Background: Gender-based violence (GBV) and violence against children (VAC) are two prevalent and highly interconnected global health challenges, yet data and research capacities to study these forms of violence and to generate evidence-based policies and programs remain limited. To address critical shortages in research capacity in Vietnam and to establish a model for other Low- and Middle-Income Countries (LMICs), we are establishing CONVERGE—the Consortium for Violence Prevention Research, Implementation, and Leadership Training for Excellence. Methods: Based on a needs assessment with partners in Vietnam, CONVERGE will provide a comprehensive research training program supporting 15 long-term, postdoctoral trainees with multi-disciplinary research training in GBV and VAC. We also will offer in-country trainings and short-courses to 40 short-term mid-career academic trainees and 60 short-term practitioner/stakeholder trainees over 5 years to build productive GBV and VAC academic, scientific, and practitioner networks. The CONVERGE training program has four components: (1) 14 h of virtual/in-person annual mentorship training to prepare research mentors and to create a pipeline of future mentors in Vietnam; (2) a one-month intensive research training for long-term postdoctoral fellows at Emory University; (3) a structured 17-month, in-country mentored research project for long-term trainees that results in a peer-reviewed manuscript and a subsequent grant submission; and, (4) week-long in-country intensive translational trainings on implementation science, advanced topics in leadership, and advanced topics in science dissemination. Opportunities for on-going virtual training and professional networking will be provided for CONVERGE trainees and mentors in Vietnam with other trainees and mentors of D43s focused on injury/violence prevention, D43s housed at Emory, and D43s with other institutions in Southeast Asia. To assess the reach, implementation, fidelity, and effectiveness of these four components, we will implement a rigorous, mixed-methods, multi-level evaluation strategy using process and outcome measures. Findings from the evaluation will be used to refine program components for future trainee and mentor cohorts and to assess long-term program impact. Discussion: Led by Emory University in the US and Hanoi Medical University in Vietnam, CONVERGE represents leading institutions and experts from around the world, with a goal of providing mentorship opportunities for early-career scientists with an interest in violence prevention.

Background Adolescence and emerging adulthood represent a period of heightened vulnerability to sexual violence (SV). While some research suggests that exposure to sexually explicit material (SEM) among adolescents and college students is associated with sexually violent behavior, our understanding of this relationship is limited. This study aimed to assess the relationship between prior exposure to several types of SEM and sexually violent behavior in a sample of first-year university men in Vietnam. Methods and findings A cohort of 739 first-year male university students completed three survey waves over 14 months, providing information on contact and non-contact sexually violent behavior, exposure to SEM, and other theorized confounders of the SEM-SV relationship. Controlling for these covariates, we estimated the average treatment effect of SEM on contact and non-contact SV using the propensity score method. We also conducted a dose-response analysis for the effect of violent SEM on SV based on frequency-of-exposure classes derived from latent class analysis. The majority of the sample reported exposure to SEM in the prior six months, with 41% of the sample reporting exposure to violent SEM. In propensity-adjusted models, exposure to violent SEM, but not other types, had a small but significant positive effect on contact and non-contact SV. These effects increased for frequent viewers of violent SEM. Models of contact SV showed endogeneity, warranting caution. Conclusions Exposure to violent SEM is prevalent among university men in Vietnam and may be contributing to sexually violent behavior. Incorporating media literacy into SV prevention programs to mitigate these potential effects may be warranted.

Objective To develop and evaluate a Nutrition Transition-FFQ (NT-FFQ) to measure nutrition transition among adolescents in South India. Design We developed an interviewer-administered NT-FFQ comprising a 125-item semi-quantitative FFQ and a twenty-seven-item eating behaviour survey. The reproducibility and validity of the NT-FFQ were assessed using Spearman correlations, intra-class correlation coefficients (ICC), and levels of agreement using Bland-Altman and cross-classification over 2 months (NT-FFQ1 and NT-FFQ2). Validity of foods was evaluated against three 24-h dietary recalls (24-HR). Face validity of eating behaviours was evaluated through semi-structured cognitive interviews. The reproducibility of eating behaviours was assessed using weighted kappa (κ w) and cross-classification analyses. Setting Vijayapura, India. Subjects A representative sample of 198 adolescents aged 14-18 years. Results Reproducibility of NT-FFQ: Spearman correlations ranged from 0·33 (pulses) to 0·80 (red meat) and ICC from 0·05 (fruits) to 1·00 (tea). On average, concordance (agreement) was 60 % and discordance was 7 % for food groups. For eating behaviours, κ w ranged from 0·24 (eating snacks while watching television) to 0·67 (eating lunch at home) with a mean of 0·40. Validity of NT-FFQ: Spearman correlations ranged from 0·11 (fried traditional foods) to 0·70 (tea) and ICC ranged from 0·02 (healthy global foods) to 1·00 (grains). The concordance and discordance were 48 % and 8 %, respectively. Bland-Altman plots showed acceptable agreement between NT-FFQ2 and 24-HR. The eating behaviours had acceptable face validity. Conclusions The NT-FFQ has good reproducibility and acceptable validity for food intake and eating behaviours. The NT-FFQ can quantify the nutrition transition among Indian adolescents.

Background: Sexual violence by young men against women is common, but efficacious primary prevention interventions tailored to men are limited in low- and middle-income settings like Vietnam. GlobalConsent, a web-based sexual violence prevention intervention tailored to university men in Hanoi, is efficacious. Implementation research is needed to understand facilitators and barriers to scaling GlobalConsent and prevention programs generally. We conducted qualitative research with key informants from three youth-focused organizational settings to understand the context of implementation in Vietnam. Methods: Interviews with university (n = 15), high-school (n = 15) and non-governmental (n = 15) key informants focused on perceptions about sexual violence among young people and prevention programming. Four focus group discussions with 22 interviewed informants, following the Consolidated Framework for Implementation Research, asked about facilitators and barriers to implementing GlobalConsent. Narratives were transcribed, translated, and coded inductively and deductively to identify salient themes. Results: Outer-setting influences included greater expectations for sex among young people alongside norms favoring men’s sexual privilege, ostensibly ambiguous and lax laws on sexual violence, government ministries as bureaucratic but potential allies, external subject-matter experts, and the media. Inner-setting influences included variable cultures regarding openness to discuss sexual violence and equitable gender norms, variable departmental coordination, limited funding and ‘red tape’ especially in public institutions, inconsistent student access to technologies, and limited time and competing priorities among students and teachers. Several actors were considered influential, including institutional leaders, human-resource staff, the Youth Union, and student-facing staff. Important characteristics of individuals for implementation included subject-matter expertise, science or social science training, younger age, engagement in social justice related activities, and more open attitudes about sex. Regarding characteristics of sexual violence prevention programming, some participants preferred online formats for busy students while others suggested hybrid or in-person formats, peer education, and incentives. Participants generally accepted the content of GlobalConsent and suggested adding more content for women, ancillary support services, and adapted content for high-school students. Conclusions: Implementation of sexual violence prevention programs in youth-focused organizations in Vietnam requires multilevel strategies that connect outer-setting subject-matter experts with supportive inner-setting leaders and student-facing staff to overcome normative and organizational constraints, and thereby, to deliver institution-wide programming.

In lower- and middle-income countries (LMICs), studies of interventions to reduce intimate partner violence (IPV) are expanding, yet measurement equivalence of the IPV construct—the primary outcome in these investigations—has not been established. We assessed the measurement equivalence of physical and sexual IPV item sets used in recent trials in LMICs and tested the impact of noninvariance on study inference. With data from four intervention trials (N = 3,545) completed before 2020, we used multiple-group confirmatory factor analysis to assess invariance across arms, over time, and across studies. We also calculated average treatment effects adjusting for covariate imbalance to assess concordance with published results. Most items functioned equivalently within studies at baseline and end line. Some evidence of longitudinal noninvariance was observed in at least one study arm in three studies, but did not meaningfully affect latent means or effect-size estimates. Evidence of partial invariance across studies at baseline and strict invariance over time was observed. Common measures of physical and sexual IPV were valid for measuring intervention impact in these samples. The study highlights the need for harmonized use of the tested scale, content validity assessments, and routine measurement equivalence testing to ensure valid inferences about intervention effectiveness.

Understanding attitudes about intimate partner violence (IPV) in cultural context is important for developing interventions to reduce IPV and its effects. This paper presents qualitative findings from research conducted in rural Bangladesh to understand men’s and women’s responses to attitudinal questions about IPV. Both men and women often responded as if the questions were about their personal behavior. A few women said that their opinion did not matter. Women’s responses were more sensitive than men's to contextual nuances in the questions, and men more often than women described their own attitudes as consistent with community norms.

According to the Demographic and Health Surveys (DHS) in poorer countries, 50% of women of reproductive age report that wife hitting or beating is justified. Such high rates may result from structural pressures to adopt such views or to report the perceived socially desirable response. In a survey experiment of 496 ever-married women 18 – 49 years in rural Bangladesh, we compared responses to attitudinal questions that (1) replicated the 2007 Bangladesh DHS wording and portrayed the wife as transgressive for unstated reasons with elaborations depicting her as (2) involuntarily and (3) willfully transgressive. The probabilities of justifying wife hitting or beating were consistently low for unintended transgressions (0.01–0.08). Willful transgressions yielded higher probabilities (0.40–0.70), which resembled those based on the DHS wording (0.38–0.57). Cognitive interviews illustrated that village women held diverse views, which were attributed to social change. Also, ambiguity in the DHS questions may have led some women to interpret them according to perceived gender norms and to give the socially desirable response of justified. Results inform modifications to these DHS questions and identify women for ideational-change interventions.

We use village census data and linear regression models to examine changes between 1975 and 2002 in the associations of parental resources with boys' and girls' schooling in four rural Guatemalan villages. Levels of schooling in 1975 were universally low for children 7–17 years. Large increases in schooling achievements occurred between 1975 and 2002. By 2002, schooling levels were comparable for younger boys and girls (7–12 years, N = 3,525) and favored older boys compared to older girls (13–17 years, N = 2,440) by about 0.5 grades. The associations of household standard of living and maternal schooling with schooling among girls diminished over time and became more comparable with these associations among boys, and the associations of household standard of living with schooling among older boys declined and became more comparable with these associations among girls. Thus, as increased social investments reduce the costs of schooling or increase the supply and quality of schooling to families, the magnitudes of the associations between parental resources and children's schooling decline and become more gender equitable at all ages. However, our results show that older boys may benefit more than older girls from social investments in schooling. These changes suggest potential needs to monitor gender gaps in schooling retention among older children, to insure gender equitable access to social investments in schooling, and to encourage parents to invest in schooling as joint measures to achieve greater schooling achievements of girls and boys.

Using data from 165 participants in a survey experiment in six Ban-gladeshi villages, we explored the levels and correlates of women’s indeterminate responses to a five-part attitudinal question on intimate partner violence (IPV) against women from the 2007 Bangladesh Demographic and Health Survey. Over 80 % had indeterminate responses to all five parts of the question. Indeterminate responses included silence or initial non-response (53–58 %), misunderstanding the question (30–37 %), and conditional opinions (7–13 %). The percentages of women who justified IPV were lower when indeterminate responses were permitted (7–12 %) than when they were not (37–57 %). Older women (≥26 years) with less schooling (≤2 grades) whose husbands were older (≥36 years), had less schooling (≤8 grades), and were at least 7 years older than the respondent often had higher odds of giving indeterminate responses. Husbands’ attributes and spousal age gaps were most consistently associated with women’s indeterminate responses. Latent power, or fears of expressing transgressive views, may underlie women’s indeterminate responses to attitudinal questions about IPV against women. Recommendations for further research are discussed.

Lack of access to acceptable sanitation facilities can expose individuals, particularly women, to physical, social, and mental health risks. While some of the challenges have been documented, standard metrics are needed to determine the extent to which women have urinationand defecation-related concerns and negative experiences. Such metrics also are needed to assess the effectiveness of interventions to mitigate them. We developed a sanitation insecurity measure to capture the range and frequency of women’s sanitation-related concerns and negative experiences. Research was conducted in rural Odisha, India with women across various life course stages to reflect a range of perspectives. This paper documents the mixed data collection methods and the exploratory and confirmatory factor analyses we employed to arrive at a final measure. The final sanitation insecurity measure includes 50 items across seven factors that reflect the physical environment, the social environment, and individual-level constraints. Most factor scores were significantly higher for unmarried women and for women who lacked access to functional latrines, indicating social and environmental influence on experiences. This measure will enable researchers to evaluate how sanitation insecurity affects health and to determine if and how sanitation interventions ameliorate women’s concerns and negative experiences associated with sanitation.