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The study identifies factors that limit effective institutional responses to domestic violence (DV) in Kyrgyzstan, in the context of recent legislative actions aimed at reducing DV through improvements in law enforcement, judicial processes, and provision of social services. The study uses qualitative, grounded theory methods to analyze interviews and focus groups with 83 professionals working in these sectors. Two major themes emerge from the analysis: (1) barriers to effective institutional responses from internal challenges and constraints, and (2) social resources and challenges identified as important to provide a better collective response. The study highlights the need for capacity development within institutions and broader social learning to overcome existing barriers and better align outcomes with the intentions of recent legislation. Standardized training, awareness-raising, enhanced roles for educators and religious leaders, better coordinated social service provision, rehabilitation for victims and perpetrators, and family-centered school-based interventions are identified as targets for improving responsiveness.

Adolescence is a critical transition period that sets the stage for adulthood and future health outcomes. Marked by key developmental milestones in brain maturation, increasing independence from parents, and greater connections to peers, adolescence is also a time of heightened risk for behavioral health problems, including substance use, violence, delinquency, and mental health issues. High school completion is a significant life course event and a powerful social determinant of health and health disparities. Jessor's Theory of Problem Behavior suggests that adolescent health behaviors and mental health problems are closely tied to poor educational outcomes and peer network formation in a reinforcing feedback loop, or vicious cycle, often leading to school failure, school disengagement, and drop-out. Schools are a novel platform through which vicious cycles can be disrupted and replaced with virtuous ones, simultaneously improving education and health. This article describes the potential for schools to transform health trajectories through interventions creating positive and supportive school climates. In addition, new models such as the Whole School Whole Community Whole Child Model promote whole child well-being, including cognitive, social, emotional, psychological, and physical development. Full-service community schools can serve as a hub coordinating and integrating all available resources to better respond to the needs of children and families. Present in every neighborhood, schools are a way to reach every school-age child and improve their health trajectories, providing an important platform for life course intervention research.

The coronavirus pandemic necessitated rapid shifts in approach for service providers working with survivors of interpersonal violence. To reduce the spread of the virus, providers and agencies implemented a rapid and unplanned expansion of virtual services while also developing new protocols to support safe and socially distant in-person services. To understand how these shifts have impacted victim service professionals and the survivors they serve, to provide guidance for on-going efforts, and to inform planning for future public health emergencies, this study asks the question: What approaches did the interpersonal violence workforce use to address social distancing needs during COVID-19? Semi-structured interviews were conducted from July to December 2020 with 33 interpersonal violence service providers from across the United States, and data were analyzed via conventional content analysis with additional steps for data credibility. Findings fall within two primary categories: 1) Technology and Virtual Service Provision; and 2) Social Distancing for In-person Services. Within each category, a number of themes emerged illustrating strengths and challenges of each approach, and the complex web of technological, safety, and public health considerations being balanced in interpersonal violence service agencies. These results provide guidance for the implementation of virtual services in an on-going manner, as well as underscoring the importance of future planning to facilitate effective in-person but physically distant services. There is also a clear need for agencies to support the interpersonal violence workforce to reduce occupational stress and enhance skills and capacities with new forms of services., Author(s): Rachel J. Voth Schrag [sup.1] , Sarah Leat [sup.2] , Bethany Backes [sup.3] , Saltanat Childress [sup.4] , Leila Wood [sup.5] Author Affiliations: (1) grid.267315.4, 0000 0001 2181 9515, [...]

Although studies have investigated and found an association between victimization and weapon carrying, few studies have examined the association between exposure to neighborhood violence (NV) and gun carrying among adolescents. The objective of this study was to examine the cross-sectional association between exposure to NV and gun carrying among adolescents. Data for this study came from the 2021 Youth Risk Behavior Survey. An analytic sample of 17,033 adolescents aged 14 to 18 years old (51.7% male) was analyzed using logistic regression with complementary log-log link function. The outcome variable investigated in this study is gun carrying and was measured as a binary variable, whereas the main explanatory variable examined in this study was exposure to NV, which was also measured as a binary variable. Of the 17,033 adolescents, 4.2% carried a weapon during the past year, and 18.7% were exposed to NV. Controlling for the effects of other factors, adolescents who were exposed to NV had more than double the odds of carrying a gun when compared to their counterparts not exposed to NV (adjusted odds ratio = 2.33, 95% Confidence Intervals [1.69, 3.23]). Other significant factors associated with gun carrying include being a male, non-Hispanic Black, being threatened or injured with a weapon, use of alcohol, cigarette smoking, and misuse of prescription opioids. High parental monitoring was protective against gun carrying. The findings of this study underscore the importance of developing age-appropriate intervention strategies to reduce gun carrying among adolescents. School counselors and other professionals working with adolescents in disadvantaged neighborhoods should actively engage parents in assessments and interventions. [ABSTRACT FROM AUTHOR]

This study explores mothers' experiences during the COVID-19 pandemic with a focus on stressors, parenting roles, and work expectations. Qualitative analysis of open-ended interviews with a diverse group of 44 mothers in the United States generated two main themes: adjusting parenting roles and career concerns for mothers. Findings reveal that mothers have internalized strong intrafamily expectations to shoulder the primary responsibility for domestic labor and child care in addition to completing their work obligations and experienced institutional gender bias in the expectations that employers have for female employees. The interviews highlight lower expectations for fathers' contributions to parenting under pandemic conditions. Implications for research and policy are discussed with a particular focus on critiquing structures that may perpetuate gender disparities. [ABSTRACT FROM AUTHOR]

The study explores the perspectives of service providers on cultural and social reasons used to justify domestic violence in Kyrgyzstan. Results indicate that cultural norms, notably patriarchal customs, immense pressure put on women to save the marriage, stigma of divorce, low status assigned to women, wide acceptance of violence as natural, and fear of retaliation were major reasons that perpetuated domestic violence. Scholars, policymakers, and service providers must collaborate to actively dispel widely accepted beliefs about gender, marriage, and women's status, and to break the cycle of abuse providing help at the individual and community levels. [ABSTRACT FROM AUTHOR]

Within the healthcare system, identification and intervention for intimate partner violence (IPV) are critical, yet often hindered by siloed operations among healthcare workers. Effective interprofessional collaboration is pivotal for timely and appropriate interventions. This article describes an interprofessional educational simulation involving nursing and social work students. Pairs engaged in risk assessment and safety planning for IPV. In the pilot run with 140 nursing and 137 social work students, post-simulation results increased confidence (t = 5.25, p = .001) and positive evaluation of IPV knowledge (t = 63.22, p = .001). Focus groups underscored team synergy, communication skills, and prior experiences as critical elements. Future projects should expand simulation scopes to address diverse situations and include additional professions interacting with survivors. [ABSTRACT FROM AUTHOR]

Nurses and social workers play pivotal roles in identifying and addressing domestic violence (DV) within healthcare settings, emphasizing the importance of their collaborative efforts. This scoping review investigates the current state of simulation education aimed at equipping nursing and social work students to screen, assess, and intervene in DV cases. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews, our automated database search identifies pertinent evidence. Results categorize articles based on 1) instructional methods and student assessment, 2) challenges faced in DV-focused Interprofessional Education (IPE), and 3) benefits derived from such education. Conclusions underscore the imperative for enhanced IPE opportunities, emphasizing the interdisciplinary collaboration required for effective DV screening, assessment, and management in healthcare settings. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is a public health problem that impacts approximately one in three women worldwide in their lifetime. The purpose of the study was to explore the lived experiences of women teachers and violence in Kenya. It also explores the intersection between intimate partner violence, HIV risk, and gender inequality. Data were collected through two focus groups of a total of 15 women teachers. We recruited women ages 21–44 from two geographically diverse urban and rural schools. The data were analyzed using a thematic analysis method to identify text themes and meaning patterns. Three contextual experiences emerged: socio-cultural influences of gender norms, masculinity and patriarchy; uneven power dynamics; and institutionalized gender inequality. Findings suggest that education alone is not sufficient to end GBV. Comprehensive and gender transformative governmental policy approaches are needed to mitigate GBV in Kenya. [ABSTRACT FROM AUTHOR]

This paper examines limitations in how law enforcement and public health systems respond to domestic violence in Kyrgyzstan. Findings from interviews with domestic violence victims show that these women are subject to ineffectual practices and negative attitudes that tend to minimize domestic abuse and disempower victims. The findings reveal several problematic issues: inconsistencies in the implementation of the law, impunity for abusers because of both personal attitudes and social affinities between the police and abusers, ineffective enforcement of protective orders, and superficial processing of domestic violence cases by the legal system. Additional barriers to help-seeking include a lack of institutional support and guidelines for offering mental health services for victims as well as a scarcity of housing, childcare, and employment opportunities for women seeking to break the cycle of abuse. The findings underscore the need for society-wide changes in attitudes toward domestic violence, stricter mechanisms for enforcing the law, and mandatory training for service providers to facilitate the provision of more accessible and affirmative support to victims., Author(s): Saltanat Childress [sup.1] , Darald Hanusa [sup.2] Author Affiliations: (1) University of Wisconsin-Madison, 0000 0001 2167 3675, grid.14003.36, , 2458 Sewell Social Sciences, 1180 Observatory Drive, WI 53706-1393, Madison, [...]

This qualitative study sought to explore facilitators and barriers to adherence to multiple medications among low-income patients with comorbid chronic physical and mental health conditions. The 50 focus group participants identified personal/contextual and health system factors as major impediments to adherence to multiple medications. These factors included medication side effects, fear of harm from medication, fear of dependence on medication, complex instructions, suboptimal communications with doctor, suspicion about doctors' and pharmaceutical companies' motives in prescribing medication, and the high cost of medications. Participants also identified motivators, both internal (self-initiated) and external (initiated by family, doctor, support groups), to ensure adherence to multiple medications. These motivators included self-discipline, sense of personal responsibility, faith, support from family members and doctors, and focused health education and self-management support. Three themes emerged that enhanced understanding of the complexity of adherence to multiple medications: (1) reaching one's own threshold for medication adherence, (2) lack of shared information and decision making, and (3) taking less than the prescribed medication. Further analysis of the data revealed that the patients perceived a lack of shared decision making in the management of their comorbid chronic conditions and their medication regimen.

This qualitative study sought to explore facilitators and barriers to adherence to multiple medications among low-income patients with comorbid chronic physical and mental health conditions. The 50 focus group participants identified personal/contextual and health system factors as major impediments to adherence to multiple medications. These factors included medication side effects, fear of harm from medication, fear of dependence on medication, complex instructions, suboptimal communications with doctor, suspicion about doctors' and pharmaceutical companies' motives in prescribing medication, and the high cost of medications. Participants also identified motivators, both internal (self-initiated) and external (initiated by family, doctor, support groups), to ensure adherence to multiple medications. These motivators included self-discipline, sense of personal responsibility, faith, support from family members and doctors, and focused health education and self-management support. Three themes emerged that enhanced understanding of the complexity of adherence to multiple medications: (l) reaching one's own threshold for medication adherence, (2) lack of shared information and decision making, and (3) taking less than the prescribed medication. Further analysis of the data revealed that the patients perceived a lack of shared decision making in the management of their comorbid chronic conditions and their medication regimen. KEY WORDS: comorbidity; disease management; focus group; medication adherence or compliance; polypharmacy, Understanding the illness experience from the point of view of patients who have multiple chronic conditions and are managing multiple medications is an area that has had some research attention, [...]

To promote safe and positive health outcomes by utilizing culturally relevant evidence-based interventions for immigrant and refugee women survivors of intimate partner violence, their active participation in research is critical. With 43.6 million immigrants and refugees living in the United States, there is a need for research studies to eliminate health disparities in these populations. However, barriers to recruiting and retaining these populations in research prevent the provision of quality and culturally informed services to meet their needs. The aim of this article is to discuss the recruitment and retention strategies employed and analyze the methodological and ethical challenges in the context of the weWomen Study. The use of a multifaceted approach informed by best practices maximized recruitment efforts and active participation that generated high numbers of immigrant and refugee women participants. The study also substantiated the need for more community-based participatory approaches to engage community members in the development of culturally appropriate approaches that instill a sense of ownership over the research process. Active research participation of immigrant and refugee survivors will help investigators understand their unique needs and facilitate the implementation of targeted evidence-based interventions. [ABSTRACT FROM AUTHOR]

Despite the global nature of domestic violence against women, few studies have examined the phenomenon in Kyrgyzstan. This grounded theory study gives voice to survivors of domestic violence by examining women's experiences of various forms of violence and the complexities surrounding Kyrgyz women's decision making about leaving violent relationships. Findings revealed that survivors move through a three-stage process of leaving: (a) reaching a turning point, (b) implementing the leaving process, and (c) reclaiming self. Participants described "turning points" as critical events or sudden realizations that the violence had become uncontrollable or intolerable, and that the problem was not going to be solved without external support. The turning points fell into four major categories, including epiphanies and moments of truth, losing hope for a change in the abuser's behavior, reaching the point of saturation and giving up, and experiencing fear for the safety of children and protecting self. The main factor that led women to leave was being confronted with the pervasive fear that the abuse would lead to permanent disability or death. In the second stage, the process of leaving was characterized by an iterative cycle of leaving and returning until women were able to weigh the costs and benefits of staying and leaving in the face of cultural, institutional, and systemic constraints. The final stage of leaving involved "reclaiming self," which was the result of cognitive shifts, finding new meanings in their experiences of abuse and attempts to leave, and support received from advocates at the shelter. Results have implications for interventions with survivors and policies addressing the problem of domestic violence in Kyrgyzstan. [ABSTRACT FROM AUTHOR]

This article develops a grounded theory of help-seeking to investigate the social and cultural determinants of help-seeking among Kyrgyz women who have experienced domestic violence. Results indicate that cultural traditions and social norms—most notably the social construction of marriage, the shame associated with divorce, and the status of daughters-in-law in Kyrgyz society—are used to justify domestic violence and prevent victims from seeking help. The proposed theory and results suggest that scholars, policymakers, and front-line contacts must emphasize dispelling myths, misconceptions, and traditional beliefs about gender and marriage to break the abusive dynamics and provide professional help. [ABSTRACT FROM AUTHOR]

This paper provides an account of the adverse impacts of domestic violence on women in Kyrgyzstan and develops a grounded theory of coping among survivors of abuse. The results indicate that women adopt a range of strategies to prevent, avert, and minimize anticipated violence. Two key aspects of coping appeared in the narratives: 1) maintaining the status quo and 2) developing agency to resist the abuse. The results suggest that Government and nongovernmental organizations must take additional action to draw women to formal violence prevention services. Providing professional help at several levels (e.g., clinical, community, and societal) and promoting problem-focused strategies as part of therapeutic intervention are essential. [ABSTRACT FROM AUTHOR]