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Conflict and Health volume 13Article : 6 Cite this article. Metrics details. Gender-based violence GBV primary prevention programs seek to facilitate change by addressing the underlying causes and drivers of violence against women and girls at a population level. Social norms are contextually and socially derived collective expectations of appropriate behaviors. To evaluate the impact of GBV prevention programs, our team sought to develop a brief, valid, and reliable measure to examine change over time in harmful social norms and personal beliefs that maintain and tolerate sexual violence and other forms of GBV against women and girls in low resource and complex humanitarian settings.

The development and testing of the scale was conducted in two phases: 1 formative phase of qualitative inquiry to identify social norms and personal beliefs that sustain and justify GBV perpetration against women and girls; and 2 testing phase using quantitative methods to conduct a psychometric evaluation of the new scale in targeted areas of Somalia and South Sudan. The psychometric properties of the item scale are strong. This will allow us to further validate the scale by triangulating its findings with GBV experiences and perpetration and assess its generalizability across diverse settings.

Gender-based violence GBV remains one of the most prevalent and persistent issues facing women and girls globally [ 1234 ]. Conflict and other humanitarian emergencies place women and girls at increased risk of many forms of GBV [ 567 ]. It includes acts that inflict physical, sexual or mental harm or suffering, threats of such acts, coercion, and other deprivations of liberty.

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These harmful acts can occur in public and in private [ 8 ]. There continues to be limited global information on the burden of GBV in humanitarian emergencies. The study found that among women, Women survivors of GBV consistently report negative impacts on physical, mental and reproductive health. Often negative health and social consequences are never addressed because women do not disclose GBV to providers or access health care or other services e. GBV primary prevention programs seek to facilitate change by addressing the underlying causes and drivers of GBV at a population level.

Increasingly, programs are also targeting transformation of social norms that justify and sustain acceptance of GBV. Social norms are contextually and socially derived collective expectations of appropriate behaviors [ 14 ]. Families and communities have shared beliefs and unspoken rules that both proscribe and prescribe behaviors that implicitly convey that GBV against women is acceptable, even normal [ 1516 ].

Diverse academic disciplines have developed different theories to explain the complexity of social norms and their influence on behavior. We use social norms theory as elaborated in social psychology [ 17 ]. For this study, we focus on developing a measure of injunctive norms—defined in this case as beliefs about what influential others e. Even with the multiple challenges of humanitarian settings e.

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In such settings, displacement and conflict have created situations where social rules about who can do what necessarily bend to accommodate new realities [ 16 ]. Women, for example, may be forced to assume new roles in the family and community, such as having decision-making power and control over household financial resources and assets and working outside the home to help support the family.

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These circumstances can provide an opportunity to initiate GBV primary prevention efforts, such as those that engage community leaders and members in critical reflection on norms that legitimate gender inequality and what actions can be taken by the individual, family, and community to change norms that cause harm [ 1516 ].

The description of the Communities Care program is published elsewhere [ 151621 ]. However, a ificant limitation for evaluating the effectiveness of GBV prevention programs such as Communities Care is the lack of validated instruments to measure change in norms supporting GBV.

Therefore, our goal was to create a brief, valid, and reliable measure to examine change over time in harmful social norms and personal beliefs that maintain and tolerate sexual violence and other forms of GBV in low resource and complex humanitarian settings. While validated instruments exist to measure attitudes towards gender roles and some types of GBV [ 2223 ], social norms are different from individual attitudes.

For nearly two decades, the Demographic and Health Surveys DHSwhich are nationally representative surveys conducted in low and middle-income countries LMIChave provided information on attitudes about the acceptability of IPV or wife beating. Scientists have also warned that changing key features of a scenario e. For example, in Uganda, researchers randomly ased participants to answer attitude and norm questions on wife beating using three separate wordings [ 26 ].

To elicit norms related to wife beating, participants were asked about the extent to which they thought other people in their village reference group would think the behavior described was justified. The study authors interpreted this difference as measurement error, arguing that question wordings without context may mis-represent attitudes and norms on violence. While context does matter, the specific details added in this study were likely critical to its findings.

The Scale is deed to measure change over time in harmful social norms and personal beliefs associated with violence against women and girls among men and women community members in low resource and complex humanitarian settings.

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The development and validation of the scale was essential for use in measuring change in harmful social norms and beliefs among community members in districts and regions implementing the Communities Care program in two countries with ongoing humanitarian crises, Somalia and South Sudan. The development and testing of the scale was conducted in two phases: 1 formative phase of qualitative inquiry to identify social norms and personal beliefs that sustain and justify GBV perpetration against women and girls across the lifespan Teens looking for sex Teven would like a womans opinion low-resource and humanitarian contexts; and 2 testing phase using quantitative methods to conduct a psychometric evaluation of the new scale in targeted areas of Somalia and South Sudan.

The formative and testing phases of the psychometric evaluation was conducted in two countries, Somalia and South Sudan. Somalia has experienced more than two decades of conflict as well as ongoing emergencies including drought, famine, and a large of internally displaced people IDPs.

Since many people stayed in Yei upon returning, there is conflict between those native to Yei and IDPs from other regions of South Sudan. Militia activity, cattle-raiding, and conflict over oil, along with the influx of people returning to South Sudan, has caused ificant challenges for access to and use of limited resources.

The districts and regions in each country were selected based on multiple factors. We focused efforts on districts and regions where GBV reporting systems existed and could be accessed to generate data on case reports and referrals. When engaging GBV survivors and other community members in research on sensitive issues it is essential to have partnerships with diverse service sectors e. The evaluation also required safe access to the sites and security while doing the study for both participants and local researchers, therefore this required establishing relationships and obtaining permission from national, regional, and district governmental authorities and ministries as well as traditional leaders in the communities.

For the formative phase, we worked with local partners to identify male and female key stakeholders e. The focus group guide was developed and translated to the local language in partnership with team members in each setting. The focus group guide focused on identification of social norms that protect women and girls from sexual violence and other forms of GBV, norms that are harmful e. For example, the team used scenarios created from aggregating GBV experiences in each setting to explore social norms about the situations and the survivor-perpetrator relationship.

We varied the perpetrator and circumstances in each scenario from the perpetrator being a family member, a known person to the family but not part of the family, and an unknown person. For each scenario, focus group participants were asked about their beliefs and norms about how the family and community would respond to victims of the sexual assault or other forms of GBV, if the assault would be reported to authorities, and reasons for reporting or not reporting the assault.

A qualitative descriptive approach was used to identify themes related to harmful and protective social norms within and across settings. The transcripts were read by three research team members to identify thematic codes.

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Themes with sub-themes were identified and defined by exemplars or quotes from the transcripts. The three researchers independently ased codes and discrepancies in coding were discussed in weekly meetings. The codes and corresponding quotes were used to write items for the scale representing each of the identified themes. The relevance of the themes and their interpretation for each context was discussed leading to a refinement of the items. Meeting participants from each country rated the importance of each item and offered suggestions on wording of the items to ensure they were capturing the relevant aspects of the different contexts and cultures.

A total of 42 focus groups 22 in Somalia and 20 in South Sudan with a total of participants in Somalia and in South Sudan were conducted. The composition of the focus groups varied by stakeholders e. Mothers, fathers, parents, community and religious leaders, and male relatives were seen as people that influenced behavior and protected women and girls from GBV.

Items for the new scale were written for each of the themes and sub-themes relevant to harmful social norms and after elimination of redundant items, 30 items remained and were presented to the in-country teams. After discussion about the focus group themes and the items with the in-country teams, a total of 18 items remained. The team then collaborated to develop introductory statements and response scales for each of two domains of the scale, personal beliefs and injunctive social norms.

The final scale to be tested in the evaluation phase had two sets of the 18 items, one for each domain. As suggested by the in-country teams, male RAs recruited and interviewed male community members and female RAs recruited and interviewed female community members. Each RA recruited participants across age groups. The RA started from a central point determined by the research coordinator each morning.

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Only one eligible household member completed the scale. RAs received detailed training on protocols for maintaining participant confidentiality and safety as well as protocols deed to ensure safety and security for the team members. If that person met the eligibility criteria and agreed to participate, the RA worked with the participant to find a private and comfortable place to provide informed consent and administer the scale.

The RA provided each potential participant with informed consent information using the script provided on the study tablet and approved by the in-country team and the Johns Hopkins Medical Institution Institutional Review Board IRB. If the eligible participant provided verbal consent the RA continued and administered the scale with brief demographic questions, including marital status, employment, and children in the household.

The responses were entered by the RA directly on the tablet. Once finished, the RA thanked the participant for their time and answered any questions prior to moving on. The 18 items generated from the formative phase were asked in two sets to capture the two domains, personal beliefs and injunctive norms. The scale was translated into Somali and the translation was reviewed by the Somalia team and revised before it was programmed into the study tablet.

As these are not commonly written languages in South Sudan, the team preferred using the English version of the scale programmed on the tablet and translated into the local language at time of administration. The South Sudan team training included discussions and decisions on correct translation of items in the two languages and then the team practiced administering with volunteers not participating in the study to ensure consistency in real-time translation across RAs and sites. For each of the two domains of the scale, we examined construct validity with factor analysis using the common factor model with oblique rotation.

Factor loadings of. Items that did not load on any factor were considered for revision or elimination from the scale. Known groups validity was examined by testing two a priori hypotheses: H 1 : The sites Somalia, Yei, South Sudan, and Warrup, South Sudan differ on social norms and personal beliefs due to differences in the extent of GBV programming within the districts of Mogadishu and regions of South Sudan; and H 2 : Men and women participants will differ on social norms and personal beliefs related to GBV.

The first hypothesis was tested with analysis of variance and the second with t-tests. The sampling frame was successfully implemented by the research team with The lack of older community members could be related to deaths in the Second Civil War from to Over half Table 1 summarizes the characteristics of the participants by country and site. There were 3 of the 18 items on the injunctive social norms scales that did not load on any factor and were thus removed from the scale.

Teens looking for sex Teven would like a womans opinion

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