Encouraging Asian Immigrant Women to Disclose Intimate Partner Violence in Primary Care Settings

Abstract

Risks of intimate partner violence (IPV) often are higher among immigrant women, due to dependency, language barriers, deportation fears, cultural beliefs, and limited access to services. In the United States, Asian immigrant women experiencing IPV often are reluctant to disclose abuse. Viewing videos that depict IPV survivors who have successfully obtained help might encourage disclosure. After conducting formative research, we created brief videos in four Asian languages (Korean, Mandarin Chinese, Thai, and Vietnamese) for use in primary care clinic consultation rooms. We then conducted in-depth interviews with 60 Asian immigrant women in California to get their perspectives on how helpful the videos might be in achieving disclosure. Most participants believed the videos would promote disclosure in clinics, although those who had been abused seemed more skeptical. Many had stereotyped views of victims, who they felt needed to be emotive to be credible. Videos should be upbeat, highlighting the positive outcomes of escaping violence and showing clearly each step of the process. Various types of IPV should be described, so that women understand the violence is not exclusively physical. Victims would need reassurance that they will not be arrested, deported, or forced to leave their abusers. Discussing the benefits of escaping violence to children could be influential. Victims also must be convinced that providers are trustworthy, confidential, and want to help. To assist immigrant populations to disclose IPV to a health provider, videos need to be culturally relevant, explain various types of violence, allay fears, and show clear processes and benefits.

Seeking Help From Primary Health-Care Providers in High-Income Countries: A Scoping Review of the Experiences of Migrant and Refugee Survivors of Domestic Violence

“…All studies identified a range of common fears, which presented major barriers to disclosure and help-seeking for migrant and refugee women. Eight studies identified financial concerns as a barrier for women; both the fear of being “left on their own” if the relationship ended or if the perpetrator were to lose their job and no longer be able to financially support the family (Ahmad et al, 2009; Bauer et al, 2000; Garnweidner-Holme et al, 2017; Kelly, 2006; Khelaifat, 2018; Montalvo-Liendo et al, 2009; Tavrow et al, 2020; Wilson et al, 2014).…”

“…Fears related to social shame or stigma of both disclosing abuse and potential separation were discussed in eight of the studies. These ranged from concerns about family honor and the fear of being ostracized by their family, and community and social networks promoting silence among victims, thus reaffirming the notion of shame (Ahmad et al, 2009; Bauer et al, 2000; Garnweidner-Holme et al, 2017; Kelly, 2006; Khelaifat, 2018; Montalvo-Liendo et al, 2009; Tavrow et al, 2020; Wilson et al, 2014).…”

“…Eight papers reported women staying in violent relationships for the sake of their children (Ahmad et al, 2009; Bauer et al, 2000; Finfgeld-Connett & Johnson, 2013; Garnweidner-Holme et al, 2017; Kelly, 2006; Khelaifat, 2018; Montalvo-Liendo et al, 2009; Tavrow et al, 2020). The motivation behind this ranged from sociocultural (social stigma regarding marriage and family) to sociopolitical (the fear that children will be taken away from them or fears of deportation).…”

“…The motivation behind this ranged from sociocultural (social stigma regarding marriage and family) to sociopolitical (the fear that children will be taken away from them or fears of deportation). The fear of deportation was reported in five of the studies and was especially pertinent for women who were undocumented or on partner visas, with some women also reporting abusers using the threat of deportation and/or child removal as a means of controlling them (Bauer et al, 2000; Finfgeld-Connett & Johnson, 2013; Kelly, 2006; Khelaifat, 2018; Tavrow et al, 2020).…”

“…While research into health-care access and uptake in HICs indicates that women subjected to DV are more likely to seek health care than non-abused women (García-Moreno et al, 2015; WHO, 2013a), there is evidence that women in low-and middle-income cuntried (LMICs) experiencing violence are less likely to access timely and adequate antenatal care (García-Moreno et al, 2015; Metheny & Stephenson, 2017; Musa et al, 2019; WHO, 2013b). Despite this, health-care providers are often the first professionals women come into contact with, thus placing them in a unique position to support victim-survivors (Bhate-Deosthali et al, 2018; Hegarty et al, 2013; Sikder et al, 2021; Taft et al, 2021; Tavrow et al, 2020; Ting & Panchanadeswaran, 2009; WHO, 2013b). However, HCPs can be hesitant to inquire about DV, despite best practice guidelines advocating for the identification and care of victim-survivors in routine health care (Ramsay et al, 2012; Valpied et al, 2017; WHO, 2013b).…”