Mechanisms for Relations of Domestic Violence to Poor Maternal and Infant Health

家庭暴力与母婴健康不良的关系机制

• 批准号: 7231234
• 负责人: Jay G Silverman
• 金额: $ 8.56万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-07-01 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7231234
• 关键词: Age; Age-Months; Anemia; Birth; Breast Feeding; Child; Child Abuse; Clinic; Data; Data Collection; Daughter; Depth; Diarrhea; Domestic Violence; Elder Abuse; Extended Family; Family; Family member; Fathers; Female of child bearing age; Fever; Focus Groups; Gestational Diabetes; Health; Hemorrhage; Household; Husband; Immunization; India; Individual; Infant; Infant Care; Infant Health; Intervention; Interview; Laws; Life; Link; Maternal Deprivation; Maternal Health; Mental Depression; Modeling; Mothers; Nutritional; Outcome; Phase; Postpartum Period; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Premature Birth; Program Development; Qualitative Research; Range; Rate; Recommendation; Reporting; Research; Research Design; Research Personnel; Respiratory distress; Safety; Services; Slum; Surveys; Time; Urban Health; Urinary tract infection; Violence; Weight; Wife; Woman; base; deprivation; genital infection; intervention program; maltreatment; men; nutrition; response

DESCRIPTION (provided by applicant): Indian women of child-bearing age are abused by both husbands and other family members at alarming rates, and women abused around the time of pregnancy are more likely to suffer complications of pregnancy, miscarry, and give birth to low weight infants and infants that do not survive. However, little is understood regarding the mechanisms responsible for these associations. The proposed study will provide qualitative and quantitative data to clarify the relations of violence against wives by both husbands and other family members (i.e., 'domestic violence') to pregnancy complications and postpartum maternal and infant health among those seeking infant immunization at a large public urban health center (UHC) located in a major slum of Mumbai, India. A sequential research design will be utilized involving two phases of qualitative study informing a final phase of quantitative study. Phase 1 will involve in-depth interviews with victims of domestic violence seeking immunization for infants 6 months of age or younger (n=40); Phase 2 will involve focus groups with fathers residing with their young infants (2 groups, total n=12-24 individuals) and mothers-in-law residing with daughters-in-law who have recently given birth (2 groups, total n=12-24 individuals). The resulting model will be integrated with findings from previous research to create a survey for mothers of young infants (n=750) attending the UHC for child immunization to quantitatively assess 1) associations of domestic violence (prior to, during and post pregnancy) to pregnancy complications (i.e., preterm delivery, preeclampsia, gestational diabetes, hemorrhage, UTI), postpartum maternal health (i.e., depression, anemia, genital infection, breastfeeding difficulties) and infant health (i.e., low weight, poor nutrition, diarrhea, respiratory distress, fever), 2) associations of domestic violence to other forms of maltreatment hypothesized based on prior research and qualitative study to represent proximal mechanisms for the effect of domestic violence on maternal and infant health (e.g., nutritional deprivation, child abuse, interference with maternal care of infant, excessive household labor demands), and 3) whether associations of domestic violence and maternal and infant health outcomes occur via (i.e., are modified by) these mechanisms. These data will be synthesized to create recommendations for family and clinic-based intervention programs, and will be broadly disseminated in the form of reports for Indian practitioners, researchers and policymakers.

描述（由申请人提供）：印度育龄妇女以惊人的速度受到丈夫和其他家庭成员的虐待，怀孕期间受到虐待的妇女更有可能遭受怀孕并发症，流产，生下低体重婴儿和无法存活的婴儿。然而，人们对这些协会的运作机制知之甚少。拟议的研究将提供定性和定量数据，以澄清丈夫和其他家庭成员对妻子的暴力行为之间的关系（即，在印度孟买的一个主要贫民窟的一个大型公共城市卫生中心（UHC）寻求婴儿免疫接种的人中，“家庭暴力”）对妊娠并发症和产后母婴健康的影响。将采用连续研究设计，包括两个阶段的定性研究，为定量研究的最后阶段提供信息。第一阶段将深入访谈寻求为6个月或以下婴儿接种疫苗的家庭暴力受害者（n=40）;第二阶段将涉及焦点小组，与年幼婴儿居住在一起的父亲（2组，共n=12-24人）和与最近分娩的儿媳居住在一起的婆婆（2组，共n=12-24人）。由此产生的模型将与以前的研究结果相结合，为参加UHC儿童免疫接种的幼儿母亲（n=750）创建一项调查，以定量评估1）家庭暴力（怀孕前，怀孕期间和怀孕后）与怀孕并发症（即，早产、先兆子痫、妊娠糖尿病、出血、UTI），产后产妇健康（即，抑郁症、贫血、生殖器感染、母乳喂养困难）和婴儿健康（即，体重低、营养不良、腹泻、呼吸窘迫、发烧），2）家庭暴力与其他形式的虐待的关联，这些虐待是基于先前的研究和定性研究假设的，以代表家庭暴力对孕产妇和婴儿健康影响的近端机制（例如，营养缺乏、虐待儿童、干扰母亲对婴儿的护理、过度的家庭劳动需求），以及3）家庭暴力与母婴健康结果的关联是否通过（即，被修改）这些机制。这些数据将被综合，为家庭和诊所干预方案提出建议，并将以报告的形式广泛传播给印度的从业人员、研究人员和政策制定者。