Efficient and coordinated health care responses to intimate partner violence (IPV) are essential, given that health care settings are a major entry point for abused women who seek professional services. However, there is a lack of evidence on how IPV referrals are effectively made within health care settings. In order to help program planners and providers across sectors to address the complex and chronic issue of IPV, a greater understanding of the post-IPV identification referral process is essential. A scoping review of the evidence on IPV referral programs and processes in health care settings was undertaken to provide an overview of the state of evidence and identify pertinent gaps in existing research. The scoping review identified 13 evaluative studies and 6 qualitative, primarily nonevaluative studies that examined IPV referral programs and processes. Evaluative studies involved a variety of designs and IPV referral outcomes. Rich descriptions of barriers and facilitators to seeking referrals by victims and making referrals by health care providers emerged from the evaluative and qualitative studies, but were explored more in depth in the qualitative studies. This scoping review provides guidance on what is currently known about IPV referral programs in health care settings and provides a starting point for further research on effectiveness of referral processes.
Intimate partner violence (IPV) is a growing public health problem, and gaps exist in knowledge with respect to appropriate prevention and treatment strategies. A growing body of research evidence suggests that beyond individual factors (e.g., socio-economic status, psychological processes, substance abuse problems), neighborhood characteristics, such as neighborhood economic disadvantage, high crime rates, high unemployment and social disorder, are associated with increased risk for IPV. However, existing research in this area has focused primarily on risk factors inherent in neighborhoods, and has failed to adequately examine resources within social networks and neighborhoods that may buffer or prevent the occurrence of IPV. This study examines the effects of neighborhood characteristics, such as economic disadvantage and disorder, and individual and neighborhood resources, such as social capital, on IPV among a representative sample of 2412 residents of Toronto, Ontario, Canada. Using a population based sample of 2412 randomly selected Toronto adults with comprehensive neighborhood level data on a broad set of characteristics, we conducted multi-level modeling to examine the effects of individual- and neighborhood-level effects on IPV outcomes. We also examined protective factors through a comprehensive operationalization of the concept of social capital, involving neighborhood collective efficacy, community group participation, social network structure and social support. Findings show that residents who were involved in one or more community groups in the last 12 months and had high perceived neighborhood problems were more likely to have experienced physical IPV. Residents who had high perceived social support and low perceived neighborhood problems were less likely to experience non-physical IPV. These relationships did not differ by neighborhood income or gender. Findings suggest interesting contextual effects of social capital on IPV. Consistent with previous research, higher levels of perceived neighborhood problems can reflect disadvantaged environments that are more challenged in promoting health and regulating disorder, and can create stressors in which IPV is more likely to occur. Such analyses will be helpful to further understanding of the complex, multi-level pathways related to IPV and to inform the development of effective programs and policies with which to address and prevent this serious public health issue.
There is a paucity of high-quality research in the area of bicycle skills training programmes. Educational and skills training bicycling programmes may increase knowledge of cycling safety, but this does not seem to translate into a decrease in injury rate, or improved bicycle handling ability and attitudes.
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