attainment, premarital economic activity, later age at first marriage, and greater proximity to natal (or birth) family had significant, adjusted associations with lower generalized anxiety. Measures of womens agency in marriage had mixed associations with generalized anxiety, but their inclusion modestly reduced the coefficients for premarital resources. Parallel qualitative findings confirmed nuanced associations between womens exclusive decision-making and their mental health. Efforts to enhance womens education and premarital economic activity might be combined with efforts to delay first marriage and ensure womens extra-marital social support to maximize their empowerment and its mental-health benefits.

Women's age at first marriage and postmarital agency in Egypt

Early - or child - marriage (before age 18) may diminish womens ability to exercise agency, or their capacity to act upon their goals. Using a propensity score adjustment approach, we analyzed data from 2394 married women ages 35-49 years who participated in the 2006 Egypt Labor Market Panel Survey (ELMPS). We examined whether womens first marriage at age 18 or older was associated with their post-marital agency, measured in terms of their influence in family decisions, freedom of movement in public spaces, and unfavorable views about intimate partner violence against wives. In bivariate analyses, womens age at first marriage was positively associated with their decision-making and more equitable gender attitudes. However, once we controlled for selection into age-at-first-marriage groups, there were no significant differences between the two age-at-first-marriage groups in any dimension of womens agency. We examined the sensitivity of the non-significant age-at-first-marriage effects to possible violations of the strong ignorability assumption and the results did not alter our conclusions. The assumption that womens age at first marriage is a proxy for their post-marital agency, as defined here, warrants further study.

Community Economic Status and Intimate Partner Violence Against Women in Bangladesh: Compositional or Contextual Effects?

In this research, we used a multi-level contextual-effects analysis to disentangle the household- and community-level associations between income and intimate partner violence (IPV) against women in Bangladesh. Our analyses of data from 2,668 women interviewed as part of the World Health Organization (WHO) multi-country study on women’s health and domestic violence against women showed that household income was negatively associated with women’s risk of experiencing IPV. Controlling for residence in a low-income household, living in a low-income community was not associated with women’s risk of experiencing IPV. These results support a household-level, not community-level, relationship between income and IPV in Bangladesh.

Measuring Attitudes About Women’s Recourse After Exposure to Intimate Partner Violence: The ATT-RECOURSE Scale

Attitudes about intimate partner violence (IPV) against women are widely surveyed, but attitudes about women’s recourse after exposure to IPV are understudied, despite their importance for intervention. Designed through qualitative research and administered in a probability sample of 1,054 married men and women 18 to 50 years in My Hao District, Vietnam, the ATT-RECOURSE scale measures men’s and women’s attitudes about a wife’s recourse after exposure to physical IPV. Data were initially collected for nine items. Exploratory factor analysis (EFA) with one random split-half sample (N1 = 526) revealed a one-factor model with significant loadings (0.316-0.686) for six items capturing a wife’s silence, informal recourse, and formal recourse. A confirmatory factor analysis (CFA) with the other random split-half sample (N2 = 528) showed adequate fit for the six-item model and significant factor loadings of similar magnitude to the EFA results (0.412-0.669). For the six items retained, men consistently favored recourse more often than did women (52.4%-66.0% of men vs. 41.9%-55.2% of women). Tests for uniform differential item functioning (DIF) by gender revealed one item with significant uniform DIF, and adjusting for this revealed an even larger gap in men’s and women’s attitudes, with men favoring recourse, on average, more than women. The six-item ATT-RECOURSE scale is reliable across independent samples and exhibits little uniform DIF by gender, supporting its use in surveys of men and women. Further methodological research is discussed. Research is needed in Vietnam about why women report less favorable attitudes than men regarding women’s recourse after physical IPV.

Men’s Perpetration of Intimate Partner Violence in Vietnam Gendered Social Learning and the Challenges of Masculinity

Using the survey responses of 522 married men (eighteen to fifty-one years) in Vietnam, we explored how gendered social learning in boyhood and challenges to men’s expected status in marriage may increase the risk that men perpetrate intimate partner violence (IPV) against their wives. Over one-third (36.6 percent) of the participants reported having ever perpetrated psychological, physical, or sexual IPV against their current wife. Accounting for other characteristics of men in the sample, witnessing IPV as a boy, being physically maltreated as a boy, and being the same age or younger than one’s wife were associated with almost two to three times higher odds of perpetrating any IPV. Men with thirteen to eighteen completed grades of schooling had about half the adjusted odds of ever perpetrating any IPV than men with twelve or fewer completed grades (aOR = 0.56). The determinants of men’s perpetration of physical IPV and psychological IPV were, largely, similar. Programs to prevent men’s perpetration of IPV should address the parenting practices of boys that legitimize men’s aggression and gendered status expectations in marriage, which when challenged, may lead husbands to respond with violence. Engaging men to endorse nonviolent masculinities is an important consideration for future intervention.

Violence in childhood, attitudes about partner violence, and partner violence perpetration among men in Vietnam

PURPOSE We assess the association of mens exposure to violence in childhood-witnessing physical violence against ones mother and being hit or beaten by a parent or adult relative-with their attitudes about intimate partner violence (IPV) against women. We explore whether mens perpetration of IPV mediates this relationship and whether mens attitudes about IPV mediate any relationship of exposure to violence in childhood with perpetration of IPV. METHODS Five hundred twenty-two married men 18-51 years in Vietnam were interviewed. Multivariate regressions for ordinal and binary responses were estimated to assess these relationships. RESULTS Compared with men experiencing neither form of violence in childhood, men experiencing either or both had higher adjusted odds of reporting more reasons to hit a wife (aOR, 1.43; 95% CI, 1.03-2.00 and aOR, 1.66; 95% CI, 1.05-2.64, respectively). Mens lifetime perpetration of IPV accounted fully for these associations. Compared with men experiencing neither form of violence in childhood, men experiencing either or both had higher adjusted odds of ever perpetrating IPV (aOR, 3.28; 95% CI, 2.15-4.99 and aOR, 4.56; 95% CI, 2.90-7.17, respectively). Attitudes about IPV modestly attenuated these associations. CONCLUSIONS Addressing violence in childhood is needed to change mens risk of perpetrating IPV and greater subsequent justification of it.

Women’s agency and its relationship to current contraceptive use in lower- and middle-income countries: A systematic review of the literature

ABSTRACT Research shows a positive relationship between women’s empowerment and reproductive health. Yet we know little about the quantitative relationship between women’s agency and contraceptive use. We conducted a systematic review of peer-reviewed literature assessing the link between women’s decision-making and freedom of movement with their contraceptive use in lower- and middle-income countries. Of 102 articles that met the initial screening criteria, 12 met all inclusion and exclusion criteria. Of the 12 included studies, consistently positive associations with contraceptive use were found in those that measured decision-making and freedom of movement as separate constructs. Composite measures had a less clear relationship with contraceptive use. In conclusion, women’s agency is associated with women’s contraceptive use in lower- and middle-income countries. However, the relationship is sensitive to how agency and its components are measured. Our review suggests the need for consistent validation of scales for women’s agency as well as more rigorous research using standardised and validated scales, when possible. Longitudinal and intervention studies in lower- and middle-income countries will be useful for understanding the causal impact of women’s agency on contraceptive use, and will help to inform policies and programmes to increase contraceptive use in these settings.

Why do women justify violence against wives more often than do men in Vietnam

Intimate partner violence (IPV) harms the health of women and their children. In Vietnam, 31% of women report lifetime exposure to physical IPV, and surprisingly, women justify physical IPV against wives more often than do men. We compare men’s and women’s rates of finding good reason for wife hitting and assess whether differences in childhood experiences and resources and constraints in adulthood account for observed differences. Probability samples of married men (n = 522) and women (n = 533) were surveyed in Vietnam. Ordered logit models assessed the proportional odds for women versus men of finding more “good reasons” to hit a wife (never, 1-3 situations, 4-6 situations). In all situations, women found good reason to hit a wife more often than did men. The unadjusted odds for women versus men of reporting more good reasons to hit a wife were 6.55 (95% confidence interval [CI] = [4.82, 8.91]). This gap disappeared in adjusted models that included significant interactions of gender with age, number of children ever born, and experience of physical IPV as an adult. Having children was associated with justifying wife hitting among women but not men. Exposure to IPV in adulthood was associated with justifying wife hitting among men, but was negatively associated with justification of IPV among women. Further study of the gendered effects of resources and constraints in adulthood on attitudes about IPV against women will clarify women’s more frequent reporting than men’s that IPV against women is justified.