Empowering Chinese abused women : a community-based participatory approach

Abstract

Intimate partner violence (IPV) against women is a priority global health issue. Apart from the serious negative consequences for women’s health, IPV against women can lead to huge economic and health burdens on the community. In response to these serious health consequences and the high prevalence of IPV against women, interventions have been developed and demonstrated to have positive effects in preventing violence and addressing negative health outcomes. However, those interventions were theory-driven and developed in a top-down way based on an outside-expert approach, without women’s involvement and input. This approach is contrary to the principle of empowerment, which is the key of such interventions. A community-based participatory approach (CBPA) is adopted to empower Chinese abused women is this study. The objectives of this thesis are first to develop a culturally appropriate intervention for Chinese abused women using a CBPA based on such women’s expressed needs and the services and support they require. Through bringing women, professionals and community service providers together, a tripartite collaboration is established with engagement of the actual users throughout the process of development. The second objective is to assess the feasibility, acceptability and usefulness of an intervention developed under CBPA. A qualitative approach with three phases is adopted. Phase 1 was in the form of semi-structured focus group interviews with community-dwelling Chinese abused women in Hong Kong aimed at exploring their views of the services available, as well as their needs and preferences for services and support in response to violent victimisation. Phase 2 involved the use of CBPA to develop a needs-based, culturally appropriate empowerment intervention for women experiencing IPV. Phase 3 involved the implementation of the intervention and the use of semi-structured focus group and individual interviews to assess the feasibility, acceptability and usefulness of the Phase 2 intervention. In Phase 1, 11 abused Chinese women were interviewed in three focus groups. Conventional content analysis revealed that the women had a range of needs, personal, family and social, and their desires for services and support were multi-faceted and diverse. Personal needs were physical, emotional and concerned with parenting. As to family needs, the women were worried about family relationships; while they wanted informal social support on the social network side. The services and support the women wanted included mindfulness activity, relaxation and diversional therapy for stress reduction, whole-family activities (especially outdoors) to enhance family relationships, peer groups for sharing mutual support, and services to connect them to the community resources available. Three themes emerged from the focus group interviews in Phase 1, representing three levels of intervention: individual, family and community. In Phase 2, an integrated multi- component intervention was developed comprising a four-part, women-centred programme, “Women-centred, we are with you”, for Chinese abused women using CBPA. The intervention was based on the above-mentioned three levels, considered by the women to be the best model to address their complex and multi-faceted needs. In Phase 3, the “Women-centred, we are with you” programme was completed in four months, from October 2015 to January 2016. Afterwards, it was evaluated and the women’s experience of participating in CBPA explored; with 11 women interviewed in two focus groups and one as an individual. Conventional content analysis revealed that the women had high levels of satisfaction with the programme, which was well received. It was feasible to conduct the programme; the women showed high adherence, and women benefited from it in their well- being, family relationships and social networks. They gained a sense of achievement and their self-confidence was enhanced through participating in CBPA, which gave them more freedom and a sense of power and control over their own needs. The findings of this study suggest that abused women‘s needs should be assessed before any intervention so that an individualised and tailor-made type can be provided. Also, abused women had multi-faceted needs which should be addressed through multi-component interventions. The CBPA was also found to be a better approach for developing a tailor-made and culturally appropriate intervention for abused women. This is the first study to adopt CBPA in developing an intervention for community-dwelling Chinese abused women in Hong Kong, and there is evidence that participants found it acceptable, useful and feasible.