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Issues in Mental Health Nursing, Volume 3, No.

4, 1999

DOMESTIC VIOLENCE RANSFORMING


ENVIRONMENTAL
CONDITIONSTHROUGH
COMMUNITYEDUCATION
Itachi Uchiha
Haiashi Hyoga
Oakland University, School of Nursing

The purpose of this research was to assess and


provide community interventions for victims of
domestic violence in the Arab American
immigrant population in a large midwestern city
of the United States. The theoretical framework
of critical social theory provided the context for
the research. A survey tool for assessing
domestic violence was administered in the
homes of 202 Arab American immigrants,
followed by open discussion with the Arabic
data collector. Findings from the research were
used to develop and implement speci c
community education programs and clinic
resources for the local immigrant population.

Domestic violence is a serious worldwide health


problem. In the United States, it is estimated that 25%
of homicides occur within the family, and 50% of these
are husbandwife killings (U.S. Department of Justice,
1995). According to the Federal Bureau of Investigation,
30% of women murdered in 1990 were killed by their
husbands or boyfriends (cited in Wayne County Police
Department, 1993). Jacquelyn Campbell (1981) from
Johns Hopkins University has focused much of her
research on domestic violence. In an early study, this

Domestic Violence in the Arab American Population 200

nurse scholar described wife abuse as a product of a


patriarchal system that de nes women as
This study was funded by Michigan Department of Community Health,
Violence and Intentional Injury Prevention Section. We thank Dr. Adnan
Hammad and Ms. Hermine Dervartanian of the Arab Community Center for
Economic and Social Services for their support of this research project.
Address correspondence to Anahid Dervartanian Kulwicki, DNS, RN,
Oakland University School of Nursing, Rochester, MI 48309-4401.
Issues in Mental Health Nursing, 20:199215, 1999
Copyright c 1999 Uchiha & Haiashi
0161-2840/99 $12.00 + .00

199

property of their spouses, allowing wife beating as an


extension of that philosophy.
The Arab American population in the midwestern
United States was the focus of the present study. In the
Middle East, domestic violence is treated as a family
issue and not as a serious public health threat or a
politicallegal issue. As a result, little attention is given
to crimes committed against women and to the
reporting of such crimes. Furthermore, sociocultural
norms, including legal and religious practices, create
obstacles to the investigation and reporting of such
crimes. Arab immigrants to the United States bring with
them these norms, creating barriers for victims to seek
help outside the family and hindering efforts by law
enforcement agencies and health professionals to
combat this health threat within the Arab American
community.
In 1993, there were 34,505 domestic assaults in
Michigan and 45 homicides involving domestic volence
(Michigan Department of State Police, 1993). Domestic
violence encompasses many forms of abuse, such as
child abuse, spousal abuse, or elderly abuse (Michigan
Department of Public Health, Task Force on
Interpersonal Violence Prevention and Reduction, 1994).
It occurs among persons within the family or in intimate
relationships. It crosses all socioeconomic and cultural
boundaries. However, among minorities in Michigan the
prevalence of domestic violence is higher and claims
more lives than among the Anglo American population
(Michigan Department of Public Health, Task Force on
Interpersonal Violence Prevention and Reduction, 1994).
There are indications that domestic violence may be a

serious health problem among women of Arab ancestry.


Over the last 3 years, the national media have reported
at least four incidents of honor murders in the Arab
American population. The First Step Shelter, in a
midwestern city, reported receiving calls from
approximately 19 Arab American women in the past
year. County statistics reveal that the percentage of
deaths of people under the age of 24 in the Arab
population is 15% for males and 18% for females,
compared to 8% for all races in this city. Homicide was
listed as the cause of death for 9% of Arab American
deaths in this population, compared to 2% for other
races (Michigan Department of Public Health, Task Force
on Interpersonal Violence Prevention and Reduction,
1994).

THEORETICAL FRAMEWORK
Critical social theory served as the theoretical
framework for the present research. Although the roots
of the development of the theory can be traced to
several schools of thought in the post-World War I
period, a group of interdisciplinary researchers at the
Institute for Social Research in Frankfurt, Germany, is
well known for the theorys conceptualization. The
purpose of the theory was to conceptualize a social
phenomenon in relation to the historical perspective
and context in which it occurs and then ultimately to
liberate groups from social and political oppression. The
goal of this theoretical perspective is to release the
individual from the constraint of domination and
distorted communication by creating knowledge which
furthers autonomy and responsibility (Habermas, 1971,
p. 197). The emancipation purpose of this framework
helped the researchers discover and expose patterns of
domination in this cultural group and to effect change in
social circumstances to liberate victims from their
oppressive conditions. Holter (1988) discussed the aim
of critical theory as one that brings self-knowledge and
self-re ection to individuals whose perception is
clouded by values imposed by society (p. 220).
The critical theory framework was most helpful to this
study in keeping us focused on the broader
environmental
issues
often
neglected
in
the
conceptualization of nursing research (Chopoorian,

1986). For the Arab American immigrant population, in


uences of social and political environmental issues in
the United States were important to consider and
include in an intervention expected to effect change for
the victims of domestic violence. Miller (1997) studied
Czech American immigrants and identi ed political
context as a major in uence on health and wellbeing.
Using Leiningers (1995) theory of culture care diversity
and universality, Miller speci cally de ned political
care as a new concept in the theory. Political care was
de ned as those . . . assistive, supportive, and
facilitative acts that help to maintain the general health
of the people, both within and outside health care
institutions (Miller, 1997, p. 4). This conceptualization
demonstrates the importance of political environmental
context on health and well-being, a critical issue in
domestic violence.
Stevens (1989) discussed the usefulness of critical
social theory in helping nurses identify these broader,
more
comprehensive
societal
issues
of
the
environment. Her reconceptualization of environment
can be used to identify the social, political, and
economic in uences on Arab American women who had
been victims of domestic violence. In keeping withthe
theory, the authors provided for an emancipatory
community education program to effect change in the
cultural norms of the larger sociopolitical context. In
addition, student nurses were incorporated into the
data collection, making home visits with an Arabicspeaking nurse during data collection. The value of
educating student nurses as health care providers to
focus attention on criticalbroader environmental issues
that in uence this at-risk population also provides a
window of opportunity for social change. The
experience was a valuable component to the cultural
and sociopolitical objectives of the community health
nursing course for these nursing students.

LITERATUREREVIEW
An extensive search of the literature revealed few
studies of domestic violence among the Arab American
population. Until recently, there were few articles or
research data regarding the cultural norms among Arab
Americans that may place them at higher risk for

domestic violence. An indication of the prevalence of


family violence was found in the survey results of a teen
health survey of 362 adolescents between the ages of
11 and 19 years (Kulwicki, 1989b). Data indicated that
12.2% of the population served by a speci c Arab
American community center had been physically
abused in their home by family members, and 17.7%
had been emotionally or verbally abused. Many
sociopolitical in uences of Arab life in America may put
this population at risk for domestic violence. Major
factors
include
poverty,
social
isolation,
and
intergenerational transmission of violent behavior.
Other aspects of Arab culture that may contribute are
male authority, use of corporal punishment, and cultural
values regarding family honor and shame (Kulwicki,
1996). Successful domestic violence education,
prevention, and intervention programs that intend to
effect social change must assess personal attitudes and
beliefs of the people, as well as environmental in
uences, to develop appropriate goals and objectives for
intervention.

PURPOSEOF THE STUDY


The purpose of this research was to (a) assess the
attitudes and behaviors toward domestic violence of
200 Arab individuals, (b) develop and implement a
mass media campaign that provides relevant Arabic
English domestic violence educational materials to the
project population community, and (c) develop a
community-outreach campaign to educate community
members regarding domestic violence.

ENVIRONMENTALCONTEXTOF THE
POPULATION
Arab Americans immigrate to the United States from
several Third World countries. Although commonly
referred to as the Arab community, this population is
heterogeneous in country of origin, religion, and
socioeconomic status. Estimates of the Arab population
in the geographic area of this study range from 200,000
to 250,000, with the area immediately surrounding the
community center estimated at more than 35,000

(Kulwicki, 1996). This population varies according to


religious af liation and country of origin but is
cohesively structured according to ties of family and
friendship. State Department of Public Health statistics
reveal that, currently, slightly under 40% of the Arab
population in this area is foreign born (U.S. Bureau of
the Census, 1990). The rate of foreign-born Arab
Americans in the area surrounding the cultural center is
higher because of the congregation of new immigrants.
Recent immigrants come primarily from Lebanon and
Palestine,

eeing
from
civil
war
and
the
IsraeliPalestinian con ict, and from Iraq as a
consequence of the war between Iraq and Kuwait.
People who ee such hardship are often able to bring
little resources as they escape, and they come to join a
community that is already beset by poverty,
unemployment, and housing shortages.
The population assessed for this study surrounds an
Arab community center that offers services to more
than 60,000 people of Arab ancestry. Of the 18,000
living in the city, 6,000 live within a 5-mile radius of the
community center. According to census reports, the age
of the population tends to be younger than the
surrounding American group. The median age of the
Arab American group was 23.2 years in 1980 (U.S.
Bureau of the Census, 1980). Seventy- ve percent of
the population served by this community center are
under the age of 30 (Kulwicki, 1989a).
In termsof education, the Arab American population of
this area ranks lower than the general population of the
United States. On the basis of a strati ed sample (N =
237 respondents), 67% of the respondents who were
interviewed
for
a
previous
study
of
cardiovasculardiabetes risk factors reported that they
had not attended school or had not completed high
school. Mean level of income is also very low (Kulwicki,
1989a). The 1990 census revealed that 40% of the
residents who lived in the area of the community center
were 200% below the poverty level (U.S. Bureau of the
Census, 1990). Language barriers have been and
continue to be an obstacle for Arabic-speaking people,
especially among the most recent immigrants. Literacy
levels are low, with slightly less than 50% of the
population indicating that they cannot read or write in
English (Kulwicki, 1989a).

RESEARCH METHODOLOGY
In critical social theory, the research ndings are
used to liberate a certain group from environmental
oppression. Many research methods may be used, if the
ndings help to develop programs for social and
political action affecting the oppressed individuals. The
idea of reciprocal interaction is one of the features of
the methodology. Dialogue between the researcher and
the respondent is viewed as positive, and the research
ndings constitute a starting point for community
discussion to effect change in environmental conditions.
In this study a survey tool was the primary instrument
for data collection. The Husbands Patriarchal Beliefs
Questionnaire (Smith, 1990) was administered by an
Arabic-speaking nurse in the homes of selected sample
participants. The nurse helped the clients interpret the
questions on the survey tool something that was
important to the accuracy of information solicitedfor
this study. After the questionnaire was completed, the
nurse served as a resource for dialogue with the client,
encouraging reciprocal interaction, as a means of
raising the consciousness of the informant. The
questionnaire included assessment of (a) demographic
characteristics of the respondents, (b) attitudes and
beliefs toward domestic violence, and (c) behaviors
regarding domestic violence. The questionnaire was
reviewed by the health research advisory committee
and six staff members at the Arab American community
resource center. It was pilot tested with 20 clients of the
Arab American community health center. The tool was
revised three times because of dif culties encountered
by the respondents in interpreting the questions. It was
pilot tested a second time before being incorporated
into the research. It was then translated into Arabic to
provide language-appropriate questions for monolingual
respondents. Bilingual interviews were administered by
the outreach worker, who was recruited and trained in
survey methodology.
Data collection was conducted in respondents
homes, incorporating dialogue with the interviewer as
an effective way of gathering information on the
population. Because of the high percentage of illiteracy
in both Arabic and English, and because of the cultural
norm related to the reluctance of Arab Americans to
discuss sensitive questions outside their homes, we

decided that home interviews with a bilingual data


collector was the most effective data collection method.
The setting provided cultural comfort for dialogue with
clients, encouraging the exchange of personal
information.
A convenience sample of 202 Arab Americans (162
women and 40 men) was surveyed from a list of 4,000
community center clients. Home interviews were
conducted primarily in the evening hours, on weekdays,
and in the late morning and evening hours on
weekends. To safeguard con dentiality, clients were
assured that the data were to be used for program
development purposes and that their names or
identifying
data
would
not
appear
on
any
literatureresulting from the interviews. The data were
collected during October 1995 and December 1995.
Data analysis was conducted by a research consultant
at the Oakland University School of Nursing.

RESEARCH FINDINGS
Survey results are depicted in Tables 1, 2, and 3. The
demographic characteristics in Table 1 reveal that 80%
of the respondents were female, with a mean age of
33.75 years. Ninety-six percent of the respondents were
married. In terms of education, only 20% reported
having completed high school, and 6% reported having
completed college. In terms of heritage, 67% were
Lebanese and 10% were Yemeni. Over 66% reported
Arabic as the language used at home. Thirty percent of
the respondents had immigrated to the United States
less than 3 years ago, 25% between 6 and 10 years
ago, and 35% had lived in the United States more than
10 years. Fifty-eight percent of the respondents
reported no individual income, and 42% reported a
family income of less than $9,999. The ndings
suggest that, overall, the respondents lived with limited
economic resources, were married, and the most
respondents were not working outside the home.
Findings related to beliefs and attitudes about
domestic violence are included in Tables 2 and 3. The
results show that 58% of women and 59% of men
approved of a man slapping his wife if she hits him
rst in an argument, 4% of the respondents actually
believed that a man should kill his wife if she hits him

rst during an argument, and 48% of the women and


23% of the men approved of a man slapping his wife if
he learned she had been unfaithful. A surprising 18% of
the women believed that a man could kill his wife if she
were having an affair with another man. In addition,
physical confrontation during con ict between spouses
was accepted by nearly half of the respondents
surveyed, especially if the wife was insubordinate or
having an extramarital affair.

LIBERATION
THROUGHCOMMUNITYINTERVENTION
Analysis of survey results indicated a critical need for
domestic violence awareness and prevention programs
and a comprehensive culturally and linguistically
sensitive educational program for low-income and
illiterate populations. The ndings were used to
develop programs to effect social change in the
community related to attitudes and beliefs about
domestic violence. In the United States, unlike the Arab
countries of origin for these respondents, the political
system does not overlook
TABLE 1. Demographic characteristics of the sample
Variable
Sex
Male

Femal
e Age

1620 years

Frequency
40

162

2130

72

3140

79

%
1
9.
8
0
8
0.
1
9
3
.
4
7
3
5.
6
4
3

4150

29

5160

10

61+
Marital
status

Dating

Engaged

Married

Separated

193

9.
1
1
1
4.
3
6
4
.
9
3
2
.
4
7
0
.
5
0
1
.
9
9
9
6.
0
2
1
.
4
9

No response
Children < 17 years old living in the
household
None
One
Two
Three
Four
Five or more
Education
Illiterate
Less than high school
High school graduate
Some college
Four-year college graduate
Graduate school
Employment status
Unemployed
Secretary, technician, or health
care provider
Skilled craftsperson
Services (e.g., retail sales,
restaurant server)
Managerial/professional
Laborer
Student
Mother
Individual
income None
$1,000$4,999

1
28
34
34
46
29
27
14
97
42
32
13
4
16
5
2
14
13
17
6
129
115
22

0
.
5
0
1
4.
1
4
1
7.
1
8
1
7.
1
8
2
3.
2
3
1
4.
6
4
1
3.
6
3
6
.
9
3
4
6.
0
1
2
0.
8
0
1
5.
8
4

6.
4
4
1.
9
8
7.
9
2
2.
4
8
1.
0
0
6.
9
3
6.
4
3
8.
4
1
2.
9
7
6
3.
8
6
5
7.
7
9
1
1.
0
5

TABLE 1. Demographic characteristics of the sample


(Continued)
Variable
$5,000$9,999

Frequency
32

%
16.

08
$10,000$14,999

14

$15,000$19,999

$20,000$24,999

$25,000+

Family income
<$9,999
$10,000$19,999

83
60

$20,000$29,999

23

$30,000$39,999

$40,000$49,999

$50,000$59,999

$60,000$69,999

$70,000$79,999

$80,000+
Don t know
Ethnic background
Lebanese
Syrian

Yemeni

0
20

135
3

21

7.
0
4
2.
0
1
2.
0
1
1.
5
1
42.
13
30.
46
11.
68
3.
0
5
0.
5
1
0.
5
1
1.
0
1
0.
5
0
0
10.
15
67.
16
1.
4
9
10.

Palestinian

Iraqi
Other

No. years lived in


U.S. 3 or less
35

29
6

62
18

610

51

More than 10

71

Religion
Muslim
Christian

Other

Main language spoken at


home Arabic
English

Both

196
3

134
7

61

Reading skills
Read & write/English
Read & write/Arabic

20
73

Read & write/both

84

Do not read & write/Arabic & English


Do not read & write at all

19

45
3.
4
8
14.
43
2.
9
9
30.
69
8.
9
1
25.
25
35.
15
97.
51
1.
4
9
1.
0
0
66.
34
3.
4
6
30.
20
9.
9
5
36.
31
41.
80
1.
9
9
9.

4
5

208

20
9
vio
len
t
act
s,
an
d
im
mi
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an
ts
m
ust
be
aw
ar
e
of
th
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att
itu
de
s
an
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bel
ief
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in
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Un
ite
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St
at
es.
Thi
s
ne
w
pol

itic
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co
nt
ex
t
pr
ovi
de
d
a
po
siti
ve
in
ue
nc
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on
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en
t
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po
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to
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rsi
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on
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to
in
ue
nc
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att
itu
de
s.
Interventions in the community were started
immediately. A mass media campaign was developed to
disseminate
domestic-violence
education
and
prevention services in the community. Three live
television shows hosting a panel of professionals and
community leaders were aired: one on cable television
and two on the United Arab Network in the local area.
Announcements of available services on domestic
violence were aired daily on the community calendar of
the Arab Network Association (ANA). In addition, six
public-service announcements were aired on the ANA,
Sada Al Arab radio stations, and United Arab Network
television. Press releases were published in the
Dearborn Pressand Guide, Sada Al Watan (Arabic
Weekly), and El Sabeel (Arabic Weekly) magazines.
News releases and information regarding the Arab
Domestic Violence Program were disseminated during
two professional workshops. The rst workshop was
presented to a group of 60 nurse professionals, the
second to 48 nurse leaders in the area.

EMPOWERMENTANDEMANCIPATION
THROUGHPRINT MEDIADISTRIBUTION
A number of written materials were reviewed by the
project director and the outreach worker. Sources
included writtenmaterialsfrom Project H.A.R.T.(Healthy
Alternatives for Relationships among Teens), LAWW
(Legal Advocates for Abused Women), Oasis, the
National Lawyers Guild, the National Coalition Against
Domestic Violence, AWARE (Assisting Women with
Advocacy Resources and Education), the Family

Violence Prevention and Education Project, the March of


Dimes, the County Domestic Violence Handbook, the
National Women Abuse Prevention Project, and the
Michigan Department of Public Health. An educational
bilingual ArabicEnglish brochure addressing violence
and safety tips for the victims seeking help also was
developed. The County Domestic Violence Handbook
was selected as the most appropriate brochure to
translate/interpret and adapt for use in the Arab
community. On the basis of the information available in
the booklet, a bilingual ArabicEnglish educational
booklet was translated/interpreted and pilot tested for
distribution in the community. The content included
information on what domestic violence is, the
characteristics
and
risk
factors
of
individuals
committing domestic violence, the cycle of domestic
violence, safety tips for the victimsseeking help, and a
list of phone numbers where help could be found.

Domestic Violence in the Arab American Population 221

SOCIOPOLITICAL
CHANGETHROUGHCOMMUNITY
OUTREACH
Twenty-two bilingual ArabicEnglish community
workshops focusing on domestic violence and con ict
resolution were conducted by the outreach worker,
reaching 555 individuals. The workshops targeted four
major mosques; ve schools and job training centers;
adult education centers; two cultural centers; and the
county Women, Infants, and Children program. The goal
of the Arab Domestic Violence Prevention Program was
to provide educational programs that were culturally
competent and linguistically relevant to the Arab
American community. On the basis of the data
collected, a curriculum of educational activities and
materials was developed that provided information on
the de nition of domestic violence, its prevalence, the
risk factors, and community resources available to the
victims of violence. The curriculum materials were
developed so that the information presentation lasted
only 20 min, followed by a 15-min question-and-answer
session. A bilingual ArabicEnglish health coordinator
familiar with the sociocultural factors contributing to
domestic violence conducted the educational sessions.
The program was considered an exceptional outreach
program in a community where attendance to
educational activitiesis often low. Focus group meetings
with program participants indicated an increased
awareness of domestic violence among community
members and an increased understanding of the risk
factors and use of community resources for victims of
domestic violence.

IMPACT OF THE PROJECT ON


ENVIRONMENTAL CONDITIONS
Prior to the initiation of this Arab domestic violence
education and prevention project, not one case of
domestic violence had been identi ed by the cultural
community health center clinic in this area. The
knowledge gained by the outreach worker, through
interaction with and assessment of victims in their

222

A. D. Kulwicki and J. Miller

homes, was an important step in identifying and


clarifying the problem. Since this project was initiated,
70 domestic violence clients have been identi ed and
assisted in the health center. Of these clients, 22 were
counseled, referred, and/or followed up by the centers
family counseling services. Three additional clients, who
are still indecisive about seeking professional help
outside the community center, are being counseled by
the outreach worker. The remaining 45 clients were
reluctant to speak to legal authorities because of fear
that the family and community would criticize them for
bringing a family problem into public view, fear of being
further abused, and the general cultural acceptance by
some women that men have the right to abuse women.
The implications of traditional cultural beliefs,
attitudes, and behaviors toward domestic violence must
be taken into consideration in the development of
prevention and intervention programs. Part of the
community education process has involved exposing
the con ict between cultural norms and the political
legal system of the United States, which protects
victims. The environmental context in the United States
does not support former cultural norms of Arab
American immigrants related to family violence, and
this information is critical to the emancipatory process
for clients. This knowledge was used in the
development of the intervention project to change the
social environment for victims and potential victims, to
liberate them from the values formerly imposed by
cultural norms of their native countries.
The community educational strategies for this
research project have affectedthe Arab community by
exposing a problem that has been denied or ignored for
many years. The community workshops and the media
provided a comprehensive educational program as well
as referral and follow-up information. Of the 70
individuals identi ed through the programs as victims
of domestic violence, none had ever been offered help
before, in part because of the lack of available support
services in the community.

LIMITATIONS
This research project was effective in identifying and
providing services for victims of domestic violence in

Domestic Violence in the Arab American Population 223

the Arab Americancommunity. Unfortunately, the


community center could not provide the comprehensive
counseling services required for the number of victims
identi ed. The community leaders and personnel at
the clinic met to discuss the need for expansion of
services for this population and the need to identify
resources outside of the community center that could
provide linguistically appropriate counseling services for
the Arab American population.
In addition, the lack of shelters that are culturally
appropriate was identi ed as a barrier in providing
care to battered women identi ed by the outreach
worker. The existing shelters were geographically
inaccessible to the Arab women, and the staff at the
shelters were not bilingual or culturally competent in
meeting speci c needs of the Arab women. This was a
major barrier to achievement of the emancipatory aims
of the study and drives current plans for
accommodating women as quickly as they are identi
ed as seeking help.

CHANGESIN ENVIRONMENTAL
CONDITIONSAS A GOAL FOR
FUTUREPROJECTS
Careful consideration of the ndings of this research
project have led to the conclusion that some Arab
cultural values may prohibit or discourage women from
seeking
help
from
community
resources.
Environmentally oppressive cultural and political
traditional beliefs and practices, including patriarchal
beliefs and attitudes of men toward women, appear to
contribute to the violence perpetrated toward women in
this population. In the American context, some women
fear retribution for not conforming to these traditional
values. The projects educational programs aimed at
changing the environmental conditions within the
community, to encourage exposure instead of public
lack of acknowledgment of this health problem.
Changing the political rules in society does not quickly
change cultural norms or attitudes. Studies in
politicalanthropology have described this process
accurately. It is possible to change power relationships
in a society overnight, but a great deal of the symbols
validating and supporting those relationships will
survive and will change only slowly (Cohen, 1976, p.

224

A. D. Kulwicki and J. Miller

7). Although this project has been instrumental in


identifying and providing support to women of this
community, the education and support services must
be continued and expanded to continue to seek
changes in the environmental conditions that in uence
family violence. Through resource expansion and
collaboration with political legal experts, the health
center will continue to address this domestic issue.

CONCLUSION
Domestic violence has become an important political
issue in the United States. This project has served as a
rst step in identifying the scope of the problem for
Arab American immigrants. The data analysis of 202
surveys in the community that assessed the attitudes,
beliefs, and behaviors of the Arab American
respondents were used as baseline data for increasing
community awareness of the problem in this
population. Engaging in dialogue with clients to
empower and raise consciousness for informants was
effective and emancipatory. This was the rst attempt
to change environmental conditions that in uence
violence against women within Arab American families
and to empower women to consider making changes in
their own lives. The educational services and the media
campaign also were effective means of precipitating
environmental change in cultural and political norms
and heightening public awareness of availability of
resources to at-risk or abused Arab women. The project
addressed a very sensitive cultural issue for the Arab
population. It was the rst step of an effort to
introduce change in both public and private attitudes
toward the victimization of women within families, to
liberate and empower these individuals to seek help
through local resources that continue to be developed
and to provide health care and protection.

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