Factors associated with physical violence against children in Haiti: a national population-based cross-sectional survey.

Considering the recent sociopolitical and environmental stress in Haiti, from the COVID pandemic to repeated natural disasters, we aimed to identify risk and protective factors associated with childhood physical violence (CPV) after the 2010 earthquake. A population-based national survey was administered to 13-24-year-old Haitians in 2012. A three-stage clustered sample design was utilized. Adjusted prevalence ratios (aPR) and risk ratios (aRR). 64% of survey respondents experienced CPV were estimated. Respondents who reported emotional and/or sexual abuse prior to age 12 were twice as likely to be victims of physical violence later during childhood (emotional aRR 1.9, 95% CI 1.3-2.7; sexual aRR 2.1, 95% CI 1.4-3.1). Feeling close or very close to one's mother was protective (aPR 0.66, 95% CI 0.47-0.92). This study is the first to describe risk and protective factors and also delineate temporality of exposures associated with CPV.Supplemental data for this article is available online at https://doi.org/10.1080/17457300.2021.1996398.

Prevalence of physical violence against children in Haiti: A national population-based cross-sectional survey.

Although physical violence against children is common worldwide, there are no national estimates in Haiti. To establish baseline national estimates, a three-stage clustered sampling design was utilized to administer a population-based household survey about victimization due to physical violence to 13-24 year old Haitians (n=2,916), including those residing in camps or settlements. Descriptive statistics and weighted analysis techniques were used to estimate national lifetime prevalence and characteristics of physical violence against children. About two-thirds of respondents reported having experienced physical violence during childhood (67.0%; 95% CI 63.4-70.4), the percentage being similar in males and females. More than one-third of 13-17 year old respondents were victimized in the 12 months prior to survey administration (37.8%; 95% CI 33.6-42.1). The majority of violence was committed by parents and teachers; and the perceived intent was often punishment or discipline. While virtually all (98.8%; 95% CI 98.0-99.3) victims of childhood physical violence were punched, kicked, whipped or beaten; 11.0% (95% CI 9.2-13.2) were subject to abuse by a knife or other weapon. Injuries sustained from violence varied by victim gender and perpetrator, with twice as many females (9.6%; 95% CI 7.1-12.7) than males (4.0%; 95% CI 2.6-6.1) sustaining permanent injury or disfigurement by a family member or caregiver (p-value<.001). Our findings suggest that physical violence against children in Haiti is common, and may lead to severe injury. Characterization of the frequency and nature of this violence provides baseline estimates to inform interventions.

Behavioral weight control treatment with supervised exercise or peer-enhanced adventure for overweight adolescents.

OBJECTIVE: To evaluate the efficacy of behavioral weight control intervention with a peer-enhanced activity intervention versus structured aerobic exercise in decreasing body mass index (BMI) and z-BMI in overweight adolescents. STUDY DESIGN: Participants were randomized to 1 of 2 group-based treatment conditions: (1) cognitive behavioral treatment with peer-enhanced adventure therapy or (2) cognitive behavioral weight control treatment with supervised aerobic exercise. Participants included 118 overweight adolescents, ages 13 to 16 years, and a primary caregiver. Changes in BMI, standardized BMI, percent over BMI, and waist circumference were examined. RESULTS: Analysis of variance on the basis of intent-to-treat indicated significant decreases in all weight change outcomes at the end of treatment, with significant decreases maintained at the 12-month follow-up. No differences in treatment conditions were observed. Secondary analyses indicated that adherence with attendance and completion of weekly diet records contributed significantly to reductions in BMI. CONCLUSIONS: A cognitive behavioral weight control intervention combined with supervised aerobic exercise or peer-enhanced adventure therapy is equally effective in short-term reduction of BMI and z-BMI in overweight adolescents. Adherence, as measured with session attendance and self-monitoring, is a key dimension of weight change.