Prevalence of interpersonal violence against children in sport in six European countries.

BACKGROUND: Investigating prevalence of child abuse in sport is a relatively new field of research, born from the need for credible data on this phenomenon. OBJECTIVE: To establish prevalence rates of interpersonal violence against children in sport in six European countries. PARTICIPANTS AND SETTING: The sample (N = 10,302) consists of individuals aged 18-30 who had participated in organized sport prior to age 18 (49.3 % male, 50 % female). METHODS: A self-report questionnaire was developed (the Interpersonal Violence Against Children in Sport Questionnaire or IVACS-Q) to measure prevalence of five categories of interpersonal violence (neglect, psychological violence, physical violence, non-contact sexual violence, and contact sexual violence) against children who participate in sport. Validation testing (published separately) showed reasonable levels of convergent and divergent validity. Prevalence rates are calculated by national context, whether inside or outside sport, and by sex (male/female). RESULTS: Prevalence of IVACS inside sport differed by category: psychological violence (65 %, n = 6679), physical violence (44 %, n = 4514), neglect (37 %, n = 3796), non-contact sexual violence (35 %, n = 3565), and contact sexual violence (20 %, n = 2060). Relatively small geographical differences were found. Across all categories, males (79 %, n = 4018) reported significantly more experiences inside sport than females (71 %, n = 3653) (χ2(1) = 92.507, p < .000). Strong correlations were found between experiencing violence inside and outside sport. CONCLUSIONS: Interpersonal violence against children in sport is widespread. The sector's approach to prevention must recognize the risks to female and male children (and all children) and the additional vulnerabilities of abused children. Further comparative and longitudinal research within sport is required.

Women's assessment of the quality of hospital-based perinatal care by mode of birth in Romania during the COVID-19 pandemic: Results from the IMAgiNE EURO study.

OBJECTIVE: To assess women's perceptions of the quality of maternal and newborn care (QMNC) received in hospitals in Romania during the COVID-19 pandemic by mode of birth. METHODS: A validated anonymous online questionnaire based on WHO quality measures. Subgroup analysis of spontaneous vaginal birth (SVB), emergency cesarean, and elective cesarean and multivariate analyses were performed, and QMNC indexes were calculated. Maternal age, educational level, year of birth, mother born in Romania, parity, type of hospital, and type of professionals assisting the birth were used for multivariate analysis. RESULTS: A total of 620 women completed the survey. Overall, several quality measures suggested gaps in QMNC in Romania, with the lowest QMNC indexes reported for provision of care and availability of resources. Women who had either elective or emergency cesarean compared with those who had SVB more frequently lacked early breastfeeding (OR 2.04 and 2.13, respectively), skin-to-skin contact (OR 1.73 and 1.75, respectively), rooming-in (OR 2.07 and 1.96, respectively), and exclusive breastfeeding at discharge (OR 2.27 and 1.64, respectively). Compared with elective cesarean, emergency cesarean had higher odds of ineffective communication by healthcare providers (OR 1.65), lack of involvement in choices (OR 1.58), insufficient emotional support (OR 2.07), and no privacy (OR 2.06). Compared with other modes of birth, a trend for lower QMNC indexes for emergency cesarean was observed for all domains, while for elective cesarean the QMNC index for provision of care was significantly lower. CONCLUSION: Quality indicators of perinatal care remain behind targets in Romania, with births by cesarean the most affected. GOV IDENTIFIER: NCT04847336.

WHO Standards-based questionnaire to measure health workers' perspective on the quality of care around the time of childbirth in the WHO European region: development and mixed-methods validation in six countries.

OBJECTIVES: Develop and validate a WHO Standards-based online questionnaire to measure the quality of maternal and newborn care (QMNC) around the time of childbirth from the health workers' perspective. DESIGN: Mixed-methods study. SETTING: Six countries of the WHO European Region. PARTICIPANTS AND METHODS: The questionnaire is based on lessons learnt in previous studies, and was developed in three sequential phases: (1) WHO Quality Measures were prioritised and content, construct and face validity were assessed through a Delphi involving a multidisciplinary board of experts from 11 countries of the WHO European Region; (2) translation/back translation of the English version was conducted following The Professional Society for Health Economics and Outcomes Research guidelines; (3) internal consistency, intrarater reliability and acceptability were assessed among 600 health workers in six countries. RESULTS: The questionnaire included 40 items based on WHO Standards Quality Measures, equally divided into four domains: provision of care, experience of care, availability of human and physical resources, organisational changes due to COVID-19; and its organised in six sections. It was translated/back translated in 12 languages: Bosnian, Croatian, French, German, Italian, Norwegian, Portuguese, Romanian, Russian, Slovenian, Spanish and Swedish. The Cronbach's alpha values were ≥0.70 for each questionnaire section where questions were hypothesised to be interrelated, indicating good internal consistence. Cohen K or Gwet's AC1 values were ≥0.60, suggesting good intrarater reliability, except for one question. Acceptability was good with only 1.70% of health workers requesting minimal changes in question wording. CONCLUSIONS: Findings suggest that the questionnaire has good content, construct, face validity, internal consistency, intrarater reliability and acceptability in six countries of the WHO European Region. Future studies may further explore the questionnaire's use in other countries, and how to translate evidence generated by this tool into policies to improve the QMNC. TRAIL REGISTRATION NUMBER: NCT04847336.