Development of an audio-computer assisted self-interview to investigate violence and health in the lives of adults with developmental disabilities

BackgroundAudio computer-assisted self-interviews (ACASIs) have safely and effectively obtained sensitive research data from the general public and have been recommended for use with people with disabilities. However, few studies have used ACASIs with people with disabilities and ACASIs have not been used to investigate the relationship between disability, interpersonal violence (IPV), and physical and psychological health among people with developmental disabilities (PWDD).ObjectiveWe developed an accessible ACASI specifically designed to allow PWDD to answer questions independently, while privately and securely collecting anonymous data related to their disability, IPV experiences, and physical and psychological health.MethodsWe used a safety protocol to apply community based participatory research (CBPR) principles and an iterative process to create, test, and administer a cross-sectional ACASI survey to 350 adults with developmental disabilities in urban and rural locales.ResultsMost participants completed the ACASI independently and reported that its accessibility features allowed them to do so. Most also agreed that the ACASI was easy to use, its questions were easy to understand, and that they would prefer using an ACASI to answer IPV and health-related questions rather than in a face-to-face interview. The majority agreed that health and safety were critical issues to address.ConclusionsACASI technology has the potential to maximize the independent and private participation of PWDD in research on sensitive topics. We recommend further exploration into accessibility options for ACASI technology, including hardware and Internet applications.     

Factors associated with reporting of abuse against children and adolescents by nurses within Primary Health Care

OBJECTIVE:

to analyze the factors associated with the underreporting on the part of nurses within Primary Health Care of abuse against children and adolescents.

METHOD:

cross-sectional study with 616 nurses. A questionnaire addressed socio-demographic data, profession, instrumentation and knowledge on the topic, identification and reporting of abuse cases. Bivariate and multivariate logistic regression was used.

RESULTS:

female nurses, aged between 21 and 32 years old, not married, with five or more years since graduation, with graduate studies, and working for five or more years in PHC predominated. The final regression model showed that factors such as working for five or more years, having a reporting form within the PHC unit, and believing that reporting within Primary Health Care is an advantage, facilitate reporting.

CONCLUSION:

the study''s results may, in addition to sensitizing nurses, support management professionals in establishing strategies intended to produce compliance with reporting as a legal device that ensures the rights of children and adolescents.     

Changes in outlet densities affect violence rates

BACKGROUND: Previous assessments of empirical relationships between alcohol outlets and rates of interpersonal violence have been conducted using cross-sectional spatial data, data collected across small geographic units such as Census Tracts and zip codes. These assessments demonstrate that the availability of alcohol, measured by the number and types of alcohol outlets, is related to violence. These analyses have examined many potential confounds of the outlets-violence connection (i.e., population and place characteristics) and statistically corrected for biases that arise in analyses of spatial data. The current study contributes the first observation of longitudinal relationships between alcohol outlets and violence. METHOD: The study examined longitudinal data from 581 consistently defined zip code areas represented in the California Index Locations Database, a geographic information system that coordinates population and ecological data with spatial attributes for areas across the state. Six years of data were collected on features of local populations (e.g., household size) and places (e.g., retail markets) thought to be related to 1 measure of violence (i.e., hospital discharges related to violent assaults). Assault rates were related to changes in population and place characteristics using random effects models with controls for spatial autocorrelation (n x t = 3,486 observations). Changes in population and place characteristics of bordering (spatial lagged) areas were also considered. RESULTS: Lower median household income and greater percentages of minorities (African American, Hispanic, and Asian) were related to increased rates of violence. Ten percent increases in numbers of off-premise outlets and bars were related to 1.67 and 2.06% increases in violence rates across local and lagged spatial areas. Every 6 outlets accounted for 1 additional violent assault that resulted in at least 1 overnight stay at hospital. These effects increased with larger male populations, doubling with every 3% increase in percent males. CONCLUSION: Assault rates were most strongly related to median household incomes and minority populations within zip code areas. Controlling for changes in assault rates related to these measures, greater numbers of licensed alcohol retail establishments, especially bars and off-premise outlets, were related to rates of assault. Failures to regulate the growth in numbers of bars will increase rates of violence, especially in urban areas.     

Alcohol Abuse or Dependence Among Mexican American Women Who Report Violence

BACKGROUND: Violence against women has been linked to alcohol disorders in various populations. Few studies have assessed alcohol disorders among assaulted women in a general population of Mexican Americans. This study examined alcohol disorders among Mexican American women who reported physical or sexual assault. METHODS: Participants were women (n = 1516, ages 18-59) living in Fresno County, California, who were enrolled in a population-based, randomized household survey of Mexican-origin men and women. Crude and adjusted odds ratios (ORs) were calculated for alcohol dependence/abuse (ADA) and physical or sexual assault by a current partner or someone other than a current partner. RESULTS: Women who reported lifetime physical or sexual assault were significantly more likely to meet criteria for ADA (OR = 8.2; 95% confidence interval [CI], 4.4-15.4). After we adjusted for birthplace, age, income, and parental problem drinking, assaulted women were still 4.7 times more likely to meet criteria for ADA (CI, 2.1-10.4). Physical or sexual assault by someone other than a partner was more strongly associated with ADA (OR = 8.7; CI, 4.5-16.9) than assault by a current partner (OR = 3.2; CI, 1.3-7.6). Both physical (OR = 9.0; CI, 4.7-17.0) and sexual assault (OR = 4.7; CI, 2.2-10.0) by either type of perpetrator were associated with ADA. CONCLUSION: There is a strong association between reporting violence and having a lifetime history of ADA. Although temporal order could not be established, these findings highlight the importance of screening for physical and sexual assault in settings that treat alcohol disorders as well as screening for alcohol disorders among women who seek services related to previous or current violence.     

Physical and Sexual Abuse among Homeless and Unstably Housed Adults Living with HIV: Prevalence and Associated Risks

We examined the prevalence and risks associated with interpersonal (physical and sexual) abuse among HIV-seropositive homeless or unstably housed adults. Data were obtained from the Housing and Health Study of participants living in Baltimore, Chicago, and Los Angeles (n = 644). We used logistic regression to identify risks associated with abuse. About 77% of men and 86% of women reported ever experiencing abuse. Women were at greater risk than men for intimate partner physical abuse, childhood sexual abuse (CSA), and adulthood sexual abuse. Men and women experiencing intimate partner physical abuse reported increased risk of unprotected sex. Other risks associated with abuse include sex exchange; lifetime alcohol abuse; and depressive symptoms. Abuse prevalence among sample exceeds those found in other samples of general USA, HIV-seropositive, and homeless populations. Identifying persons at risk of abuse is needed to reduce risk among homeless or unstably housed persons living with HIV.     

Relationships Between Physical and Non-Physical Forms of Intimate Partner Violence and Depression among Urban Minority Adolescent Females

BACKGROUND: Little is known about intimate partner violence (IPV) and depression among low income, urban African American and Hispanic adolescent females. METHOD: Interviews with 102 urban African American and Hispanic adolescent females examined physical abuse, emotional/verbal abuse, and threats, and their unique and combined associations with depression. RESULTS: One-quarter of the sample experienced all three types of abuse. Non-physical forms of IPV were significantly associated with depression. CONCLUSIONS: Some urban adolescent females from lower income households experience high rates of IPV. Physical and non-physical forms of IPV are important in understanding and responding to depression in this population.     

Who or what do young adults hold responsible for men’s drunken violence?

BackgroundMen are more likely than women to perpetrate serious violence when they have consumed alcohol, but alcohol does not affect all men in the same way. This paper considers young adults’ attribution about agency (the capacity to act) in men’s drunken violence.MethodsInterviews about alcohol use in night-time venues, streets or private parties were conducted with 60 young adults aged 18–24 in Melbourne, Australia, and analysed thematically. Participants included seven men who identified as having initiated violence when drunk.ResultsSome interviewees stated that men chose to be violent, or that men’s violence when they were drunk was purposeful and therefore involved some component of choice. However, much alcohol-related violence enacted by young men was understood (both by men who reported violence and by other young adults) as impelled by forces outside their control. These forces were: diffusely defined effects of drinking alcohol; proclivities of men and masculinity, and the interaction of alcohol and men’s bodies to override capacity for judgement and produce an irresistible urge to fight. The latter was at times explained as caused by the mutually reinforcing actions of alcohol and testosterone, providing a particularly persuasive account of men’s violence as biologically-determined.ConclusionThese categories encapsulate a set of discursive resources that contribute to the rationalisation, naturalisation and production of men’s violence. Participants tended to regard alcohol, masculinities and testosterone as inciting violence predictably and consistently, suggesting that men themselves had relatively little agency over its occurrence. In contrast, research evidence indicates that these actors do not cause violence in any uniform way and that their effects are contingent on changing configurations of factors. Highlighting discrepancies between young adults’ understandings of responsibility for men’s drunken violence, and those expressed in research, presents additional opportunities for intervention.     

Passage à l’acte familicide et filicide : deux réalités distinctes ?

The objective of this study is to compare men who killed their wives and at least one of their children (familicide) with men who exclusively killed one or more of their children (filicide), using socio-demographic, criminological, situational and psychological-psychiatric variables. The data was obtained from the Coroner’s files in Québec for the period of 1986 to 1998. A total of 16 men who committed familicide were compared with 36 men who committed filicide. The results of the analyses indicate that there are significant differences between the two groups of men. Men who committed familicide are older, are more often born out of Canada and more often use a firearm as well as overkill while committing the offence in comparison to men who committed filicide. These men are also more often in the process of a conjugal separation, they have more often experienced losses (i.e. job loss, etc.) and they show more symptoms of depression in the year prior to the homicide, compared to filicidal men. Based on these results, the individuals who committed familicide exhibit a different dynamic than those individuals who committed filicide. These results have an important impact on the treatment of these individuals as well as on prevention.