Preventing violence against women in high-prevalence settings: A multidisciplinary approach from psychology, political science and global health

According to the World Health Organisation (WHO, 2013), violence against women (VAW) is a pandemic in many parts of the world with severe implications for women's physical and mental health. In the world's highest prevalence settings, eight out of ten women will experience physical or sexual violence from an intimate partner or stranger in their lifetime (WHO 2005, 2013). This is an enormous health and human rights issue, and yet we know very little about how it should be addressed. The proposed research programme draws on my specialisation in preventing violence against women for the highest prevalence settings, developed through over 30 peer-reviewed publications and increasingly large grants for projects in Afghanistan, Iraq, Rwanda, and the Amazon. High prevalence settings (where over 50% of women experience violence) present unique challenges for violence prevention: violence is widely accepted as normal by both men and women (Tran et al. 2016), those seeking help frequently experience stigma, discrimination, and further violence from family, community members, police and health professionals (Odero et al. 2014), and evidence of health system responses to VAW are largely non-existent (Garcia-Moreno et al., 2015). This research programme works in partnership with indigenous communities in Samoa and Peru to build an evidence base for how to prevent violence in high prevalence settings. Through well-established partnerships with local organisations, I will work with community members, leaders and local representatives in both settings to adapt innovative tools for measuring violence against women and establish ethical guidelines for how to research violence appropriately and sensitively. I will then create a theory of change for how to engage high-prevalence communities in reducing violence against women. These initial stages of the research culminate in the co-creation of an intervention to prevent violence against women in partnership with local communities that draws on the theory of change and ethical guidelines, followed by testing the effectiveness of the intervention using the highest standards of evaluation methodologies so that the intervention can potentially be rolled out in other high-prevalence communities around the world. This is a truly multidisciplinary project that requires an integration of skills and methods from across psychology, political science and global health epidemiology to be effective. To achieve this, I will draw on my unique background in the sociology of gender (PhD), community psychology (MSc, post-doc), and humanities (BA), and complement this with mentoring from the world's leading experts in process tracing methods from political science (Prof Jeremy Shiffman, JHU), VAW prevention interventions (Prof David Osrin, UCL), and the evaluation of community interventions in global health (Dr Andrew Copas, UCL) alongside training in epidemiology, statistics, and research leadership. Each stage of the research will include a knowledge-exchange activity between Peru and Samoa to build local research capacity and establish connections with scholars working on violence prevention in high-prevalence settings across Asia, South America and in the UK. Knowledge-exchange activities, an international advisory committee and public enagement will provide a means of linking local actors with global organisations I have worked with in the past including the Sexual Violence Research Initiative (SVRI), the South African MRC's Gender and Health Research Unit, UN Women, and the World Bank. In the short-term, the research has the potential to improve women's lives in Samoa and Peru by reducing the violence they experience. For the longer-term future, the development of new tools, theoretical frameworks and an intervention to prevent violence against women in high-prevalence settings has the potential to improve women's lives in similar settings all over the world.

First and foremost, the research will benefit women experiencing violence in high-prevalence settings, with immediate benefits for communities in Samoa and Peru where the study takes place, and longer-term benefits for other high-prevalence communities around the world. The research will be done in partnership with remote indigenous communities experiencing high levels of violence against women (VAW) in both countries. Communities will be directly involved in carrying out the research and working with the research team to design an intervention that is relevant for their local setting. By engaging communities as part of the research process, the final intervention design has the potential to successfully address local sociocultural and political concerns, thus ensuring the long-term sustainability of the intervention for these indigenous communities. The aim is to create an intervention that drastically reduces VAW prevalence, with benefits for the community as a whole and especially for women affected by violence. By reducing violence, women's mental and physical health will also improve, meeting their basic human right to live a life free of suffering and abuse.

Local communities will also benefit economically from the research. Peer researchers from the communities will be extensively trained in data collection techniques and ethics, and paid to collect and analyse qualitative and quantitative data. This will provide alternative job creation for these remote aborginal communities where subsistence farming is currently the primary economic activity. Training local peer researchers to collect and analyse data about their own communities will build research capacity for future research studies in these areas, and provide greater ownership and control of aborginal communities over the collection and utilisation of their personal information for research purposes.

In the longer term, the impacts of the intervention for communities in Samoa and Peru will be extended to other high-prevalence communities around the world by developing a generalisable theory of change for how communities can be engaged to prevent violence in high-prevalence settings, and ethical guidelines that ensure future research on VAW in high-prevalence settings maximises potential gains for local indigenous communities and minimises potential harms. These broader impacts will be achieved through a cross-comparison of the data arising from the two research sites combined with a secondary data analysis of data from the Fellow's previous projects in other high-prevalence settings, including Afghanistan, Kashmir, and the Peruvian Amazon. The analysis of multiple datasets from different settings will help ensure generalisability of the results of the project to other similar settings around the world.