Hrev_master Healthcare in Low-resource Settings 2025; volume 13:13072 Determinant factors related to female adolescents’ attitudes toward gender-based violence Rr Dian Tristiana,1 Ika Nur Pratiwi,1 Ah Yusuf,1 R Endro Sulistyono2 1Faculty of Nursing, Airlangga University, Surabaya, East Java; 2Faculty of Nursing, University of Jember, East Java, Indonesia Abstract The prevalence of violence, especially against female adoles- cents and children, is still quite high. This study aimed to analyze the factors that influence attitudes toward gender-based violence among female adolescents. We employed a cross-sectional research design, and the study population consisted of 107 adoles- cents in Surabaya who accessed the Google form. The statistical analysis used the chi-square test for the adolescent’s characteris- tics and Spearman’s rank correlation with α=0.05. The study found a significant correlation (p<0.005) between adolescents’ attitudes toward gender-based violence and their father and moth- er’s education levels. Additionally, school climate (p<0.005) and family conflict (p<0.005) also correlated with these attitudes. Adolescents’ formative years are primarily centered around their homes and schools, making these environments crucial for shap- ing their beliefs and actions. Therefore, they present valuable opportunities for educating young people about gender-based vio- lence. The research emphasizes the need for comprehensive changes in teenagers’ attitudes, calling for active participation from teenagers themselves, their families, schools, society, and social media regulations. Introduction Violence against women represents a significant worldwide concern for both human rights and public health, leading to endur- ing social, developmental, and health repercussions for women and their children.1 Despite a significant global decline over the past 30 years, intimate partner violence against young women continues to persist.2 In 2023, Indonesia reported 401,975 cases of violence against women, indicating that women were the primary victims of violence.3 Violence against women in Indonesia dispro- portionately affects young women. In 2023, East Java emerged as one of the top three provinces in Indonesia with the highest report- ed cases of gender-based violence.3 The prevalence of violence, particularly toward female adolescents and children, in Indonesia remains relatively high.4 The UNICEF report on the national situ- ation states that 40% of children aged 13-15 in Indonesia have experienced physical attacks at least once a year, and 50% report being bullied at school. Violence against women had physical consequences, such as injury, disability, and chronic pain,5 and psychological conse- quences, such as depressive symptoms,6 Post-Traumatic Syndrome Disorders (PTSD), stress, anxiety, and other mental dis- orders,5,7 and social consequences.8 Research conducted in the past has suggested that an unhealthy or hostile environment can contribute to a rise in violent behavior within a community.9 Some communities use violence to enforce expectations for young women’s behavior, leading to gender-based violence.10 Attitudes, traditions, and customs that diminish women’s autonomy can fuel gender-based violence and significantly influence the status and role of females within both the household and society.11 When people are exposed to a social norm through socialization, they often integrate it into their value system. Exposure can occur through various means, including education, personal experience, and the individual’s context. Prescriptive gender norms convey Correspondence: Rr Dian Tristiana, Faculty of Nursing, Airlangga University, Jl. Mulyorejo, Kampus C Universitas Airlangga, Surabaya, 60115 East Java, Indonesia. E-mail: diantristiana@fkp.unair.ac.id Key words: gender-based violence; adolescents; mental health. Contributions: all authors contributed equally to developing the design, data collection, data analysis, writing the manuscript, and reviewing it to ensure compliance with article writing guidelines. Conflict of interest: the authors declare no potential conflict of interest. Ethics approval and consent to participate: this research was approved by the Research Ethics Committee of the Faculty of Nursing of Airlangga University. Consent for publication: all respondents provided informed consent for their anonymized data to be published in this article. Availability of data and materials: the datasets used and/or analyzed dur- ing the current study are available from the corresponding author upon reasonable request. Funding: this research was financially supported by Kemendikbudristek Dikti in 2023. Acknowledgments: the authors thank all respondents of this study and the Kemendikbudristek Dikti for financial support. Received: 9 September 2024. Accepted: 27 October 2024. Early access: 21 January 2025. This work is licensed under a Creative Commons Attribution 4.0 License (by-nc 4.0). ©Copyright: the Author(s), 2025 Licensee PAGEPress, Italy Healthcare in Low-resource Settings 2025; 13:13072 doi:10.4081/hls.2025.13072 Publisher's note: all claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organi- zations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher. [page 80] [Healthcare in Low-resource Settings 2025;13:13072] expectations regarding the roles of girls and boys in the family and society, encompassing gender-appropriate behavior and emotional regulation.12 Focusing on attitudes and beliefs can enhance research into understanding gender-based violence in female adolescents. Attitude refers to how a person views and evaluates something or someone, including their predisposition or tendency to respond positively or negatively toward a particular idea, object, person, or situation. This concept is typically structured along three dimen- sions: cognitive (perceptions and beliefs), affective (likes and dis- likes, feelings, or evoked emotions), and behavioral (actions or expressed intentions based on cognitive and affective responses).13 Children and adolescents who are exposed to violence in their home environment, community, school, and peers, both as witness- es and victims of «poly-victim,» are increasing.14 Exposure to vio- lence in children and adolescents negatively affects academic achievement15 and contributes to mental health issues, including anxiety, depression, PTSD, aggression, and substance abuse.16 This study aimed to analyze the determinant factors related to gender- based violence attitudes in female adolescents. Materials and Methods This study used a quantitative method with a cross-sectional approach. A cross-sectional study design is a type of observational study design in which the investigator measures the outcome and exposures of the study participants simultaneously.17 In this study, respondents were asked to fill out a questionnaire at one time. The study focused on female adolescents aged 16-18 in Surabaya, the capital of East Java, Indonesia. East Java was ranked as one of the top three provinces with the highest rates of violence against women in 2023.3 Data were collected using a structured self-administered questionnaire. The questionnaire consisted of five parts: socio-demographic information, attitude toward gender- based violence, school climate, family conflict, and victimization behaviors. The sample included female adolescents aged 16-18 years and adolescents attending a senior high school in Surabaya. To gather participants for our study, we utilized social media plat- forms to post specific inclusion criteria, which individuals could complete through a Google form. This form asked respondents to provide details about their school of origin to verify that they met the specific inclusion criteria for our study. The G-form will auto- matically close after 107 respondents have filled it out. This clo- sure is essential to ensure that the data are comprehensive and rep- resentative of diverse perspectives. The attitude toward gender-based violence questionnaire was measured in a 12-item,18 investigator-derived measure that assessed adolescents’ agreement on a Likert scale (i.e., strongly agree = 1, agree = 2, disagree = 3, and strongly disagree = 4) to a series of statements. This questionnaire was created to be easily understandable for young adolescents. It includes questions that explore attitudes toward gender roles in the realms of work, school, family, and finances. Items include the perception of female adolescents toward statements about “female going to school,” “husband’s right to punish wives,” and “women’s partici- pation in social events and employment.” The 12 items were summed into a composite score that ranged from 12 to 48. Higher values on this scale represented greater disagreement with aspects of female autonomy and participation in society, which we term patriarchal gender attitudes. The validity and reliability of the questionnaire were assessed using a sample of 15 female adoles- cents. The results indicated a correlation range of 0.482-0.644, sur- passing the critical value of 0.444. As a result, the twelve question- naire questions were deemed to be valid. Furthermore, the Cronbach’s alpha value was determined to be 0.785. The USAID Campo SRGBV toolkit19 was used to administer the school climate questionnaire. The questionnaire included 10 statements regarding the school’s climate regarding violence. The validity and reliability results indicated a correlation range of 0.558-0.608, surpassing the critical value of 0.444. As a result, the twelve questionnaire questions were deemed to be valid. Furthermore, the Cronbach’s alpha value was determined to be 0.735. The family conflict questionnaire was measured using the Rochester Youth Development Scale. These items assess the par- ent’s perception of a hostile and conflict-filled family environment. Respondents are asked to indicate how often hostile situations have occurred in their families in the past 30 days, not including their children’s fights with each other. Point values are assigned as indicated above. Point values are summed and then divided by the total number of items. The intended range of scores is 1-4, with a higher score indicating a higher level of hostility and conflict with- in the family. The validity and reliability test results indicated a correlation range of 0.740-0.884, surpassing the critical value of 0.444. As a result, the twelve questionnaire questions were deemed to be valid. Furthermore, the Cronbach’s alpha value was deter- mined to be 0.778. The victimization behaviors questionnaire was measured using the Problem Behavior Frequency Scale. These items assess the fre- quency of relational and overt victimization. Respondents were asked how frequently they had been subjected to specific victim- ization behaviors over the previous month. Scoring and analysis point values for each subscale are assigned as follows: never = 1; 1-2 times = 2; 3-5 times = 3; 6-9 times = 4; 10-19 times = 5; 20 or more times = 6. Point values for each subscale are summed. High scores indicate higher levels of victimization. The results of the validity and reliability test indicated a correlation range of 0.538- 0.828, surpassing the critical value of 0.444. As a result, the twelve questionnaire questions were deemed to be valid. Furthermore, the Cronbach’s alpha value was determined to be 0.871. First, the collected data were coded, checked, and entered using Microsoft Excel and then exported into SPSS version 23 for analysis. The results of the univariable analysis (descriptive results) were presented as frequencies and percentages. The bivari- able analysis was carried out to determine the association of each independent variable with the outcome variable. Finally, a variable with p<0.05 was considered statistically significant. This research was approved by the Research Ethics Committee of the Faculty of Nursing. The respondents gave informed consent, and they could leave the study at any time and decide not to answer the question. The researchers kept the data confidential. Results and Discussion The results of this research showed that the average age of respondents was 17.59. Most fathers’ education is a bachelor’s degree/diploma, and they work as employees. The majority of mothers’ education is a bachelor’s degree/diploma, and they are housewives. In this study, the results showed that the educational level of the father (p<0.001) and mother (p<0.001) was related to the attitude toward gender-based violence of female adolescents. Adolescent age (p>0.001), father’s job (p>0.001), and mother’s job (p>0.001) were not related to the attitude toward gender-based Article [Healthcare in Low-resource Settings 2024;12:xxx] [page 81] violence of female teenagers (Table 1). This study found that parental education level is related to female adolescents’ attitudes toward gender-based violence, while parental employment was not related. In this study, most fathers were employed, while the mothers were housewives. A working father can still achieve a healthy work-life balance, like a working or stay-at-home mother. Unemployed individuals are not at a high- er risk of experiencing family violence compared to employed individuals.20 The findings indicate that in families with minimal conflict, the well-being and satisfaction of the members are more closely associated with their attitudes toward gender-based vio- lence than with the employment status of the parents. Previous studies found that years of schooling are positively associated with egalitarian gender role attitudes,21 and there was a significant relationship between parents’ education level and chil- dren’s violence.22 Parental education is related to an individual’s ability to understand information, ease of accessing media, and educational institutions fostering the development of “modern” world values.21 Parents play an important role in providing chil- dren with an early understanding of gender equality; the better par- ents’ role in educating children about gender issues, the better a child’s understanding of gender will be created.23 The role of par- ents can also improve child adjustment abilities24 related to gender role attitudes. These results indicate that increasing parents’ knowledge about attitudes towards gender-based violence needs to be done from the start; for example, it needs to be applied to cou- ples who want to get married, such as premarital education to give them insight into viewing gender roles and training for families to cope with conflicts and enhance parenting skills, specifically designed for parents with adolescent children. The majority of female adolescents said that they had a posi- tive school climate: mutual respect for friends (55.1%), teachers treating female and male students equally (47.7%), and the school taking action when a student hurts another student (50.5%). The majority of female adolescents also said that they had low family conflict and low victimization behavior. However, almost half of female adolescents disagree that women have the same behavior as men, such as speaking harshly, having the same rights in making decisions in the family, being a leader, and being a career woman (Table 2). Gender stereotypes can lead to oversimplified and inac- curate views of gender groups. These stereotypes can exaggerate the differences between males and females, leading to discrimina- tion against certain groups, causing individuals to lose their indi- viduality25 and contributing to gender-based violence. This research shows that school climate (p<0.001) and family conflict (p<0.001) are related to attitudes towards gender-based violence. Meanwhile, victimization behavior (p>0.001) was not related to attitudes toward gender-based violence. The results of this study show that the majority of female adolescents have ade- quate attitudes toward gender-based violence (77%), have a posi- tive school climate (82.2%), low family conflict (48.6%), and have low victimization behavior (84.1%) (Table 3). School climate and family conflict are linked to female adoles- cents’ attitudes toward gender-based violence. Based on social learning theory, this framework helps us understand how gender norms contribute to the intergenerational transmission of violence. Violent behavior is learned in childhood through behavioral mod- eling and observations of parents and peers.26 Family is the place where children are growing up. Previous studies indicated that when children experience violence while growing up, it is related to favorable attitudes toward violence against spouses and indirect- ly affects violent behavior.27 Schools are part of society and reflect traditions and values, which are norms of interaction and explicit and implicit rules and codes; at the same time they play a crucial role in social change. Although schools are recognized as places of learning, personal development, and empowerment, they are too often places of discrimination and violence, particularly against female students.28 The family and school environments are the environments where most adolescents spend their time. Behaviors learned at school and in the family are what shape the attitudes and behavior of adolescent girls, which means that these two environ- ments are places that need to be exposed to information about gen- Article Table 1. Demographic data of respondents and their relationship to female adolescents' attitudes toward gender-based violence (n=107). Variable Frequency (f) Percentage (%) Mean Attitude toward GBV p r Age (years) 17,59 0.121 Father education level 0.001 .351 Elementary 1 0.9 Junior high school 2 1.9 Senior high school 42 39.3 College 62 57.9 Mother education level 0.001 .343 Elementary 3 2.8 Junior high school 16 15 Senior high school 40 37.4 College 48 44.9 Mother work 0.095 - Housewife 64 59.8 Working 43 40.2 Father work 0.240 - Employee 96 89.7 Entrepreneur 7 6.5 Mechanic 1 0.9 Teacher 2 1.9 Retired 1 0.9 [page 82] [Healthcare in Low-resource Settings 2025;13:13072] der-based violence. Prior victimization was found unrelated to adolescents’ attitudes toward gender-based violence. The results of this study indicated that previous experience related to violent behavior is not a predictor of attitudes toward violent behavior. The majority of adolescents in this study experience low victimiza- tion. The perception of female adolescents regarding whether women can experience violent behavior can be influenced by the culture surrounding adolescents. In Indonesia, many still adhere to a patriarchal culture, as evidenced by the attitudes of female ado- lescents who believe that women and men are unequal in terms of education, behavior, family roles, and societal roles. Previous research indicates that a cheerful family and school environment can protect against aggressive adolescent behavior. The psychoso- cial environment significantly influences attitudes toward social aggression, highlighting the importance of parenting styles and resilience.29 Besides, universalism, benevolence, tradition/confor- mity, and security had the strongest negative effects on attitudes toward interpersonal violence and direct as well as indirect nega- tive effects on interpersonal violent behavior.30 The findings of this study indicate that a majority of female adolescents have positive attitudes toward gender-based violence, experience a positive school environment, and have low levels of Article Table 2. Attitude toward gender-based violence. Variable Attitude toward gender-based violence Strongly agree Agree Not agree Strongly not (%) (%) (%) agree (%) Swearing is worse for a girl than for a boy 26 (24.3) 36 (33.6) 40 (37.4) 5 (4.7) On a date, the boy should be expected to pay all expenses 22 (20.6) 30 (28) 41 (38.3) 14 (13.1) On the average, girls are as smart as boys 7 (6.5) 7 (6.5) 31 (29) 62 (57.9) More encouragement in a family should be given to sons than daughters to go to college 10 (9.3) 19 (17.8) 53 (49.5) 25 (23.4) It is all right for a girl to want to play rough sports like football 13 (12.1) 24 (22.4) 37 (34.6) 33 (30.8) In general, the father should have greater authority than the mother in making family decisions 32 (29.9) 41 (38.3) 28 (26.2) 6 (5.6) It is all right for a girl to ask a boy out on a date 19 (17.8) 28 (26.2) 35 (32.7) 25 (23.4) It is more important for boys than girls to do well in school 7 (6.5) 19 (17.8) 44 (41.1) 37 (34.6) If both husband and wife have jobs, the husband should do a share 8 (7.5) 9 (8.4) 34 56 of the housework such as washing dishes and doing the laundry 31.8 52.3 Boys are better leaders than girls 35 (32.7) 30 (28) 35 (32.7) 7 (6.5) Girls are better directed to be good wives than to be career women 24 (22.4) 31 (29) 18 (16.8) 34 (31.8) Girls should have the same freedom as boys 5 (4.7) 12 (11.2) 34 (31.8) 56 (52.3) School climate never seldom sometimes often Friends respect each other 2 (1.9) 25 (23.4) 21 (19.6) 59 (55.1) Teachers treat female and male student fairly 7 (6.5) 21 (19.6) 28 (26.2) 51 (47.7) Teachers threaten to hurt students 49 (45.8) 28 (26.2) 21 (19.6) 9 (8.4) Schools take action when a student hurts another student 7 (6.5) 19 (17.8) 27 (25.2) 54 (50.5) Students are afraid to go to class because they are afraid of being punished 15 (14) 42 (39.3) 39 (36.4) 11 (10.3) Teachers/schools take action when there are reports of violence 3 (2.8) 24 (22.4) 16 (15) 64 (59.8) Students are punished excessively when they make small mistakes 25 (23.4) 40 (37.4) 30 (28) 12 (11.2) Gangs/groups at school are a source of problems 10 (9.3) 46 (43) 35 (32.7) 16 (15) Violence is a problem here 26 (24.3) 36 (33.6) 27 (25.2) 18 (16.8) Students are punished unfairly 22 (20.6) 33 (30.8) 33 (30.8) 19 (17.8) Family conflict often sometimes seldom never How often do arguments/fights occur in your house? 11 (10.3) 14 (13.1) 47 (43.9) 35 (32.7) How often does one of your family members lose control and get angry for no logical reason? 19 (17.8) 26 (24.3) 25 (23.4) 37 (34.5) How often do fights occur in your house, such as hitting, pulling, slapping, 4 (4.7) 17 (15.9) 26 (24.3) 59 (55.1) throwing things or threatening with weapons? Victimization behaviors never 1-2 times 3-5 times 6-9 times 10-19 times 20-more Friends say they won't be friends with you until you do what your friends want 37 (34.6) 21 (19.6) 20 (18.7) 27 (25.2) 2 (1.9) Someone is spreading gossip about you 19 (27.1) 43 (40.2) 15 (14) 19 (9.3) 6 (5.6) 4 (3.7) Left intentionally by other people during class activities 38 (35.5) 30 (28) 25 (23.4) 7 (6.5) 2 (1.9) 5 (4.7) Friends prevent other people from being friends with you by saying bad things about you 27 (25.2) 48 (44.9) 18 (16.8) 6 (5.6) 5 (4.7) 3 (2.8) Friends lie about you so that other friends won't like you 32 (29.9) 35 (32.7) 16 (15) 14 (13.1) 6 (5.6) 4 (3.7) Friends who are angry with you retaliate against you by banning you from joining their group 38 (35.5) 32 (29.9) 18 (16.8) 13 (12.1) 5 (4.7) 1 (0.9) [Healthcare in Low-resource Settings 2025;13:13072] [page 83] family conflict and victimization behavior. However, almost half of the female adolescents surveyed disagree that women can exhibit the same behaviors as men, such as speaking assertively, having equal decision-making rights in the family, occupying lead- ership positions, and pursuing careers. This result suggests that while some behaviors are considered acceptable for women, there are still restrictions and expectations on their roles and behaviors. For instance, the study’s female adolescents supported the notion that women can participate in activities traditionally associated with men, such as playing football or enjoying the same freedoms. Still, they were less likely to agree that women can hold equal decision-making power in the family or assume leadership roles. A prior study stated that there were stereotypes for adolescents to adults that women should be communal and avoid being domi- nant, including being a leader; men should be agentic, indepen- dent, masculine in appearance, and interested in science and tech- nology, but avoid being weak, emotional, shy, and feminine in appearance.31,32 This excerpt highlights the influence of norms and culture on adolescents, particularly in Indonesia. Despite progress in gender equality, traditional beliefs persist, such as the perception of men as natural leaders and decision-makers in families. It emphasizes the significant impact of family, school, societal norms, media, and political images on shaping adolescent females’ attitudes toward gender-based violence. The findings of this study suggest that school climate and fam- ily conflict strongly influence the attitudes of adolescent females toward gender-based violence. The government has implemented numerous campaigns to prevent violence in schools, and adoles- cents have also been exposed to messages promoting gender equal- ity. Increased support from high schools in preventing violence can enhance adolescents’ awareness of the issue. The research under- scores the need for comprehensive efforts to change adolescents’ attitudes, involving themselves, their families, schools, society, social media, and national policies. Continuously increasing awareness about gender equality and preventing violence against women is crucial in schools, families, and communities. This effort can be accomplished through govern- ment initiatives such as integrating gender equality into the cur- riculum, establishing violence prevention programs in schools, providing education on preventing gender violence, and utilizing social media platforms like TV programs, Instagram, and YouTube to disseminate information on gender violence prevention. These activities can be accomplished through school-based education and the implementation of gender equality programs. Additionally, families play a crucial role in the development of adolescents. It is essential to provide parents with the understanding and skills to address family conflicts positively, which can be achieved through parenting skills training by means of government initiatives, edu- cational programs for parents in schools, and community-based family health programs in conjunction with local health services for families with adolescent children. The study’s limitation is that it relies on self-reporting from adolescent girls about their experiences of violence in the past 12 months, which introduces the possibility of underreporting due to personal reasons, such as fear of retaliation, shame, or stigma asso- ciated with being a victim of violence. Research has shown that individuals who have experienced violence may be hesitant to dis- close the full extent of their experiences due to these personal fac- tors. To address this, we have taken proactive measures to protect the anonymity of all participants involved in the process. This anticipation includes using pseudonyms, keeping personal infor- mation confidential, and ensuring that all data is securely stored and accessed only by authorized individuals. Further research should explore the characteristics of parents and families, includ- ing parenting patterns, attitudes toward gender equality, and atti- tudes toward gender-based violent behavior. Additionally, a deeper examination of the broader environment around adolescent girls related to violent behavior against women is needed. Effective pro- grams should also be developed to raise awareness among teenage females about violence against women and promote gender equal- ity across various domains. Conclusions Parents play an essential role in teaching children about gender equality. Educating parents about attitudes toward gender-based violence is critical, and this education should begin even before couples get married, perhaps through premarital education. Gender norms are linked to the perpetuation of violence across genera- tions, and children learn violent behavior through observing their parents and peers. Adolescents spend most of their time at home and school, so these environments are critical for shaping their atti- tudes and behaviors. They should, therefore, be targeted for infor- Article Table 3. Relationship between school climate, family conflict, victimization behavior, and attitude toward gender-based violence. Variable Frequency (f) Percentage (%) Attitude toward GBV p r Attitude toward GBV - - Positive 26 24.3 Fair 77 72 Negative 4 3.7 School climate 0.000 -.607 Positive 68 82.2 Negative 39 12.1 Family conflict 0.000 .562 Low 52 48.6 Medium 46 43 High 9 8.4 Victimization behaviors 0.156 Low 90 84.1 Medium 16 15 High 1 0,9 [page 84] [Healthcare in Low-resource Settings 2025;13:13072] mation about gender-based violence. The findings suggest that comprehensive changes in teenagers’ attitudes need to involve teenagers themselves, their families, schools, society, and social media policies. References 1. Stöckl H, Sorenson SB. Violence Against Women as a Global Public Health Issue. Annu Rev Public Health 2024;45:277–94. 2. Cao Y, Lu H, Duan P, et al. Global, regional, and national bur- dens of interpersonal violence in young women aged 10–24 years from 1990 to 2019: a trend analysis based on the global burden of disease study 2019. Front Psychol 2023;14: z12418 62. 3. The National Commission on Violence against Women. Siaran Pers Komnas Perempuan tentang Peluncuran Catatan Tahunan Kasus Kekerasan Terhadap Perempuan Tahun 2023 [Internet]. 2024 [cited 2024 Sep 22]. Available from: https://kom- nasperempuan.go.id/siaran-pers-detail/siaran-pers-komnas- perempuan-tentang-peluncuran-catatan-tahunan-kasus-kek- erasan-terhadap-perempuan-tahun-2023 4. Thenniarti D. Prevalensi Kekerasan Terhadap Perempuan dan Anak Indonesia, Turun. Info Publik [Internet]. 2021. Available from: https://infopublik.id/kategori/nasional-sosial- budaya/593169/prevalensi-kekerasan-terhadap-perempuan- dan-anak-indonesia-turun 5. Falschung A. Gender-Based Violence Causing Severe Multiple Injuries; a Case Report. Adv J Emerg Med 2018;2:e35. 6. Patel R, Gupte SS, Srivastava S, et al. Experience of gender- based violence and its effect on depressive symptoms among Indian adolescent girls: Evidence from UDAYA survey. PLoS One 2021;16:e0248396. 7. Friedberg R, Baiocchi M, Rosenman E, et al. Mental health and gender-based violence: An exploration of depression, PTSD, and anxiety among adolescents in Kenyan informal set- tlements participating in an empowerment intervention. PLoS One2023;18:e0281800. 8. García-Montes R, Fares-Medina S, Diaz-Caro I, et al. The impact of violence on women’s health. The present as a reflec- tion of the past: A qualitative study. PLoS One 2022;17: e0273973. 9. Kingston B, Smokowski PR, MacFarland A, et al. Testing the Nurturing Environments Framework on Youth Violence Across Ethnically and Geographically Diverse Urban and Rural Samples of Adolescents. Youth Soc 2020;53:784-810. 10. Sommer M, Muñoz-Laboy M, Williams A, et al. How gender norms are reinforced through violence against adolescent girls in two conflict-affected populations. Child Abuse Negl 2018;79:154–63. 11. Tonsing JC, Tonsing KN. Understanding the role of patriarchal ideology in intimate partner violence among South Asian women in Hong Kong. Int Social Work 2017;62:161–71. 12. Lomazzi V. The cultural roots of violence against women: indi- vidual and institutional gender norms in 12 countries. Soc Sci 2023;12:117. 13. Vargas-Sánchez A, Plaza-Mejía MÁ, Porras-Bueno N. Attitude. Encycl Tour 2016;58–62. 14. Boxer P, Sloan-Power E. Coping with violence: a comprehen- sive framework and implications for understanding resilience. Trauma Violence Abus 2013;14:209-21. 15. Supol M, Satyen L, Ghayour-Minaie M, Toumbourou JW. Effects of family violence exposure on adolescent academic achievement: a systematic review. Trauma Violence Abus 2021;22:1042-56. 16. Heinze JE, Stoddard SA, Aiyer SM, et al. Exposure to violence during adolescence as a predictor of perceived stress trajecto- ries in emerging adulthood. J Appl Dev Psychol 2017;49:31- 38. 17. Setia MS. Methodology series module 3: cross-sectional stud- ies. Indian J Dermatol 2016;61:261. 18. Galambos NL, Petersen AC, Richards M, Gitelson IB. The Attitudes Toward Women Scale for Adolescents (AWSA): A study of reliability and validity. Sex Roles 1985;13:343–56. 19. USAID. School-related gender-based violence measurement toolkit [Internet]. USAID; 2020 [cited 2023 Dec 8]. Available from: https://www.edu-links.org. 20. Rodriguez E, Lasch KE, Chandra P, Lee J. The relation of fam- ily violence, employment status, welfare benefits, and alcohol drinking in the United States. West J Med 2001;174:317. 21. Du H, Xiao Y, Zhao L. Education and gender role attitudes. J Popul Econ 2021;34:475–513. 22. Risma D, Solfiah Y, Satria D. The relationship between par- ents’ gender and children violence. Proc UR Int Conf Educ Sci 2019;0:144–51. 23. Nurhafizah N, Ardi Z. The Parent’s role and children’s under- standing of gender concept; a correlational study in Indonesia. J Couns Educ Technol 2019;2:48–56. 24. Jin X. How gender stereotype in education impact female stu- dents’ development in secondary school. J Educ Humanit Soc Sci 2023;12:229-34. 25. Wang IY, Cheung RYM. Parents’ gender role attitudes and child adjustment: the mediating role of parental involvement. Sex Roles 2023;89:425–41. 26. Bunston W, Pavlidis T, Cartwright P. Children, family violence and group work: some do’s and don’ts in running therapeutic groups with children affected by family violence. J Fam Violence 2016;31:85–94. 27. Markowitz FE. Attitudes and family violence: Lintergenerational and cultural theories. J Fam Violence 2001;16:205–18. 28. Mingude AB, Dejene TM. Prevalence and associated factors of gender based violence among Baso high school female stu- dents, 2020. Reprod Health 2021;18:1–11. 29. de la Villa Moral M, Ovejero A. Adolescents’ Attitudes to bul- lying and its relationship to perceived family social climate. Psichotema 2021;33. 30. Seddig D, Davidov E. Values, attitudes toward interpersonal violence, and interpersonal violent behavior. Front Psychol 2018;9:308961. 31. Koenig AM. Comparing prescriptive and descriptive gender stereotypes about children, adults, and the elderly. Front Psychol 2018;9:381468. 32. Koburtay T, Abuhussein T, Sidani YM. Women Leadership, Culture, and Islam: Female Voices from Jordan. J Bus Ethics 2023;183:347–63. Article [Healthcare in Low-resource Settings 2025;13:13072] [page 85]