10/29/2014. The Role of Economic Factors and Economic Support in Preventing and Escaping From Intimate Partner Violence (IPV)

Transcription

1 The Role of Economic Factors and Economic Support in Preventing and Escaping From Intimate Partner Violence (IPV) Jennifer L Matjasko, Ph.D. Behavioral Scientist Centers for Disease Control and Prevention OPRE Webinar October 29 th, 2014 Disclaimer, disclosure, acknowledgements q The findings and conclusions in this presentation are those of the author and do not necessarily represent the official position of the Centers for Disease Control and Prevention q The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: No relationships to disclose q Many thanks to my CDC colleagues at the Division of Violence Prevention: Phyllis Holditch Niolon and Linda Anne Valle* Matjasko, J. L., Niolon, P. H., & Valle, L. A. (2013). The role of economic factors and economic support in preventing and escaping from intimate partner violence. Journal of Policy Analysis and Management, 32, Overview q IPV Typologies q Risk and protective factors for IPV by Typology (highlighting role of economic factors) q Evidence base for IPV prevention programs and policies q The role of economic support in IPV prevention q CDC s Economic Development Initiative q Lingering questions 1

2 10/29/2014 IPV Typologies: The Dynamics of Intimate Partner Violence Power and Control Distinguishes Between Different Types of IPV q Intimate Terrorism High levels of relationship violence Patterns of power and control by one partner Mostly perpetrated by men q Situational Couple Violence Violence typically does not characterize the relationship Neither partner is using coercive or controlling relationship tactics Usually stems from an escalation in a specific conflict Johnson (2008; 2011). Economic Factors and IPV Typologies: Intimate Terrorism 2

3 Economic Factors and IPV Typologies: Situational Couple Violence Financial Stress and Conflict Escalation: Family Stress Model Conger & Conger (2008). q Intimate Terrorism Other Risk Factors q Situational Couple Violence à Implication: Both typologies carry serious risks for injury and require a public health approach to address all forms of IPV PUBLIC HEALTH APPROACH TO ADDRESS IPV 3

4 A Public Health Approach to IPV q Focus is on prevention q Comprehensive Focused on reducing risk, strengthening protective factors Multisector approach q Prevention strategies based on strong evidence q Apply science to reduce IPV-related injury and mortality 4

5 THE STATE OF THE EVIDENCE FOR IPV PREVENTION 5

6 The State of the Evidence for IPV Programs and Policies q Dyadic Interventions E.g., PREP q IPV Screening E.g., screening in healthcare settings q Coordinated Community Response (CCR) q Mandated programs for male batterers E.g., Domestic Abuse Intervention Project (i.e., Duluth Model) The Potential Role for Economic Support in IPV Prevention Frieden (2010). State of the Evidence: Economic Support and IPV Prevention q Economic Programs and Policies and IPV Research TANF Sanctions and Time Limits Unemployment Benefits, etc. q LIMITED Evidence q Microfinance Programs: Rigorous evidence of effectiveness Example: Grameen Bank, created in Bangladesh in 1976 by Nobel Peace Prize Winner Muhammad Yunus The practice of providing financial resources to individuals in order to build capital (e.g., small loans for entrepreneurship activities, individual development accounts, microcredit) 6

7 Microfinance and Health Rosenberg et al 2011 Sherman et al, 2006 Ashburn et al, 2008 Schuler et Sherman et al, 1997 al, 2010 Odek et al, 2009 Dunbar et al, 2010 Pronyk et al, 2008 CDC Efforts in Addressing Economic Factors q Economic Development Initiative (EDI), a crosscutting, cross-division collaboration Division of Violence Prevention Division of HIV/AIDS Prevention Division of STD Prevention Division of Diabetes Translation Key Intervention Development Activities Four groups informed several components of the intervention development process: Core Study Group (Seven experts in MF research and intervention development, IPV research, HIV research, community expert) National Consultation Meeting (A larger body of national experts) Local Advisory Groups (based in 3 geographically diverse urban areas with relatively high HIV/STD rates: Oakland, CA; New Orleans, LA; Washington, DC) Literature Reviews (Extensive reviews) Key products that will be informed by all four groups: Theory of Change/Logic Model Development Intervention Manual 7

8 Key Themes from Experts and Community Stakeholders 1) Addressing social determinants of health is critical and needed 2) Requires a needed collaboration between the health and financial sectors There are existing organizations that are ready to implement the MF Intervention (e.g., health clinic in DC) 3) The need to address racism within the intervention 4) Build in safety planning/resources for those who may be experiencing IT or SCV 5) Foster community trust Figure 1: Theory of Change 12 to 18 months 12 to 24 months 24 to 60 months Individual Components Short- term Outcomes Intermediate Outcomes Long- term Outcomes Education, Training and Tools and Resources Knowledge and Skills Financial Status Individual Impact Overall Impact Basic Business Education Decrease in Material Financial Financial Education & * There is specific content about racism and discrimination in this component Intro Training on Business Development Personal Effectiveness Access to Business Development and Financial Tools Case Management and Support Services Knowledge of skills required for business development Ability to assess self- employment and business options Financial Capability Skills Ability to construct and follow a household budget Ability to track spending Planning ahead and saving for the future Understanding and using/managing financial/banking products Gaining and exercising financial knowledge Personal Effectiveness Skills Better time management Expansion of networks Improved relationships Solving problems and Growth and/or Survival Initiated/Increased Savings Built, Improved, and/or Repaired Credit Social Support for Hardship Positive coping strategies Financial Self- Efficacy Future Orientation and Hopefulness or Optimism Peer Norms for Financial Well- being Cultural Pride and Civic Engagement Locus of Control Healthier Communication Behaviors Control Increased Income and Net Assets Decreased material hardship and economic stress Decreased Risky Sexual Behaviors Increased Skills in Intimacy Negotiation Gender Equity / Partner Financial Stability and Well- being HIV/STD Risk Reduction Intimate Partner Violence Risk Reduction Maintenance of Healthy Peer, Intimate, and Family Relationships thinking critically Financial Control Relationship Short and long- term planning Relationship Power Quality Making decisions about the future Communicating effectively Increased Mental Health Challenging Gender Norms Knowledge of stress management techniques decreased Structural Outcomes: Collaboration and integration across health and economic sectors Indicates outcomes that are hypothesized to overlap with and reinforce HIV/IPV health behavior change mediators. Figure 1: Theory of Change 12 to 18 months 12 to 24 months 24 to 60 months Individual Components Short- term Outcomes Intermediate Outcomes Long- term Outcomes Education, Training and Tools and Resources Knowledge and Skills Financial Status Individual Impact Overall Impact Basic Business Education Decrease in Material Financial Financial Education & * There is specific content about racism and discrimination in this component Intro Training on Business Development Personal Effectiveness Access to Business Development and Financial Tools Case Management and Support Services Knowledge of skills required for business development Ability to assess self- employment and business options Financial Capability Skills Ability to construct and follow a household budget Ability to track spending Planning ahead and saving for the future Understanding and using/managing financial/banking products Gaining and exercising financial knowledge Personal Effectiveness Skills Better time management Expansion of networks Improved relationships Solving problems and Growth and/or Survival Initiated/Increased Savings Built, Improved, and/or Repaired Credit Social Support for Hardship Positive coping strategies Financial Self- Efficacy Future Orientation and Hopefulness or Optimism Peer Norms for Financial Well- being Cultural Pride and Civic Engagement Locus of Control Healthier Communication Behaviors Control Increased Income and Net Assets Decreased material hardship and economic stress Decreased Risky Sexual Behaviors Increased Skills in Intimacy Negotiation Gender Equity / Partner Financial Stability and Well- being HIV/STD Risk Reduction Intimate Partner Violence Risk Reduction Maintenance of Healthy Peer, Intimate, and Family Relationships thinking critically Financial Control Relationship Short and long- term planning Relationship Power Quality Making decisions about the future Communicating effectively Increased Mental Health Challenging Gender Norms Knowledge of stress management techniques decreased Structural Outcomes: Collaboration and integration across health and economic sectors Indicates outcomes that are hypothesized to overlap with and reinforce HIV/IPV health behavior change mediators. 8

9 CDC s Microfinance Intervention (Beta Version) Future Directions: CDC s Economic Development Initiative Continue to build and strengthen partnerships inside and outside of the CDC Refine curriculum/components testing Individual-level implementation and randomized evaluation of the MF intervention Community-level evaluation of the MF intervention Future Directions: CDC s Economic Development Initiative Continue to build and strengthen partnerships inside and outside of the CDC Refine curriculum/components testing Individual-level implementation and randomized evaluation of the MF intervention Community-level evaluation of the MF intervention 9

10 Lingering questions for the field q Replicate/confirm IPV Typologies q The evidence for economic support and IPV prevention is promising but needs to be tested q Build and understand the evidence base for IPV prevention accounting for typologies Thank you! Questions? jmatjasko@cdc.gov For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA Telephone, CDC-INFO ( )/TTY: cdcinfo@cdc.gov Web: 10