Introduction: Intimate partner violence (IPV) is a widespread social structural problem that affects a great proportion of Ecuadorian women. IPV is a sexually, psychologically, or physically coercive act against an adult or adolescent woman by a current or former intimate partner. Not-for-profit groups in Ecuador report that 70% of women experience 1 of the forms of IPV sometime during their lifetime, but population-based surveys suggest that 41% of Ecuadorian women are exposed to emotional violence, 31% physical violence, and 12% sexual violence by their spouse or partner over their lifetime. Despite the high prevalence, the response of the Ecuadorian government has been insufficient to reduce the number of victims and to provide adequate legal and health services for the prevention and treatment of IPV. Given the power of economic data to influence policy making, the goal of this study is to produce the first estimate of the economic impact of IPV in Ecuador and to identify the policy paths in which these estimates would have the greatest impact for Ecuador.

Methods: Using a bottom-up method for estimating the economic burden of IPV and a national prevalence of IPV based on a population-based survey in the 2003–2004 year, the total economic burden is estimated at approximately $109 million adjusted to the 2012 United States (U.S.) currency rate. Results: Based on a prevalence of 255,267 women who were victims of IPV in the 2003–2004 year, the total economic burden is estimated at approximately $109 million adjusted to the 2012 the U.S. currency rate. The largest cost category contributing to the economic burden was the costs of healthcare services to treat injuries associated with IPV events.

Conclusion: The asymmetry between the economic burden of IPV and the amount of government resources devoted to IPV prevention efforts suggests the need for a greater role to be played by the government and other factors in society in the area of IPV prevention. [West J Emerg Med. 2013;14(4):347–353.]

Objective: The objectives of this analysis were to: 1) assess the impact of sociodemographic factors, and perceived costs and benefits on engagement in a parenting program designed to prevent child maltreatment, 2) determine if perceived costs and benefits mediated the association between sociodemographic factors and engagement, and 3) assess whether or not race/ethnicity moderated the relationship between sociodemographic factors, perceived costs and benefits, and engagement.

Methods: Perceived costs and benefits of the intervention were assessed from parents providing self-reports, including satisfaction/ usefulness of the program (benefits), and time/difficulty associated with the program (costs). Engagement was defined as attendance at both the mid-point and then the number of visits attended throughout the remainder of the intervention. To investigate the direct and indirect effects (through perceived costs and benefits) of parental sociodemographic factors (education, age, gender, number of children, household income) on program engagement, data were analyzed with structural equation modeling (SEM). To assess the potential moderating effect of race/ethnicity, separate models were tested for White and African-American parents.

Results: Perceived benefits positively impacted attendance for both White (n=227) and African-American (n=141) parents, whereas perceived costs negatively influenced attendance only for White parents. Parent education and age directly impacted attendance for White parents, but no sociodemographic factor directly impacted attendance for African-American parents. The indirect impact of sociodemographic characteristics on attendance through perceived costs and perceived benefits differed by race/ethnicity.

Conclusions: Results suggest that White parents participate in a parenting program designed to prevent child maltreatment differently based upon their perceived benefits and costs of the program, and based on benefits only for African-American parents. Parental perception of costs and/or benefits of a program may threaten the effectiveness of interventions to prevent child maltreatment for certain racial/ethnic groups, as it keeps them from fully engaging in empirically validated programs. Different methods may be required to retain participation in violence prevention programs depending upon race/ethnicity.

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