Effect of face-to-face interview versus computer-assisted self-interview on disclosure of intimate partner violence among African American women in WIC clinics Público

Abstract

Background : African American women in the United States report intimate partner violence (IPV) more often than the general population of women. Still, women often under-report IPV because of shame, embarrassment, fear of retribution, or low expectation of legal support. African American women may be especially unlikely to report IPV because of poverty, low social support, and past experiences of discrimination. Purpose: To determine the context in which low-income African American women disclose IPV. Methods: Consenting African American women receiving Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) services in WIC clinics were randomized to complete an IPV screening (Revised Conflict Tactics Scales, Short-Form) via computer-assisted self-interview (CASI) or face-to-face interview (FTFI). Results: Women (n=368) reported high rates of lifetime and prior year verbal (48%, 34%), physical (12%, 7%), sexual (10%, 7%), and any (49%, 36%) IPV, as well as IPV-related injury (13%, 7%). Mode of screening, but not interviewer race, affected disclosure. Women screened via FTFI reported significantly more lifetime and prior-year negotiation (aOR: 10.54, 3.97) and more prior-year verbal (aOR: 2.10), sexual (aOR: 4.31), and any (aOR: 2.02) IPV than CASI- screened women. Discussion: African American women in a WIC setting disclosed IPV more often in face-to-face than computer screening, and race-matching of client and interviewer did not affect disclosure. Findings highlight the potential value of face-to-face screening to identify women at risk of IPV. Programs should weigh the costs and benefits of training staff versus using computer-based technologies to screen for IPV in WIC settings. Keywords : African American women, Intimate Partner Violence, Screening, Response Effects.

Table of Contents

Chapter 1: Introduction..................................................................................1
Context .........................................................................................................1
Problem Statement ..........................................................................................3
Purpose of the Project .....................................................................................4
Background ....................................................................................................5
IPV in the United States ...................................................................................5
Health Consequences of IPV ..............................................................................6
IPV Disclosure .................................................................................................7
Interviewer-Client Race-Matching .......................................................................8
Computer-Assisted Self-Interview .......................................................................9

Significance ...................................................................................................10
Chapter 3: Manuscript ...................................................................................12
Contribution of the Student ..............................................................................13
Abstract .......................................................................................................14
Introduction ...................................................................................................15
Methods ........................................................................................................19
Study Design ..................................................................................................19
Setting ..........................................................................................................19
Sample Inclusion and Exclusion Criteria and Power ................................................20
Data Collection ...............................................................................................20
Instruments ..................................................................................................21
Variables ......................................................................................................22
Data Analysis ................................................................................................23
Results .........................................................................................................24
Exposure Variables .........................................................................................24
Characteristics of the Sample ..........................................................................25
Rates of IPV Disclosure by Race of Interviewer and Mode of Interview ....................25
Logistic Regression Models ...............................................................................26
Discussion ....................................................................................................27
Limitations ...................................................................................................30
Conclusions ..................................................................................................31
References ...................................................................................................32
Tables and Figures .........................................................................................37
Table 1.1. Characteristics of the Sample, Overall and by Interviewer Race and Mode

of Interview ...................................................................................................37
Table 1.2. Distribution of Self-Reported Intimate Partner Violence, by Interviewer

Race and Mode of Interview ..............................................................................37
Table 1.3. Unadjusted and Adjusted Odds Ratios (95% Confidence Intervals) of

Reporting IPV by Type, by Interviewer Race and Mode of Interview .........................38
Chapter 4: Conclusions and Recommendations ...............................................39
References ..................................................................................................42

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Palavra-chave	Intimate Partner Violence Response Effects African American women Screening
Committee Chair / Thesis Advisor	Yount, Kathryn, Emory University
Committee Members	VanderEnde, Kristin E, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs Georgia state or local health department

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