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Background: Suicide, especially by firearm, remains a leading cause of death in military populations in the USA. Reducing access to firearms, especially during high risk times, may help prevent suicide and other forms of violence. The purpose of this study was to adapt a promising existing lethal means safety intervention (Project Safe Guard, PSG) for cross-cutting violence prevention and peer support in active-duty service communities using community engagement methods. Methods: A two-pronged community-engaged research approach was employed, including the Community Translation (CT) process that engaged 15 Service Members from one installation to help adapt PSG successfully. In addition, qualitative data was collected from 40 active-duty service members and military violence prevention specialists through in-depth interviews and focus group discussions. Results: Qualitative data and CT feedback led to site-specific PSG adaptations. Participants emphasized the importance of peer-to-peer discussions and highlighted resource allocation, leadership support, and stigma on firearm ownership as potential implementation challenges. Conclusions: Findings demonstrate the feasibility of community-engaged research to adapt lethal means safety interventions within military populations. PSG implementation should consider resource allocation, leadership support, and addressing stigma. This study has implications for future policies and standards for performing research on sensitive topics, particularly among military populations. [ABSTRACT FROM AUTHOR]

Purpose: Reproductive coercion (RC) is a type of intimate partner violence that involves interference in contraceptive and reproductive decisions. A multi-methods design explored correlates (quantitative) and contributors (qualitative) of partner-perpetrated RC across the socioecological framework among intimate partner violence survivors (IPV) in Nairobi, Kenya. Methods: Quantitative analyses utilize baseline data from the myPlan Kenya trial (n=327). Multivariable Poisson regression examined the association between postulated correlates and overall RC (range: 0-9), and sub-types of pregnancy coercion (range: 0-5) and condom manipulation (range: 0-4). In-depth interviews (IDIs; n=30) conducted at three-month follow-up among women indicating RC experience at baseline explored women's perceived contributors to RC via inductive thematic analysis. Results: Within the past three months, over 80% of IPV survivors experienced any RC, and IPV survivors experienced 3.8 RC behaviors on average. Factors associated with overall RC included not wanting their last child at all (aIRR =1.28; p=0.009), partner's concurrent partnership (aIRR=1.33; p<0.001), and inconvenient contraceptive method use (aIRR=1.36; p=0.01), whereas increased couple communication was protective against RC (aIRR=0.96; p<0.001). IDIs revealed potential contributors to RC, including partner's desire for children; partner fear of contraceptive side effects; cultural norms surrounding family planning use within marriage; decision-making power disparities reinforced by economics; partner's fear of abandonment; and presence of children from previous relationships. Conclusions: Results indicate individual- and couple-level characteristics are crucial for understanding RC for Nairobi's IPV survivors. Knowledge of RC risk factors can assist practitioners in mitigating against reproductive interference, and ensuring women are using contraceptive methods most suited to their circumstances and aligned with their reproductive preferences. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) harms women physically, sexually, and psychologically. Safety strategies, or harm reduction techniques implemented by women undergoing recurrent violence, may help mitigate the negative health, economic, and social consequences of IPV. This study aimed to understand recommended and utilized safety strategies among three urban informal settlements in Nairobi, Kenya. Semi-structured key informant discussions (KIDs; n = 18) with community-based service providers and focus group discussions (FGDs; n = 49) with IPV survivors were conducted. All interviews were audio-recorded, transcribed, and translated verbatim from Swahili to English. Inductive thematic analysis was used to structure codes. Convergence matrices were used to analyze emergent strategies by data source (service providers vs. IPV survivors). Women preferred safety strategies that they could implement unassisted as first line of harm reduction. Strategies included removing stressors, proactive communication, avoidance behaviors, sexual and reproductive health (SRH), economic, leaving partner for safety, child safety, and securing personal property. Strategies recommended by service providers and utilized by IPV survivors differed, with clear divergence indicated for leaving the abusive relationship, SRH, and personal property strategies. Innovative strategies emerged from IPV survivors for safeguarding property. Similar to upper-income and other low and middle-income contexts, women experiencing IPV in urban informal settlements of Nairobi actively engage in behaviors to maximize safety and reduce harm to themselves and their families. Integration of strategies known to be helpful to women in these communities into community-based prevention and response is strongly encouraged. Increased synergy between recommended and implemented safety strategies can enhance programming and response efforts. [ABSTRACT FROM AUTHOR]