Adapting a low-cost intimate partner violence (IPV) and mental health response intervention for women in informal settlements in Kenya

PROJECT SUMMARY/ABSTRACT The purpose of this International Research Scientist Development Award (K01) is to provide the candidate with the training and expertise needed to transition into an independent global health researcher with expertise in the science of violence- and health-related intervention in informal settlements. Globally, 30% of women have experienced intimate partner violence (IPV). Prevention and response to IPV is critical; yet few interventions have been adapted for residents of informal settlements. Currently, 56% of the 3 million residents in Nairobi, the capital city of Kenya, live in informal settlements, and this population is likely to double by 2050. Research carried out in 2012 in Kibera, the largest informal settlement in Nairobi, reported that 85% of women have experienced IPV in their lifetime and a 2018 study reported that 66% of women in similar Nairobi settlements experienced IPV in the past year. Women experiencing IPV are more likely to also experience depression, anxiety, and post- traumatic stress. In 2014, Kenya identified reduction of and response to violence against women (VAW) as a priority health area in national policies and strategic plans; yet, no screening or response protocols have been adopted in clinics in informal settlements for IPV survivors. The aims of this study are, therefore, to: 1) identify potential facilitators and barriers to screening and intervention for IPV and related mental health challenges in healthcare settings in informal settlements in Kenya; 2) combine an IPV (WINGS) and mental health (PM+) response intervention and adapt the combined (WINGS+PM+) intervention for use in existent healthcare settings in informal settlements in Nairobi; and 3) pilot test the adapted WINGS+PM+ intervention through a randomized control trial with 130 women to assess the safety, feasibility, and acceptability of WINGS+PM+ versus PM+-only as the foundation for a low-cost IPV services package that can expand services to women experiencing IPV in informal settlements. The proposed career development plan has been designed to augment the applicant's experience researching VAW and women's health in informal settlements in Kenya and enable her to: 1) gain research skills in the design and adaptation of violence- and health-related interventions, with an emphasis on low-cost interventions that can be carried out by lay community members in healthcare settings in informal settlements; 2) obtain methodological expertise in the design, adaptation, delivery, and assessment of feasibility and acceptability of interventions; 3) cultivate important relationships with global health experts, intervention scientists, and healthcare providers in informal settlements in Kenya and East Africa, and 4) increase her professional skills for a successful independent global health research career, including grantsmanship, manuscript writing, and collaborative interdisciplinary and international research. The training goals will be achieved through didactic courses, specialized workshops and seminars, hands-on research, and mentoring from an interdisciplinary team of experts in both the U.S. and Kenya. The research findings and methodological skills to be gained from this IRSDA (K01) have important applicability for health research in Kenya.