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Study Design Article

Ngutulu Kagwero (agents of change): study design of a participatory comic pilot study on sexual violence prevention and post-rape clinical care with refugee youth in a humanitarian setting in Uganda

Carmen H. Logiea Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada;b Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada;c Centre for Gender and Sexual Health Equity, Vancouver, BC, Canada;d United Nations University Institute for Water, Environment & Health (UNU-INWEH), Hamilton, ON, CanadaCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0002-8035-433XView further author information
ORCID Icon,
Moses Okumue School of Social Work, University of North Carolina Chapel Hill, Chapel Hill, NC, USA;f School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL, USAORCID Iconhttps://orcid.org/0000-0003-2555-3077View further author information
ORCID Icon,
Simon Odong Lukoneg Uganda Refugee and Disaster Management Council, Yumbe, UgandaView further author information
,
Miranda Louteth Dalla Lana School of Public Health, University of Toronto, Toronto, ON, CanadaORCID Iconhttps://orcid.org/0000-0002-6293-3047View further author information
ORCID Icon,
Alyssa McAlpinea Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, CanadaORCID Iconhttps://orcid.org/0000-0003-1591-4107View further author information
ORCID Icon,
Maya Latifa Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, CanadaView further author information
,
Isha Berryh Dalla Lana School of Public Health, University of Toronto, Toronto, ON, CanadaORCID Iconhttps://orcid.org/0000-0003-3138-664XView further author information
ORCID Icon,
Nelson Kisubig Uganda Refugee and Disaster Management Council, Yumbe, UgandaView further author information
,
Simon Mwimaf School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL, USA;i National AIDS Coordinating Program, Ugandan Ministry of Health, Kampala, UgandaORCID Iconhttps://orcid.org/0000-0003-2745-2026View further author information
ORCID Icon,
Peter Kyambaddei National AIDS Coordinating Program, Ugandan Ministry of Health, Kampala, Uganda;j Most at Risk Population Initiative (MARPI), Kampala, UgandaORCID Iconhttps://orcid.org/0000-0002-9606-218XView further author information
ORCID Icon,
Stella Neemak Department of Anthropology & Sociology, Makerere University, Kampala, UgandaORCID Iconhttps://orcid.org/0000-0001-8687-1525View further author information
ORCID Icon,
Eusebius Smalll School of Social Work, University of Texas Arlington, Arlington, TX, USAORCID Iconhttps://orcid.org/0000-0001-9027-3632View further author information
ORCID Icon,
Senkosi Moses Balyejjusam Department of Sociology and Social Administration, Kyambogo University, Kampala, UgandaORCID Iconhttps://orcid.org/0000-0001-7121-0855View further author information
ORCID Icon &
Joshua Musinguzii National AIDS Coordinating Program, Ugandan Ministry of Health, Kampala, UgandaView further author information
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Article: 1940763 | Received 17 Dec 2020, Accepted 04 Jun 2021, Published online: 17 Aug 2021

References

  • Inter-Agency Standing Committee. Guidelines for integrating gender-based violence interventions in humanitarian action: reducing risk, promoting resilience and aiding recovery. Geneva: Inter-Agency Standing Committee; 2015.
  • World Health Organization. Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: World Health Organization; 2013.
  • Stark L, Landis D. Violence against children in humanitarian settings: a literature review of population-based approaches. Soc Sci Med. 2016;152:125–12.
  • Vu A, Adam A, Wirtz A, et al. The prevalence of sexual violence among female refugees in complex humanitarian emergencies: a systematic review and meta-analysis. PLoS Curr. 2014;6. DOI:https://doi.org/10.1371/currents.dis.835f10778fd80ae031aac12d3b533ca7.
  • Stark L, Ager A. A systematic review of prevalence studies of gender-based violence in complex emergencies. Trauma Violence Abuse. 2011;12:127–134.
  • Wirtz AL, Pham K, Glass N, et al. Gender-based violence in conflict and displacement: qualitative findings from displaced women in Colombia. Confl Health. 2014;8:1–14.
  • Ward J, Vann B. Gender-based violence in refugee settings. Lancet. 2002;360:s13–s14.
  • Rubenstein BL, Lu LZN, MacFarlane M, et al. Predictors of interpersonal violence in the household in humanitarian settings: a systematic review. Trauma Violence Abuse. 2020;21:31–44.
  • Singh NS, Smith J, Aryasinghe S, et al. Evaluating the effectiveness of sexual and reproductive health services during humanitarian crises: a systematic review. PloS One. 2018;13:e0199300.
  • Singh NS, Aryasinghe S, Smith J, et al. A long way to go: a systematic review to assess the utilisation of sexual and reproductive health services during humanitarian crises. BMJ Glob Health. 2018;3:e000682.
  • Hall KS, Manu A, Morhe E, et al. Stigma and the social environment of adolescent sexual and reproductive health in ghana: understanding “bad girl”. J Adolesc Health. 2016;58:S4.
  • Hokororo A, Kihunrwa AF, Kalluvya S, et al. Barriers to access reproductive health care for pregnant adolescent girls: a qualitative study in Tanzania. Acta paediatrica. 2015;104:1291–1297.
  • Barot S. In a state of crisis: meeting the sexual and reproductive health needs of women in humanitarian situations. Guttmacher Policy Rev. 2017;20:7.
  • Murray SM, Robinette KL, Bolton P, et al. Stigma among survivors of sexual violence in Congo: scale development and psychometrics. J Interpers Violence. 2018;33:491–514.
  • Abrahams N, Jewkes R. Barriers to post exposure prophylaxis (PEP) completion after rape: a South African qualitative study. Cult Health Sex. 2010;12:471–484.
  • Bartels SA, Scott JA, Leaning J, et al. Demographics and care-seeking behaviors of sexual violence survivors in South Kivu province, Democratic Republic of Congo. Disaster Med Public Health Prep. 2012;6:393–401.
  • Starzynski LL, Ullman SE, Filipas HH, et al. Correlates of women’s sexual assault disclosure to informal and formal support sources. Violence Vict. 2005;20:417–432.
  • Muuo S, Muthuri SK, Mutua MK, et al. Barriers and facilitators to care-seeking among survivors of gender-based violence in the Dadaab refugee complex. Sex Reprod Health Matt. 2020;28:1722404.
  • United Nations High Commissioner for Refugees. Consequences of Underfunding in 2020. Geneva: United Nations High Commissioner for Refugees; 2020.
  • Cone D. Exacerbating the other epidemic: how COVID-19 is increasing violence against displaced women and girls. Refugees International. 2020. [cited 2020 Dec 5] Available from: https://www.refugeesinternational.org/reports/2020/7/31/exacerbating-the-other-epidemic-how-covid-19-is-increasing-violence-against-displaced-women-and-girls
  • International Federation of Red Cross and Red Crescent Societies. Prevention and response to sexual and gender-based violence in COVID-10: a protection, gender & inclusion (PGI) technical guidance note. Geneva: International Federation of Red Cross and Red Crescent Societies; 2020.
  • Roesch E, Amin A, Gupta J, et al. Violence against women during covid-19 pandemic restrictions. BMJ. 2020;7:m1712.
  • United Nations Population Fund Arab States Regional Humanitarian Response Hub. COVID-19: reporting on gender-based violence during public health crises: a Companion Guide to A Journalist’s Handbook. New York: United Nations Population Fund; 2020.
  • UNICEF; International Resuce Committee. COVID-19 - GBV risks to adolescent girls and interventions to protect and empower them. Geneva: UNICEF; 2020.
  • Bartels SA, Michael S, Roupetz S, et al. Making sense of child, early and forced marriage among Syrian refugee girls: a mixed methods study in Lebanon. BMJ Glob Health. 2018;3:e000509.
  • Gottschalk N. Uganda: early marriage as a form of sexual violence. Forced Migrat Rev. 2007;27:3.
  • Roupetz S, Garbern S, Michael S, et al. Continuum of sexual and gender-based violence risks among Syrian refugee women and girls in Lebanon. BMC Womens Health. 2020;20:176.
  • United Nations Women. Reforming the laws that forced women to marry their rapists. United Nations. 2019. [cited 2020 Dec 5] Available from: https://www.unwomen.org/en/news/stories/2019/6/feature-story-of-change-reforming-laws-that-forced-women-to-marry-their-rapists
  • McMahon SP, Judy L, Koenick RA. Conceptualizing the engaging bystander approach to sexual violence prevention on college campuses. J Coll Stud Dev. 2011;52:16.
  • Jewkes R, Wilan S, Heise L, et al. Effective design and implementation elements in interventions to prevent violence against women and girls. What works to prevent VAWG? Global programme synthesis product series. Pretoria: South African Medical Research Council; 2020.
  • Foster AM, Evans DP, Garcia M, et al. The 2018 Inter-agency field manual on reproductive health in humanitarian settings: revising the global standards. Reprod Health Matters. 2017;25:18–24.
  • Inter-Agency Working Group on Reproductive Health in Crises. Inter-Agency field manual on reproductive health in humanitarian settings. New York: Inter-Agency Working Group on Reproductive Health in Crises; 2018.
  • Onyango MA, Hixson BL, McNally S. Minimum Initial Service Package (MISP) for reproductive health during emergencies: time for a new paradigm? Glob Public Health. 2013;8:342–356.
  • Green MJ, Myers KR. Graphic medicine: use of comics in medical education and patient care. Bmj. 2010;340. DOI:https://doi.org/10.1136/bmj.c863
  • Vujcich D, Thomas J, Crawford K, et al. Indigenous youth peer-led health promotion in Canada, New Zealand, Australia, and the USA: a systematic review of the approaches, study designs, and effectiveness. Front Public Health. 2018;6:31.
  • Tekle-Haimanot R, Preux PM, Gerard D, et al. Impact of an educational comic book on epilepsy-related knowledge, awareness, and attitudes among school children in Ethiopia. Epilepsy Behav. 2016;61:218–223.
  • Unger JB, Cabassa LJ, Molina GB, et al. Evaluation of a fotonovela to increase depression knowledge and reduce stigma among Hispanic adults. J Immigr Minor Health. 2013;15:398–406.
  • Ashwal G, Thomas A. Are comic books appropriate health education formats to offer adult patients? AMA J Ethics. 2018;20:134–140.
  • Ghose T, Shubert V, Poitevien V, et al. Effectiveness of a viral load suppression intervention for highly vulnerable people living with HIV. AIDS & Behav. 2019;23:10.
  • Chan A, Brown B, Sepulveda E, et al. Evaluation of fotonovela to increase human papillomavirus vaccine knowledge, attitudes, and intentions in a low-income Hispanic community. BMC Res Notes. 2015;8:10.
  • Sanchez KK, Michael O, Eghaneya BH, et al. Culturally adapted depression education and engagement in treatment among Hispanics in primary care: outcomes from a pilot feasibility study. BMC Fam Pract. 2019;20. DOI:https://doi.org/10.1186/s12875-019-1031-7
  • Bosqui T, Mayya A, Younes L, et al. Disseminating evidence-based research on mental health and coping to adolescents facing adversity in Lebanon: a pilot of a psychoeducational comic book ‘somoud’. Confl Health. 2020;14. DOI:https://doi.org/10.1186/s13031-020-00324-7
  • Moore T. Strengths-based narrative storytelling as therapeutic intervention for refugees in Greece. World Federat Occup Therap Bull. 2017;3:7.
  • Williams I. Autography as autotherapy: psychic pain and the graphic memoir. J Med Humanities. 2011;32:14.
  • Czerwiec MK. Taking turns: stories form HIV/AIDS care unit 371. University Park, Pennsylvania: Pennsylvania State University Press; 2017.
  • Czerwiec MK, Huang MN. Hospice comics: representations of patient and family experience of illness and death in graphic novels. J Med Humanities. 2017;38:18.
  • Mertens DM. Transformative Mixed Methods: addressing Inequities. Am Behav Sci. 2012;56:802–813.
  • Smith JR, Ho LS, Langston A, et al. Clinical care for sexual assault survivors multimedia training: a mixed-methods study of effect on healthcare providers’ attitudes, knowledge, confidence, and practice in humanitarian settings. Confl Health. 2013;7:14.
  • Ward C. The attitudes toward rape victims scale: construction, validation, and cross-cultural applicability. Psychol Women Quart. 1988;12:127–146.
  • Thabane L, Ma J, Chu R, et al. A tutorial on pilot studies: the what, why and how. BMC Med Res Methodol. 2010;10. DOI:https://doi.org/10.1186/1471-2288-10-1.
  • Bell ML, Whitehead AL, Julious SA. Guidance for using pilot studies to inform the design of intervention trials with continuous outcomes. Clin Epidemiol. 2018;10:5.
  • United Nations High Commissioner for Refugees. Uganda refugee response monitoring: settlement fact sheet Bidi Bidi. Geneva: United Nations High Commissioner for Refugees; 2017.
  • United Nations High Commissioner for Refugees. Uganda settlement profile bidibidi- October 2020. Geneva: United Nations High Commissioner for Refugees; 2020.
  • United Nations High Commissioner for Refugees. UNHCR monthly protection update sexual and gender-based violence. Geneva: United Nations High Commissioner for Refugees; 2019.
  • Lavrakas PJ. Purposive sample. Encyclopedia of survey research methods. Thousand Oaks, California: Sage publications; 2008.
  • Etikan I, Musa SA, Alkassim RS. Comparison of convenience sampling and purposive sampling. Am J Theoretic Appl Stat. 2016;5:1–4.
  • Logie CH, Okumu M, Latif M, et al. Exploring resource scarcity and contextual influences on wellbeing among young refugees in Bidi Bidi refugee settlement, Uganda: findings from a qualitative study. Confl Health. 2021;15:1–11.
  • Attride-Stirling J. Thematic networks: an analytic tool for qualitative research. Qual Res. 2001;1:21.
  • Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:25.
  • Jewkes R, N M, Jama N. Stepping Stones: a training manual for sexual and reproductive health communication and relationship skills. South Africa: Medical Research Council; 2010.
  • Michau L, S S. SASA! Faith: a training manual to prepare everyone involved in SASA! Faith. Kampala, Uganda: Raising Voices; 2016.
  • International Rescue Committee Inc. Clinical care for sexual assault survivors: a multimedia training tool facilitator’s guide. New York: International Rescue Committee Inc; 2014.
  • Hollaback. Bystander intervention training. [cited 2020 Dec 5] Available from: https://www.ihollaback.org/bystander-resources/
  • Dworkin SL. Sample size policy for qualitative studies using in-depth interviews. Arch Sex Behav. 2012;41:2.
  • Krueger RAC, Casey MA. Participants in a focus group. Focus groups: a practical guide for applied research. Los Angeles: Sage Publications; 2008.
  • Hennink MM, Kaiser BN, Weber MB. What influences saturation? Estimating sample sizes in focus group research. Qual Health Res. 2019;29:24.
  • Johnson M, O’Hara R, Hirst E, et al. Multiple triangulation and collaborative research using qualitative methods to explore decision making in pre-hospital emergency care. BMC Med Res Methodol. 2017;17:11.
  • Meijer PC, Verloop N, Beijaard D. Multi-method triangulation in a qualitative study on teachers’ practical knowledge: an attempt to increase internal validity. Qual Quantity. 2002;36:24.
  • Faul F, Erdfelder E, Lang AG, et al. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:16.
  • Anteneh B, Belachew SA, Endeshaw A, et al. Knowledge, attitude and practices of medical and health science students on the antiretroviral based HIV post-exposure prophylaxis in an Ethiopian hospital: an institutional based cross-sectional study. BMC Health Serv Res. 2019;19:1–9.
  • Mathewos B, Birhan W, Kinfe S, et al. Assessment of knowledge, attitude and practice towards post exposure prophylaxis for HIV among health care workers in Gondar, North West Ethiopia. BMC Public Health. 2013;13:508.
  • Logie CH, Wang Y, Lalor P, et al. Pre and post-exposure prophylaxis awareness and acceptability among sex workers in Jamaica: a Cross-sectional study. AIDS Behav. 2020;24:1–14.
  • Slaby R, Wilson-Brewer R, DeVos H. Final report for aggressors, victims, and bystanders project. Newton, MA: Education Development Center; 1994.
  • Banyard VL, Plante EG, Moynihan MM. Rape prevention through bystander education: bringing a broader community perspective to sexual violence prevention. US Depart Justice. 2005;1–206.
  • Pulerwitz J, Barker G. Measuring attitudes toward gender norms among young men in Brazil: development and psychometric evaluation of the GEM scale. Men Masculinities. 2008;10:322–338.
  • Ebell MH. Screening instruments for depression. Am Fam Physician. 2008;78:244–246.
  • James S, Pisa PT, Imrie J, et al. Assessment of adolescent and youth friendly services in primary healthcare facilities in two provinces in South Africa. BMC Health Serv Res. 2018;18:809.
  • Sinclair VG, Wallston KA. The development and psychometric evaluation of the Brief Resilient Coping Scale. Assessment. 2004;11:94–101.
  • Dobility. SurveyCTO. [cited 2020 Dec 5] Available from: https://www.surveycto.com/
  • Gillies PA, Stork A, Bretman M. Streetwize UK: a controlled trial of an AIDS education comic. Health Educ Res. 1990;5:27–33.
  • Muzumdar JM, Pantaleo NL. Comics as a medium for providing information on adult immunizations. J Health Commun. 2017;22:783–791.
  • Krasnoryadtseva A, Dalbeth N, Petrie KJ. The effect of different styles of medical illustration on information comprehension, the perception of educational material and illness beliefs. Patient Educ Couns. 2020;103:556–562.
  • Gallagher-Thompson D, Tzuang M, Hinton L, et al. Effectiveness of a fotonovela for reducing depression and stress in Latino dementia family caregivers. Alzheimer Dis Assoc Disord. 2015;29:146.
  • Towey F. Conference: comics and medicine. Lancet Oncol. 2014;15:927.
  • Waite M. Writing medical comics. J Vis Commun Med. 2019;42:144–150.
  • McNicol S. Humanising illness: presenting health information in educational comics. Med Humanit. 2014;40:49–55.
  • McNicol S. The potential of educational comics as a health information medium. Health Inf Libraries J. 2017;34:20–31.
  • Uganda Legal Information Institute. Domestic Violence Act. Kampala, Uganda: Uganda Legal Information Institute; 2010.
  • Ministry of Health. The national policy guidelines on post exposure prophylaxis for HIV, hepatitis B and hepatitis C. Kampala, Uganda: Ministry of Health; 2017.
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