Systematic review of structural interventions for intimate partner violence in low- and middle-income countries: organizing evidence for prevention.
Systematic review of structural interventions for intimate partner violence in low- and middle-income countries: organizing evidence for prevention.
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DOI：
10.1186/s12889-015-2460-4
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发表时间：
2015-11-23
影响因子：
4.5
通讯作者：
Stephenson R
中科院分区：
文献类型：
--
作者：
Bourey C;Williams W;Bernstein EE;Stephenson R
尽管全球对亲密伴侣暴力（IPV）的关注日益增加，但对IPV预防证据的系统评估仍然有限。在低收入和中等收入国家尤其如此，在这些国家，研究人员经常通过当前的干预策略而不是综合的IPV模型来组织证据。将结构性干预的概念应用于IPV，我们系统地回顾了此类干预措施对预防低收入和中等收入国家男性对女性IPV的定量影响，以便(a)突出当前IPV研究和规划的机会，(b)展示结构性干预如何提供一个组织框架，通过该框架建立IPV预防的证据基础。我们通过系统地检索PubMed和Web of Science，审查选定研究的参考文献，并联系23位专家来确定文章。入选标准包括2000年1月至2015年5月在同行评议文献中发表的英文原创研究。研究通过(a) IPV发病率或流行程度，或(b)研究作者提出的与IPV理论相关的次要结局，评估了结构性干预措施对低收入和中等收入国家男性对女性IPV预防的定量影响。初步筛选后，我们评估全文文章纳入，并提取研究特征、结果和偏倚风险的数据，使用为综述开发的表格。来自9个国家的20篇文章（16项研究）符合纳入标准，代表13项随机对照试验和7项附加研究，所有这些研究都报告了经济、社会或经济和社会联合干预的结果。在p < 0.05或95%置信区间（不包括统一性）标准化后，13项研究显示至少一项主要或次要结局有统计学显著影响，包括IPV降低和控制行为；改善经济福祉；增强关系质量、赋权或社会资本；IPV的可接受性降低；新的求助行为；更公平的性别规范。然而，偏倚风险以有意义的方式变化。我们的研究结果支持结构性干预措施预防IPV的潜在有效性。结构性干预作为一个组织框架，可以通过巩固现有证据来推进IPV预防；强调评估范围更广的干预措施的机会，包括政治、法律和实际方法；并强调改进此类干预措施评估的机会。本文的在线版本（doi:10.1186/s12889-015-2460-4）包含补充材料，授权用户可以使用。
Despite growing attention to intimate partner violence (IPV) globally, systematic evaluation of evidence for IPV prevention remains limited. This particularly is true in relation to low- and middle-income countries (LMIC), where researchers often organize evidence by current interventions strategies rather than comprehensive models of IPV. Applying the concept of structural interventions to IPV, we systematically reviewed the quantitative impact of such interventions for prevention of male-to-female IPV in LMIC in order to (a) highlight current opportunities for IPV research and programming and (b) demonstrate how structural interventions may provide an organizing framework through which to build an evidence base for IPV prevention. We identified articles by systematically searching PubMed and Web of Science, reviewing references of selected studies, and contacting 23 experts. Inclusion criteria included original research, written in English, published between January 2000 and May 2015 in the peer-reviewed literature. Studies evaluated the quantitative impact of structural interventions for the prevention of male-to-female IPV in LMIC through (a) IPV incidence or prevalence or (b) secondary outcomes theoretically linked to IPV by study authors. After initial screening, we evaluated full text articles for inclusion and extracted data on study characteristics, outcomes, and risk of bias, using forms developed for the review. Twenty articles (16 studies) from nine countries met inclusion criteria, representing 13 randomized control trials and seven additional studies, all of which reported results from economic, social, or combined economic and social interventions. Standardized at p < 0.05 or 95 % confidence intervals not including unity, 13 studies demonstrated statistically significant effects for at least one primary or secondary outcome, including decreased IPV and controlling behaviors; improved economic wellbeing; enhanced relationship quality, empowerment, or social capital; reduced acceptability of IPV; new help seeking behaviors; and more equitable gender norms. Risk of bias, however, varied in meaningful ways. Our findings support the potential effectiveness of structural interventions for IPV prevention. Structural interventions, as an organizing framework, may advance IPV prevention by consolidating available evidence; highlighting opportunities to assess a broader range of interventions, including politico-legal and physical approaches; and emphasizing opportunities to improve evaluation of such interventions. The online version of this article (doi:10.1186/s12889-015-2460-4) contains supplementary material, which is available to authorized users.