Adapting a low-cost intimate partner violence (IPV) and mental health response intervention for women in informal settlements in Kenya

项目总结/摘要 该国际研究科学家发展奖（K 01）的目的是为候选人提供 转变为独立的全球卫生研究人员所需的培训和专业知识， 非正规住区中与暴力和健康有关的干预科学。全球30%的女性 亲密伴侣暴力（IPV）预防和应对IPV至关重要;但干预措施很少 为非正规住区的居民进行了调整。目前，在内罗毕的300万居民中， 在肯尼亚的首都，有许多人居住在非正规住区，到2050年，这一人口可能会翻一番。研究工作 2012年，在内罗毕最大的非正式定居点基贝拉， 2018年的一项研究报告称，在类似的内罗毕定居点，66%的妇女经历过 IPV去年经历IPV的女性更有可能经历抑郁、焦虑和产后抑郁。 创伤压力2014年，肯尼亚将减少和应对暴力侵害妇女行为确定为 国家政策和战略计划中的优先保健领域;然而， 在非正规住区的诊所为IPV幸存者提供服务。因此，本研究的目的是：1）识别 潜在的促进者和障碍，以筛选和干预IPV和相关的心理健康挑战， 肯尼亚非正规住区的医疗保健环境; 2）联合收割机结合IPV（WINGS）和心理健康（PM+） 响应干预，并调整组合（WINGS+PM+）干预，以用于现有的医疗保健环境 在内罗毕的非正规住区;和3）试点测试通过随机 一项在130名女性中进行的对照试验，旨在评估WINGS+PM+与仅PM+相比的安全性、可行性和可接受性 作为低成本IPV服务包的基础，可以将服务扩展到 非正式定居点。拟议的职业发展计划旨在增强申请人的 在肯尼亚非正规住区研究暴力侵害妇女问题和妇女健康问题的经验，使她能够： 在设计和调整与暴力和健康有关的干预措施方面的研究技能，重点是 低成本的干预措施，可由非专业社区成员在非正式的医疗保健环境中进行， 2）获得设计、调整、交付和可行性评估方面的方法学专门知识 和干预措施的可接受性; 3）培养与全球卫生专家的重要关系， 科学家和医疗保健提供者在肯尼亚和东非的非正式定居点，和4）增加她的 专业技能，成功的独立全球卫生研究事业，包括granectin， 手稿写作，以及跨学科和国际合作研究。培训目标将是 通过教学课程、专门讲习班和研讨会、实践研究和指导实现 来自美国和肯尼亚的跨学科专家团队。研究结果和方法 从该IRSDA（K 01）中获得的技能对肯尼亚的卫生研究具有重要的适用性。

PROJECT SUMMARY/ABSTRACT The purpose of this International Research Scientist Development Award (K01) is to provide the candidate with the training and expertise needed to transition into an independent global health researcher with expertise in the science of violence- and health-related intervention in informal settlements. Globally, 30% of women have experienced intimate partner violence (IPV). Prevention and response to IPV is critical; yet few interventions have been adapted for residents of informal settlements. Currently, 56% of the 3 million residents in Nairobi, the capital city of Kenya, live in informal settlements, and this population is likely to double by 2050. Research carried out in 2012 in Kibera, the largest informal settlement in Nairobi, reported that 85% of women have experienced IPV in their lifetime and a 2018 study reported that 66% of women in similar Nairobi settlements experienced IPV in the past year. Women experiencing IPV are more likely to also experience depression, anxiety, and post- traumatic stress. In 2014, Kenya identified reduction of and response to violence against women (VAW) as a priority health area in national policies and strategic plans; yet, no screening or response protocols have been adopted in clinics in informal settlements for IPV survivors. The aims of this study are, therefore, to: 1) identify potential facilitators and barriers to screening and intervention for IPV and related mental health challenges in healthcare settings in informal settlements in Kenya; 2) combine an IPV (WINGS) and mental health (PM+) response intervention and adapt the combined (WINGS+PM+) intervention for use in existent healthcare settings in informal settlements in Nairobi; and 3) pilot test the adapted WINGS+PM+ intervention through a randomized control trial with 130 women to assess the safety, feasibility, and acceptability of WINGS+PM+ versus PM+-only as the foundation for a low-cost IPV services package that can expand services to women experiencing IPV in informal settlements. The proposed career development plan has been designed to augment the applicant's experience researching VAW and women's health in informal settlements in Kenya and enable her to: 1) gain research skills in the design and adaptation of violence- and health-related interventions, with an emphasis on low-cost interventions that can be carried out by lay community members in healthcare settings in informal settlements; 2) obtain methodological expertise in the design, adaptation, delivery, and assessment of feasibility and acceptability of interventions; 3) cultivate important relationships with global health experts, intervention scientists, and healthcare providers in informal settlements in Kenya and East Africa, and 4) increase her professional skills for a successful independent global health research career, including grantsmanship, manuscript writing, and collaborative interdisciplinary and international research. The training goals will be achieved through didactic courses, specialized workshops and seminars, hands-on research, and mentoring from an interdisciplinary team of experts in both the U.S. and Kenya. The research findings and methodological skills to be gained from this IRSDA (K01) have important applicability for health research in Kenya.