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Intimate Partner Violence Among Low-Income Pregnant Women: Multilevel Analysis

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Intimate partner violence (IPV) during pregnancy is a serious public health issue. The field of IPV is dominated by seondary and tertiatry prevention tailored to victims. IPV in the transition to parenthood warrants special attention on risk assessment and primary prevention from an ecological perspective and an approach directed at the potential perpetrators. Most recent contextual studies, however, have focused on IPV in women in general; less than half of these studies used mutli-level analysis, most were small in size (ranged from 157 cases locally to 1,440 couples nationally), and most mainly relied on police crime reports or national surveys, which are prone to selection and reporting bias. Studies on pregnant women mainly focused on individual victim risk factors. Purpose of the research: The Objectives of this secondary data analysis is to focus on the male, and to use an ecological perspective and multi-level analysis to investigate the impact of multiple social contexts (neighborhood & family) on (physical) IPV during pregnancy. Prenatal care visit data is used because of its potentially practical strength as a window of opportunity within health care systems to catch the full spectrum of violence profiles in a population. The Study Aims include testing hypoteses designed to examine whether & how: 1) individual and family factors are associated with the women's experience of IPV during pregnancy; 2) neighborhood-level risk factors are associated with IPV; and, 3) individual, family, and neighborhood level factors jointly influence the risk of IPV and ascertain cross-level main and interactive effects. Methods: The proposed study will analyze neighborhood data from the 2000 Census and local Sheriff and Police 1997-2001 crime reports. The individual and family level data is from face-to-face interviews conducted during the Rural Perinatal Emphasis Research Center project at the University of Alabama at Birmingham in 1997-2001. It included a sample of 3,032 (82.9% African American) low-income women in prenatal care visits in 4 county health departments in Birmingham. The neighborhood is defined as a census tract. The geocoding rate is 98.3%; one third of the current sample size could achieve at least 80% power. It will incorporate a multi-level (two-level) analysis (e.g., SAS GLIMMIX macro) to obtain precise and robust estimates. Implications for Prevention: This study will contribute to existing knowledge on IPV by examining a city sample of low-income, pregnant women in the Southeast. Findings from this study will shed light on the role of environmental factors in IPV. These data can be used in the development of social policies and health promotion interventions to reduce IPV during pregnancy. This study facilitates the involvement of professionals from clinical services, psychology, public health, criminal justice, sociology and law enforcement agencies as community partners in the long term research agenda focused on the prevention of IPV in Birmingham.
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