Dataset Information

Confirmatory factor analysis of the WHO Violence Against Women instrument in pregnant women: results from the BRISA prenatal cohort.

ABSTRACT:

Background

Screening for violence during pregnancy is one of the strategies for the prevention of abuse against women. Since violence is difficult to measure, it is necessary to validate questionnaires that can provide a good measure of the phenomenon. The present study analyzed the psychometric properties of the World Health Organization Violence Against Women (WHO VAW) instrument for the measurement of violence against pregnant women.

Methods

Data from the Brazilian Ribeirão Preto and São Luís birth cohort studies (BRISA) were used. The sample consisted of 1,446 pregnant women from São Luís and 1,378 from Ribeirão Preto, interviewed in 2010 and 2011. Thirteen variables were selected from a self-applied questionnaire. Confirmatory factor analysis was used to investigate whether violence is a uni-or-multidimensional construct consisting of psychological, physical and sexual dimensions. The mean-and-variance-adjusted weighted least squares estimator was used. Models were fitted separately for each city and a third model combining data from the two settings was also tested. Models suggested from modification indices were tested to determine whether changes in the WHO VAW model would produce a better fit.

Results

The unidimensional model did not show good fit (Root mean square error of approximation [RMSEA] ?= 0.060, p < 0.001 for the combined model). The multidimensional WHO VAW model showed good fit (RMSEA = 0.036, p = 0.999 for the combined model) and standardized factor loadings higher than 0.70, except for the sexual dimension for SL (0.65). The models suggested by the modification indices with cross loadings measuring simultaneously physical and psychological violence showed a significantly better fit compared to the original WHO model (p < 0.001 for the difference between the model chi-squares).

Conclusions

Violence is a multidimensional second-order construct consisting of psychological, physical and sexual dimensions. The WHO VAW model and the modified models are suitable for measuring violence against pregnant women.

SUBMITTER: Ribeiro MR

PROVIDER: S-EPMC4274028 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Confirmatory factor analysis of the WHO Violence Against Women instrument in pregnant women: results from the BRISA prenatal cohort.

Ribeiro Marizélia Rodrigues Costa MR de Britto e Alves Maria Teresa Seabra Soares MT Batista Rosângela Fernandes Lucena RF Ribeiro Cecília Cláudia Costa CC Schraiber Lilia Blima LB Barbieri Marco Antônio MA Bettiol Heloisa H da Silva Antônio Augusto Moura AA

PloS one 20141222 12

<h4>Background</h4>Screening for violence during pregnancy is one of the strategies for the prevention of abuse against women. Since violence is difficult to measure, it is necessary to validate questionnaires that can provide a good measure of the phenomenon. The present study analyzed the psychometric properties of the World Health Organization Violence Against Women (WHO VAW) instrument for the measurement of violence against pregnant women.<h4>Methods</h4>Data from the Brazilian Ribeirão Pre ...[more]

PMID: 25531654

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Project description:PurposeViolence against women during pregnancy is a serious public health concern due to its significant adverse health consequences for both the mother and the baby. This study aims to systematically identify common health problems and synergistic health correlates of intimate partner violence (IPV) that specifically affect pregnant women.MethodsWe mine large-scale electronic health record (EHR) data from the IBM Explorys database to identify health problems that are prevalent in both IPV and pregnancy populations, as well those that are synergistically associated with the presence of IPV during pregnancy. For this purpose, we develop methods that enhance the statistical reliability of identified patterns by constructing confidence intervals that take into account systematic bias and measurement errors in addition to the variance in estimation.ResultsWe identify with high confidence 668 and 2750 terms that are respectively prevalent in respectively IPV and pregnancy populations. Of these terms, 279 are common. We also identify 16 synergistic health correlates with high confidence. Our results suggest that mental health, substance abuse, and genitourinary complications are prevalent among pregnant women exposed to IPV. The synergistic terms we identify reveal potential conditions that can be direct consequences of trauma (e.g., tibial fracture), long-term health consequences (e.g., chronic rhinitis), markers associated with the demograhics of affected populations (e.g., acne), and risk factors that potentially increase vulnerability during pregnancy (e.g., disorders of attention and motor control).ConclusionsOur results indicate that IPV significantly affects the well-being of pregnant women in multiple ways. The findings of this study can be useful for screening of IPV in pregnant women. Finally, the methodology presented here can also be useful for investigating the synergy between other medical conditions using EHR databases with privacy constraints.

Project description:IntroductionTo make valid comparisons across groups, a measurement instrument needs to be measurement invariant across those groups. The present study evaluates measurement invariance for experience of violence among adolescent girls and young women (AGYW) in two informal settlements in Nairobi, Kenya.MethodsWe used survey data collected from 1,081 AGYW aged 15-22 years from two Nairobi's informal settlements of Korogocho (n = 617) and Viwandani (n = 464) in 2017 through DREAMS (an initiative aimed at reducing HIV incidence among AGYW with a core package of evidence-based interventions) impact evaluation project. Experience of violence was measured using the 15-item WHO's violence against women instrument, and factorial (non)invariance assessed within exploratory structural equation modeling (ESEM) framework. Cross-group measurement invariance was assessed using Bayesian Multiple Indicator Multiple Causes (MIMIC) model across site, age groups, self-reported invitation to participate in DREAMS, marital status, currently in school, education level, religion, ethnic groups, ever had sex, slept hungry at night past 4 weeks, and wealth index.ResultsThe mean and median ages of the AGYW were 17.9 years and 17 years, respectively. About 59% reported having had sex and 58% of AGYW were in school. The percentage reporting each act of violence varied from 1.6% ("attacked you with a weapon") to 26.5% ("insult you or make you feel bad about yourself"). About 44% (n = 474) of participants experienced ≥1 acts of violence, and 2.7% (n = 29) experienced at least half of the 15 acts. The structure underlying the 15 items was configurally similar to that proposed by WHO, with three factors reflecting either psychological, physical, or sexual violence. Noninvariance was detected for five items-spread across the three domains. Three of five items showed noninvariance only for sleeping hungry at night in the past 4 weeks. As the majority of items did not show evidence of noninvariance, differences in latent mean scores likely reflect actual differences and may not be attributable to measurement artifacts.ConclusionsUsing state-of-the-art statistical techniques on a widely used instrument for measuring exposure to violence among women, this study provides support for the subscales of psychological, physical and sexual violence in a Kenyan AGYW population. The instrument supports comparisons across groups within this population. This is crucial when comparing violence against girls/women prevalence rates and to understand challenges and exchange strategies to reduce abuse or violence experienced by AGYW, or women in general.

Project description:BackgroundIntimate partner violence (IPV) is a global problem that affects one-third of all women. The present study aims to develop and determine the validity of a screening instrument for the detection of IPV in pregnant women in Tanzania and Vietnam and to determine the minimum number of questions needed to identify IPV.MethodAn IPV screening instrument based on eight questions was tested on 1,116 Tanzanian and 1,309 Vietnamese women who attended antenatal care before 24 gestational weeks. The women were re-interviewed during their 30th-34th gestational week where the World Health Organization (WHO) IPV questionnaire was used as the gold standard. In all, 255 combinations of eight different questions were first tested on the Tanzanian study population where sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated. In the evaluation of the performance of the question combinations, different IPV types and the frequency of abusive acts were considered. The question combinations that performed best in Tanzania were subsequently evaluated in the Vietnamese study population.ResultsIn Tanzania, a combination of three selected questions including one question on emotional IPV, one on physical IPV and one on sexual IPV was found to be most effective in identifying women who are exposed to at least one type of IPV during pregnancy (sensitivity = .80; specificity = .74). The performance of the identified combination was slightly less effective in Vietnam (sensitivity = .74; specificity = .68). Focusing on different IPV types, the best performance was found for exposure to physical IPV in both Tanzania (sensitivity = .93; specificity = .70) and Vietnam (sensitivity = .96; specificity = .55). In both countries, the sensitivity increased with the frequency of abuse whereas the specificity decreased.ConclusionBy asking pregnant women three simple questions we were able to identify women who were exposed to IPV during pregnancy in two different countries. The question combination performed best in assessing physical IPV where it identified 93% and 96% of Vietnamese and Tanzanian women, respectively, who were exposed to physical IPV.

Project description:BackgroundIntimate partner violence (IPV) against pregnant women is a recognized global public health problem affecting all spheres of women and unborn infants. In Ethiopia, although inconsistent, individual studies avail; there is a dearth of systematic reviews and meta-analysis about the prevalence and associated factors of intimate partner violence. Thus, the present study was aimed at determining the pooled prevalence of IPV and its determinant factors during pregnancy.MethodsThe report of meta-analysis follows the Preferred Reporting Items for Systematic Review and Meta-Analysis 20 guideline (PRISMA 20). Databases including PubMed/Medline, CINAHL, SCOPUS, HINARI (research4life), AJOL, IRIS, and AIM were searched. Heterogeneity test was assessed by the Cochrane chi-square (χ2) and quantified by I 2 statistics test. Publication bias was tested by funnel plots and Egger's test. Sensitivity test and subgroup analysis were also performed. Effect size was calculated by random effects model.ResultsA total of 26 studies, including data from 13, 912 participants, were included in the analysis. The prevalence of IPV ranged from 7% to 81% with overall estimated pooled prevalence of 37% (30% -44%, I 2 = 96.5%, p ≤ 0.001). Of this, the prevalence of physical, sexual, and psychological violence was 24% (95% CI; 19%-30%), 21% (95% CI; 16%-26%), and 27% (95% CI; 22%-32%), respectively. Factors such as lack of formal education, childhood violence, rural residency, low decision-making power, family history of violence, attitude, unplanned and unwanted pregnancy by women and partners, late initiation of antenatal care, partner alcohol, and khat use were associated with IPV.ConclusionMore than one-third of pregnant women experienced IPV. The most prevalent form of IPV was psychological violence followed by physical and sexual violence. The identified risk for IPV including victim, pregnancy, and perpetrator-related factors indicated the need of a holistic approach in the promotion, prevention, and treatment of IPV. The finding of this study suggests the need of strengthening women empowerments (capacity building) against traditional beliefs, attitudes, and practices. This study also suggests the need of evaluation and strengthening the collaborative work among different sectors such as policy-makers, service providers, administrative personnel, and community leaders, including the engagement of men partners.

Project description:Few studies have used structural equation modeling to analyze the effects of variables on violence against women. The present study analyzed the effects of socioeconomic status and social support on violence against pregnant women who used prenatal services. This was a cross-sectional study based on data from the Brazilian Ribeirão Preto and São Luís birth cohort studies (BRISA). The sample of the municipality of São Luís (Maranhão/Brazil) consisted of 1,446 pregnant women interviewed in 2010 and 2011. In the proposed model, socioeconomic status was the most distal predictor, followed by social support that determined general violence, psychological violence or physical/sexual violence, which were analyzed as latent variables. Violence was measured by the World Health Organization Violence against Women (WHO VAW) instrument. The São Luis model was estimated using structural equation modeling and validated with 1,378 pregnant women from Ribeirão Preto (São Paulo/Brazil). The proposed model showed good fit for general, psychological and physical/sexual violence for the São Luís sample. Socioeconomic status had no effect on general or psychological violence (p>0.05), but pregnant women with lower socioeconomic status reported more episodes of physical/sexual violence (standardized coefficient, SC = -0.136; p = 0.021). This effect of socioeconomic status was indirect and mediated by low social support (SC = -0.075; p<0.001). Low social support was associated with more episodes of general, psychological and physical/sexual violence (p<0.001). General and psychological violence indistinctly affected pregnant women of different socioeconomic status. Physical/sexual violence was more common for pregnant women with lower socioeconomic status and lower social support. Better social support contributed to reduction of all types of violence. Results were nearly the same for the validation sample of Ribeirão Preto except that SES was not associated with physical/sexual violence.

Dataset Information

Confirmatory factor analysis of the WHO Violence Against Women instrument in pregnant women: results from the BRISA prenatal cohort.

Background

Methods

Results

Conclusions

Publications

Confirmatory factor analysis of the WHO Violence Against Women instrument in pregnant women: results from the BRISA prenatal cohort.

Similar Datasets

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