Design, implementation, and evaluation of a PRECEDE-PROCEED model-based intervention to reduce Intimate Partner Violence against women in Afghan men living in Refugee Camp of Torbat Jam County (Iran): Protocol for an Embedded study

Design, implementation, and evaluation of a PRECEDE-PROCEED model-based intervention to reduce Intimate Partner Violence against women in Afghan men living in Refugee Camp of Torbat Jam County (Iran): Protocol for an Embedded study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Study protocol Design, implementation, and evaluation of a PRECEDE-PROCEED model-based intervention to reduce Intimate Partner Violence against women in Afghan men living in Refugee Camp of Torbat Jam County (Iran): Protocol for an Embedded study Mohammad Rahimian, Masoumeh Abbasi Shavazi, Mohammad Ali Morowati Sharifabad, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4578090/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective More than a third of women around the world have experienced intimate partner violence (IPV). IPV is an important public health issue and a human rights issue. IPV has more severe consequences in refugees. More than 2.5 million Afghan refugees and immigrants live in Iran. The PRECEDE-PROCEED model is one of the most practical health promotion modes in interventions. The purpose of this study is to investigate the IPV situation in Afghan refugees living in Torbat Jam camp and its relationship with their health and quality of life and to design an intervention program to reduce it based on the PRECEDE-PROCEED health promotion model. Method This study employs an embedded mixed-method study with quantitative, qualitative and intervention phases study that was designed at the Afghan refugee population living in Iran's Torbat Jam camp. Quality of life data will be collected with the SF-12 questionnaire, mental health status information with the DASS-21 questionnaire, and IPV status information with the Haj Yahya violence against women questionnaire. In the qualitative phase, information will be collected in the form of in-depth interviews with the participants. By carrying out the qualitative phase, the factors affecting IPV will be determined and the necessary interventions to reduce and prevent it will be carried out based on the PRECEDE-PROCEED model of health promotion. Results Demographic variables and descriptive tables will be presented, the relationship of IPV with demographic variables, health status and quality of life will be measured. Predictors of IPV should be identified. Conclusions The results of this intervention will show the relationship between health status and quality of life with IPV, which can be used to design interventions. intimate partner violence refugee health status quality of life PRECEDE-PROCEED model Figures Figure 1 Figure 2 Figure 3 Background Intimate partner violence(IPV) refers to behavior by an intimate partner or ex-partner that causes physical, sexual or psychological harm, including physical aggression, sexual coercion, psychological abuse and controlling behaviors[ 1 , 2 ]. Although both men and women experience intimate partner violence, more women are affected by IPV[ 2 ]. Violence against women – particularly intimate partner violence and sexual violence – is a major public health problem and a violation of women's human rights[ 1 , 3 ]. IPV is a prevalent issue across countries [ 4 ] and, almost one third (27%) of women aged 15–49 years who have been in a relationship report that they have been subjected to some form of physical and/or sexual violence by their intimate partner[ 1 , 5 ]. Individuals who experience IPV, suffer from reduced quality of life, pain and discomfort[ 2 ], IPV can negatively affects women’s physical, mental, sexual, and reproductive health, and may increase the risk of acquiring HIV in some settings[ 1 ] and damages individuals, their children, communities, and the wider economic and social fabric of society [ 4 ] as well as IPV in pregnancy increases the likelihood of miscarriage, stillbirth, pre-term delivery and low birth weight babies[ 1 ]. Unfortunately, the incidence of violence against women and the resulting death is increasing [ 6 ]. IPV is multifactorial in its nature [ 7 ] such as individual factors (young age; low level of education; witnessing or experiencing violence as a child; harmful use of alcohol and drugs; personality disorders), relationship factors (conflict or dissatisfaction in the relationship; male dominance in the family; economic stress; man having multiple partners), community and societal factors(gender-inequitable social norms; poverty; low social and economic status of women; weak legal sanctions against IPV within marriage; lack of women’s civil rights, including restrictive or inequitable divorce and marriage laws; weak community sanctions against IPV) [ 6 , 8 ]. Some professional organizations recommend screening all women for violence [ 4 ]. Violence against women is preventable[ 1 ]. comprehensive, multi-sectoral, long-term collaboration between governments and civil society at all levels of the ecological framework are need[ 8 ]. However systematic reviews have shown that there are relatively few IPV prevention/intervention programs[ 9 ], The health sector has an important role to play to provide comprehensive health care to women subjected to violence, and as an entry point for referring women to other support services they may need[ 1 ]. legislative reform and media campaigns recommended to increase IPV awareness, and Comprehensive services from the health, legal, and law enforcement sectors should be made available to survivors [ 10 ]. Social science theories of IPV have explained various causes of IPV, including men’s pathology, power relations, cultural norms, and learned behavior theory. However, no single theory has enough empirical support to explain the entire phenomena[ 11 ]. The PRECEDE-PROCEED model was introduced in the 1970s by Green and Kreuter as a planning and evaluation model and is widely used in many fields including in analyzing the determinants of behavioral changes related to health status improvement over time [ 12 ]. PRECEDE (Predisposing Reinforcing and Enabling Constructs in Educational Diagnosis and Evaluation) an acronym that is a good summary of the enabling, predisposing and reinforcing factors able to change a behavior, aims to make the appropriateness of the program to the needs of the populations and PROCEED (Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development by 4 steps regarding performance, realization and evaluations of the intervention and the impact of the intervention on the behavioral determinants [ 12 ]. As Fig. 1 shows this model is a multistep approach for the development and implementation of a health promotion program and consists of eight phases: social assessment, epidemiological assessment, educational/ecological assessment, administrative/policy assessment and intervention planning, implementation, process evaluation, impact evaluation, and performance evaluation[ 13 ]. The immigrant population is at a special risk of IPV due to the change in social status, the longtime of migration and the norms of the country of origin [ 7 ] also, research results show that immigrant and refugee women are more vulnerable to intimate partner violence due to broken social and support networks, lack of access to employment with sufficient income, and being dependent on an intimate partner [ 14 ]. Currently, Iran is the third host country for refugees in the world with the presence of Afghan immigrants.[ 15 ] About 2.5 million Afghans live in Iran [ 16 ] However, in recent years, the Iranian government has introduced policies aimed at increasing access to education, health care, and livelihood services for Afghan refugees residing in Iran[ 17 ].Taking care of the refugee and more vulnerable populations in every country and advancing the care of immigrant women affected by IPV will allow for advanced public health measures for the whole nation [ 7 ]. The prevalence of violence and insecurity among refugees living in camps or shelters is lower than homeless people and those living in public emergency accommodation[ 18 ].Despite the long-term presence of Afghans in Iran, not much comprehensive research has been conducted on the status of intimate partner violence. Due to the effectiveness of empowerment interventions and dialectical behavior therapy (DBT) in improving self-esteem, self-efficacy and regulation of emotions among victims of violence, these studies have received special attention among different treatments for IPV victims [ 19 ]. Methods Study design: This study employs an embedded mixed-method study with quantitative, qualitative and intervention phases. Figure 2 shows a diagram with the different phases of the study. The participants: Torbat Jam Foreign Refugee Camp of Iran, located 10 km from Torbat Jam city and 120 km from Mashhad city, was established in 1994 and has accepted, accommodated and provided services to about 5000 Afghan refugees[ 20 ]. The participants in the first phase of the (quantitative) study are married Afghan women who currently live with their husbands in Torbat Jam refugee camp. In the second (qualitative) phase, the participants will be women who reported the highest IPV score in the first phase and their spouses. The participants of the intervention phase will also be selected from the first group. Sample size calculation: The sample size in the first phase of the study (quantitative phase) to investigate the prevalence of intimate partner violence in the community was estimated based on the information of Khoshdel et al.'s [ 15 ] study, which estimated the prevalence at 80%, with an error of 5% and accuracy of 5%, and with adjustments for a limited population of 189 people. In this way, the sample size was considered to be 226 people, including 20% attrition. In the second phase of this study (qualitative phase), targeted sampling will be done from among the people who participated in the first phase of the study (the highest score of the violence questionnaire and with the maximum variety) until the saturation limit is reached. The sample size in the intervention phase will be calculated according to the information obtained from the first phase. Participants assessment and measurements: Demographic data such as the age of the woman and her husband, the level of education of the woman and her husband, family composition, years of marriage, the status of the worker and her husband, current intimate relationship information, immigration status, alcohol consumption and substance abuse of the woman and her husband in writing and Self-reporting will be reported. The state of quality of life is measured by S-F12 questionnaire. In addition to using the DASS 21 questionnaire, which measures stress, anxiety, and depression, the health status is assessed by asking questions about the effects and physical injuries of violence, such as abortion, fracture, bone fracture, tooth fracture, bruise, scratch, tear, puncture, burn, tooth extraction. More serious injuries such as injuries to the head, eyes, ears, chest and abdomen, as well as blood sugar, blood pressure and lipid measurements will be measured. The IPV situation will also be measured with Haj Yahya et al.'s standard questionnaire (32 items and 4 factors to measure mental, physical, sexual and economic violence). Procedure: The implementation steps of the study are shown in Fig. 3: A) The first phase (quantitative): In this phase, the first and second steps of the PRECEDE-PROCEED model will be done as follows: a. The first stage (social assessment): The first step begins with the final result, which is the quality of life of women living in Torbat Jam refugee camp. Different objective and subjective methods are available to check the quality of life, at this stage SF-12 standard quality of life questionnaire will be used to measure the quality of life. The SF-12 questionnaire is a general tool for measuring the health status of people aged 14 and over, which includes 12 questions and two mental and physical scales and 8 subscales (physical performance, limitations in playing physical roles, physical pains, general health, energy and Vitality is social functioning, playing an emotional role, and mental-psychological health. b. The second stage (epidemiological, behavioral and environmental assessment): At this stage, important health problems and the health status of the participants are examined. At this stage, the health status of Afghan women living in Torbat Jam refugee camp is analyzed using three indicators of anxiety, stress and depression (DASS21)[1] , some physiological indicators (including blood sugar, blood fat, blood pressure) as well as some injuries caused by violence in women, such as a history of abortion due to violence, broken bones, broken teeth, etc. will be investigated. Also, to determine the status of IPV in Afghan women living in Torbat Jam refugee camp, Haj Yahya's standard questionnaire for measuring violence against women will be used. This questionnaire has 32 items and 4 factors to measure mental, physical, sexual and economic violence, and its validity and reliability have been confirmed in various studies in Iran. B) The second phase (qualitative), after collecting the necessary information in the first phase and analyzing them, the second phase of the current study (qualitative phase) will begin. In this phase, the study of the third phase of the PRECEDE-PROCEED model (educational and ecological survey) will be conducted. In the qualitative phase of this study, the semi-structured interview method will be used to collect information with an emphasis on predisposing, enabling and strengthening factors. At this stage, the researcher will participate in focus groups or conduct individual interviews with the participants while taking notes of the conversations, and with their permission, the conversations will be recorded and implemented on the same day. An interview guide will be used to guide the interview. The duration of each interview is expected to be 30–60 minutes, and data analysis will begin at the same time as data collection. The experiences and opinions of women and men about the dimensions, reasons and factors of violence against women will be collected with emphasis on predisposing, enabling and strengthening factors. In this phase of the study, which can be considered a qualitative study of phenomenology, behavioral and environmental factors that are closely related to IPV behavior are examined. Predisposing factors such as knowledge, attitude, beliefs, values, capacities and beliefs, enabling factors such as access to resources, rules and regulations, skills, etc., and reinforcing factors such as family, social groups, community leaders, decision makers and, … are identified, explained and categorized in this phase. C) The third phase (intervention phase), in this phase of the study, based on the results obtained from the qualitative phase, with the localization of the existing conditions, the necessary interventions will be designed and implemented based on the fourth to eighth stages of the PRECEDE-PROCEED model. a. The fourth and fifth stages of the PRECEDE-PROCEED model (administrative & policy assessment and intervention alignment and implementation): Based on the qualitative phase, and the analysis of predisposing, strengthening and enabling factors, programs for intervention will be predicted. These interventions can include a range of life skills training, including increasing self-awareness, problem solving, effective communication, emotion management, empathy, interpersonal relationships, and introduction and coordination with available counseling and support centers, providing face-to-face and online counseling facilities, support Asking volunteer organizations and institutions to help (welfare, women's affairs of the governorship, etc.) and make special policies for this population. b. Sixth to eighth steps of the PRECEDE-PROCEED model (evaluation of process, impact and outcome): At this stage, evaluation will be done by using the questionnaires of the first phase of the study and also by checking the implementation process of the programs. The evaluation of the process will include the review and monitoring of the number of training sessions, the number of participants, access to training resources and the satisfaction of the participants. The Impact evaluation will examine the immediate impact of the programs on the IPV situation, and the Outcome evaluation will examine the health status and quality of life of Afghan women living in Torbat Jam refugee camp, after the interventions. Data analysis: SPSS software will be used for data analysis in quantitative phase. The data will be analyzed by implementing statistical tests of the descriptive statistics, compare means, Pearson’s correlations and linear regression analysis. Qualitative data analysis will be conducted using the conventional thematic analysis methodology, following the six-step framework(Familiarizing Yourself with the Data, Generating Initial Codes, Searching for Themes, Reviewing Themes, Defining and Naming Themes, Producing the Report/Manuscript) proposed by Braun and Clarke[ 21 ]. Ethics and dissemination: This embedded study protocol with the code IR.SSU.SPH.REC.1402.099 has been approved by the Research Ethics Committee of Shahid Sadoughi University of Medical Sciences. The rights of the participants will be respected by measures such as obtaining written informed consent to participate in the study, allowing note taking or audio recording of interviews, deleting audio files after the research is completed, and using a code instead of a name in all questionnaires. Participation in the research is optional and participants can withdraw from the study at any time. This research will be conducted based on international health research regulations and ethical guidelines for sharing and research exploitation of public data generated in Iran's health system. Declarations Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors . Competing interests : The authors declare no competing interests. Data Availability statement: Data sharing is not applicable to this article as no new data were created or analyzed in this study. Acknowledgments: We will being grateful to Shahid Sadoughi University of Medical Sciences for supporting this research. We wish to thank Torbat-Jam University of Medical Sciences, and Torbat Jam Governorate as well as all Afghan men and women who will participate in this study. References Violence against women [https://www.who.int/news-room/fact-sheets/detail/violence-against-women] Modi MN, Palmer S, Armstrong A: The role of Violence Against Women Act in addressing intimate partner violence: A public health issue . Journal of women's health 2014, 23 (3):253-259. Schafer J, Caetano R, Clark CL: Rates of intimate partner violence in the United States . American Journal of Public Health 1998, 88 (11):1702-1704. O'Doherty L, Hegarty K, Ramsay J, Davidson LL, Feder G, Taft A: Screening women for intimate partner violence in healthcare settings . Cochrane Database Syst Rev 2015, 2015 (7):Cd007007. Yakubovich AR, Stöckl H, Murray J, Melendez-Torres GJ, Steinert JI, Glavin CEY, Humphreys DK: Risk and Protective Factors for Intimate Partner Violence Against Women: Systematic Review and Meta-analyses of Prospective-Longitudinal Studies . Am J Public Health 2018, 108 (7):e1-e11. Kargar Jahromi M, Jamali S, Rahmanian Koshkaki A, Javadpour S: Prevalence and Risk Factors of Domestic Violence Against Women by Their Husbands in Iran . Glob J Health Sci 2015, 8 (5):175-183. Fridman SE, Prakash N: Intimate Partner Violence (IPV) as a Public Health Crisis: A Discussion of Intersectionality and Its Role in Better Health Outcomes for Immigrant Women in the United States (US) . Cureus 2022, 14 (5):e25257. W.H.O: Understanding and addressing violence against women: Intimate partner violence . In . ; 2012: 12. Feder L, Niolon PH, Campbell J, Whitaker DJ, Brown J, Rostad W, Bacon S: An Intimate Partner Violence Prevention Intervention in a Nurse Home Visitation Program: A Randomized Clinical Trial . J Womens Health (Larchmt) 2018, 27 (12):1482-1490. Dicola D, Spaar E: Intimate Partner Violence . Am Fam Physician 2016, 94 (8):646-651. Dalal K: Does economic empowerment protect women from intimate partner violence? J Inj Violence Res 2011, 3 (1):35-44. Saulle R, Sinopoli A, De Paula Baer A, Mannocci A, Marino M, De Belvis AG, Federici A, La Torre G: The PRECEDE-PROCEED model as a tool in Public Health screening: a systematic review . Clin Ter 2020, 171 (2):e167-e177. Kim J, Jang J, Kim B, Lee KH: Effect of the PRECEDE-PROCEED model on health programs: a systematic review and meta-analysis . Syst Rev 2022, 11 (1):213. Pogarell A, Garthus-Niegel S, Mojahed A, von Verschuer C, Rokyta U, Kummer W, Schellong J: Community Case Study on Trauma-Specific Treatment and Counseling for Refugee Women Exposed to Intimate Partner Violence . Front Psychiatry 2019, 10 :891. Delkhosh M, Merghati Khoei E, Ardalan A, Rahimi Foroushani A, Gharavi MB: Prevalence of intimate partner violence and reproductive health outcomes among Afghan refugee women in Iran . Health care for women international 2019, 40 (2):213-237. Dadras O, Nakayama T, Kihara M, Ono-Kihara M, Seyedalinaghi S, Dadras F: The prevalence and associated factors of adverse pregnancy outcomes among Afghan women in Iran; Findings from community-based survey . Plos one 2021, 16 (1):e0245007. Shams L, Tajik M, Heidari P, Nasiri T, Mohammadshahi M: Quality of life of Iranian and Afghan pregnant women in rural Iran . Ann Ig 2022, 34 (1):70-78. Lebano A, Hamed S, Bradby H, Gil-Salmerón A, Durá-Ferrandis E, Garcés-Ferrer J, Azzedine F, Riza E, Karnaki P, Zota D, Linos A: Migrants' and refugees' health status and healthcare in Europe: a scoping literature review . BMC Public Health 2020, 20 (1):1039. Taccini F, Rossi AA, Mannarini S: Women's EmotionS, Trauma and EmpowErMent (W-ES.T.EEM) study protocol: a psychoeducational support intervention for victims of domestic violence - a randomised controlled trial . BMJ Open 2022, 12 (8):e060672. Torbet Jam guest city for foreign immigrants [https://atba.khorasan.ir/RContent/0003P84D -%D9%85%D8%B9%D8%B1%D9%81%DB%8C- %D9%85%D9%87%D9%85%D8%A7%D9%86%D8%B4%D9%87%D8%B1-%D8%A7%D8%AA%D8%A8%D8%A7%D8%B9- %D9%88-%D9%85%D9%87%D8%A7%D8%AC%D8%B1% DB%8C%D9%86-%D8%AE%D8%A7%D8%B1%D8%AC%DB%8C-%D8%B4%D9%87%D8%B1%D8%B3%D8%AA% D8%A7%D9%86-%D8%AA%D8%B1%D8%A8%D8%AA- %D8%AC%D8%A7%D9%85.aspx] Kiger ME, Varpio L: Thematic analysis of qualitative data: AMEE Guide No. 131 . Medical teacher 2020, 42 (8):846-854. Footnotes Depression Anxiety Stress Scales Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4578090","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Study protocol","associatedPublications":[],"authors":[{"id":320481663,"identity":"3afd04b2-3a69-4b76-8c67-44902abbadd6","order_by":0,"name":"Mohammad 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citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Although both men and women experience intimate partner violence, more women are affected by IPV[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Violence against women \u0026ndash; particularly intimate partner violence and sexual violence \u0026ndash; is a major public health problem and a violation of women's human rights[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. IPV is a prevalent issue across countries [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] and, almost one third (27%) of women aged 15\u0026ndash;49 years who have been in a relationship report that they have been subjected to some form of physical and/or sexual violence by their intimate partner[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Individuals who experience IPV, suffer from reduced quality of life, pain and discomfort[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e], IPV can negatively affects women\u0026rsquo;s physical, mental, sexual, and reproductive health, and may increase the risk of acquiring HIV in some settings[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] and damages individuals, their children, communities, and the wider economic and social fabric of society [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] as well as IPV in pregnancy increases the likelihood of miscarriage, stillbirth, pre-term delivery and low birth weight babies[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Unfortunately, the incidence of violence against women and the resulting death is increasing [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIPV is multifactorial in its nature [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] such as individual factors (young age; low level of education; witnessing or experiencing violence as a child; harmful use of alcohol and drugs; personality disorders), relationship factors (conflict or dissatisfaction in the relationship; male dominance in the family; economic stress; man having multiple partners), community and societal factors(gender-inequitable social norms; poverty; low social and economic status of women; weak legal sanctions against IPV within marriage; lack of women\u0026rsquo;s civil rights, including restrictive or inequitable divorce and marriage laws; weak community sanctions against IPV) [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Some professional organizations recommend screening all women for violence [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eViolence against women is preventable[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. comprehensive, multi-sectoral, long-term collaboration between governments and civil society at all levels of the ecological framework are need[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. However systematic reviews have shown that there are relatively few IPV prevention/intervention programs[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e], The health sector has an important role to play to provide comprehensive health care to women subjected to violence, and as an entry point for referring women to other support services they may need[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. legislative reform and media campaigns recommended to increase IPV awareness, and Comprehensive services from the health, legal, and law enforcement sectors should be made available to survivors [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eSocial science theories of IPV have explained various causes of IPV, including men\u0026rsquo;s pathology, power relations, cultural norms, and learned behavior theory. However, no single theory has enough empirical support to explain the entire phenomena[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. The PRECEDE-PROCEED model was introduced in the 1970s by Green and Kreuter as a planning and evaluation model and is widely used in many fields including in analyzing the determinants of behavioral changes related to health status improvement over time [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. PRECEDE (Predisposing Reinforcing and Enabling Constructs in Educational Diagnosis and Evaluation) an acronym that is a good summary of the enabling, predisposing and reinforcing factors able to change a behavior, aims to make the appropriateness of the program to the needs of the populations and PROCEED (Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development by 4 steps regarding performance, realization and evaluations of the intervention and the impact of the intervention on the behavioral determinants [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. As Fig.\u0026nbsp;1 shows this model is a multistep approach for the development and implementation of a health promotion program and consists of eight phases: social assessment, epidemiological assessment, educational/ecological assessment, administrative/policy assessment and intervention planning, implementation, process evaluation, impact evaluation, and performance evaluation[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe immigrant population is at a special risk of IPV due to the change in social status, the longtime of migration and the norms of the country of origin [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] also, research results show that immigrant and refugee women are more vulnerable to intimate partner violence due to broken social and support networks, lack of access to employment with sufficient income, and being dependent on an intimate partner [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Currently, Iran is the third host country for refugees in the world with the presence of Afghan immigrants.[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] About 2.5\u0026nbsp;million Afghans live in Iran [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] However, in recent years, the Iranian government has introduced policies aimed at increasing access to education, health care, and livelihood services for Afghan refugees residing in Iran[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].Taking care of the refugee and more vulnerable populations in every country and advancing the care of immigrant women affected by IPV will allow for advanced public health measures for the whole nation [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The prevalence of violence and insecurity among refugees living in camps or shelters is lower than homeless people and those living in public emergency accommodation[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].Despite the long-term presence of Afghans in Iran, not much comprehensive research has been conducted on the status of intimate partner violence.\u003c/p\u003e \u003cp\u003eDue to the effectiveness of empowerment interventions and dialectical behavior therapy (DBT) in improving self-esteem, self-efficacy and regulation of emotions among victims of violence, these studies have received special attention among different treatments for IPV victims [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\"\u003e\n \u003ch2\u003eStudy design:\u003c/h2\u003e\n \u003cp\u003eThis study employs an embedded mixed-method study with quantitative, qualitative and intervention phases. Figure 2 shows a diagram with the different phases of the study.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec4\"\u003e\n \u003ch2\u003eThe participants:\u003c/h2\u003e\n \u003cp\u003eTorbat Jam Foreign Refugee Camp of Iran, located 10 km from Torbat Jam city and 120 km from Mashhad city, was established in 1994 and has accepted, accommodated and provided services to about 5000 Afghan refugees[\u003cspan\u003e20\u003c/span\u003e]. The participants in the first phase of the (quantitative) study are married Afghan women who currently live with their husbands in Torbat Jam refugee camp. In the second (qualitative) phase, the participants will be women who reported the highest IPV score in the first phase and their spouses. The participants of the intervention phase will also be selected from the first group.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec5\"\u003e\n \u003ch2\u003eSample size calculation:\u003c/h2\u003e\n \u003cp\u003eThe sample size in the first phase of the study (quantitative phase) to investigate the prevalence of intimate partner violence in the community was estimated based on the information of Khoshdel et al.\u0026apos;s [\u003cspan\u003e15\u003c/span\u003e] study, which estimated the prevalence at 80%, with an error of 5% and accuracy of 5%, and with adjustments for a limited population of 189 people. In this way, the sample size was considered to be 226 people, including 20% attrition.\u003c/p\u003e\n \u003cp\u003e\u003cimg src=\"https://myfiles.space/user_files/122228_c8a1650c59388082/122228_custom_files/img1720608197.png\"\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003eIn the second phase of this study (qualitative phase), targeted sampling will be done from among the people who participated in the first phase of the study (the highest score of the violence questionnaire and with the maximum variety) until the saturation limit is reached. The sample size in the intervention phase will be calculated according to the information obtained from the first phase.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec6\"\u003e\n \u003ch2\u003eParticipants assessment and measurements:\u003c/h2\u003e\n \u003cp\u003eDemographic data such as the age of the woman and her husband, the level of education of the woman and her husband, family composition, years of marriage, the status of the worker and her husband, current intimate relationship information, immigration status, alcohol consumption and substance abuse of the woman and her husband in writing and Self-reporting will be reported. The state of quality of life is measured by S-F12 questionnaire. In addition to using the DASS 21 questionnaire, which measures stress, anxiety, and depression, the health status is assessed by asking questions about the effects and physical injuries of violence, such as abortion, fracture, bone fracture, tooth fracture, bruise, scratch, tear, puncture, burn, tooth extraction. More serious injuries such as injuries to the head, eyes, ears, chest and abdomen, as well as blood sugar, blood pressure and lipid measurements will be measured. The IPV situation will also be measured with Haj Yahya et al.\u0026apos;s standard questionnaire (32 items and 4 factors to measure mental, physical, sexual and economic violence).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec7\"\u003e\n \u003ch2\u003eProcedure:\u003c/h2\u003e\n \u003cp\u003eThe implementation steps of the study are shown in Fig.\u0026nbsp;3:\u003c/p\u003e\n \u003cspan\u003eA) The first phase (quantitative): In this phase, the first and second steps of the PRECEDE-PROCEED model will be done as follows:\u003cbr\u003e\n \u003cspan\u003ea. The first stage (social assessment):\u003cbr\u003e\u003c/span\u003e\u003cbr\u003e\n \u003c/span\u003e\n \u003cp\u003eThe first step begins with the final result, which is the quality of life of women living in Torbat Jam refugee camp. Different objective and subjective methods are available to check the quality of life, at this stage SF-12 standard quality of life questionnaire will be used to measure the quality of life. The SF-12 questionnaire is a general tool for measuring the health status of people aged 14 and over, which includes 12 questions and two mental and physical scales and 8 subscales (physical performance, limitations in playing physical roles, physical pains, general health, energy and Vitality is social functioning, playing an emotional role, and mental-psychological health.\u003c/p\u003e\n \u003cdiv\u003e\n \u003cp\u003eb. The second stage (epidemiological, behavioral and environmental assessment):\u003c/p\u003e\n \u003c/div\u003e\n \u003cp\u003eAt this stage, important health problems and the health status of the participants are examined. At this stage, the health status of Afghan women living in Torbat Jam refugee camp is analyzed using three indicators of anxiety, stress and depression (DASS21)[1]\u003ca href=\"#Fn1\" id=\"#FNLinkFn1\"\u003e\u003c/a\u003e, some physiological indicators (including blood sugar, blood fat, blood pressure) as well as some injuries caused by violence in women, such as a history of abortion due to violence, broken bones, broken teeth, etc. will be investigated. Also, to determine the status of IPV in Afghan women living in Torbat Jam refugee camp, Haj Yahya\u0026apos;s standard questionnaire for measuring violence against women will be used. This questionnaire has 32 items and 4 factors to measure mental, physical, sexual and economic violence, and its validity and reliability have been confirmed in various studies in Iran.\u003c/p\u003e\n \u003cp\u003e\u003cspan\u003eB) The second phase (qualitative), after collecting the necessary information in the first phase and analyzing them, the second phase of the current study (qualitative phase) will begin. In this phase, the study of the third phase of the PRECEDE-PROCEED model (educational and ecological survey) will be conducted.\u003cbr\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003eIn the qualitative phase of this study, the semi-structured interview method will be used to collect information with an emphasis on predisposing, enabling and strengthening factors. At this stage, the researcher will participate in focus groups or conduct individual interviews with the participants while taking notes of the conversations, and with their permission, the conversations will be recorded and implemented on the same day. An interview guide will be used to guide the interview. The duration of each interview is expected to be 30\u0026ndash;60 minutes, and data analysis will begin at the same time as data collection. The experiences and opinions of women and men about the dimensions, reasons and factors of violence against women will be collected with emphasis on predisposing, enabling and strengthening factors. In this phase of the study, which can be considered a qualitative study of phenomenology, behavioral and environmental factors that are closely related to IPV behavior are examined. Predisposing factors such as knowledge, attitude, beliefs, values, capacities and beliefs, enabling factors such as access to resources, rules and regulations, skills, etc., and reinforcing factors such as family, social groups, community leaders, decision makers and, \u0026hellip; are identified, explained and categorized in this phase.\u003c/p\u003e\n \u003cspan\u003eC) The third phase (intervention phase), in this phase of the study, based on the results obtained from the qualitative phase, with the localization of the existing conditions, the necessary interventions will be designed and implemented based on the fourth to eighth stages of the PRECEDE-PROCEED model.\u003cbr\u003e\n \u003cspan\u003ea. The fourth and fifth stages of the PRECEDE-PROCEED model (administrative \u0026amp; policy assessment and intervention alignment and implementation):\u003cbr\u003e\u003c/span\u003e\u003cbr\u003e\n \u003c/span\u003e\n \u003cdiv\u003e\n \u003cp\u003eBased on the qualitative phase, and the analysis of predisposing, strengthening and enabling factors, programs for intervention will be predicted. These interventions can include a range of life skills training, including increasing self-awareness, problem solving, effective communication, emotion management, empathy, interpersonal relationships, and introduction and coordination with available counseling and support centers, providing face-to-face and online counseling facilities, support Asking volunteer organizations and institutions to help (welfare, women\u0026apos;s affairs of the governorship, etc.) and make special policies for this population.\u003c/p\u003e\n \u003c/div\u003e\n \u003cp\u003e\u003cspan\u003eb. Sixth to eighth steps of the PRECEDE-PROCEED model (evaluation of process, impact and outcome):\u003cbr\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003eAt this stage, evaluation will be done by using the questionnaires of the first phase of the study and also by checking the implementation process of the programs. The evaluation of the process will include the review and monitoring of the number of training sessions, the number of participants, access to training resources and the satisfaction of the participants. The Impact evaluation will examine the immediate impact of the programs on the IPV situation, and the Outcome evaluation will examine the health status and quality of life of Afghan women living in Torbat Jam refugee camp, after the interventions.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec8\"\u003e\n \u003ch2\u003eData analysis:\u003c/h2\u003e\n \u003cp\u003eSPSS software will be used for data analysis in quantitative phase. The data will be analyzed by implementing statistical tests of the descriptive statistics, compare means, Pearson\u0026rsquo;s correlations and linear regression analysis.\u003c/p\u003e\n \u003cp\u003eQualitative data analysis will be conducted using the conventional thematic analysis methodology, following the six-step framework(Familiarizing Yourself with the Data, Generating Initial Codes, Searching for Themes, Reviewing Themes, Defining and Naming Themes, Producing the Report/Manuscript) proposed by Braun and Clarke[\u003cspan\u003e21\u003c/span\u003e].\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec9\"\u003e\n \u003ch2\u003eEthics and dissemination:\u003c/h2\u003e\n \u003cp\u003eThis embedded study protocol with the code IR.SSU.SPH.REC.1402.099 has been approved by the Research Ethics Committee of Shahid Sadoughi University of Medical Sciences. The rights of the participants will be respected by measures such as obtaining written informed consent to participate in the study, allowing note taking or audio recording of interviews, deleting audio files after the research is completed, and using a code instead of a name in all questionnaires. Participation in the research is optional and participants can withdraw from the study at any time. This research will be conducted based on international health research regulations and ethical guidelines for sharing and research exploitation of public data generated in Iran\u0026apos;s health system.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors\u003cspan dir=\"RTL\"\u003e.\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e:\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability statement:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData sharing is not applicable to this article as no new data were created or analyzed in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe will being grateful to Shahid Sadoughi University of Medical Sciences for supporting this research. We wish to thank Torbat-Jam University of Medical Sciences, and Torbat Jam Governorate as well as all Afghan men and women who will participate in this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003e\u003cstrong\u003eViolence against women \u003c/strong\u003e[https://www.who.int/news-room/fact-sheets/detail/violence-against-women]\u003c/li\u003e\n\u003cli\u003eModi MN, Palmer S, Armstrong A: \u003cstrong\u003eThe role of Violence Against Women Act in addressing intimate partner violence: A public health issue\u003c/strong\u003e. \u003cem\u003eJournal of women\u0026apos;s health \u003c/em\u003e2014, \u003cstrong\u003e23\u003c/strong\u003e(3):253-259.\u003c/li\u003e\n\u003cli\u003eSchafer J, Caetano R, Clark CL: \u003cstrong\u003eRates of intimate partner violence in the United States\u003c/strong\u003e. \u003cem\u003eAmerican Journal of Public Health \u003c/em\u003e1998, \u003cstrong\u003e88\u003c/strong\u003e(11):1702-1704.\u003c/li\u003e\n\u003cli\u003eO\u0026apos;Doherty L, Hegarty K, Ramsay J, Davidson LL, Feder G, Taft A: \u003cstrong\u003eScreening women for intimate partner violence in healthcare settings\u003c/strong\u003e. \u003cem\u003eCochrane Database Syst Rev \u003c/em\u003e2015, \u003cstrong\u003e2015\u003c/strong\u003e(7):Cd007007.\u003c/li\u003e\n\u003cli\u003eYakubovich AR, St\u0026ouml;ckl H, Murray J, Melendez-Torres GJ, Steinert JI, Glavin CEY, Humphreys DK: \u003cstrong\u003eRisk and Protective Factors for Intimate Partner Violence Against Women: Systematic Review and Meta-analyses of Prospective-Longitudinal Studies\u003c/strong\u003e. \u003cem\u003eAm J Public Health \u003c/em\u003e2018, \u003cstrong\u003e108\u003c/strong\u003e(7):e1-e11.\u003c/li\u003e\n\u003cli\u003eKargar Jahromi M, Jamali S, Rahmanian Koshkaki A, Javadpour S: \u003cstrong\u003ePrevalence and Risk Factors of Domestic Violence Against Women by Their Husbands in Iran\u003c/strong\u003e. \u003cem\u003eGlob J Health Sci \u003c/em\u003e2015, \u003cstrong\u003e8\u003c/strong\u003e(5):175-183.\u003c/li\u003e\n\u003cli\u003eFridman SE, Prakash N: \u003cstrong\u003eIntimate Partner Violence (IPV) as a Public Health Crisis: A Discussion of Intersectionality and Its Role in Better Health Outcomes for Immigrant Women in the United States (US)\u003c/strong\u003e. \u003cem\u003eCureus \u003c/em\u003e2022, \u003cstrong\u003e14\u003c/strong\u003e(5):e25257.\u003c/li\u003e\n\u003cli\u003eW.H.O: \u003cstrong\u003eUnderstanding and addressing violence against women: Intimate partner violence\u003c/strong\u003e. 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Findings from community-based survey\u003c/strong\u003e. \u003cem\u003ePlos one \u003c/em\u003e2021, \u003cstrong\u003e16\u003c/strong\u003e(1):e0245007.\u003c/li\u003e\n\u003cli\u003eShams L, Tajik M, Heidari P, Nasiri T, Mohammadshahi M: \u003cstrong\u003eQuality of life of Iranian and Afghan pregnant women in rural Iran\u003c/strong\u003e. \u003cem\u003eAnn Ig \u003c/em\u003e2022, \u003cstrong\u003e34\u003c/strong\u003e(1):70-78.\u003c/li\u003e\n\u003cli\u003eLebano A, Hamed S, Bradby H, Gil-Salmer\u0026oacute;n A, Dur\u0026aacute;-Ferrandis E, Garc\u0026eacute;s-Ferrer J, Azzedine F, Riza E, Karnaki P, Zota D, Linos A: \u003cstrong\u003eMigrants\u0026apos; and refugees\u0026apos; health status and healthcare in Europe: a scoping literature review\u003c/strong\u003e. \u003cem\u003eBMC Public Health \u003c/em\u003e2020, \u003cstrong\u003e20\u003c/strong\u003e(1):1039.\u003c/li\u003e\n\u003cli\u003eTaccini F, Rossi AA, Mannarini S: \u003cstrong\u003eWomen\u0026apos;s EmotionS, Trauma and EmpowErMent (W-ES.T.EEM) study protocol: a psychoeducational support intervention for victims of domestic violence - a randomised controlled trial\u003c/strong\u003e. \u003cem\u003eBMJ Open \u003c/em\u003e2022, \u003cstrong\u003e12\u003c/strong\u003e(8):e060672.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eTorbet Jam guest city for foreign immigrants \u003c/strong\u003e[https://atba.khorasan.ir/RContent/0003P84D\u003cbr\u003e-%D9%85%D8%B9%D8%B1%D9%81%DB%8C-\u003cbr\u003e%D9%85%D9%87%D9%85%D8%A7%D9%86%D8%B4%D9%87%D8%B1-%D8%A7%D8%AA%D8%A8%D8%A7%D8%B9-\u003cbr\u003e%D9%88-%D9%85%D9%87%D8%A7%D8%AC%D8%B1%\u003cbr\u003eDB%8C%D9%86-%D8%AE%D8%A7%D8%B1%D8%AC%DB%8C-%D8%B4%D9%87%D8%B1%D8%B3%D8%AA%\u003cbr\u003eD8%A7%D9%86-%D8%AA%D8%B1%D8%A8%D8%AA-\u003cbr\u003e%D8%AC%D8%A7%D9%85.aspx]\u003c/li\u003e\n\u003cli\u003eKiger ME, Varpio L: \u003cstrong\u003eThematic analysis of qualitative data: AMEE Guide No. 131\u003c/strong\u003e. \u003cem\u003eMedical teacher \u003c/em\u003e2020, \u003cstrong\u003e42\u003c/strong\u003e(8):846-854.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Footnotes","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003e Depression Anxiety Stress Scales\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"intimate partner violence, refugee, health status, quality of life, PRECEDE-PROCEED model","lastPublishedDoi":"10.21203/rs.3.rs-4578090/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4578090/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eMore than a third of women around the world have experienced intimate partner violence (IPV). IPV is an important public health issue and a human rights issue. IPV has more severe consequences in refugees. More than 2.5\u0026nbsp;million Afghan refugees and immigrants live in Iran. The PRECEDE-PROCEED model is one of the most practical health promotion modes in interventions. The purpose of this study is to investigate the IPV situation in Afghan refugees living in Torbat Jam camp and its relationship with their health and quality of life and to design an intervention program to reduce it based on the PRECEDE-PROCEED health promotion model.\u003c/p\u003e\u003ch2\u003eMethod\u003c/h2\u003e \u003cp\u003eThis study employs an embedded mixed-method study with quantitative, qualitative and intervention phases study that was designed at the Afghan refugee population living in Iran's Torbat Jam camp. Quality of life data will be collected with the SF-12 questionnaire, mental health status information with the DASS-21 questionnaire, and IPV status information with the Haj Yahya violence against women questionnaire. In the qualitative phase, information will be collected in the form of in-depth interviews with the participants. By carrying out the qualitative phase, the factors affecting IPV will be determined and the necessary interventions to reduce and prevent it will be carried out based on the PRECEDE-PROCEED model of health promotion.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eDemographic variables and descriptive tables will be presented, the relationship of IPV with demographic variables, health status and quality of life will be measured. Predictors of IPV should be identified.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe results of this intervention will show the relationship between health status and quality of life with IPV, which can be used to design interventions.\u003c/p\u003e","manuscriptTitle":"Design, implementation, and evaluation of a PRECEDE-PROCEED model-based intervention to reduce Intimate Partner Violence against women in Afghan men living in Refugee Camp of Torbat Jam County (Iran): Protocol for an Embedded study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-18 16:06:03","doi":"10.21203/rs.3.rs-4578090/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ea71dfd4-2eaa-44b4-991a-f29fc2a7bdac","owner":[],"postedDate":"July 18th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-08-09T07:32:06+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-18 16:06:03","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4578090","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4578090","identity":"rs-4578090","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}