Volume 24, Issue 2 (Summer 2018)                   IJPCP 2018, 24(2): 124-135 | Back to browse issues page


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Bolhari J, Amiri T, Karimi Keisomi I, Mohseni Kabir M. Domestic Violence Prevention Advocacy Program: A Pilot Study in Tehran Urban Area. IJPCP. 2018; 24 (2) :124-135
URL: http://ijpcp.iums.ac.ir/article-1-2737-en.html
1- Department of Community Psychiatry, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Spiritual Health Research Center, Iran University of Medical Sciences, Tehran, Iran.
2- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran , E-mail: tinaamiri888@gmail.com
3- Research Expert, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran.
4- Department of Health Psychology, Faculty of Psychology, islamic Azad university, karaj, iran
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Extended Abstract
1. Introduction

Domestic violence is recognized as a common and major threat to the health of victims, who in addition to physical problems, can suffer from other aspects of the health [1]. The elimination or limitation of violence requires numerous interventions that are monitored and supported by individuals, communities on the macro and micro policies and culture of the country. In particular, there is an urgent need for the preventive and management chain of violence to engage effectively and simultaneously in all organizations of stakeholders [10]. In Iran, due to the lack of support and system chains, women rarely report domestic violence to judicial systems, and in some cases, the judicial system does not pay close attention to such issues [30]. Deterring spouse and child abuse requires comprehensive and extensive preventive interventions in primary health care in the country, support organizations, NGOs, social security, welfare, judiciary, police, emergency services, community-based organizations, an all-out cooperation and support are required [1, 24]. Since there has been no comprehensive and effective support/protection in the implementation of domestic violence prevention program by the Ministry of Health, this study is conducted in one district of Tehran urban area.
2. Method
This study is a quantitative, qualitative and an experimental study on the implementation of support system in the context to the applied research and the health services system. The study population consisted of some residents from district 9 and the sample included the West Health Center in the West Tehran, the Center for Intervention in the Welfare Organization Crisis, the Social Cultural Part of the Municipality, the Family Court, the Police Station (Police Force), the Association for the Defense of Victims of Violence, the Emergency Center of the country, and most of the units of the West Tehran Health Center. In this catchment area, all married women who were victims of violence as well as supporting services were selected and covered by the advocacy interventions.
The instrument was a questionnaire for monitoring and evaluation, interview, observation, distribution written documents and staff reports. In implementation of this study, the spouse abuse prevention program at Tehran’s West Health Center and its covered population were on pilot study on advocacy and supporting program. The prime stages of the study included: invitation to other agencies Scientific and Work Committee, working with them with an official agreement, education of the risk groups, distribution of educational pamphlets and brochures, screening cases, registration of cases, monthly and annual reports and preparing other help or services like crisis intervention. All data gathered and interventions were approved by the ethical research committee of the University.
3. Results
The quantitative findings from the evaluation of the program showed most satisfactory service delivery in the field of encounter and communication (64%), while quality of presenting services (34%) and quality of support and management (32%) had the lowest rate. Other finding showed few internal and external collaboration, little co-operation for the supporting cases and few domestic violence registrations and reports. Qualitative data showed in many centers that staff was interested and motivated to help the victims and the program and a positive attitude towards the acquisition of the program among managers and professionals. However, the loneliness of the victims, the lack of medical and psychosocial support, the absence of supportive laws, the lack of high-level jurisdiction in the courts, the rules of the judiciary and law enforcement and the vacancy of NGOs and scientific associations are reported in the studied district. There was also lack of lawyers, especially free of charge lawyers who defend the victims, ignoring the opinions of the attorney, witnesses, family and more importantly not interfering with the social workers’ point of view, which was widely seen in the project.
4. Discussion
This study showed that, during the outbreak, implications and new dimensions of domestic violence are reported every day not only in Iran but the world, despite the various efforts that have been made in the past decade to identify and prevent domestic violence in the country, there is no investment and support by individuals, organizations, institutions, planners and managers of the country to find a resolution. The Ministry of Health has succeeded in developing the National Program on Safety and Domestic Violence Prevention and pursuing its gradual implementation in the country which needs a comprehensive and extensive support. This advocacy pilot study showed that the victims of domestic violence, health workers, managers, welfare manpower, emergency services, municipalities, the judiciary and police, while having an interest to participate in the project and support the victims of violence, systematically they do not have a proper co-operation. It is necessary that a national movement, at a macro level should be linked to a supportive program, provided by the national deed.
Ethical Considerations
Compliance with ethical guideline

According to the ethics committee of Iran University of Medical Sciences, interviews with individuals could be made if they were satisfied. Participants could withdraw from the research if they did not want it. The cases in which the participants name  was registered for referral or training was classified as confidential.
Funding
This study was funded and ordered by the Office of Mental Health and Addiction in Ministry of Health with the support of Iran University of Medical Sciences and Faculty of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry). 
Conflict of interest
The authors declared no conflict of interest.
Acknowledgements
Extensive scientific collaboration of Dr. Mana Tabatabai Rad and Mrs. Maryam Zamani has contributed to the success of this project, which is appreciated.
 
References
  1. Hugl Wajek JA, Cairo D, Shah S, McCreary B. Detection of domestic violence by a domestic violence advocate in the ED. The Journal of Emergency Medicine. 2012; 43(5):860-5. [DOI:10.1016/j.jemermed.2009.07.031] [PMID]
  2. Tjaden PG, Thoennes N. Extent, nature, and consequences of intimate partner violence. National Institute of Justice and the Centers for Disease Control. 2000. [DOI:10.1037/e300342003-001]
  3. Coker AL, Sanderson M, Dong B. Partner violence during pregnancy and risk of adverse pregnancy outcomes. Pediatric and Perinatal Epidemiology. 2004; 18(4):260-9. [DOI:10.1111/j.1365-3016.2004.00569.x] [PMID]
  4. Çaha Ö. Attitudes towards the status of women in Turkish society: The case of Istanbul. European Journal of Economic and Political Studies. 2010; 3(2):145-62.
  5. Walby S, Allen J. Domestic violence, sexual assault and stalking: Findings from the British Crime Survey. London: Home Office; 2004.
  6. Wallach HS, Sela T. The importance of male batters’ attributions in understanding and preventing domestic violence. Journal of Family Violence. 2008; 23(7):655. [DOI:10.1007/s10896-008-9189-0]
  7. Cremers M, Krabel J, Calmbach M, Federal Ministry for Family Affairs, Senior Citizens, Women and Youth. Male educators in Kita: A study on the situation of men in early childhood education. 2010; Berlin: Federal Ministry for Family Affairs, Senior Citizens, Women and Youth.
  8. Faramarzi M, Esmailzadeh S, Mosavi S. Prevalence and determinants of intimate partner violence in Babol City, Islamic Republic of Iran. Eastern Mediterranean Health Journal. 2005; 11(5-6):870-9. [PMID]
  9. Balali Meybodi F, Hassani M. Prevalence of violence against women by their partners in Kerman. Iranian Journal of Psychiatry and Clinical Psychology. 2009; 15(3):300-7.
  10. Ghasemi M. Impact of domestic violence on the psychological wellbeing of children in Iran. Journal of Family Studies. 2009; 15(3):284-95. [DOI:10.5172/jfs.15.3.284]
  11. Ahmadi B, Soleiman E. Effectiveness of health education in intimate partner violence prevention. Social Welfare Quarterly. 2011; 40(11):237-57.
  12. Mehrad BF. Evaluation of national policy about domestic violence against women in Iran. Journal of Educational, Health and Community Psychology. 2014; 3(1):25-31.
  13. Moore AM, Frohwirth L, Miller E. Male reproductive control of women who have experienced intimate partner violence in the United States. Social Science & Medicine. 2010; 70(11):1737-44. [DOI:10.1016/j.socscimed.2010.02.009] [PMID]
  14. Rasoulian M, Habib S, Bolhari J, Hakim Shooshtari M, Nojomi M, Abedi S. Risk factors of domestic violence in Iran. Journal of environmental and public health. 2014; 2014.
  15. UN Division for the Advancement of Women. Violence against women: Good practices in combating and eliminating violence against women; The Austrian model of intervention in domestic violence cases. Vienna: UN Division for the Advancement of Women; 2005.
  16. Ashtiani A. [Women status in Islamic Republic of Iran (Persian)]. Tehran: The Center for Women and Family Affairs; 2008.
  17. L, Riger S, Schewe P, Howard A, Wasco S. Effectiveness of hotline, advocacy, counseling, and shelter services for victims of domestic violence: A statewide evaluation. Journal of Interpersonal Violence. 2004; 19(7):815-29. [DOI:10.1177/0886260504265687] [PMID]
  18. Bowker LH, Maurer L. The effectiveness of counseling services utilized by battered women. Women & Therapy. 1987; 5(4):65-82. [DOI:10.1300/J015V05N04_08]
  19. Campbell R, Baker CK, Mazurek TL. Remaining radical? Organizational predictors of rape crisis centers’ social change initiatives. American Journal of Community Psychology. 1998; 26(3):457-83. [DOI:10.1023/A:1022115322289] [PMID]
  20. Weisz A. Legal advocacy for domestic violence survivors: The power of an informative relationship. Families in Society: The Journal of Contemporary Social Services. 1999; 80(2):138-47. [DOI:10.1606/1044-3894.656]
  21. Tutty LM. Post-shelter services: The efficacy of follow-up programs for abused women. Research on Social Work Practice. 1996; 6(4):425-41. [DOI:10.1177/104973159600600402]
  22. Tutty LM, Bidgood BA, Rothery MA. Support groups for battered women: Research on their efficacy. Journal of Family Violence. 1993; 8(4):325-43. [DOI:10.1007/BF00978097]
  23. Hyman A, Schillinger D, Lo B. Laws mandating reporting of domestic violence: Do they promote patient well-being?. JAMA. 1995; 273(22):1781-7. [DOI:10.1001/jama.1995.03520460063037] [PMID]
  24. Sherman LW, Smith DA, Schmidt JD, Rogan DP. Crime, punishment, and stake in conformity: Legal and informal control of domestic violence. American Sociological Review. 1992; 57(5):680-90. [DOI:10.2307/2095921]
  25. National Research Council. Violence in families: Assessing prevention and treatment programs. Washington, D.C.: National Academies Press; 1998.
  26. Rasulian M, Bolhari J, Nojomi M, Habib S, Mirzaei Khoshalani M. [Theories and interventional models of intimate partner violence: Suggesting an interventional model based on primary health care system in Iran (Persian)]. Iranian Journal of Psychiatry and Clinical Psychology. 2015; 21(1):3-16.
  27. Leye E, Githaiga A, Temmerman M. Health care strategies for combating violence against women in developing countries. Gent: University of Ghent; 1999.
  28. Lee A, Coles J, Lee S, Kulkarni J. Primary healthcare practitioners’ screening practices and attitudes towards women survivors of child abuse. Mental Health in Family Medicine. 2012; 9(3):181. [PMID] [PMCID]
  29. Eckhardt CI, Murphy CM, Whitaker DJ, Sprunger J, Dykstra R, Woodard K. The effectiveness of intervention programs for perpetrators and victims of intimate partner violence. Partner Abuse. 2013; 4(2):196-231. [DOI:10.1891/1946-6560.4.2.196]
  30. Roberts AR. Crisis intervention handbook: Assessment, treatment, and research. Oxford: Oxford University Press; 2005.
  31. Farhi F. Religious intellectuals, the “Woman question,” and the struggle for the creation of a democratic public sphere in Iran. International Journal of Politics, Culture, and Society. 2001; 15(2):315-39. [DOI:10.1023/A:1012929303594]
  32. Bolhari J, Rasulian M, Habib S, Nojomi M, Abedi Sh HS. [Final report of intimate partner violence prevention in primary health care of Iran (Persian)]. Tehran: Tehran Psychiatric Institute in Collaboration with Health and Women’s offices of Ministry of Health; 2011.
  33. Ministry of Health (IR Iran). [Policy paper’s draft on safety and domestic violence prevention in Iran (Persian)]. Tehran: Ministry of Health; 2003.
  34. Bolhari J, Karimikeisami E, Mohsenikabi M, Tabatabairad M, Zamani M. [Final report of domestic violence prevention advocacy program: A pilot program in urban area of Tehran City (Persian)]. Tehran: School of Behavioral Sciences and Mental Health; 2017.
  35. Vakili M, Nadrian H, Fathipoor M, Boniadi F, Morowatisharifabad MA. Prevalence and determinants of intimate partner violence against women in Kazeroon, Islamic Republic of Iran. Violence and Victims. 2010; 25(1):116. [DOI:10.1891/0886-6708.25.1.116] [PMID]
  36. Taherkhani S, Negarandeh R, Simbar M, Ahmadi F. Iranian women’s experiences with intimate partner violence: A qualitative study. Health Promotion Perspectives. 2014; 4(2):230. [PMID] [PMCID]
  37. Kishor S, Johnson K. Profiling domestic violence: A multi-country study. Washington, D.C.: United States Agency for International Development (USAID).2004. [PMID] [PMCID]
  38. Roberts AR. Handbook of domestic violence intervention strategies: Policies, programs, and legal remedies. Oxford: Oxford University Press; 2002.
  39. Abramsky T, Watts CH, Garcia Moreno C, Devries K, Kiss L, Ellsberg M, et al. What factors are associated with recent intimate partner violence? Findings from the WHO multi-country study on women's health and domestic violence. BMC Public Health. 2011; 11(1):109. [DOI:10.1186/1471-2458-11-109] [PMID] [PMCID]
  40. Dasarband B, Panaghi L, Mootabi F. Relationship between spouse abuse and depression in women: The moderating role of personality characteristics. Iranian Journal of Psychiatry and Clinical Psychology. 2017; 23(1):38-49. [DOI: 10.18869/nirp.ijpcp.23.1.38]
Type of Study: Original Research | Subject: Psychiatry and Psychology
Received: 2017/08/9 | Accepted: 2018/01/28 | Published: 2018/07/24

References
1. Hugl Wajek JA, Cairo D, Shah S, McCreary B. Detection of domestic violence by a domestic violence advocate in the ED. The Journal of Emergency Medicine. 2012; 43(5):860-5. [DOI:10.1016/j.jemermed.2009.07.031] [PMID] [DOI:10.1016/j.jemermed.2009.07.031]
2. Tjaden PG, Thoennes N. Extent, nature, and consequences of intimate partner violence. National Institute of Justice and the Centers for Disease Control. 2000. [DOI:10.1037/e300342003-001] [DOI:10.1037/e300342003-001]
3. Coker AL, Sanderson M, Dong B. Partner violence during pregnancy and risk of adverse pregnancy outcomes. Pediatric and Perinatal Epidemiology. 2004; 18(4):260-9. [DOI:10.1111/j.1365-3016.2004.00569.x] [PMID] [DOI:10.1111/j.1365-3016.2004.00569.x]
4. Çaha Ö. Attitudes towards the status of women in Turkish society: The case of Istanbul. European Journal of Economic and Political Studies. 2010; 3(2):145-62.
5. Walby S, Allen J. Domestic violence, sexual assault and stalking: Findings from the British Crime Survey. London: Home Office; 2004.
6. Wallach HS, Sela T. The importance of male batters' attributions in understanding and preventing domestic violence. Journal of Family Violence. 2008; 23(7):655. [DOI:10.1007/s10896-008-9189-0] [DOI:10.1007/s10896-008-9189-0]
7. Cremers M, Krabel J, Calmbach M, Federal Ministry for Family Affairs, Senior Citizens, Women and Youth. Male educators in Kita: A study on the situation of men in early childhood education. 2010; Berlin: Federal Ministry for Family Affairs, Senior Citizens, Women and Youth.
8. Faramarzi M, Esmailzadeh S, Mosavi S. Prevalence and determinants of intimate partner violence in Babol City, Islamic Republic of Iran. Eastern Mediterranean Health Journal. 2005; 11(5-6):870-9. [PMID] [PMID]
9. Balali Meybodi F, Hassani M. Prevalence of violence against women by their partners in Kerman. Iranian Journal of Psychiatry and Clinical Psychology. 2009; 15(3):300-7.
10. Ghasemi M. Impact of domestic violence on the psychological wellbeing of children in Iran. Journal of Family Studies. 2009; 15(3):284-95. [DOI:10.5172/jfs.15.3.284] [DOI:10.5172/jfs.15.3.284]
11. Ahmadi B, Soleiman E. Effectiveness of health education in intimate partner violence prevention. Social Welfare Quarterly. 2011; 40(11):237-57.
12. Mehrad BF. Evaluation of national policy about domestic violence against women in Iran. Journal of Educational, Health and Community Psychology. 2014; 3(1):25-31.
13. Moore AM, Frohwirth L, Miller E. Male reproductive control of women who have experienced intimate partner violence in the United States. Social Science & Medicine. 2010; 70(11):1737-44. [DOI:10.1016/j.socscimed.2010.02.009] [PMID] [DOI:10.1016/j.socscimed.2010.02.009]
14. Rasoulian M, Habib S, Bolhari J, Hakim Shooshtari M, Nojomi M, Abedi S. Risk factors of domestic violence in Iran. Journal of environmental and public health. 2014; 2014.
15. UN Division for the Advancement of Women. Violence against women: Good practices in combating and eliminating violence against women; The Austrian model of intervention in domestic violence cases. Vienna: UN Division for the Advancement of Women; 2005.
16. Ashtiani A. [Women status in Islamic Republic of Iran (Persian)]. Tehran: The Center for Women and Family Affairs; 2008.
17. L, Riger S, Schewe P, Howard A, Wasco S. Effectiveness of hotline, advocacy, counseling, and shelter services for victims of domestic violence: A statewide evaluation. Journal of Interpersonal Violence. 2004; 19(7):815-29. [DOI:10.1177/0886260504265687] [PMID] [DOI:10.1177/0886260504265687]
18. Bowker LH, Maurer L. The effectiveness of counseling services utilized by battered women. Women & Therapy. 1987; 5(4):65-82. [DOI:10.1300/J015V05N04_08] [DOI:10.1300/J015V05N04_08]
19. Campbell R, Baker CK, Mazurek TL. Remaining radical? Organizational predictors of rape crisis centers' social change initiatives. American Journal of Community Psychology. 1998; 26(3):457-83. [DOI:10.1023/A:1022115322289] [PMID] [DOI:10.1023/A:1022115322289]
20. Weisz A. Legal advocacy for domestic violence survivors: The power of an informative relationship. Families in Society: The Journal of Contemporary Social Services. 1999; 80(2):138-47. [DOI:10.1606/1044-3894.656] [DOI:10.1606/1044-3894.656]
21. Tutty LM. Post-shelter services: The efficacy of follow-up programs for abused women. Research on Social Work Practice. 1996; 6(4):425-41. [DOI:10.1177/104973159600600402] [DOI:10.1177/104973159600600402]
22. Tutty LM, Bidgood BA, Rothery MA. Support groups for battered women: Research on their efficacy. Journal of Family Violence. 1993; 8(4):325-43. [DOI:10.1007/BF00978097] [DOI:10.1007/BF00978097]
23. Hyman A, Schillinger D, Lo B. Laws mandating reporting of domestic violence: Do they promote patient well-being?. JAMA. 1995; 273(22):1781-7. [DOI:10.1001/jama.1995.03520460063037] [PMID] [DOI:10.1001/jama.1995.03520460063037]
24. Sherman LW, Smith DA, Schmidt JD, Rogan DP. Crime, punishment, and stake in conformity: Legal and informal control of domestic violence. American Sociological Review. 1992; 57(5):680-90. [DOI:10.2307/2095921] [DOI:10.2307/2095921]
25. National Research Council. Violence in families: Assessing prevention and treatment programs. Washington, D.C.: National Academies Press; 1998.
26. Rasulian M, Bolhari J, Nojomi M, Habib S, Mirzaei Khoshalani M. [Theories and interventional models of intimate partner violence: Suggesting an interventional model based on primary health care system in Iran (Persian)]. Iranian Journal of Psychiatry and Clinical Psychology. 2015; 21(1):3-16.
27. Leye E, Githaiga A, Temmerman M. Health care strategies for combating violence against women in developing countries. Gent: University of Ghent; 1999.
28. Lee A, Coles J, Lee S, Kulkarni J. Primary healthcare practitioners' screening practices and attitudes towards women survivors of child abuse. Mental Health in Family Medicine. 2012; 9(3):181. [PMID] [PMCID] [PMID] [PMCID]
29. Eckhardt CI, Murphy CM, Whitaker DJ, Sprunger J, Dykstra R, Woodard K. The effectiveness of intervention programs for perpetrators and victims of intimate partner violence. Partner Abuse. 2013; 4(2):196-231. [DOI:10.1891/1946-6560.4.2.196] [DOI:10.1891/1946-6560.4.2.196]
30. Roberts AR. Crisis intervention handbook: Assessment, treatment, and research. Oxford: Oxford University Press; 2005.
31. Farhi F. Religious intellectuals, the "Woman question," and the struggle for the creation of a democratic public sphere in Iran. International Journal of Politics, Culture, and Society. 2001; 15(2):315-39. [DOI:10.1023/A:1012929303594] [DOI:10.1023/A:1012929303594]
32. Bolhari J, Rasulian M, Habib S, Nojomi M, Abedi Sh HS. [Final report of intimate partner violence prevention in primary health care of Iran (Persian)]. Tehran: Tehran Psychiatric Institute in Collaboration with Health and Women's offices of Ministry of Health; 2011.
33. Ministry of Health (IR Iran). [Policy paper's draft on safety and domestic violence prevention in Iran (Persian)]. Tehran: Ministry of Health; 2003.
34. Bolhari J, Karimikeisami E, Mohsenikabi M, Tabatabairad M, Zamani M. [Final report of domestic violence prevention advocacy program: A pilot program in urban area of Tehran City (Persian)]. Tehran: School of Behavioral Sciences and Mental Health; 2017.
35. Vakili M, Nadrian H, Fathipoor M, Boniadi F, Morowatisharifabad MA. Prevalence and determinants of intimate partner violence against women in Kazeroon, Islamic Republic of Iran. Violence and Victims. 2010; 25(1):116. [DOI:10.1891/0886-6708.25.1.116] [PMID] [DOI:10.1891/0886-6708.25.1.116]
36. Taherkhani S, Negarandeh R, Simbar M, Ahmadi F. Iranian women's experiences with intimate partner violence: A qualitative study. Health Promotion Perspectives. 2014; 4(2):230. [PMID] [PMCID] [PMID] [PMCID]
37. Kishor S, Johnson K. Profiling domestic violence: A multi-country study. Washington, D.C.: United States Agency for International Development (USAID).2004. [PMID] [PMCID] [PMID] [PMCID]
38. Roberts AR. Handbook of domestic violence intervention strategies: Policies, programs, and legal remedies. Oxford: Oxford University Press; 2002.
39. Abramsky T, Watts CH, Garcia Moreno C, Devries K, Kiss L, Ellsberg M, et al. What factors are associated with recent intimate partner violence? Findings from the WHO multi-country study on women's health and domestic violence. BMC Public Health. 2011; 11(1):109. [DOI:10.1186/1471-2458-11-109] [PMID] [PMCID] [DOI:10.1186/1471-2458-11-109]
40. Dasarband B, Panaghi L, Mootabi F. Relationship between spouse abuse and depression in women: The moderating role of personality characteristics. Iranian Journal of Psychiatry and Clinical Psychology. 2017; 23(1):38-49. [DOI: 10.18869/nirp.ijpcp.23.1.38] [DOI:10.18869/nirp.ijpcp.23.1.38]

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