Title: Intimate partner violence and post-migration stressors reported by refugee women
accessing settlement services
Version: 2 Date: 22 Nov 2024
Reviewer's report:
Thank you for the opportunity to review “Intimate partner violence and post-migration stressors
reported by refugee women accessing settlement services” this is an interesting manuscript that
fills an interesting gap in the existing literature by exploring IPV with refugee women in a “non-
traditional” setting. This manuscript reads well, but there are just a few areas that might benefit
from minor revisions to strengthen the message and improve clarity. I hope these comments are
found useful to the authors.
Specific Aim/Research Objectives – It would be helpful if the authors had a clear statement of
the research aim or research objective. At times the text was dense and this will help with clarity.
The authors state this is a mixed methods study (focus group) however, there are no details
presented on the methods used for the qualitative aspect of this study.
The authors identified distress as measured using the Kessler Psychological Distress Scale,
however there was no clear definition of distress. The introduction identifies depression and
anxiety. On pg 5-6 the authors state “ While pre-migration stressors are well understood
to be cause for poor mental health (Department of Social Services, 2017), stressors in the
post-migration period are increasingly recognized as significant to psychological functioning
(Cooper, Enticott, Shawyer, & Meadows, 2019; Li, Liddell, & Nickerson, 2016; Wu et al.,
2021). Depression and anxiety are common experiences for former refugees. (Blackmore et al.,
2020). However, psychological distress can include sadness, anxiety, restlessness, tension, loss
of interest, and unhappiness, it can manifest as fatigue, avoidance of social situations, fear, anger,
and moodiness. Having some consistency, guiding definition and connecting this to the decision
and rationale around the use of the Kessler. Would strengthen this manuscript.
The timeline and methods were not always clear. It might be helpful to include a figure to outline
what happened when. It was not always clear the full scope of the intervention – it seems to
include IPV screening and follow up, not sure the intensity, duration of follow up etc.. It is
understood that the details of the intervention are reported elsewhere, but some details on the
follow up conversation here would help understand/contextualize the results (average length of
time for example). There is data about actions taken, are these a focus of the intervention.
Further it was not always clear about pre/post data the result. At one point it states: “Full consent
was taken at the time of the survey, after informing participants that the key focus of the survey
was the IPV screening conducted at study sites at the time of their initial consent to re-contact”
pg. 10-11 and other point it states “The survey was conducted approximately three months
following participants’ visit to the settlement service” pg 7
Including the wording of family violence question would be helpful as it is outlined in the results
“the survey included a question on violence by other family members for those who identified
IPV”
The authors reported “As reported, we found no association between length of residency in
Australia  and disclosure of abuse, with women who had arrived less than two years earlier being
as likely as those who had been in Australia five years or more, to report abuse. On the one
hand, those who recently arrived may be more likely to have experienced recent abuse due to
exacerbating stressors of forced migration and/or the conflict which typically” It is not clear how
this was defined and measures. Specifically there are mentions of various times like immediate
post arrival, yet the time frame here is less than 2 years, which seems like a long time. More
details about timeframes would be helpful.
Some minor points.
The acronym UNHCR does not appear to be spelled out anywhere in the manuscript, it there a
formal name? If so, it would be useful to spell this out.
There are a number of typos in the manuscript, to help with a revision I will include below:
Pg 7: Our initial plan for a comparative study using interrupted time servies became unfeasible
due to delays caused by the Australian international border closure during the COVID-19
pandemic.
Pg 8: They wereinvited to register initial interest in participating in a telephone survey on
women’s health and safety and their experience of the service
Pg 8: Recognising that other forms of family violence occur, the survey included a question on
violence by other family members for those who identified IPV
Pg 14: Among participants who answered the psychological distress items, 24% (n=74) gave
responses indicating probable serious psychological distress on the K6, with 11 10 responses
missing
Pg 16: Of these two,,one made a comment that the caseworker had suggested she seek a referral
to a psychiatrist by her family doctor