Abstract
The Enhanced Maternal and Child Health Nurse Home Visiting Program in Victoria—Nurses Working With Women and Children Experiencing Family Violence
Catina Adams1, Angela Taft1, and Leesa Hooker1
1La Trobe University, Melbourne, Victoria, Australia
Cultural Considerations and Recommendations for HIV Testing Services Among Hispanic or Latin American Victims of Intimate Partner Violence
Oluwamuyiwa Winifred Adebayo1 and Jessica Williams2
1The Pennsylvania State University, State College, Pennsylvania, USA
2University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Meaning, Context, and Indigenous Structures for the Management of Family Violence in a Yoruba Subethnic Community: A Qualitative Pilot Study
Adekemi E. Olowokere1, Oluwasayo B. Ogunlade1, Ojo Agunbiade1, Aanuoluwapo O. Olajubu1, and Oyeyemi O. Oyelade1
1Obafemi Awolowo University, Ile-Ife, Nigeria
Documented interventions for the management of family violence are based majorly on law enforcement and the judicial referral system in developed countries. This is contrary to the societal belief that happenings within the family cycle should be kept secret in the Nigerian setting. This makes the victim of family violence to suffer in silence and has often resulted in a lot of psychological disturbance and its attendant’s problem among affected couples. It will be of utmost importance as a preliminary study to a larger study aiming at developing an indigenous intervention for management of family violence to understand family violence as perceived by this population. This study explored the meaning and context of family violence and the indigenous structure use for its management among a Yoruba subethnic group. This was an exploratory cross-sectional study in which 20 community stakeholders were recruited through purposive sampling. The data were collected via in-depth interview (IDI) and focus group discussion (FGD). Data analysis was done using Atlas.ti qualitative software. The result shows that family violence was seen as being synonymous to all forms of physical violence that occurs within a family relationship. There was no single word in the subgroup that could be used to represent family violence. While other forms of family violence (sexual, psychological, and economical) were seen as causes of Family violence. Religious leaders were identified as key indigenous structure for effective management of family violence among other indigenous structures which include extended family mediation and community/royal father interventions. The study showed that these groups of people are also affected by the male dominance belief in the society which has contributed to men perpetration of violence in the family. The study concluded that an indigenous intervention that will help control family violence must focus on strengthening community structures, most importantly, the religious institutions on how to instill mutual respect among couples and train them on conflict resolution skills as family violence in the group is seen as issues that should not be taken out of community structure.
Hair Cortisol as a Biomarker of Chronic Stress Among Saudi Women Who Are Survivors of Abuse
Eman Alhalal1 and Rawaih Falatah1
1King Saud University, Riyadh, Saudi Arabia
The Effects of an Intimate Partner Violence Educational Intervention on Nurses: A Quasi-Experimental Study
Eman Alhalal1
1King Saud University, Riyadh, Saudi Arabia
Sexual Violence on College Campuses: Opportunities for Improvement in Research and Practice
Jocelyn C. Anderson1, RaeAnn E. Anderson2, and Candace Burton3
1The Pennsylvania State University, State College, Pennsylvania, USA
2University of North Dakota, Grand Forks, North Dakota, USA
3University of California–Irvine, Irvine, California, USA
Sexual violence (SV) continues to be prevalent on college campuses. Despite high rates of SV, most students do not seek formal services to address these experiences, leaving them open to a myriad of negative consequences. This symposia will present findings from three unique studies to highlight opportunities for improving our understanding of and response to SV on campuses. First, we examine how measurement affects our understanding of SV among those reporting partners as perpetrators of violence. Results from a mixed-methods study examining how women of color experience reporting on campus and a randomized controlled trial of a health center–based prevention and response intervention will provide insights into improving services for students.
Modifying the Sexual Experiences Survey to Assess Intimate Partner Sexual Violence Among College Women
RaeAnn Anderson, Samantha Holmes, Nicole Johnson, and Dawn Johnson
Research highlights the existing lack of precision in assessing experiences of SV. The assessment of intimate partner sexual violence (IPSV) typifies the challenges of measurement in two areas of violence research—intimate partner violence (IPV) and SV. The goal of this study was to evaluate strategies for assessing IPSV and how a modified version of the Sexual Experiences Survey–Short Form Victimization (SES-SFV) may improve measurement of IPSV. Two samples of college women were recruited. In Sample 1 (N = 236), we compared the number of IPSV cases identified by the Severity of Violence Against Women Scales (SVAWS) and a modified version of the SES-SFV. In Sample 2 (N = 207), participants completed the SVAWS and were randomly assigned to either a traditional SES-SFV or the modified SES-SFV. The rates of IPSV were nearly double when participants received the modified SES-SFV compared with the SVAWS. Results suggest that optimal measurement of IPSV needs to combine strategies currently used in the fields of IPV and SV.
Reporting Intimate Partner Violence and Sexual Violence: A Mixed-Methods Study of Concerns and Considerations Among College Women of Color
Candace Burton, Jeanine Guidry, and Jessica Cabrera
Little is known about how women of color evaluate the benefits of reporting IPV/SV to authorities but evidence suggests that they often choose not to report. The purpose of this mixed-methods study was to explore how university-affiliated women of color experienced structural stress in their daily lives and whether or not that stress influenced their thinking about the possibility of reporting IPV/SV to authorities. Participants identifying as Latinx/Hispanic or Black/African American reported the highest such stress, and felt that there was not always a potential gain in safety with reporting IPV/SV.
Giving Information for Trauma Support and Safety: A Campus Health Center Intervention to Address Sexual Violence
Elizabeth Miller, Kelley Jones, Heather McCauley, Jocelyn Anderson, Carla Chugani, Robert Coulter, Janine Talis, Dana Rofey, Duncan Clark, and Kalaeb Abebe
This cluster randomized controlled trial (RCT) collected data from 2,291 students on 28 college campuses. Intervention site providers received training and support in implementing the Giving Information for Trauma Support and Safety (GIFTSS) intervention; control site providers implemented a brief alcohol counseling intervention. Generalized linear mixed models accounting for within-college clustering were used to test for differences in change from baseline to follow-up by treatment arm. Students reported high rates of past 30-day alcohol use (74%), binge drinking (50%), and lifetime SV (55%). Intervention implementation varied widely by site (17%–91%). Overall, clinic staff found the intervention useful and agreed it could be implemented at the provider level. Primary implementation barriers were time and competing patient priorities. Providers noted variation in implementation based on patient and visit characteristics (e.g., patient gender). Clinic support—particularly in adopting strategies for universal dissemination of the GIFTSS card and prompts within the medical record—was seen as helpful.
Strengthening Health Systems’ Response to Violence Against Women: Implementation Research Among Health Care Providers in Maharashtra, India
Sanjida Arora1, Prachi Avalaskar1, Sangeeta Rege1, Padma Deosthali1, Sarah Meyer2, and Avni Amin2
1Centre for Enquiry Into Health and Allied Themes (CEHAT), Mumbai, India
2World Health Organization, Geneva, Switzerland
Structural Factors Influencing Experiences of Intimate Partner Violence for Indigenous Women in the United States
Joyell Arscott1, Brittany Jock1, Meredith Bagwell-Gray2, Emily Loerzel3, Richelle Bolyard1, Teresa Brockie1, Victoria O’Keefe4, Catherine McKinley5, Jacquelyn Campbell1, and Gail Dana-Sacco1
1Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
2The University of Kansas School of Social Welfare, Lawrence, Kansas, USA
3University of Washington, Seattle, Washington, USA
4Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
5Tulane University School of Social Work, New Orleans, Louisiana, USA
Methodological Innovation to Explore Obstetric Violence in Brazil by a Multiregional Critical Ethnography
Margareth S. Zanchetta1, Sepali Guruge1, Oona St. Amant1, Ingryd C. Ventura Felipe1, Dakota Carrie1, Dorin d’Souza1, Vanessa Fofie1, Hilary Hwu1, Milena Oliva1, Hannah Stahl1, John Tadeo1, Walterlânia Silva Santos2, Hannah Argumedo-Stenner1, Francesca Aviv1, Henry Parada1, Karline Wilson-Mitchell1, Delmar Teixeira Gomes3, Zuleyce Lessa3, Jordan Tustin1, Erica Dumont4, Kleyde Ventura4, Waglânia Freitas5, and Ana Luiza de Oliveira Carvalho6
1Ryerson University, Toronto, Ontario, Canada
2University of Brasília, Brasília, Brazil
3Federal University of Juiz de Fora, Juiz de Fora, Brazil
4Federal University of Minas Gerais, Belo Horizonte, Brazil
5Federal University of Paraíba, João Pessoa, Brazil
6Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
Strengthening the Health System Response to Domestic Violence in Occupied Palestinian Territory
Loraine J. Bacchus1, Abdulsalam Alkaiyat2, Amira Shaheen2, Ahmed Alkhayyat2, Hiba Od2, Rana Halaseh2, Gene Feder3, and Manuela Colombini1
1London School of Hygiene & Tropical Medicine, London, United Kingdom
2An-Najah National University, Nablus, Palestine
3University of Bristol, Bristol, United Kingdom
What Now: Exploring The Emergency Health Care Response To Domestic Violence in Regional Hospitals
Shannon Bakon1, Annabel Taylor1, Silke Meyer2, and Mark Scott3
1CQUniversity Brisbane, Brisbane, Queensland, Australia
2Monash University, Melbourne, Victoria, Australia
3Caboolture Hospital, Caboolture, Queensland, Australia
The Association Between Intimate Partner Violence and Functional Gastrointestinal Disorders and Symptoms Among Adult Women: A Systematic Review
Ohud Banjar1, Marilyn Ford-Gilboe1, Deanna Befus1, and Bayan Alilyyani1
1Western University, London, Ontario, Canada
Considering Trauma- and Violence-Informed Care in the Canadian and Rwandan Contexts
Helene Berman1, Nadine Wathen1, Vincent Sezibera2, Clementine Kanazayire2, and Aimee Utuza Josephine1
1University of Western Ontario, London, Ontario, Canada
2University of Rwanda, Kigali, Rwanda
Globally it is estimated that one out of every three women continue to report some form of violence each year. The health effects are profound, effecting virtually every aspect of everyday life; yet, so often these effects are insidious, hidden from even the most astute health providers. In recent years, the notion of Trauma- and Violence-Informed Care (TVIC) has gained considerable traction, particularly within Canada. In contrast to the more commonly understood construct of Trauma-Informed Care, TVIC is broadly conceptualized to take into account multiple and intersecting forms and effects of structural, systemic, and interpersonal violence. The ultimate goal is the creation of safe environments and care interactions for clients and staff. In this Symposium, we describe an ongoing collaboration to address global health equity in general, and TVIC in particular, among colleagues in Canada and Rwanda.
Interest in TVIC in Canada continues to expand, even explode. Health and social service organizations from public health to policing and child welfare have sought training and resources to support trauma- and violence-informed policy and practice. In response, a group of community leaders, service providers, and researchers has come together as the Gender, Trauma, & Violence Knowledge Incubator (GTV Incubator). GTV Incubator members have delivered dozens of workshops, have developed capacity through student projects, and are designing online curriculum to spread the reach of these efforts. This presentation will provide an overview of the core principles of TVIC and highlight several research projects that are examining TVIC mobilization, uptake, and impact, including through health promotion to the public. We will also comment on our progress in developing appropriate metrics and methods for research and evaluation of TVIC initiatives.
Violence against women, including physical, sexual, and emotional harm, is of great concern to humanity. In Rwanda, women’s lifetime experience of physical or sexual violence almost doubled from 34% in 2005 to 56% in 2010, placing this country among those with high prevalence domestic violence versus gender-based violence (DHS reports). Moreover, recent mental health reports in Rwanda have estimated that one third of the population presents with depression comorbid to the traumas related to post-traumatic stress disorder (PTSD) from the genocide. Both violence and the traumas from the genocide are assumed to be predictors of various mental and social difficulties, including drug and alcohol addictions, school drop-outs, poor academic and professional performance, and lowered life satisfaction. While TVIC is not a widely understood concept in Rwanda, we believe that it holds a great deal of relevance in the post-genocide context. We examine this idea and consider how TVIC can assist policy makers to elaborate strategies that mitigate adverse outcomes from violence and the genocide.
More than 50% of the Rwandan population is less than 20 years old and the median age of the population is 22.7 years old. At the time of the 1994 Genocide against the Tutsi people of Rwanda, I was a young adolescent. Since that time, I have witnessed and experienced consequences of the genocide on the general population, and especially on women, children, and youth. The “Post” genocide reparation commitment from the government helped Rwanda to be recognized for its progress in achieving the Millennium Development Goals (MDGs), including the Promotion of Gender Equality and Empowerment of Women. However, unplanned pregnancies, particularly among adolescent girls, have remained a significant challenge. The negative physical and mental health sequelae are enormous, and it is clear that innovative solutions are needed. In this presentation, I consider the relevance of TVIC as a potential model to address the challenges of teen pregnancy in a manner that is holistic, empowering, and relevant.
“ . . . But How Do I Ask That?” Adapting the Tag Team Simulation Methodology to Support Undergraduate Health Students’ Confidence, Understanding, and Skills When Working With Families Affected by Family Violence
Laura Biggs1 and Stephen Guinea1
1Australian Catholic University, Fitzroy, Victoria, Australia
To introduce participants to the fundamental concepts and principles of TTS methodology;
To provide attendees with an experience of the Tag Team methodology developed for preparing undergraduate students for working with families affected by gender-based violence;
To discuss the techniques required for applying this TTS in participants’ own practice settings.
Adaptation of the Danger Assessment for Thai Women: A Delphi Study
Tipparat Udmuangpia1,2, Supawadee Thaewpia1, Wacharee Amornrojawutthi1, Prapatsri Shawong1, Yaowaret Kamanat3, Pilin Nisatea4, and Tina Bloom2
1Boromarajonani College of Nursing, Khon Kaen, Thailand
2University of Missouri, Columbia, Missouri, USA
3Khon Kaen Hospital, Khon Kaen, Thailand
4Sakon Nakhon Hospital, Sakon Nakhon, Thailand
Screening for Intimate Partner Violence and Sexual Violence in a College Health Clinic
Toni Boyajian1 and Claire Bode1
1University of Maryland–Baltimore, Baltimore, Maryland, USA
Intimate partner violence (IPV) and sexual violence (SV) are serious, preventable public health problems that affect millions of Americans.1 A national survey revealed a third of women and men experience IPV/SV in their lifetime.2 IPV/SV occurs across the lifespan and more often in certain life stages. More than half of individuals who have experienced violence report their first incident before 25 years old.3 A national college health survey revealed 9% of students experienced an abusive relationship. Nine percent report having been sexually touched without consent within the past 12 months.4 An opportunity exists for early detection and support services for IPV/SV within the young adult population and health clinic setting. Health care providers (HCPs) in college health clinics (CHCs) seldom screen for IPV/SV. Ninety percent of university students who had experienced IPV/SV reported not being asked at their most recent visit to their CHC.5 Only 15% of HCPs in CHCs reported screening for IPV/SV.6 At a mid-Atlantic public university, only screening for “forced or coerced sex” is routinely asked during specific visits. There is strong recommendation to screen universally for IPV/SV, particularly in CHCs.7 Routine and universal screening using the E-HITS screening tool8 will be implemented for 13 weeks in a CHC. The screening tool will be integrated into the patient preparation process and electronic health record. HCPs will be supported by trauma-informed training with a focus on IPV/SV and campus/community resources. Students will complete the screening in the exam room privately. A statement of confidentiality, limits of confidentiality, and reporting will be included and reviewed prior to completing the tool. The data collection will be the number of patients screened and the number of patients seen. In addition, data on the number of patients with positive screens who are referred for counseling and/or provided with resources will be collected as well. These data will be analyzed and findings will be discussed with the key stakeholders. Strategies for next steps will be discussed to allow the continuation of IPV/SV screening at this CHC.
An Integrative Review of Community Nurse–Led Interventions to Identify and Respond to Domestic Abuse in the Postnatal Period
Marie Boyle1
1Community Health Organisation, Limerick, Ireland
Interagency training, including refresher updating, supervision, and mentorship;
Clear guidelines, referral pathways, safety protocols, and safety planning guidance;
Collaborative working, with the development of stronger links with domestic abuse services;
Organizational support with enhanced resources; and
Commitment at government level to the provision of domestic abuse services.
The Experience of Trauma and Post-Traumatic Growth
Hulda Saedis Bryngeirsdottir1
1University of Akureyri, Akureyri, Iceland
Research on the effects of trauma have largely focused on their negative consequences. The purpose of this study was to increase knowledge and deepen understanding of psychological trauma and how people achieve post-traumatic growth. Phenomenology was chosen as a research approach. Data were collected in 14 interviews with 12 individuals who had experienced psychological trauma and post-traumatic growth. Participants were aged 34 to 52 years, seven women and five men. The title of the study, “Like Going Down a Black Slope and Then Coming Up the Green Hillside,” metaphorically describes the participants’ experience of trauma and post-traumatic growth. It describes the difficult journey which started with the trauma. The participants felt powerless after the trauma but considered internal factors, such as perseverance, hardiness, and the courage to face their situation the most important in their processing of the trauma. They all experienced more traumas on the journey and expressed the need for support and caring in their situation. They also noted the positive impact of dealing with new projects. All participants felt that the onset of post-traumatic growth was due to an internal need for change. They experienced that their post-traumatic growth was characterized by improved and deeper relationships with others, increased personal development, positive living, increased self-knowledge and improved self-esteem. Participants described “heavy days” despite the post-traumatic growth, but they still felt like winners. Research findings indicate that the lived experience of trauma is a challenging life experience, but certain internal factors are prerequisites for post-traumatic growth. It is important that nurses and other professionals respond to their clients’ traumas through early detection and intervention, along with support, caring, and follow-up.
Community Advisories: Research Partners or Research Facilitators in Research With Women Experiencing Violence?
Vicky Bungay1, Linda Dewar2, and the STRENGTH Project CAC2
1University of British Columbia, Vancouver, British Columbia, Canada
2Inner City Women’s Initiatives, Vancouver, British Columbia, Canada
Changing Campus Climate: Engaging Students in Reducing Tolerance for Sexual Assault and Intimate Partner Violence
Candace Burton1
1University of California–Irvine, Irvine, California, USA
Social Media in Research and Education: Yes, You Need It!
Candace W. Burton1, Jeanine D. Guidry2, and RaeAnn E. Anderson3
1University of California–Irvine, Irvine, California, USA
2Virginia Commonwealth University, Richmond, Virginia, USA
3University of North Dakota, Grand Forks, North Dakota, USA
Review the current state of the science on social media and health
Explore options for conducting research on and with social media
Explore strategies for using social media in nursing education
Demonstrate some methodologies for analyzing topics of interest via social media and for utilizing social media as an educational tool.
Part I: State of the science on social media and health (15 minutes)
This section will provide an overview of the current state of social media, including platforms, uses, and controversies. Included in this overview will be some of the advantages and risks associated with social media in the area of health, some of the considerations for nurses on social media, and some basic suggestions for using and interacting with social media.
Part II: Using social media in research and education (45 minutes)
This section will provide some background on doing research with and using social media to support learning among nurses and nursing students. For research purposes, this can include exploring public opinions or perspectives on topics including intimate partner violence/sexual assault, other types of violence against women, and mental health–related topics. In education, there are tremendous opportunities to explore social media to develop patient education as well as to support student learning about diverse and vulnerable groups. Examples from panelists’ own work will be reviewed.
Studies to be discussed include
Intimate partner violence on Instagram and Pinterest
Hashtag-focused studies including #WhyIdidntreport and #NotOkay
Exploration of young adults’ exposure to rape myths online
Strategies for educational use include
Using social media for cultural competence
Expert engagement
Applying social media to student activities
Part III: Discussion of methodologies for working with social media (30 minutes)
This section will take a deeper dive into methods for conducting research using social media, and for using social media in nursing education and training. Social media interactions can be powerful as well as risky. Many topics can create vulnerability for both post authors and for researchers and educators working with social media. Care must be taken to avoid creating any ethically problematic situations as well as to adequately assess the content of the platform in question. Professional policy and regulatory considerations when working with social media will also be discussed.
Violence and Migrant Women—Challenges and Opportunities in the Care Encounter
Ulrika Byrskog1, Pia Olsson2, Birgitta Essén2, and Marie Klingberg Allvin1
1Dalarna University, Falun, Sweden
2Uppsala University, Uppsala, Sweden
Social Justice and Its Role in Education, Training, and Implications to Practice for Nurses Caring for Victims of Violence
Jacqueline Callari Robinson1 and Trisha Sheridan2
1University of Wisconsin–Milwaukee, Milwaukee, Wisconsin, USA
2Emory University, Atlanta, Georgia, USA
Nurses interact with patients across the spectrum of class and ethnicity in the provision of nursing care. However, the lack of diversity within the nursing workforce, the range of educational standards, along with discrimination, bias, prejudice, and lack of exposure to the consequences and trauma of social injustice may affect not only the nurse–patient experience, but the actual outcome of nursing care. Even with education of cultural competency, many nurses are resistant to the conversation that they individually and/or organizationally may perpetuate oppressive racial and socioeconomic practices that contribute to health disparity and discrimination. Even within the specialized field of forensic nursing, where there is a specific emphasis on trauma-informed patient-centered care, the acceptance of social injustice as a critical component of nursing care is not widely accepted nor exemplified. The future of nursing care to victims of violence must include a workforce that is educated in the traumatic effects of social injustice. Creating space for this discussion in a safe and respectful learning environment is essential for the future of the nursing profession, especially for those who care for victims of violence. Initial and continuing education on the principles of social justice including how to remove implicit bias must be part of a comprehensive and holistic approach to nursing care. This is imperative especially when dealing with those patients who seek care after violence has been perpetrated against them. This discussion will explore how to create the environment for the conversation, and design educational modules, tools, and competency standards for nurses in a variety of practice settings.
The weWomen Adaptation of myPlan for Abused Immigrant Women
Jacquelyn Campbell1, Bushra Sabri1, Joyell Arscott1, Veronica Njie-Carr2, Jill Messing3, and Nancy Glass1
1Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
2University of Maryland School of Nursing, Baltimore, Maryland, USA
3Arizona State University, Phoenix, Arizona, USA
In the United States and elsewhere where studied, immigrant women have an increased risk of intimate partner violence (IPV) and of homicide by an intimate partner or ex-partner. The myPlan online and app-based IPV intervention and its adaptations have been shown to be a useful intervention for abused women in many countries and contexts. The weWomen study adapted the myPlan intervention for U.S. immigrant women using formative data from focus groups of 62 IPV service providers and 83 in-depth interviews of immigrant women survivors (Asian = 30, Latina = 30, African = 23) to contextualize the intervention for immigrant women. The data were first thematically analyzed for risk and protective factors and for suggested safety strategies to be included in the intervention. For instance, an important theme was extended family (primarily hers) as a protective factor while his extended family for some survivors was identified as an important risk factor. Therefore, her extended family was added as a priority in the priority selection part of myPlan and if highly valued, strategies about getting assistance from her extended family in the plan section. As studies and career were seldom indicated as a protective (or risk) factor, that priority was removed in the weWomen adaptation of myPlan. We also incorporated many of the suggested strategies for staying safe while staying in the relationship into the intervention plans, as neither our survivors nor our immigrant IPV service providers found leaving an abusive partner a viable option in most cases of abuse among immigrant women. The planning section also emphasizes the total confidentiality (from Immigration and Customs Enforcement [ICE] and other governmental agencies) and many language access of the National DV hotline/chatline (www.thehotline.org). The version of the Danger Assessment incorporated into the weWomen intervention was the DA-I, the previously developed Danger Assessment for Immigrant Women based on data on abused immigrant in the United States (www.dangerassessment.org). Thus, this adaptation of a well-tested existing intervention based on data from immigrant women and key informants currently being randomized controlled trial (RCT) tested will hopefully provide individualized assistance to abused immigrant women and strategies for adapting interventions for marginalized groups.
Talking About “In the Kitchen Jokes”: Exploring the Impact of Structural Violence on Young Women and Men
Eugenia Canas1 and Helene Berman1
1Western University, London, Ontario, Canada
Structural violence has been variously conceptualized as the institutionally permitted sanctioning of micro-aggressive gestures and overt discrimination. Due to the embedded nature of structural violence, its examination requires supporting individuals in connecting their daily, even embodied, felt experience with institutional-level policies and values. A critical emancipatory approach of this nature holds particular challenges when working with youth populations, particularly if they have previously been excluded from knowledge-generation, advocacy, or policy-making processes. A space to foster critical awareness and language among young men and women is needed. This presentation draws from work conducted under a national, 5-year Canadian Institutes for Health Research (CIHR) grant titled “Promoting Health Through Collaborative Engagement With Youth: Overcoming, Resisting, and Preventing Structural Violence.” In the course of this research, young women and men from across Canada (ages 16–24) participated in group discussions about their everyday lives, to identify how structural violence affects their well-being. Their insights—derived through diverse processes of art-making, and individual and group reflections—underscored the ubiquitous and permitted nature of structural violence, as well as its ability to affect them in gendered ways through the lifespan. In this presentation, we describe these discussions among young men and women of immigrant, LGBTQ+ (lesbian, gay, bisexual, transgender, and queer), and First Nations backgrounds as a process of consciousness-raising. Seeing and talking about structural violence together served to validate the complexity of these youths’ individual experiences, and find places for resistance through artistic expression, advocacy, and solidarity. In describing this research, we outline steps taken throughout the national grant and its associated projects to link youths’ experiences to organizational and policy-making agendas. Implications for researchers, community organizations, and policy makers will be provided, with a focus on creating supportive spaces for resistance and action.
Measuring Gender Role Attitudes Among Chinese Women: Comparing the Gender Role Egalitarian Attitude Test With an Instrument for Traditional Gender Roles
Jiepin Cao1, Susan Silva1,2, and Rosa Gonzalez-Guarda1
1Duke University, Durham, North Carolina, USA
2Duke University Medical Center, Durham, North Carolina, USA
Gender role attitudes, embedded in specific social and cultural contexts, have been identified to be a crucial factor shaping individual’s behavior relevant to intimate partner violence (IPV), including IPV victimization and perpetration. Gender roles in China are influenced by a long history of Confucius tradition where females are viewed as subordinate to males. However, China has experienced rapid social and economic development in the past decades, resulting in significant improvements in women’s social status. This change could potentially contribute to the shift toward more flexible and egalitarian gender roles between males and females. Although measurement tools have been created to capture gender role attitudes, there are no widely accepted tools available to measure this concept that captures gender dynamics within Chinese society. While two scales have been culturally tailored to the Chinese population, there are no psychometric data available on these for Chinese women so far. Thus, the purpose of this study is to assess psychometric performances of these two measurement tools, namely, the Gender Role Egalitarian Attitude Test and an Instrument for Traditional Gender Roles, among Chinese women. A cross-sectional design using survey data will be used. A total number of 250 Chinese women will be recruited from the largest crowdsourcing platform in China named zbj.com with 19 million registered users. The recruitment information for this study will be posted on zbj.com and registered users with interests in this study will be directed to the eligibility screening. For eligible participants, an online survey that includes demographic questions and these two tools will be administered after their informed consent. For each tool, construct validity will be assessed using confirmatory factor analysis (CFA) and the internal consistency of the entire scale and any subscales identified by the CFA will be evaluated with Cronbach’s alphas. The psychometric properties of the two tools measuring gender role attitudes among Chinese women will be compared, providing crucial information about their relative utility. The findings will provide valuable methodological information regarding the measurement of gender role attitudes in Chinese women, further informing future evaluation of intervention or prevention programs aiming to shift gender role attitudes in China.
What’s in a Name? How the Advertised Study Title Effects Sexual Assault Self-Reporting
Emily M. Carstens Namie1, RaeAnn E. Anderson1, and Paige Michel1
1University of North Dakota, Grand Forks, North Dakota, USA
Sexual assault (SA) affects approximately one in four college students. Prior researchers have noted that the context of studying SA may affect reported rates of SA and its correlates. National surveys on crime tend to find lower rates of SA than those studying health and the survey context of “questions about crime” has been cited as one possible explanation for this finding. We advertised four different studies in the psychology subject pool which appear to be about the topics of SA, health, crime, and alcohol, respectively, but all included the same set of questionnaires. We hypothesized that reported rates of sexual assault victimization (SAV) and sexual assault perpetration (SAP) would vary by study condition. Participants were 792 university undergraduate students. SAV was measured with the Sexual Experiences Survey–Short Form Victimization (SES-SFV), Conflict Tactics Scale–2 (CTS2), and the Childhood Trauma Questionnaire (CTQ). SAP was measured with the Sexual Experiences Survey–Short Form Perpetration (SES-SFP), and CTS2. Analyses of SAV measures revealed no differences in reports of SAV among type of study advertised on the SES-SFV and the CTS2. However, when measuring SAV with the CTQ, there were significantly more reports when the study was advertised as a SA study than one pertaining to crime or health but not when advertised as one researching alcohol use, χ2(3) = 12.456, p = .006. Analyses of SAP measures revealed no differences in reports of SA among type of study advertised. Secondary analyses investigating related correlates including personality and attitudinal factors are ongoing. The preliminary results of this study suggest that researchers have significant leeway in how studies are advertised such that, as long as data are collected anonymously, it will not adversely affect reported rates of sexual violence, except possibly when using the CTQ. Furthermore, this has ethical implications in that researchers do not need to be concerned that transparency will decrease data quality.
Fostering a Trauma- and Violence-Informed Community: Developing Strategies to Inform Public Education
Jessica Carswell1, C. Nadine Wathen1,2, Victoria Smye1, and Susan Macphail3
1Western University, London, Ontario, Canada
2Centre for Research & Education on Violence Against Women & Children, London, Ontario, Canada
3TVIC Educator & Consultant
Trauma and violence are pervasive public health issues. Social and systemic barriers intensify the effects of such experiences and negatively affect access to health and social services. Equity-oriented care practices combat these challenges, supporting health care settings to attend to and reduce the poor health outcomes associated with these experiences. Trauma- and violence-informed care (TVIC) is a key element of equity-oriented care, promoting the emotional, physical, and cultural safety of those accessing services—TVIC can be thought of as a “universal precaution,” minimizing harm in the care process. Work is being done to incorporate TVIC principles into organizational policies and practices, but little research has been done to translate this knowledge into information that informs communities and individuals accessing services. Therefore, we describe an ongoing research study that seeks to extend work that incorporates TVIC principles into organizational policies and practices. In collaboration with a community-based mental health organization in London, Ontario, Canada, this research utilizes qualitative methods to investigate how to use TVIC principles to frame and share TVIC information with the general community and individuals accessing services, and what barriers and facilitators may affect this process. Semi-structured interviews with staff and a document review of policies and procedures regarding public education and TVIC-related practices will help determine actions, priorities, and other relevant, equity-promoting considerations that are central to this investigation. The Exploration Stage of the Active Implementation Frameworks will be used to guide the data analysis and co-produce with the community partner effective recommendations for action. We will provide findings from the analysis to date and share our learnings that will inform recommendations for action at the community level. This Canadian research project is a critical first step in externally focused efforts to support broader community awareness and action regarding trauma, violence, equity, and cultural safety. This is important because social norms and structures can perpetuate the trauma, violence, and inequities experienced by vulnerable and marginalized groups—and inequities affect individuals, communities, and society.
Exposure to Intimate Partner Violence Over 10 Years and Child Health Outcomes at Age 10: Findings From the Maternal Health Study
Laura Conway1, Deirdre Gartland1,2, Stephanie Brown1,2,3, Fiona Mensah1,2,3, Sheena Reilly1,2,4, Emma Sciberras1,5, Rebecca Giallo1,2; the Maternal Health Study Team
1Murdoch Children’s Research Institute, Parkville, Victoria, Australia
2The University of Melbourne, Melbourne, Victoria, Australia
3Royal Children’s Hospital, Parkville, Victoria, Australia
4Griffith University, Gold Coast, Queensland, Australia
5Deakin University, Melbourne, Victoria, Australia
“Stealthing” and Other Forms of Coercive Condom Use Resistance: An Under-Examined Type of Violence Against Women
Kelly Cue Davis1, Mitchell Kirwan1, Rachel Van Daalen1, and Nolan Eldridge1
1Arizona State University, Phoenix, Arizona, USA
Nonconsensual condom removal—also termed “stealthing”—has received increased international media attention recently. Stealthing—a situation in which a man agrees to use a condom, but then removes the condom before or during intercourse without his partner’s knowledge or consent—is a type of sexual assault in some countries. In addition, other forms of coercive condom use resistance, such as emotional manipulation, deception, condom sabotage, and physical force, have been identified but are under-examined. The present study used a cross-sectional online survey to investigate the factors associated with stealthing and other coercive condom use resistance tactics in a nationwide sample of 18- to 30-year-old men (N = 104) residing in the United States who reported a history of coercive condom use resistance. Participants completed survey measures assessing sexual aggression history, alcohol expectancies related to sexual aggression, and alcohol use during their most recent coercive condom use resistance event. More than 18% (n = 19) of the participants reported having engaged in stealthing at least once since the age of 14. Of the men who had engaged in stealthing, they reported engaging in this behavior an average of 3.95 times (SD = 4.50), with a range of 1 to 21 times (maximum possible). Logistic regression analyses indicated that after controlling for social desirability, men with a more severe sexual aggression history (odds ratio [OR] = 2.82) had significantly higher odds of having engaged in stealthing behavior; history of psychological and physical intimate partner violence was not significantly predictive of stealthing. Regarding all coercive condom use behaviors, participants with stronger beliefs that alcohol increases the likelihood of their perpetration of sexual aggression (OR = 2.20) were more likely to have consumed alcohol when using coercive condom use resistance, while participants with stronger beliefs that alcohol increases women’s vulnerability to sexual coercion (OR = 2.20) were more likely to have used coercive condom use resistance with partners who had been drinking alcohol. Findings suggest that prevention efforts focusing on stealthing and other forms of coercive condom use resistance could benefit from targeting sexually aggressive men and addressing their beliefs about alcohol use and sexual aggression.
Testing the Acceptability and Feasibility of the Men With Conscience Sexual Violence Prevention Intervention in a Pilot-RCT at Two Universities in the Western Cape
Tania de Villiers1 and Naeemah Abrahams2
1University of Cape Town, Cape Town, South Africa
2South African Medical Research Council, Cape Town, South Africa
The main outcome of this study is a South African–designed, context-specific sexual violence prevention intervention for use in South African university settings, ready to be tested in a fully powered RCT.
Research dissemination, that is, publications in peer-reviewed journals, report back to the university communities, and presentation at local and international conferences.
Opportunity for developing emerging researchers, that is, master’s and PhD studies.
Rural–Urban Differences in Intimate Partner Violence–Related Emergency Department Visits: Implications for Prevention
Nancy R. Downing1, Maria Perez-Patron1, Brandie D. Taylor2, and Nora Montalvo-Liendo1
1Texas A&M University, College Station, Texas, USA
2Temple University, Philadelphia, Pennsylvania, USA
Building an Intersectoral Network to Champion Supports for Trans Survivors of Sexual Assault: Survey Findings From Health and Community Leaders
Janice Du Mont1,2, Sarah Daisy Kosa1,3, Megan Saad1,3, and Sheila Macdonald1,3
1Women’s College Hospital, Toronto, Ontario, Canada
2University of Toronto, Toronto, Ontario, Canada
3Ontario Network of Sexual Assault/Domestic Violence Treatment Centres, Toronto, Ontario, Canada
Results From a Novel Elder Abuse Nurse Examiner e-Learning Curriculum
Janice Du Mont1, Sarah Daisy Kosa1,2, and Sheila Macdonald1,2
1Women’s College Hospital, Toronto, Ontario, Canada
2Ontario Network of Sexual Assault/Domestic Violence Treatment Centres, Toronto, Ontario, Canada
An Evaluation of a Forensic Nursing e-Learning Curriculum on Trans-Affirming Care for Sexual Assault Survivors
Janice Du Mont1,2, Sarah Daisy Kosa1,3, and Sheila Macdonald3
1Women’s College Hospital, Toronto, Ontario, Canada
2University of Toronto, Toronto, Ontario, Canada
3Ontario Network of Sexual Assault/Domestic Violence Treatment Centres, Toronto, Ontario, Canada
Sex Ratios at Birth in Australia According to Mother’s Country of Birth: A National Study of All 5,614,847 Live Births in 1997–2016
Kristina Edvardsson1, Mary-Ann Davey2, Rhonda Powell1, and Anna Axmon3
1La Trobe University, Melbourne, Victoria, Australia
2Monash University, Melbourne, Victoria, Australia
3Lund University, Lund, Sweden
Exploring Authentic Empathy and Male Victim Stigma Management in the Practice Narratives of Victim Service Providers
Chuka Nestor Emezue1
1University of Missouri, Columbia, Missouri, USA
In spite of hegemonic masculine notions that stereotype male victims of sexual violence are weak, unmanly, or deviants of heteronormativity, anecdotal, research, and media evidence indicate more men are disclosing sexual assault to trusted members of their social support system—including victim service providers (VSP). We identify VSPs as those who provide direct or indirect rehabilitative services (not limited to health, legal, criminal, and counseling services) for male victims of sexual violence. Few studies consider the roles VSPs play in the context of stigma management with male victims. The purpose of this study is to explore VSP stigma awareness, stigma discourse, and stigma management practices (i.e., stigmatization, non-stigmatization, or de-stigmatization).
Immigrant Male Batterers: A Systematic Review of Treatment Gaps, Therapeutic Disparities, and Theoretical Misfirings in Intervention Programs
Chuka Emezue1
1University of Missouri, Columbia, Missouri, USA
Batterer Intervention Programs (BIPs) show minimal evidence of treatment efficacy in curbing post-intervention recidivism. These interventions offer even less significant treatment potential for Immigrant Male Batterers (IMB), who contend with pre- and post-migration barriers to prevention and treatment in BIPs. Accordingly, best practices and treatment components of BIPs with promising results among IMB are inconclusive. Vital treatment components of promising BIPs and entry points for treatment uptake are discussed. A comprehensive literature search for quantitative and qualitative outcomes/intervention studies was conducted in 10 electronic databases based on these inclusion criteria: published between 1990 and 2018, interventional and observational/non-interventional studies targeting IMB, compared the effects of a new or modified curricula with standard curricula, and studies with immigrant versus non-immigrant group comparison. Study participants were mostly Hispanic men in the United States. Low to moderate intimate partner and domestic violence (IPV/DV) was frequently reported. Study outcomes were highly heterogeneous. Culturally specific programs included modified BIP curricula, and involved IMB in the subsequent iterative design of interventions, allowing for negotiation in cultural expressions of masculinity produced promising short-term results in changing IPV positive attitudes and increasing accountability in dyadic violence. However, long-term IPV/DV reductive effects remain inconclusive. Findings will have implications for culture congruent prevention and intervention program designed to address immigrant IPV outcomes, establish intervention entry points and areas of treatment divergence, uncover emergent contexts of immigrant-specific intimate partner violence (IPV), and recommend improvements to develop culturally differentiated IPV intervention protocol.
Rural Attitudes Toward Intimate Partner Violence
Tracy A. Evanson1*, Shawnda Schroeder1, and Barbara Zust2*
1University of North Dakota, Grand Forks, North Dakota, USA
2Gustavus Adolphus College, St. Peter, Minnesota, USA
*Both Drs. Evanson and Zust are presenting authors at the conference.
Definitions and Data on Femicide
Cristina Fabre1 and Cathrine H. Bärtel1
1European Institute for Gender Equality (EIGE), Vilnius, Lithuania
The definition of femicide is often considered to be “the killing of women and girls because they are female.” What separates the killing of women from a case of femicide is the gender-based motivation. However, the definition of femicide continues to be discussed, and none of the European Union Member States (MS) has codified it. An additional obstacle to combat femicide is the lack of administrative data available. In Europe, only 17 MS collect data and provide insight into the killing of women by their intimate partners, which demonstrates a key issue of data collection and risk assessment on femicide. Collecting data related to the victim–perpetrator relationship in conjunction with homicide data including variables such as motive or context is lacking across Europe. Risk assessment procedures and risk management strategies could efficiently protect women victims of intimate partner violence and prevent their revictimization and even their killing. The European Institute for Gender Equality (EIGE) has developed a Risk Assessment Guide based on some overarching principles: victims-centered and victims’ safety approach, gender and intersectionality approach, and child sensitive. It identified the most relevant risk factors, which can include fear of the perpetrator, recent separation or estrangement, disputes on child custody, pregnancy, stalking, and coercive behavior. The purpose of the identification of risk factors is to feed into effective risk management strategies, specifically with a multi-agency approach including police as well as the health sector, as it is especially underrepresented when it comes to data collection on the issue, despite it, often, being the initial institutional body to get in contact with the victim. Currently, EIGE is working on a new study, on femicide and administrative data. The study will act as a reference tool for ensuring a standardized categorization of femicide and improve data collection on violence against women in the area. These standardizations will be based on an evidence-based report, which will include police and medical-forensic evidence that reveals the “gender-based motives” of femicide. With the study, EIGE seeks to strengthen MS responses to combating intimate partner violence and acquiring a deepened understanding on the issue of femicide.
The Ethical Dilemma of Mandatory Reporting Laws in the United States: Observations of a Harm Reduction Outreach Nurse
Sarah Febres-Cordero1 and Kylie Smith1
1Emory University, Atlanta, Georgia, USA
Family Violence Reform in Victoria, Australia: How Mental Health Services Manage Systemic Change
Sabin Fernbacher1
1Sabin Fernbacher Consulting
The Victorian Royal Commission Into Family Violence 2016 saw an unprecedented focus on violence against women and children in Australia. Accepting all 227 recommendations, the Victorian Government set a new agenda for sweeping reforms and progressed immediately to implementation. The commission’s report highlighted systemic gaps, and subsequent recommendations addressed those gaps through a variety of strategies from policy to new service types and shared responsibilities. Sweeping changes include a multi-agency risk assessment framework, establishment of multi-agency support, support and safety hubs, and legislative reform. Policy development, the need to align state government and organizational policies with the new risk assessment framework, practice guidance and workforce development are part of this far-reaching reform. The commission highlighted the unique position of health and mental health professionals to identify and respond to family violence. It recognized the need for mental health services to get better at identifying and responding to family violence. Victorian mental health services have lacked clarity about their role and responsibilities regarding family violence. The commission’s recommendations included the need for a Chief Psychiatrist Guideline on Family Violence. It recommended establishment of Family Violence Advisers for mental health services to increase the capabilities of this sector. The published chief psychiatrist guideline went beyond its remit and includes practice guidance and organizational change strategies, and clearly outlines organizational responsibilities for this change. It aimed to assist mental health services to align their organizations within this new environment and take clear responsibility for family violence. While the Chief Psychiatrist guideline and practice guide outlines what ought to occur, the advisers are in a position to support some of the changes toward increasing organizational capabilities. The author of the Chief Psychiatrist Guideline has engaged with those responsible for its implementation to seek feedback about its practical application, including challenges. This presentation will look at the translation of those new policies into practice and the role of the Family Violence Advisers. Gains and challenges regarding this implementation will also be discussed.
Birth Outcomes in a Swedish Population of Women Reporting a History of Violence Including Domestic Violence During Pregnancy: A Longitudinal Cohort Study
Hafrún Finnbogadóttir1, Kathleen Baird2, and Li Thies-Lagergren3
1Malmö University, Malmö, Sweden
2Griffith University, Gold Coast, Queensland, Australia
3Lund University, Lund, Sweden
Midwives’ Experiences to Meet Pregnant Women Who Are Exposed to Intimate Partner Violence at Prenatal Ward
Hafrún Finnbogadóttir1, Ella Torkelsson2, Cecilia Barna Christensen2, and Eva-Kristin Persson3
1Malmö University, Malmö, Sweden
2Malmö University Hospital, Malmö, Sweden
3Lund University, Lund, Sweden
Burndawan: The Co-Design, Development, and Launch of an Online Indigenous Family Violence Resource
Renee Fiolet1, Laura Tarzia1,2, Renee Owen3,4, Syd Fry3, Kaley Nicholson3, Corrina Eccles3, Jasmin Knox3, May Owen3, and Kelsey Hegarty1,2
1The University of Melbourne, Melbourne, Victoria, Australia
2The Royal Women’s Hospital, Melbourne, Victoria, Australia
3Wadawurrung Aboriginal Advisory Group
4Barwon Health, Geelong, Victoria, Australia
You’re a Whore, but You’re Also a Black Whore: Indigenous Experiences of Family Violence
Renee Fiolet1, Laura Tarzia1,2, Renee Owen3,4, Syd Fry3, Kaley Nicholson3, Corrina Eccles3, Jasmin Knox3, May Owen3, and Kelsey Hegarty1,2
1The University of Melbourne, Melbourne, Victoria, Australia
2The Royal Women’s Hospital, Melbourne, Victoria, Australia
3Wadawurrung Aboriginal Advisory Group
4Barwon Health, Geelong, Victoria, Australia
Physical and Emotional Intimate Partner Violence and Women’s Mental, Physical, and Sexual Health After Childbirth: An Australian Pregnancy Cohort Study
Kelly Fitzpatrick1,2, Stephanie Brown1,2, Kelsey Hegarty2,3, Fiona Mensah1,2,4, and Deirdre Gartland1
1Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
2The University of Melbourne, Melbourne, Victoria, Australia
3The Royal Women’s Hospital, Melbourne, Victoria, Australia
4Royal Children’s Hospital, Melbourne, Victoria, Australia
Attending to Context and Complexity: Evolving a Promising Health Promotion Intervention for Women Separating From an Abusive Partner
Marilyn Ford-Gilboe1, Colleen Varcoe2, and Kelly Scott Storey3; for the iHEAL Team
1Western University, London, Ontario, Canada
2University of British Columbia, Vancouver, British Columbia, Canada
3University of New Brunswick, Fredericton, New Brunswick, Canada
The negative effects of intimate partner violence (IPV) are broad, linked, and often continue after separation, affecting women’s safety, mental and physical health, social relationships, economic situation, and parenting. Women’s differing needs, priorities, resources, and living conditions affect how they seek help and the types of support that might be helpful. As such, comprehensive interventions that consider the context and complexity of women’s lives and are tailored to their unique circumstances, priorities, and needs are most likely to show benefits. These types of interventions are congruent with relational nursing practice approaches and can provide a way of operationalizing research evidence and theory, including concepts such as Trauma- and Violence-Informed Care (TVIC). Importantly, evaluations of “complex” interventions should retain a focus on complexity and context; that is, they should be designed to not only capture more than group differences on main outcomes, but also account for who benefits, how, and why. However, few such nursing interventions have been developed and tested, particularly in the context of separating from an abusive partner.
To address these gaps, we developed iHEAL, a comprehensive, trauma- and violence-informed intervention for women who are in the transition of separating from an abusive partner. Supported by a Clinical Supervisor, community health nurses, who have completed standardized iHEAL Education, work in partnership with women for ~6 month (10–18 sessions) to address a broad range of issues that affect women’s safety, health, and well-being. Tailoring the intervention to the individual woman’s priorities, needs, and context, and to the community in which she lives, is a key feature that could enhance successful integration into different service settings. iHEAL is woman-led, with a strong focus on complementing and extending, rather than duplicating, existing services. It is flexible enough to fit the needs of all women, with potential to reduce inequities.
In three separate studies (including one with Indigenous women), women found iHEAL safe and acceptable; substantial improvements in women’s health and quality of life were maintained 6 months after iHEAL ended. We are now examining the effectiveness and cost-effectiveness of a revised version of iHEAL in a randomized controlled trial of 331 Canadian women. We are also exploring who benefits from iHEAL and why, how iHEAL education and experience shape the nurses’ practice, and the conditions needed to support broader scale-up if effective. Intervention delivery ends in February 2020; 18-month follow-up assessments continue until March 2021.
describe the theoretical and empirical foundations of iHEAL and its’ unique delivery model, summarizing key lessons from research to date
illustrate the principles, strategies, and processes used to develop, test, adapt, and evolve iHEAL in ways that attend to complexity and context
explore how insights from this research could strengthen interventions and services for women experiencing IPV in different contexts
Gender Matters: Testing the Composite Abuse Scale (Revised)–Short Form With a Sample of Canadian Adults
Marilyn Ford-Gilboe1, Nadine Wathen1, Nancy Perrin2, Sue O’Donnell3, Kelly Scott-Storey3, Colleen Varcoe4, Jenn McGregor1, Alice Pearl Sedziafa1, and Joanne Hammerton1
1Western University, London, Ontario, Canada
2Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
3University of New Brunswick, Fredericton, New Brunswick, Canada
4University of British Columbia, Vancouver, British Columbia, Canada
Promoting Healthy Relationship Formation Among Young Adolescents in the Rio Grande Valley
Nina Fredland1 and Elif Isik1
1Texas Woman’s University, Houston, Texas, USA
One in four women experience intimate partner violence (IPV) and 7 million children live in homes where IPV occurs. Such exposure interferes with healthy development and healthy relationship formation. These youth are at increased risk for negative outcomes because their mothers experienced IPV. There is evidence that arts-based interventions are enjoyed by youth and have a positive impact on attitudes and potentially can change behavior.
Intimate Partner Violence Across the First 10 Years of Mothering and Associated Mental and Physical Health Outcomes
Deirdre Gartland1,2, Kelly Fitzpatrick1, Fiona Mensah1,2, and Stephanie Brown1,2
1Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
2The University of Melbourne, Melbourne, Victoria, Australia
Engaging With Uncertainty and Complexity: Primary Care Responses to Intimate Partner Violence
Claire Gear1, Jane Koziol-McLain1, and Elizabeth Eppel2
1AUT University, Auckland, New Zealand
2Victoria University of Wellington, Wellington, New Zealand
When a Longitudinal Study Becomes Trauma-Informed Care: The Experiences of Field Nurses
Heidi Gilroy1 and Angeles Nava2
1Children’s Memorial Hermann Hospital, Houston, Texas, USA
2Texas Woman’s University, Houston, Texas, USA
To determine the effectiveness of criminal justice and safe shelter interventions for women who had experienced intimate partner violence, a study was funded to document mental health and functioning outcomes in 300 women for 7 years. Three researchers recruited women and then visited them every 4 months for 7 years. The women had the same researcher throughout the program. The researchers used a scripted tool to collect information. No intervention was given to the women in the study; however, the women reported behavior change as a result of the relationship developed from the brief interaction in each visit. We do not believe that the study results were affected by the behavioral changes because all women had the same experience of an assigned researcher with a scripted tool. We do believe that some lessons learned from this experience might help inform future longitudinal studies as well as advocacy interventions for women who have experienced intimate partner violence. The purpose of this presentation is to share those lessons learned with researchers and advocates.
Acculturation, Acculturation Stress, Adverse Childhood Experiences, and Intimate Partner Violence Among Latinx Immigrants in the United States
Rosa M. Gonzalez-Guarda1, Brian E. McCabe2, Miriam Quizhpilema Rodriguez1, and Richard C. Cervantes2
1Duke University School of Nursing, Durham, North Carolina, USA
2Auburn University, Auburn, Alabama, USA
3Behavioral Assessment Inc., Beverly Hills, California, USA
Recent Latinx (gender inclusive term for individuals of Latin American origin) immigrants report less exposure to intimate partner violence (IPV) than their more established counterparts. Research suggests that years in the United States and acculturation to American culture are risk factors for IPV victimization in this population. Nevertheless, little is known about the relative contribution of acculturation versus the stress associated with this process (i.e., acculturation stress). In addition, research exploring the influence of acculturation on IPV risks among Latinx immigrants has seldom considered the influence of exposures to other stressful experiences on IPV risk such as childhood and immigration-related adversity. The purpose of this presentation is to examine the relationships among acculturation, acculturation stress, adverse childhood experiences, and IPV among Latinx immigrants. Baseline data from a longitudinal study of 385 community-dwelling Latinx immigrants between the ages of 18 and 44 in the research triangle area of North Carolina were collected. Bilingual and bicultural researchers collected data in participants’ homes using standardized measures for acculturation (Bidimensional Acculturation Scale), acculturation stress (Hispanic Stress Inventory 2–Immigrant Version), adverse childhood experiences (ACE–International Questionnaire), and IPV victimization (Conflict Tactics Scale), which had previously been validated with Latinx immigrants. The majority of the sample were female and emigrated from Mexico to be with family or for financial opportunities. Multiple logistic regression controlling for age, gender, age of immigration, and education showed that acculturation stress was related to IPV victimization, but acculturation and adverse childhood experiences were not. In fact, participants with high levels of acculturation stress had about twice the odds of reporting IPV victimization. It appears that acculturation stress plays a role in increasing risk for IPV among Latinx immigrants as they adapt to American life. Interventions are needed to help minimize exposure to stress and improve coping skills during this critical period and to prevent the potential toxic effects that this has on conflict and violence in intimate relationships. Additional research is also needed to examine these relationships among Latinx immigrant subgroups, including subgroups based on country of origin, gender identity and sexual orientation, and geographical regions in the United States, among others.
Learning From a Domestic Violence and Advocacy Model Within Primary Care, the Story of Identification and Referral to Improve Safety
Melanie Goodway1, Annie Howell1, and Medina Johnson2
1IRISi, United Kingdom
2IRISi, Honorary Contract University of Bristol, Bristol, United Kingdom
IRISi works to promote and improve the health care response to gender-based violence. IRIS (Identification and Referral to Improve Safety) is our innovative, evidence-based, domestic violence and abuse (DVA) training, support, and referral program for general practice. Research shows that 80% of women in a violent relationship seek help from health services, and these are often a woman’s first, or only, point of contact. Therefore, we know a dedicated training and support package is vital to address DVA, aid prevention, and provide appropriate responses. Tested and positively evaluated in a randomized controlled trial, the IRIS program is recognized as the gold standard for supporting clinicians in general practice to recognize and respond to their patients affected by DVA. Women in IRIS trained practices are six times more likely to be referred to specialist support and 22 times more likely to have a conversation about DVA with their clinician. After training, clinicians report improved knowledge and skills around DVA, increased confidence to deal with and respond to disclosures and can assess immediate risk, knowing then where to refer patients for support. This training is an advance in education for primary health care professionals who often have little prior knowledge of the dynamics of DVA, the health impacts, and how to respond appropriately and safely to disclosures. We know that clinicians, practice teams, and patients benefit greatly from the IRIS program and would recommend it, with patients feeling safer, more able to cope, and reporting they visited their general practice less frequently, Since 2010, IRIS teams have fully trained practice teams in more than 850 general practices and directly supported more than 14,000 women. We expect that many more women will have had a conversation about DVA with their primary health care clinician and that many of these women will subsequently seek support. Our session will delve further into the evidence base we have for the importance of a health care response to DVA, sharing lessons learned and best practice for working with health care professionals, specifically within general practice and for nursing teams.
Speaking Out About #FGM: Messages and Visuals on Twitter
Jeanine P. D. Guidry1, Candace W. Burton2, Liza Ngenye3, Iona Coman4, and Kellie E. Carlyle1
1Virginia Commonwealth University, Richmond, Virginia, USA
2University of California–Irvine, Irvine, California, USA
3La Sierra University, Riverside, California, USA
4Texas Tech University, Lubbock, Texas, USA
Self-Esteem in the Context of Intimate Partner Violence: A Concept Analysis
Ayse Guler1 and Carolyn R. Smith1
1University of Cincinnati, Cincinnati, Ohio, USA
concept analysis, self-esteem, violence against women, intimate partner violence or domestic violence or partner abuse
The Influences of Psychosocial and Cultural Factors on Women’s Responses to Intimate Partner Violence
Ayse Guler1 and Carolyn R. Smith1
1University of Cincinnati, Cincinnati, Ohio, USA
social factors, psychological factors, cultural factors, intimate partner violence or domestic violence or partner abuse; psychosocial factors
Effect of Antenatal Screening for Sickle Cell Disease on Intimate Partner Violence in the Sickle Cell Belt in Central India
Nafisa Halim1, Patricia L. Hibberd1,2, Archana Patel3,4, and Anuradha Shrikhande3
1Boston University School of Public Health, Boston, Massachusetts, USA
2Boston University School of Medicine, Boston, Massachusetts, USA
3Indira Gandhi Government Medical College, Nagpur, India
4Lata Medical Research Foundation, Nagpur, India
Autosomal recessive sickle cell disease (SCD) is on the rise globally. Screening for SCD can be misunderstood and can lead to intimate partner violence (IPV), abandonment, and adverse outcomes but the frequency and risk of these outcomes is unknown. India is home to 27% of the world’s SCD births. SCD symptoms appear later in life in India; pregnant women may not know their SCD status. The “solubility test” which cannot distinguish between SCD and asymptomatic sickle cell trait (SCT) is used to screen for SCD in pregnancy. A positive test may be misunderstood as the pregnant woman having SCD, and not SCT. Pregnant women with a positive solubility test are counseled to return for hemoglobin electrophoresis to determine whether they have SCD or SCT. They are asked to bring their partner for the same test. Women with a positive solubility test and their partner undergo further testing to determine the SCD risk in the unborn child. We hypothesize that a positive solubility test increases the risk of adverse pregnancy outcomes, due to IPV. Informing a partner of a positive solubility test may result in IPV in India. Men may react with threats of or actual physical, emotional, or economic IPV (forced exile from the home, refusal to buy food for the family), blaming women of deception (intentionally hiding her status at the time of marriage), or for poor health and quality of life of the unborn child, associating the family with a stigmatized disease. IPV further compounds adverse pregnancy outcomes in both those with SCD and SCT. We are conducting a study in Central India to address this hypothesis in which we will report rates of IPV in 91 pregnant women with negative and 91 with positive solubility tests (a) just before the women are informed of the solubility test result and (b) during pregnancy. We will also report pregnancy outcomes. Our data collection ends in December 2019, and data analysis in March 2020. Results will be ready for dissemination by June 2020, and will inform programs improving pregnancy and fetal outcomes in women with SCD/SCT in India and elsewhere.
In the Claws of Death: Fundamental Aspects of Intimate Partner Violence From the Perspective of Female Survivors
Sigridur Halldorsdottir1 and Sigrun Sigurdardottir1
1University of Akureyri, Akureyri, Iceland
The purpose of this phenomenological research was to study fundamental aspects of intimate partner violence (IPV) from the perspective of female survivors. In-depth interviews were conducted with nine survivors. The interviews were audiotaped, transcribed, and thematically analyzed. The results show that the violence started in “the beginning phase” of the women’ relationships. The men were very often angry and displeased, wanted to know and control all the women’s actions, and expected obedience. The women never knew what to expect. In “the silencing phase,” the men used verbal abuse and intense humiliation and little by little the women felt they never did or said anything right and they were silenced. The women hoped that violent attacks would not be repeated. The men cut the women’s human contacts and took everything they could from them. The women began to experience a great sense of helplessness and hopelessness and began to feel almost invisible and being not even there. Looking back, all the women felt that their very lives had been threatened. They felt lifeless in “the claws of death.” The worst was the feeling of intense sense of guilt that robbed the women of basic human dignity. All the women used metaphors when trying to describe how they felt in “the living death phase.” In “the awakening phase,” something or someone came to the women’s aid and helped them escape from the claws of death. The women’s hearts began to “melt” and they began to feel again. “The way back to health and healing phase” was long and arduous for all the women. The authors conclude that IPV is extremely dangerous, and all efforts must be made to empower female survivors’ help-seeking and to help women in the healing process after being in such a life-threatening situation.
Intimate Partner Violence as a Human Rights Violation
Sigridur Halldorsdottir1 and Sigrun Sigurdardottir1
1University of Akureyri, Akureyri, Iceland
A Multidisciplinary System-Level Approach to Intimate Partner Violence Screening Among Obstetric Patients: A Quality Improvement Initiative
Casey Harrison1, Annmarie Zimmermann2, and Kathleen Shurpin1
1Stony Brook University, Stony Brook, New York, USA
2Universal Primary Care, Olean, New York, USA
A Combined Behavioral Economics and Cognitive-Behavioral Therapy Intervention to Reduce Alcohol Use and Intimate Partner Violence Among Couples in Bengaluru, India: Results of a Pilot Study
Miriam Hartmann1, Saugato Datta2, Erica N. Browne1, Prarthana Appiah3, Rachel Banay2, Vivien Caetano2, Rosii Floreak2, Hannah Spring2, Anurada Sreevasthsa3, Susan Thomas3, Sumithra Selvam3, and Krishnamachari Srinivasan3
1RTI International, San Francisco, California, USA
2ideas42, New York City, New York, USA
3St. John’s Research Institute, Bengaluru, India
Alcohol use and intimate partner violence (IPV) are interconnected issues, with evidence showing hazardous drinking is an important contributing factor to IPV occurrence and severity in both developed and developing country settings. Despite this, only a limited number of alcohol reduction interventions have been tested in low- and middle-income countries (LMIC) for their efficacy in reducing IPV. This pilot intervention study tested a 1-month combined behavioral economics and cognitive-behavioral therapy intervention to reduce hazardous alcohol use and IPV in Bengaluru, India. Sixty couples were randomized to one of three study arms to test the effect of incentives-only and incentives plus counseling interventions compared with a control condition. Male participants in all arms took regular breathalyzer tests over the course of the intervention with those in the incentive arms earning a reward for sobriety (breath alcohol content [BrAC] < 0.01 g/dl). Couples in the incentives plus counseling arm participated in four weekly counseling sessions. Violence experienced by female participants was measured using the Indian Family Violence and Control Scale. Results showed that alcohol use decreased in both intervention arms. The counseling arm had a greater proportion of negative BrAC samples compared with the control arm (0.96 vs. 0.76, p = .03). Violence also decreased in both intervention arms, with the reduction persisting; the estimated mean violence score for the counseling arm was 10.8 points lower than the control arm at 4-month follow-up visit (p = .02). This study contributes important evidence to the field of alcohol reduction and IPV prevention approaches in LMIC settings and adds to the evidence suggesting that alcohol reduction is a modifiable means of addressing IPV. Given implementation feasibility and acceptability, as well as a dearth of other high-impact IPV interventions, this study shows value in continuing to explore the mechanisms at play in violence reduction, and testing efficacy in other settings.
Transforming the Health System to Address Domestic and Family Violence: How Do We Know We Are There?
Kelsey Hegarty1, Jane Koziol-McLain2, Elizabeth McLindon1, and Jo Spangaro3
1The University of Melbourne, Melbourne, Victoria, Australia
2Centre for Interdisciplinary Trauma Research, Auckland, New Zealand
3University of Wollongong, Wollongong, New South Wales, Australia
Testing a Brief Online Engagement Tool to Promote Men’s Help-Seeking for Domestic Violence and Abuse
Kelsey Hegarty1, Mohajer Hameed1, Laura Tarzia1, Simone Tassone2, Matt Addison2, and Adam Hasandedic3
1The University of Melbourne, Melbourne, Victoria, Australia
2No to Violence, Australia
3Nexus Primary Health, Melbourne, Victoria, Australia
Baseline Findings From Safe Pregnancy—Promoting Safety Behaviors in Antenatal Care Among Norwegian, Pakistani, and Somali Pregnant Women: A Randomized Controlled Trial
Lena Henriksen1, Eva Marie Flaaten1, Jeanette Angelshaug1, Milada Cvancarova Småstuen1, Lisa Garnweidner-Holme1, Josef Noll2, Berit Schei3, Angela Taft4, and Mirjam Lukasse1
1Oslo Metropolitan University, Oslo, Norway
2University of Oslo, Oslo, Norway
3The Norwegian University of Science and Technology, Trondheim, Norway
4La Trobe University, Melbourne, Victoria, Australia
Training Health Care Providers to Respond to Intimate Partner Violence Against Women: A Cochrane Systematic Review
Leesa Hooker1, Naira Kalra2, Sonia Reisenhofer1, Gian Luca Di Tanna3, and Claudia Garcia-Moreno4
1La Trobe University, Melbourne, Victoria, Australia
2Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
3The George Institute for Global Health, Newtown, New South Wales, Australia
4World Health Organization, Geneva, Switzerland
Talking to Fathers Who Have Abused: Enhancing the Child Focus in Social Child Welfare Investigations
Ole Hultmann1, Ulf Axberg¹, Anders Broberg2, Maria Eriksson3, and Clara Iversen4
1VID Specialized University, Stavanger, Norway
2University of Gothenburg, Gothenburg, Sweden
3Ersta Sköndal Bräcke University College, Stockholm, Sweden
4Uppsala University, Uppsala, Sweden
Existing structured interviews and risk assessments with perpetrators of partner violence focus on the violence itself and the risk of repeated violence. These approaches lack relevant aspects of parenting, such as feelings of remorse, how the parent understands the child’s and the adult victim’s reactions to the violence, and whether perpetrators can identify problems that affect their relationship with the child. This study is conducted within the context of the Swedish iRiSk project (Insatser och risk-/skyddsbedömningar för våldsutsatta barn), which aims to develop structured risk and safety interviews in child welfare investigations. This paper presents a study that focuses on fathers as perpetrators. It examines (a) the feasibility of a structured interview, as assessed by professionals; (b) to what extent violent fathers are able to reflect on their violent behavior and its effect on parenting during the structured interview; and (c) to what extent violent fathers can provide relevant information to a child welfare investigation. The goal of the project is to improve the quality of risk and safety assessments and the protection of vulnerable children by enhancing the child focus in child welfare investigations about intimate partner violence and child abuse. The structured interview will be tested by professionals within child welfare investigations and with fathers who are in contact with a crisis center. Participants in the project are recruited through the Swedish iRiSk project funded by the Swedish National Board of Health and Welfare. Recorded interviews with the fathers will be analyzed according to scoring principles of the Parent Development Interview. The structured interview and the outline of the project will be presented as well as preliminary feedback from participating units and analyses of interview transcript.
Symptom Cluster Pattern Recognition in Formerly Abused Women: A Pilot Feasibility Study
Dori Steinberg1, Jiepin Cao1, and Qing Yang1
1Duke University School of Nursing, Durham, North Carolina, USA
Qualitative Re-Appraisal of Perspectives, Prevalence, and Management of Family Violence Among the Yoruba People—A Study of Cohorts From Ile-Ife, Nigeria
Omolola O. Irinoye1 and Oluwasayo B. Ogunlade1
1Obafemi Awolowo University, Ile-Ife, Nigeria
Results showed multiple words and descriptions of abuse and violence with no single word or conceptualization in the local Yoruba language to capture the concepts. Common forms of family violence identified were verbal assaults from parents to children, among couples, siblings; physical assault of children by parents, physical assault of parents by children; neglect of children, parents, spouses (mostly wives); sexual harassment; and sexual violence. Neglect of wives and children was perceived to be increasing, estimated to occur in one of four houses. Sexual harassment and sexual violence were perceived to be rare in family relationships in cultural context, but the latter was not considered an issue in marital context. A variant of sexual “touching” of young girls by young men was said to be tolerated among unmarried young men of a subethnic group. Age and gender were dominant factors in the use of common forms of violence. Informal approaches were common and more culturally acceptable in managing family violence but perceived inadequate.
The study concluded that family violence is a common phenomenon among the study population. The average nurse, irrespective of place of practice, needs to be appropriately trained to be sensitized to the burden of tolerated family violence in cultural context, to engage in risk assessment, family education and advocacy, and active intervention.
Intimate Partner Violence Against Women and the Nordic Paradox: An Intersectional and Multilevel Analysis in the European Union
Anna Karin Ivert1,2, Maria Wemrell1,3, Enrique Gracia4, Marisol Lila4, and Juan Merlo1,5
1Lund University, Malmö, Sweden
2Malmö University, Malmö, Sweden
3Lund University, Lund, Sweden
4University of Valencia, Valencia, Spain
5Center for Primary Health Care Research, Region Skåne, Malmö, Sweden
Nurse Home Visitors’ Efforts to Prevent, Recognize, and Respond to Child Maltreatment
Susan Jack1, Andrea Gonzalez1, Lil Tonmyr2, Lenora Marcellus3, Colleen Varcoe4, Charlotte Waddell5, and Harriet MacMillan1
1McMaster University, Hamilton, Ontario, Canada
2Public Health Agency of Canada, Ottawa, Ontario, Canada
3University of Victoria, Victoria, British Columbia, Canada
4University of British Columbia, Vancouver, British Columbia, Canada
5Simon Fraser University, Vancouver, British Columbia, Canada
Critical Lessons Learned About Adapting, Implementing, and Evaluating Intimate Partner Violence Innovations for Home Visiting in International Practice Contexts
Susan Jack1, Shauna Conway2, Tine Gammelgaard Aaserud3, Emma Larkin2, Sarah Tyndall4, Deirdre Webb2, and Ann Rowe5
1McMaster University, Hamilton, Ontario, Canada
2Public Health Agency, Belfast, Northern Ireland
3Nurse–Family Partnership, Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway
4Family Nurse Partnership National Unit, London, United Kingdom
5Nurse–Family Partnership International Program, Denver, Colorado, USA
Considerable resources are invested in the development and evaluation of new practice innovations to support nurses and midwives identify and respond to intimate partner violence (IPV). In the United States, work has been invested to develop, pilot, evaluate, and scale an IPV innovation for the Nurse–Family Partnership (NFP) home visitation program. Internationally, six NFP programs (Australia, Canada, England, Northern Ireland, Norway, and Scotland) subsequently adopted and adapted the NFP IPV innovation. The objective of this symposium is to discuss critical lessons learned about adapting, implementing, and evaluating existing IPV innovations into new international contexts. The adoption of the NFP IPV intervention will be used as a case example. International leads from four countries will describe their local initiatives and then provide practical recommendations for researchers and decision makers committed to introducing and evaluating IPV innovations.
1. NFP IPV Innovation (5 minutes)
An overview of the five intervention components, including the clinical pathway and nursing curriculum.
2. Leveraging the Power of Collaboration and Committed Partnerships (15 minutes)
The benefits and challenges of multiple countries working simultaneously to adapt the same innovation yet tailor it to different contexts will be identified and discussed. The importance of central coordination, collaboration, and identification of similarities and differences in contexts will be considered.
3. Adapting existing interventions to reflect local needs and contexts (15 minutes)
The process of adaptation for a new context (Norway) will be explored, including identification of types of individual, team, organizational, community, and cultural adaptations required. Issues of language and translation, “fit” with local policy and service configurations as well as the balance between innovation and building on good nursing practice will be discussed.
4. Implementing new innovations in practice (15 minutes)
Changes to existing clinical practices require a committed local champion, leadership, support, and facilitated guidance. Examples from a checklist to support organizational readiness to adopt a new innovation will be summarized.
5. Practice-based evaluation (15 minutes)
It is good practice to evaluate adapted program innovations for local acceptability and feasibility within a new context. Findings of the Northern Ireland IPV innovation service evaluation will be shared. Reflections on the integration of the IPV innovation into a context of integrated health and social care services and the Northern Ireland policy context in relation to safeguarding and domestic violence risk assessment will be discussed. Considerations for existing nurse–client relationships will also be addressed.
6. How research methodology can support implementation (15 minutes)
A description of rapid cycle testing methodology and how this was used to support implementation of the innovation in England will be provided. Reflections on the benefits and drawbacks of short testing cycles and how these were used to combine quantitative data feedback with practitioner consultation will be discussed. These frequent conversations with teams around practice experience and reflection on practitioner-generated quantitative data created a dynamic which supported timely responses to challenges in the nurse experience of delivering the innovation and enabled rich learning to inform ongoing adaptation of this innovation into a new context.
Remaining time will be dedicated to discussion with attendees.
The PATH to Knowledge Mobilization: Expanding Our Reach Using the ABELE Method
Kimberley T. Jackson1, Tara Mantler1, and Sheila O’Keefe-McCarthy2
1Western University, London, Ontario, Canada
2Brock University, St. Catharines, Ontario, Canada
EMBRACE: Engaging Mothers in a Breastfeeding Intervention to Promote Relational Attachment, Child Health, and Maternal Empowerment
Kimberley T. Jackson1, Tara Mantler1, Brenna Velker1, and Shauna Burke1
1Western University, London, Ontario, Canada
Validity and Reliability of Sullivan’s Quality of Life Scale Among Women With Histories of Intimate Partner Violence
Diana A. Jaradat1, Marilyn Ford-Gilboe2, Carol Wong2, and Helene Berman2
1Jordan University of Science and Technology, Irbid, Jordan
2Western University, London, Ontario, Canada
Organizational Implementation of Trauma- and Violence-Informed Care: A Multiple Case Study Analysis
Tanaz Javan1 and Nadine Wathen1
1Western University, London, Ontario, Canada
Health and social inequities are increasing, especially for those already marginalized by systemic barriers such as poverty, and who face discrimination and racism. Many people across the socioeconomic spectrum have experienced various forms of trauma and violence; for those facing structural barriers and marginalization, these exposures, and their consequences, are often worse, making it even more difficult to access health and social services. There is a need to explicitly integrate equity-oriented care to overcome barriers and improve outcomes by addressing both individual and social/structural determinants of health. A core aspect of equity-oriented care is attention to the effects of trauma and violence and a commitment to minimizing harm by adopting what we call trauma- and violence-informed care (TVIC). This study is a multiple case study examining the implementation processes of TVIC in select organizations in London, Ontario.
“You Need More Understanding”: Perinatal and Motherhood Experiences of Icelandic Mothers Who Are Survivors of Childhood Sexual Abuse
Inga Vala Jónsdóttir1,2,3, Sigrún Sigurðardóttir4, Sigríður Halldórsdóttir4, and Sigríður Sía Jónsdóttir4
1Akureyri Hospital, Akureyri, Iceland
2Health Care Institution of North Iceland (Akureyri Health Clinic), Akureyri, Iceland
3Home Delivery and Home Service Midwife
4University of Akureyri, Akureyri, Iceland
childhood sexual abuse, survivor, perinatal period, motherhood, midwife, womenʼs health, phenomenology, interviews
Explore the Ethical Challenges for a Research on the Effect of Group Therapy in Restoring the Psychological Well-Being of Women Survivors Raped During Genocide Against Tutsis
Clémentine Kanazayire1, Jeanne Marie Ntete1, and Germaine Tuyisenge2
1University of Rwanda, Kigali, Rwanda
2Simon Fraser University, Vancouver, British Columbia, Canada
raped women, ethical challenge, genocide against Tutsis
Developing Transnational Training for Nurses and Midwives to Support Survivors/Victims of Violence and Abuse at the Point of Access to Health Care Services
June Keeling1, Wilf McSherry2, Vaiva Hendrixson3, Gloria Macassa4, Vasiliki Deligianni-Kouimtzi5, Jutta Lindert6, Freydis Freysteinsdóttir7, Marie Chollier8, and Ausra Motiejūnienė9
1Keele University, Staffordshire, United Kingdom
2Staffordshire University, Staffordshire, United Kingdom
3Vilnius University, Vilnius, Lithuania
4University of Gävle, Gävle, Sweden
5Aristotle University of Thessaloniki, Thessaloniki, Greece
6University of Applied Sciences Emden/Leer, Emden, Germany
7University of Iceland, Reykjavik, Iceland
8Centre Hospitalier Regional De Marseille Assistance Publique-Hoptaux, Marseille, France
9VUL Santara Clinics, Vilnius, Lithuania
Globally, almost a third of women experience some form of violence, coercion, or control that may significantly affect both their mental and physical health. Tackling and ending gender-based violence has been recognized by the European Commission, and is also supported by the European Union (2017) in protecting and supporting victims. The health service is one area that almost every women and girl will access at some time in their life, and this makes it an ideal forum through which to recognize victims of this violence, and provides an ideal opportunity to engage with them. To achieve more positive outcomes for survivors/victims, nurses and midwives need to be able to engage with them, recognize and assess risk, and offer constructive support. While many health care providers including nurses and midwives receive training, it is country specific, and may be irregular or incomplete. Violence against women is prevalent across all countries, and migration might result in a victim trying to access support in several countries. There is currently no standard transnational training focused on nurses and midwives. This presentation will explore the challenges, implications, strengths, and approaches of working with colleagues across Europe to develop and deliver the first transnational training program for nurses and midwives in the recognition and education in violence, abuse, and neglect. This innovative educational opportunity represents an original approach of joining forces across Europe to deliver this training.
Adapting a mHealth Intervention for Teens in Unhealthy Relationships
Rachel Kennedy1, Amber Clough1, Rachael Turner1, and Nancy Glass1
1Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
Teen dating violence (TDV) is highly prevalent and poses a serious threat to adolescent health, well-being, and safety. Recently, the first report on U.S. estimates of teen homicides due to dating violence found that 7% of teens killed were killed by a current or former partner. Prevention and response efforts are challenging to develop and implement effectively as teens have different relationship norms than adults and are less likely to access services such as hotlines or domestic violence advocates. Technology is a critical tool to reach teens and expand their access to personalized relationship health and safety information. One innovative tech-based approach is the use of chatbots. Chatbots are computer programmed “conversational agents” that mimic a conversation with a real person and are an emerging technology to leverage in delivering health interventions. We will present on our team’s development of a chatbot for teens in unhealthy relationships. We will discuss the adaption of an effective intervention for adult survivors (the myPlan App) for teens ages 15 to 17 to assess their relationship health and safety and receive tailored safety information and resources. Collaboration with youth advisors, findings from qualitative interviews with teens, advocates, and providers on how best to adapt the intervention into the chatbot platform, and implications for future development of adolescent interventions using human-centered design principles will be discussed.
Trajectories of Adolescent Cyber Dating Abuse Experiences
Rachel Kennedy1, Yu Lu2, Jacquelyn Campbell1, and Jeff Temple2
1Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
2University of Texas Medical Branch, Galveston, Texas, USA
Adolescent populations access the internet every day, allowing online spaces to shape not only their daily activity and communication but also their social and dating norms. Despite these significant trends in internet usage, available evidence around experiences of online or cyber dating abuse, harassment, or stalking has been remarkably limited and largely formative in nature. This exploration of trends in cyber dating abuse experiences will therefore help to inform these gaps in understanding and help to identify potential opportunities for intervention. The current study aims to answer the following three questions: (a) What are the trajectories of cyber dating abuse experiences among adolescents over time? (b) Do these trajectories differ by gender? (c) Are experiences of cyber dating abuse associated with dating history, amount of time spent online, or in-person dating violence experiences? This secondary data analysis is taken from the dataset of the Dating It Safe longitudinal study among seven public high schools in southeast Texas. A total of 1,042 high school students participated in the study over five time-points at 12-month intervals between 2013 and 2017, and the current analysis looks at three of these years. Data collection occurred in person during school hours or online, depending on participant school enrollment status. For the first study question in this analysis, growth mixture modeling was performed to characterize the development of cyber dating abuse over time. Multinomial regression and conditional models were then used to assess how covariates predict class membership. Findings reveal statistically significant and non-significant associations with cyber dating abuse experiences for young people, specifically highlighting the important role of partner gender, online behavior, and in-person violence use and experience in these patterns. Implications for future development of public health interventions for adolescent experiences of cyber dating abuse will be discussed.
The Influence of Peer-Based Polyvictimization on Disordered Eating Behavior: Findings From a Representative Survey of Adolescents
Melissa Kimber1, Masako Tanaka1, Andrea Gonzalez1, Jennifer Couturier1, and Harriet L. MacMillan1
1McMaster University, Hamilton, Ontario, Canada
Recognize and Respond to Family Violence: Implementation and Evaluation of VEGA
Melissa Kimber1, Donna Stewart2,3, Meredith Vanstone1, Delphine Collin-Vezina4, Gina Dimitropoulos5, Harriet L. MacMillan1
1McMaster University, Hamilton, Ontario, Canada
2University Health Network, Toronto, Ontario, Canada
3University of Toronto, Toronto, Ontario, Canada
4McGill University, Montreal, Quebec, Canada
5University of Calgary, Calgary, Alberta, Canada
Journey to Trauma Integration: Re-Trusting, Re-Building, and Re-Embracing Selfhood, Life, and the World
Sachiko Kita1
1The University of Tokyo, Tokyo, Japan
For women victims of gender-based violence (GBV), accepting and integrating trauma into their selfhood, life, and world is a long and challenging journey. We conducted a Clinical Ethnographic Narrative Interview (CENI) with 23 Japanese survivors of domestic violence to identify the phases of trauma integration and factors promoting it. We then identified a subset of 11 women who described that they had achieved integration and used grounded theory approach to discover the processes that characterized their integration journey. The results revealed six phases: “confusion,” “overwhelmed,” “awareness,” “fighting,” “overlooking,” and “integration.” In addition to these phases, other critical recovery tasks were revealed, including “rebuilding the boundary between myself and others” and “trusting others and seeking their help again.” These recovery tasks helped protect their feelings and autonomy, and enhanced their understanding and acceptance of trauma and its impacts. Implications for practice include understanding the complexity of the trauma integration processes, the skills necessary to achieve it, and possible cultural differences.
Prevalence and Covariates of Traumatic Brain Injury–Related Violence Among a Sample of College Women Experiencing Relationship Violence
Kathryn Laughon1, Nancy Perrin2, Amber Clough2, Jamie Barnes-Hoyt2, Racheal Turner2, Karen Grace2, Sherry Kausch2, and Nancy Glass2
1University of Virginia, Charlottesville, Virginia, USA
2Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
Traumatic brain injury (TBI) is a concern for women experiencing intimate partner violence (IPV). Young women ages 18 to 24 are at high risk for IPV and many young women in this age range are enrolled in higher education. Therefore, the purpose of this study was to describe individual and relationship factors associated with TBI-related IPV among young women enrolled in colleges in two U.S. states.
Enhancing the Foundational Validity of Forensic Findings in Strangulation Examinations
Kathryn Laughon1, Andrea Cimino2, and Sherry Kausch1
1University of Virginia, Charlottesville, Virginia, USA
2Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
Trauma Inquiry Using Trauma-Informed Approaches
Annie Lewis-O’Connor1
1Brigham and Women’s Hospital, Boston, Massachusetts, USA
Within the context of longitudinal medical care for adults, health care providers have a unique opportunity to inquire and respond to the traumatic life experiences affecting the health of their patients, as well as a responsibility to minimize retraumatizing these patients during medical encounters. While there is literature on screening women for intimate partner violence, and there is emerging data on pediatric screening for adverse life experiences, there is sparse literature on inquiry of broader trauma histories in adult medical settings. This lack of research on trauma inquiry results in an absence of guidelines for best practices, in turn making it challenging for policy makers, health care providers, and researchers to mitigate the adverse health outcomes caused by traumatic experiences and to provide equitable care to populations that experience a disproportionate burden of trauma. This presentation will describe best practices for trauma inquiry within an anchoring framework of trauma-informed care principles, which includes tiered screening starting with broad trauma inquiry, proceeding to risk and safety assessment, and emphasizes the importance of focusing on strength and resilience. Best practices for trauma inquiry which include tiered screening starting with broad trauma inquiry, proceeding to risk and safety assessment as indicated, and ending with connection to interventions. The focus is not on disclosure rather on what happened to you and how did that experience affect your heath.
Low Commitment to Partners and Precursors of Intimate Partner Violence Among Pregnant Women in a Home Visitation Program
Qing Li1, Jacquelyn Campbell2, and Vincent J. Palusci3
1San Diego State University, San Diego, California, USA
2Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
3New York University, New York City, New York, USA
Dating Violence Among College Students in China: A Cross-Sectional Study
Fuqin Liu1, Haiying Han2, and Judith McFarlane1
1Texas Woman’s University, Houston, Texas, USA
2Zhejiang University City College, Hangzhou, China
Subjected to Sexual Abuse During Childhood—How Is the Oral Health Experienced?
Sarah Månsson1, Louise Larsson1, and Eva Wolf1
1Malmö University, Malmö, Sweden
Sharing Personal Experiences of Accessibility and Knowledge of Violence in a Rural Context
Tara Mantler1*, Kimberley T. Jackson1, Edmund J. Walsh1, and Selma Tobah1
1Western University, London, Ontario, Canada
Women who experience intimate partner violence (IPV) in a rural context face unique barriers and inhibiting social structures compared with their urban counterparts. The purpose of this study was to explore the intersection of women’s experiences of rural health care and domestic violence services within the context of IPV in Southwestern Ontario, Canada. An interpretive case study was used consisting of in-depth qualitative interviews with eight participants who had used both health services and a rural shelter in the past 6 months. The analysis was positioned within a critical feminist intersectional lens, which allowed for exploration of larger social structures and their potentially oppressive influence on women’s experiences, as well as the complexity of lived experiences as women hold multiple roles in society. The following three themes were uncovered: (a) Strengths (What I Have)—which highlights the power of positive interactions with frontline workers in shelters and health care settings; (b) Challenges Related to Structural Violence Through Policy (What I Need)—which underscores the systemic barriers in accessing social services such as housing and receiving appropriate health care within the context of shelter curfews and policies in walk-in clinics (i.e., one issue per visit); and (c) Systems and Stigma (What Does Not Exist)—which brings to light the discomfort of neighbors close to the shelter and lack of understanding of the long-term effects of violence by health care providers. The implications of this study support the need for improved education, system-level integration, and the need to examine how policies across sectors are interacting in intended and unintended ways.
Hopes and Experiences of Women Survivors of Intimate Partner Violence When Seeing Psychologists
Sally Marsden1, Kelsey Hegarty1,2, and Cathy Humphreys1
1The University of Melbourne, Melbourne, Victoria, Australia
2The Royal Women’s Hospital, Melbourne, Victoria, Australia
Understanding Survivor Reactions and Behaviors in the Aftermath of Sexual Assault: Evaluation of an Online Curriculum
Robin Mason1, Janice Du Mont1, Stephanie Lanthier1, and Sheila Macdonald1,2
1Women’s College Hospital, Toronto, Ontario, Canada
2Ontario Network of Sexual Assault/Domestic Violence Treatment Centres, Toronto, Ontario, Canada
Sometimes the behaviors and reactions of sexual assault survivors can challenge the understanding of family, friends, and professionals. As a supportive response to disclosure has been shown to be integral to the healing of survivors, the failure to understand the full range of potential behaviors in the aftermath of sexual assault can result in non-supportive responses to the survivor’s disclosure, including questions, doubt, or disbelief expressed through verbal or nonverbal behavior. It is particularly critical that those working in the helping professions be familiar with and understand reactions to sexual assault that may appear to be counter-intuitive. Failure to do so can seriously undermine the survivor’s confidence and negatively affect any future help-seeking, while also perpetuating a problematic social discourse about how “real” survivors of sexual assault behave. We developed an evidence-informed, competency-based, online curriculum to educate health and social services providers to the basis for these commonly misunderstood reactions. In so doing, we hope to also challenge social discourses about the so-called acceptable reactions to sexual assault, thereby improving the experience of disclosure for survivors. With financial support from the province of Ontario, the curriculum was made available in 2019 without charge to health and social service providers across the province. Drawing upon lists of women’s studies programs, campus sexual assault centers, lists of participants in our other online courses, and with the support of some of the health professions colleges, we emailed information about the curriculum to approximately 2,000 individuals or organizations. By August 2019, approximately 800 individuals had registered for the online curriculum. In this session, we present participant demographics to understand where there has been the greatest uptake of the curriculum and results of the pre- and post-tests designed to evaluate changes in understanding about the common but frequently misunderstood reactions to sexual assault.
“Is There Something I Could Have Done?” Design and Implementation of Physician Education to Support Colleagues Experiencing Domestic Violence
R. Mason1, M. Kanee2, J. Sloggett3, and S. Laredo1
1Women’s College Hospital, Toronto, Ontario, Canada
2Independent Advisor and Trainer on Human Rights and Health Equity, Toronto, Ontario, Canada
3University Health Network, Toronto, Ontario, Canada
It is well-known that those who work in hospital systems face challenges in educating physician colleagues to the realities of domestic violence in our patient populations. Time constraints, “fear of opening Pandora’s Box,” feelings of inadequacy, anxiety about having to report to child welfare authorities, and just plain fear have all worked against educators’ and advocates’ best efforts to help physicians do a better job of recognizing and responding to patients who may be experiencing intimate partner violence. The untimely and tragic murder of a physician by her physician spouse, an event that significantly affected their families, patients, and colleagues, also inspired the first gathering of a group of medical chiefs of staff from three hospitals to discuss ways of responding to the news. Their first concern was providing emotional support to their colleagues, but they also wanted to undertake some significant action. They considered an education campaign but quickly realized they didn’t know enough about the issue themselves and so convened a larger group including those with some expertise in issues of intimate partner violence and abuse as well as individuals from the hospitals’ legal, communications, and human resources departments. The result? A short online course about domestic violence that was specifically developed for physician colleagues. Through action and advocacy, course completion is now required across the 12 University of Toronto–affiliated teaching hospitals. In this session, we describe (a) specific considerations in developing a course on domestic violence relevant to physicians and (b) the processes that resulted in the teaching hospitals requiring course completion as a condition of physicians maintaining their hospital privileges.
A Scoping Review That Demonstrates the Health Inequity of Cervical Cancer From Intimate Partner Violence
Amanda St Ivany1, Mercedes McCoy2, Julia Mead1, and Ivy Wilkinson-Ryan1
1Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
2University of New Hampshire, Durham, New Hampshire, USA
Intimate partner violence (IPV) is defined as behaviors intended to exert power and control over another individual, including physical, sexual, verbal, emotional, and financial abuse and or/stalking. Women with a history of IPV may suffer chronic health problems related to their physical and psychological well-being: chronic pain, insomnia, hypertension, substance use disorders, acute physical injuries (e.g., concussions, broken bones), gastrointestinal disease, and increased risk of sexually transmitted diseases and infections. Scoping review aims were to synthesize IPV screening methods and barriers for gynecological settings, explore associations between cancer type and IPV, and highlight gaps in the evidence to guide trauma- and violence-informed models of care (TVIC) to promote health equity.
The FAST-PTSD APP for Predicting Clinical PTSD 7 Years Following First Contact for Abuse Services: A New Tool for Rapid Triage
Judith McFarlane1
1Texas Woman’s University, Houston, Texas, USA
Expressive Art Therapies to Facilitate Attunement Between Mother and Child
Dorcas McLaughlin1
1Webster University, St. Louis, Missouri, USA
Teen mothers are a vulnerable group of parents for reasons other than their youth. They experience high levels of psychological distress due to the social disadvantage and adverse childhood experiences (ACEs) which precede many of these pregnancies. ACEs include traumas associated with family violence, neglect, mental illness, alcoholism, substance abuse, or criminal activity. Teen mothers may also face additional traumas, first as children and later as adults, from residing in dangerous neighborhoods with high rates of crime and unemployment. The high prevalence of psychological distress is particularly troubling in light of the evidence that trauma-related symptoms compromise maternal functioning, mothers’ physical and mental health, family relationships, and children’s development. The purpose of this presentation is to describe Mothers Growing Together (MGT), a resilience model, strength-based group intervention, tailored to low-income teen mothers. MGT integrates expressive arts therapies to improve emotional regulation, facilitate attunement, build self-esteem, cultivate positive peer relationships, and develop resilience and coping skills among teen mothers. Quantitative and qualitative data from a pilot study that evaluated the effectiveness of MGT will be discussed. Attunement with one’s self and one’s child can be strengthened in teen mothers using expressive art therapies in the delivery of services. These approaches are consistent with advances in the neurobiology of chronic stress and are therefore effective in bridging the mind–body disconnections associated with exposure to trauma and early adversities. They provide valuable tools for modifying psychological distress and improving responsive parenting. Expressive art therapies are teen friendly, easily adapted for home or group settings, and support the teen’s capacities and aspirations to be good parents. They are also easily modified for parents of varied ages and background.
Learning Objectives
Describe the neurobiology of chronic stress and its implications for the long-term physical and mental health of teen mothers and their children
Discuss the role of attunement in the management of stress and the maternal–child relationship
Explain the relationship between self-soothing and the development of empathy
Use specified expressive art therapy approaches to deliver parent teaching experiences related to strengthening maternal attunement
Survivor Health Professionals: Is Personal History of Gender-Based Violence Associated With Clinical Care of Survivor Patients and What About the Role of the Health Care Workplace?
Elizabeth McLindon1, Cathy Humphreys1, and Kelsey Hegarty1,2
1The University of Melbourne, Melbourne, Victoria, Australia
2The Royal Women’s Hospital, Melbourne, Victoria, Australia
The Health, Well-Being, and Relationships Project: How Is Nurses Health, Well-Being, Work, and Community Service Use Linked to Their Experience of Gender-Based Violence?
Elizabeth McLindon1, Kristin Diemer1, and Kelsey Hegarty1,2
1The University of Melbourne, Melbourne, Victoria, Australia
2The Royal Women’s Hospital, Melbourne, Victoria, Australia
1. What is the prevalence of GBV against Australian nurses including the perpetration of such violence?
2. What are the physical, emotional, and social health associations of such violence?
3. How have nurses experienced existing health, community, and GBV services for these issues?
4. What support needs do survivor nurses have of their union and their health care workplace?
Incidence of Cesarean Delivery Among Women With a History of Gender-Based Violence: What Do We Know?
Julia Mead1, Amanda St. Ivany1,2, and Robyn Puleo1
1Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
2Geisel School of Medicine, Lebanon, New Hampshire, USA
Understanding How Pornography Can Drive Intimate Partner Violence, and What Can Be Done About It
Darryl Mead1, Cindy Pierce2, and Mary Sharpe1
1The Reward Foundation, Edinburgh, Scotland
2Independent Author, Educator, and Speaker, Etna, New Hampshire, USA
Darryl Mead will discuss how porn has become a serious problem for an increasing number of boys and men, and what can be done. Porn creates sexual expectations for consumers. Women are portrayed in a way that reinforces the false idea that they are always sexually available and enjoy rough sex. Porn consumers often imitate what they see online, which reduces inhibitions and boosts feelings of male entitlement in a way that ignores consent or intimate pair-bonding behavior. At the same time, porn encourages extreme acts, coercion, and acceptance of sexual scripts, giving men the dominant role. How can a boy, man, or father make the journey from porn enthusiast to successfully quitting porn? How can schools, men’s groups, and online recovery communities support this journey?
Mary Sharpe will lead on two areas of educational work. The first is schools: provide lesson plans for different age groups to discuss pornography’s impact and train-the-trainer sessions to help teachers address sensitive issues and the science behind these matters. The second area is support for health care professionals. The Reward Foundation runs workshops for Continuing Professional Education accredited by the Royal College of General Practitioners. A diverse range of professionals attend: psychotherapists; sex therapists, doctors, nurses, psychiatrists, pastors, social workers, lawyers, and so on, all of whom engage with pornography consumers. Our curriculum focuses on how the brain is affected by chronic overuse of hardcore pornography and the associated addiction-related brain changes. In a radical departure from previous teachings in sexology where porn was encouraged, we will look at research from the behavioral addiction field which indicates that for some users, pornography should be recognized as an emerging addiction with the potential for harmful sexual behavior. We also discuss social prescribing as a first line of treatment.
Cindy Pierce’s focus is on educating college and high school students, as well as parents, coaches, and educators about the impact of porn on their sexual and social choices. Students need informed adults to help them navigate the cultural messaging they consume through porn, media, and social media. She explores the realities of the porn industry, specifically how women performers are purposefully dehumanized and coerced to perform acts beyond their boundaries.
Addressing Gender-Based Violence With a Viral Video
Darryl Mead1, Cindy Pierce2, and Mary Sharpe1
1The Reward Foundation, Edinburgh, Scotland
2Independent Author, Educator, and Speaker, Etna, New Hampshire, USA
We are a part of a worldwide collective of sex and relationship educators who explore innovative ways to influence public policy and public behavior around pornography consumption and gender-based violence. Since early 2019, we have collaborated to create elements of a new toolkit to engage all genders in ways that engage and motivate young people. As a proof of concept, we have created a short (2 minutes 13 second) animation, which covers many facets of problematic pornography consumption. Based on a real person, its central focus is on the way pornography induces erectile dysfunction in many boys and men as well as normalizes sexual violence against women. Two major factors influenced the video-making process: the introduction of age verification legislation by the UK government, which is being seen as a test case for the whole world, and the content had to be acceptable and credible to the international self-help movement for people with excessive or compulsive pornography consumption. The video is designed for social media use and is available under a CC BY-NC-ND 4.0 license to maximize its reach through free transmission. We hope this video will become viral and develop a life of its own. It aims to reach into communities to help prevent gender-based violence. The video ends with a list of free helpful resources from several independent sources. The video has already been integrated into different sets of lesson plans for use in schools and is used for training health care professionals. It is also featured on a number of pornography self-help sites. We have used a wide range of techniques to encourage viral transmission. We are now undertaking research to quantify its impact. The session would end with a showing of the video. Preview it at https://www.youtube.com/watch?v=Ehsh77hmgPA
Prevalence and Risk Factors for Intimate Partner Violence in Arab Countries: A Systematic Review
Amera Mojahed1, Nada Alaidarous2, Susan Garthus-Niegel3, and Janice Hegewald1
1Institute and Policlinic of Occupational and Social Medicine, Dresden, Germany
2Western University, London, Ontario, Canada
3Clinic and Policlinic of Psychotherapy and Psychosomatic, Dresden, Germany
Living With Family Violence: Teen’s Perspectives
Nora Montalvo-Liendo1, Andrew Grogan-Kaylor2, Eliza D. Alvarado3, Angeles Nava4, and Catherine Pepper5
1Texas A&M University, McAllen, Texas, USA
2University of Michigan, Ann Arbor, Michigan, USA
3Region One Education Services, Edinburg, Texas, USA
4Texas Woman’s University, Houston, Texas, USA
5Texas A&M University, Round Rock, Texas, USA
Evaluating Nurse-Led Long-Term Support Groups for Women Survivors of Intimate Partner Violence
Nora Montalvo-Liendo1, Robin Page2, Jenifer Chilton3, and Angeles Nava4
1Texas A&M, McAllen, Texas, USA
2Texas A&M, Bryan, Texas, USA
3The University of Texas at Tyler, Tyler, Texas, USA
4Texas Woman’s University, Houston, Texas, USA
Alert Signs of Dating Violence Among College Students: From the Perspective of Campus Services
Derby Munoz-Rojas1 and Cristóbal Ching-Álvarez1
1University of Costa Rica, San Jose, Costa Rica
College students represent a vulnerable group for dating violence (DV), as many of them might have few experiences on dating relationships; therefore, they might have limited resolution conflict skills. Researchers have consistently found that both victimization and perpetration of DV have negative consequences on health and well-being, including anxiety, physical injury, and low academic performance. DV in college campuses is a prevalent and complex issue that requires a public health approach to be addressed. Thus, providers of most of the student-oriented services should be engaged in detecting and responding to DV. Although screening for DV in different services (e.g., counseling and health care centers) have been worldwide implemented for many universities, in Costa Rica, it is not a common practice, leading to an inadequate recognition of this problem and therefore failing to address it. Indeed, little is known about the knowledge and ability of professionals offering health and academic services to students to recognize signs of DV. Therefore, this descriptive qualitative study aims to address this gap by identifying the perception of these professionals about alert signs of DV among college students in Costa Rica. Thirty-five professionals from the five public universities in the country were recruited for this study, including dentists, nurses, counselors, physicians, psychologists, and social workers (age = 44 + 8.5 years old, experience = 6 + 6.3 years working at the university). From a conventional content analysis of the transcription of the interviews, two themes emerged that map the complex interaction among social, sexual, physical, academic, and psychological signs of DV. Results also stressed that warning signs patterns are different between victims and perpetrators, thus screening criteria should consider this difference. Social, psychological, and cybernetic alert signs are the most difficult to recognize, as victims tend to normalize them. Perpetrators are more likely to exhibit strong personalities, while victims are more likely to report low academic performance. These findings might inform to researchers about the constructs that should be included in DV screening instruments for the country. Results might also be used for training academic and health care professionals working on campus services, so they might develop the skills to identify students going through DV experiences.
Adapting and Evaluating a Sexual Violence Prevention Program From the United States to Ghana: Camp-Life
Abdul-Aziz Seidu1, Eugene K. M. Darteh1, Amanda Odoi1, and Sarah D. Rominski2
1University of Cape Coast, Cape Coast, Ghana
2University of Michigan, Ann Arbor, Michigan, USA
Co-Development of Intervention Recommendations to Promote Screening for Traumatic Brain Injuries at Women’s Shelters Using Behavioral Science
Blake Nicol1, Paul van Donkelaar1, Karen Mason2, Kennedy Louis1, and Heather L. Gainforth1
1University of British Columbia–Okanagan, Kelowna, British Columbia, Canada
2Kelowna Women’s Shelter, Kelowna, British Columbia, Canada
Methodological and Ethical Considerations in Research With Immigrant and Refugee Survivors of Violence
Veronica P. S. Njie-Carr1, Bushra Sabri2, Jill Theresa Messing3, Allison Ward-Lasher3, Crista Johnson-Agbakwu4, Catherine McKinley (formerly Burnette)4, Nicole Campion Dialo1, Saltanat Childress5, Joyell Arscott2, and Jacquelyn C. Campbell2
1University of Maryland, Baltimore, Maryland, USA
2Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
3Arizona State University, Phoenix, Arizona, USA
4Maricopa Integrated Health System, Phoenix, Arizona, USA
5University of Texas at Arlington, Austin, Texas, USA
Promoting the health of immigrants and refugees globally continues to be a priority for the World Health Organization. In 2017, 258 million people were international migrants, a 49% increase over 17 years. Of this total, more than 43 million immigrants and refugees are living in the United States substantiating the need for quality and culturally appropriate evidence-based interventions to better understand their unique health needs across geographic borders. Immigrant and refugee women experience intimate partner violence at a higher rate with more serious negative health-related disparities than women in the host country. The purpose of this paper is to discuss the strategies employed in enrolling immigrant and refugee women participants for the weWomen Study (https://wewomen.nursing.jhu.edu/home) as the context for analyzing the methodological and ethical challenges encountered. Numerous challenges were encountered in the recruitment and retention of these “hidden” populations, including women survivors’ fear of deportation, linguistic barriers, and mistrust of providers and researchers. We utilized a multi-faceted approach informed by best practices to maximize participant enrollment, which can be replicated in similar studies. Effective strategies that include allocating adequate budget and actively engaging community collaborators through community-based participatory approaches to maximize recruitment and retention efforts are discussed. While the challenges the team experiences might have seemed insurmountable, their commitment to ensuring the integration of the unique needs of immigrant and refugee women survivors resulted in higher enrollment numbers. Immigrant and refugee survivors can contribute valuable information to inform culturally appropriate targeted evidence-based interventions to promote positive health outcomes.
Health Professionals’ Perceptions of How Gender-Sensitive Care Is Enacted Across Acute Psychiatric Inpatient Units for Women Who Are Survivors of Sexual Violence
Carol O’Dwyer1, Laura Tarzia1,3, Sabin Fernbacher3, and Kelsey Hegarty1,3
1The University of Melbourne, Melbourne, Victoria, Australia
2Consultant, Melbourne, Australia
3The Royal Women’s Hospital, Melbourne, Victoria, Australia
Nurses Involvement in the Management of Family Violence Victims in Ondo State, Nigeria
Oluwasayo Bolarinwa Ogunlade1, Adekemi Eunice Olowokere1, Ojo Melvin Agunbiade1, and Omolola Irinoye1
1Obafemi Awolowo University, Ile-Ife, Nigeria
Family violence is a public health issue with its effects on every member of the family. Recognizing primary health care settings as ideal settings to respond to victims of family violence with nurses is strategic in Nigeria. Nevertheless, there is limited information on the involvement of nurses in the detection and response strategies for the management of family violence. Hence, the study assessed primary health care nurses’ processes to identify and respond to family violence in a state in Nigeria. A descriptive qualitative design was employed with a face-to-face interview conducted with six nurses in purposely selected primary health centers. Thematic analysis of the interviews was used to define key issues and areas of interest as identified by participants. Nurses mean age was 33.67 ± 5.849 years and mean years of experience 10 ± 3.45 years. Results showed that victims of physical violence were the only victims identified but without any identification or response guidelines. Nurses were not involved in safety planning and risk assessment. Nurses respond by treating the sustained injuries, counsel the victim, and mediate with the couple. The findings gave implication for further education and training of nurses and advocacy for collaborative policies and utilizing community resources to support women and children victims of family violence.
Intimate Partner Homicides Perpetrated in West Sweden 2000–2016—A Process Perspective: The Stop Study
Karin Örmon1,2, Gunilla Krantz1,3, Henrik Lysell1,4, and Viveka Enander1,3
1The Västra Götaland Competence Centre on Intimate Partner Violence, Gothenburg, Sweden
2University of Malmö, Malmö, Sweden
3University of Gothenburg, Gothenburg, Sweden
4Karolinska Institute, Stockholm, Sweden
Risk of Vicarious Trauma for Graduate Student-Researchers Exploring Sensitive Topics: A Scoping Review of Canadian Dissertations and Theses
Elizabeth Orr1, Pamela Durepos1, Vikki Jones2, and Susan Jack1
1McMaster University, Hamilton, Ontario, Canada
2York University, Toronto, Ontario, Canada
Can Trauma- and Violence-Informed Care Promote Change? Early Insights From a Critical Ethnography of Nurses Working With Women Who Have Experienced Intimate Partner Violence
Noël Patten Lu1, Marilyn Ford-Gilboe1, Lorie Donelle1, Victoria Smye1, and Kimberley Jackson1
1Western University, London, Ontario, Canada
ENGAGE—Roadmap for Frontline Professionals Interacting With Male Perpetrators of Domestic Violence and Abuse to Ensure a Coordinated Multiagency Response to Perpetrators
Alessandra Pauncz1 and Geldschläger Heinrich2
1Psychologist, WWP EN
2Clinical Psychologist, Connexus, Spain
Domestic violence and abuse against intimate partners have a devastating impact on the health and well-being of the victims and the perpetrator, with long-term negative consequences for all involved. Adequate measures to protect victims are essential, yet a comprehensive policy to tackle this kind of violence must also address the perpetrators. The Council of Europe Convention on preventing and combating violence against women and domestic violence (Istanbul Convention) requires European Union Member States to invest in programs for domestic violence perpetrators and for sex offenders.
Within the framework of addressing perpetrators and increasing their referral to perpetrator programs a consortium of six European organizations and institutions (WWP EN, Connexus, CAM, Terres des Hommes, Psytel and the City Council of Florence) developed the project ENGAGE, within the frame of the European project REV-VAW-2016, to assist through a roadmap and a training package frontline professionals in health care or social services, child protection services, police, and others, coming into contact with male service users who are violent or abusive to their female partners. One of the most common requests from victims is for someone to work with their partner, to help him change, and to keep them and their children safe from violence. Working with these men to change their behavior is a key step toward preventing domestic violence. Responses of frontline health care professional to any disclosure, however indirect, could be significant for encouraging responsibility and motivating men toward change. It is paramount to keep in mind that the primary goal of all work with male perpetrators (including identification and referral) is to ensure the safety of women and children. The presentation will share the tools and experiences of the development of the project. Participants will be guided through the theoretical background and the practical tools that were developed in the course of the project.
Effectiveness of a Trauma-Informed IPV Training Intervention for Health Providers in Improving IPV Discussions With Patients
Nancy Perrin1, Liz Miller2, Lisa James3, Surabhi Kukke3, Amber Clough1, Karen Grace1, Annie Lewis O’Connor4, and Nancy Glass1
1Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
2University of Pittsburgh, Pittsburgh, Pennsylvania, USA
3Futures Without Violence, San Francisco, California, USA
4Brigham and Women’s Hospital, Boston, MA, USA
Intimate partner violence (IPV) is seldom addressed in primary health care settings. Both screening and patient education for IPV occur at low rates due to a lack of training for health care providers and referral pathways for women who experience IPV. The PATHS study evaluated the effectiveness of a trauma-informed IPV training intervention for providers.
The Intersection of Culturally Competent Primary Care and Domestic Violence: An Interpretive Synthesis
Bijaya Pokharel1, Jane Yelland2,3, Ann Wilson1, Sandesh Pantha1, and Angela Taft1
1La Trobe University, Melbourne, Victoria, Australia
2Murdoch Children’s Research Institute, Parkville, Victoria, Australia
3The University of Melbourne, Melbourne, Victoria, Australia
Differences in Help-Seeking Behaviors and Perceived Helpfulness of Services Between Abused and Non-Abused Women
Leesa Hooker1, Leonie Versteegh2, Helena Lindgren2, and Angela Taft1
1La Trobe University, Melbourne, Victoria, Australia
2Karolinska Institutet, Stockholm, Sweden
Trauma- and Violence-Informed Care in the K-12 Classroom: Teacher Education
Susan Rodger1 and Nadine Wathen1
1Western University, London, Ontario, Canada
Schools play a key role in providing both healthy environments where students can learn and develop and receive universal and targeted mental health support; indeed, the research evidence converges to suggest that academic engagement, learning, and belonging requires mental, physical, and relational health. This paper will describe the results of bringing a trauma- and violence-informed care approach to K-12 education, providing a framework of practice that enables schools to be safe, inclusive places for some of the most vulnerable students, including those exposed to interpersonal and structural violence. Students exposed to trauma and violence can struggle to attend, engage, and achieve at school. It is critical that students affected by trauma and violence receive appropriate and equitable support, so that they can thrive in school. National research has demonstrated that the majority of teachers feel ill-equipped to meet the mental health and inclusion needs of their students. Providing teacher education students with education about trauma, TVIC, and the ways the trauma can influence academic engagement and success may allow problematic classroom behaviors to be viewed through a health equity and inclusive education lens, promoting both the creation of a safer and more equitable learning environment for students directly affected by trauma and violence and supporting the ethic of care that is central to the helping professions, including teaching. Initial teacher education may provide the opportunity to prepare teachers with the knowledge, strategies, and self-efficacy in TVIC necessary to create classrooms and learning experiences that are safe, equitable, and meet the needs of all students. A mandatory, completely online mental health course for second-year students in a Bachelor of Education program (n = 235) at a large Canadian university introduced TVIC concepts and used a case study approach to articulate challenges for students and strategies, tools, and knowledge for teachers. Results indicate significant changes in participants’ attitudes toward TVIC and their self-efficacy in using inclusive teaching practices, as well as their expressions of intentions to create safe and welcoming classrooms and schools aligning with TVIC principles, providing support for the inclusion of these important topics for all teacher education students.
Impact of Sources of Strengths on Coping and Safety of Immigrant Survivors of Intimate Partner Violence
Bushra Sabri1, Veronica Njie-Carr2, Sarah Murray3, Joyell Arscott1, and Jacquelyn C. Campbell1
1Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
2University of Maryland, Baltimore, Maryland, USA
3Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Contextual Factors Related to Violence by Partners and In-Laws and Needs for Interventions at Multiple Levels: A Study of Women in India
Bushra Sabri1
1Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
Community Stakeholders’ Acceptability of Life Skill Building Intervention for Women Empowerment in Pakistan
Tazeen Saeed Ali1**, Rozina Karmaliani1, Judith McFarlane2, Hussain Maqbool Ahmed Khuwaja1, Shireen Shehzad Bhamani1, Nasim Zahid Shah1, Zahid Hyder Wadani1, and Asli Kulane3
1Aga Khan University, Karachi, Pakistan
2Texas Woman’s University, Houston, Texas, USA
3Karolinska Institutet, Stockholm, Sweden
mental well-being, domestic violence, LSB, women empowerment
Community Stakeholders’ Views on Strategies for Reducing Violence Against Women in Pakistan
Tazeen Saeed Ali1, Rozina Karmaliani1, Hussain Maqbool Ahmed Khuwaja1, Zahid Hyder Wadani1, Nasim Zahid Shah1, Saher Aijaz1, and Asli Kulane2
1Aga Khan University, Karachi, Pakistan
2Karolinska Institutet, Stockholm, Sweden
violence against women (VAW), violence reduction strategies, men engagement, stakeholders’ voices for VAW
Understanding Common Themes in International Research: How Narrative Interviewing Helps Us Understand Key Trauma Recovery Processes
Denise Saint Arnault1, Laura Sinko2, Maddalena Rodelli3, Ines Testoni3, Francesca Alemanno3, and Sachiko Kita4
1University of Michigan, Ann Arbor, Michigan, USA
2University of Pennsylvania, Philadelphia, Pennsylvania, USA
3Università degli studi di Padova, Padova, Italy
4University of Tokyo, Tokyo, Japan
International research has shown that trauma recovery is often blocked by cultural norms that blame survivors, shame them for leaving, minimize the significance of violence, or normalize violence. The Multicultural Study of Trauma Recovery (MiStory) is an international collaboration network that is using narrative interviewing to understand the ways that internalized cultural beliefs and social processes shape the ways that gender-based violence (GBV) survivors make meaning of their experiences and heal from them. This symposium will bring together four papers that explore interacting themes that we have found in our research. We will save ample time for discussion and reflection from the audience.
Effect of a Psychosocial Intervention on Mental Health, Social Support, and Help-Seeking Behaviors Among Abused Pregnant Women: A Pilot Randomized Controlled Trial in Nepal
Diksha Sapkota1,2,3, Kathleen Baird1,4, Amornrat Saito1,3, and Debra Anderson1,3
1Griffith University, Gold Coast, Queensland, Australia
2Kathmandu University, Dhulikhel, Nepal
3Menzies Health Institute Queensland, Brisbane, Queensland, Australia
4Gold Coast University Hospital, Gold Coast, Queensland, Australia
“We Don’t See Because We Don’t Ask”—Qualitative Exploration of Service Users’ and Health Professionals’ Views Regarding a Psychosocial Intervention Targeting Pregnant Women Experiencing Domestic and Family Violence
Diksha Sapkota1,2,3, Kathleen Baird1,4, Amornrat Saito1,3, Pappu Rijal5, Rita Pokharel5, and Debra Anderson1,3
1Griffith University, Brisbane, Queensland, Australia
2Kathmandu University, Dhulikhel, Nepal
3Menzies Health Institute Queensland, Brisbane, Queensland, Australia
4Gold Coast University Hospital, Gold Coast, Queensland, Australia
5B.P. Koirala Institute of Health Sciences, Dharan, Nepal
What Is Non-State Torture of Women and the Girl Child? What Is NST Victimization–Traumatization Informed Care?
Jeanne Sarson1 and Linda MacDonald1
1Persons Against Non-State Torture
Expanding the Role of the Registered Nurse to Address the Health Effects of Violence and Injury in Rural Older Adults Using U.S. Medicare Annual Wellness Visits
Erika Metzler Sawin1, Donna Schminkey1, Sandra Annan1, and Deborah Elkins1
1James Madison University, Harrisonburg, Virginia, USA
Testing the Relationships Between Intimate Partner Violence, Mastery, Social Support, and Mental Health in Canadian Women
Alice Pearl Sedziafa1, Marilyn Ford-Gilboe1, Kelly Scott-Storey2, and Michael Kerr1
1Western University, London, Ontario, Canada
2University of New Brunswick, Fredericton, New Brunswick, Canada
Extensive cross-sectional studies suggest personal and social resources mitigate the adverse consequences of intimate partner violence (IPV). But the literature is specifically limited in longitudinal research on the causal mechanisms linking IPV to mental health. Addressing this limitation will advance our theoretical understanding of the mechanisms shaping mental health in women who have experienced IPV. The proposed research will examine the relationship between IPV, social support, mastery, and mental health in women in varying social contexts. A multivariate structural equation technique will be used to analyze secondary longitudinal quantitative survey data collected from a sample of 462 women who have experienced IPV, recruited online through the iCAN plan 4 safety (https://icanplan4safety.ca/) trial. The proposed study has important implications. It will illuminate the personal strengths of women overcoming the effects of IPV, promote appreciation of the social support required by women with diverse social characteristics, and advance the theoretical understanding that perceptions of resources may be mutable over time and interventions can heighten these perceptions to improve mental health.
Institutional Challenges to Delivering Domestic Violence Services in Ghana: A Case of Structural Violence?
Alice Pearl Sedziafa1, Eric Y. Tenkorang2, and Emmanuel Banchani2
1Western University, London, Ontario, Canada
2Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
Stakeholders Roles and Views of Care of Women With FGM Experiencing the Postpartum Period
Rebecca Seymour1, Elizabeth Bailey1, Katherine Brown1, and Hazel Barrett1
1Coventry University, Coventry, United Kingdom
Taking the Control Out of Birth Control: Reproductive Coercion and the Nurses Role
Trisha Sheridan1, Jacqueline Callari Robinson2, and Jenanne Luse1
1Emory University, Atlanta, Georgia, USA
2University of Wisconsin–Milwaukee, Milwaukee, Wisconsin, USA
Reproductive coercion (RC) is a form of violence including birth control sabotage, pregnancy pressure, and control of pregnancy outcomes. As many as 15% to 25% of people seeking care at family planning clinics report experiencing RC, with adolescents and those experiencing intimate partner violence (IPV) reporting an even higher prevalence. While all health care providers play an important role in identifying, assessing, and responding to control of reproductive outcomes, nurses and those working with victims of violence are especially likely to encounter RC. Victims of RC are hesitant to come forward and self-identify as this form of IPV is often omitted from screening questionnaires or masked by more well-known physical or emotional violence symptoms. As a result, RC is often overlooked or neglected as a valid and impactful form of IPV. Taking this into consideration and in combination with significant under reporting, health care provider knowledge of and familiarity with this form of IPV is often limited, even by experienced nurses who are trained to recognize signs of IPV. Given the often silent nature of RC, its prevalence, and the lack of awareness among nurses, the need for increased educational opportunities is paramount. As patient advocates and clinical educators, nurses are uniquely poised to strengthen RC screening and response guidelines in the clinical setting, as well as to develop and promote educational tools for health care providers in a variety of primary and acute care settings. This session will allow participants to define and discuss RC including how it presents in a variety of clinical settings. The aim is for participants to understand their role in assessment, intervention, and referral for victims of reproductive coercion.
Creating an Instrument to Better Measure Healing in Female Survivors of Gender-Based Violence
Laura Sinko1, Andreea Beatrix Taran2, and Denise Saint Arnault2
1University of Pennsylvania, Philadelphia, Pennsylvania, USA
2University of Michigan, Ann Arbor, Michigan, USA
Violence Appraisals, Disclosure, and Service Utilization: How Culture and the Normalization of Violence Against Women Intersect in Irish and American Survivors of Gender-Based Violence
Courtney Julia Burns1, Laura Sinko2*, and Denise Saint Arnault1
1University of Michigan, Ann Arbor, Michigan, USA
2University of Pennsylvania, Philadelphia, Pennsylvania, USA
*Presenting Author
Innovations to Prevent or Respond to Gender-Based Violence
Laura Sinko1,2
1University of Pennsylvania, Philadelphia, Pennsylvania, USA
2University of Michigan, Ann Arbor, Michigan, USA
As research on gender-based violence (GBV) grows in popularity, how do we ensure that we are translating this research appropriately and are continuing to innovate in this space? The purpose of this presentation is to discuss promising new innovations to dismantle violence normalization, situate culture in our conversation about perpetration and survivorship, and highlight the importance of expanding the science of recovery in future studies of GBV. Using research from our international GBV consortium MiStory, we will highlight current research translation efforts to bridge the gap between science and practice as well as current interventions under evaluation to promote healing in this population. We hope this will inspire attendees to consider non-traditional research dissemination in their practice as well as will highlight the potential of visual interventions in capturing sociocultural elements of recovery.
Women’s Experience of Seeking Health and Social Services Following Intimate Partner Violence: Lesbian, Gay, Bisexual, Transgender, and Queer Relationships in Rural Communities
Emily Soares1, Kim Jackson1, and Tara Mantler1
1Western University, London, Ontario, Canada
Establishing the One Stop Crisis Center in Numphong Hospital, Thailand
Wichai Ussavaphark1, Somjit Somwang1, Patthayason Sukree1, and Tipparat Udmuangpia2
1Namphong Hospital, Khon Kaen, Thailand
2Boromarajonani College of Nursing, Khon Kaen, Thailand
Helping Women With Trauma Histories Require Specific Approaches in Help-Seeking: Introducing the Model of Help-Seeking Encounters
Minna Sorsa1
1Tampere University and Pirkanmaa Hospital District, Tampere, Finland
Women are worldwide disproportionately affected by depression, anxiety, and such mental disorders that go unrecognized. Women’s experience of gender-based violence (GBV) has been found to relate to post-traumatic stress disorder (PTSD), depression, suicides, and substance abuse. It has been shown that women with a trauma history may not have words to express their needs, and thus specific woman-centered approaches within interventions are needed. There are elements in the women’s vulnerable background and experiential level that cause problems in connecting to new persons within care encounters. The aim of this presentation is to introduce the Model of Help-Seeking Encounters, which is directed toward meeting with women with a complex history of trauma as they seek help. The Model was developed in a multimethod study with the approach of help-seeking. The data were collected in Finland and the methods used include client interviews, an ethnographic field study, and interviews with staff within service encounters within primary care, social work, mental health care, and substance services. The opportunity for connections is created in the different interfaces where a micro-level of moments can prove valuable in the process of involvement. Engagement is the co-creation of possibilities between workplace staff and the client. It is not a single act, emotion, or verbal communication, but a complex intertwined system. The sensitivity of the worker is one tool for engaging the client in manifold ways: Even the smallest events are viewed as valuable. The work entails complexity in the negotiations over vulnerability. Engagement involves the intentional client in the process: The client needs to participate and become an acting and sensing part of the change, which occurs on an experiential level. The staff need sufficient time and resources to be available with an approach of perseverance. The goal of the meetings between clients and staff is to grow the grasp of life and the interfaces when clients can connect. The study questions whether current role expectations and operating within care structures are exclusive rather than inclusive by nature. Addressing the issue is important as half of women with GBV do not use formal services because they regard violence as normal.
A Realist Analysis of Mechanisms Underpinning Intimate Partner Violence Screening and Decisions to Disclose Abuse in Antenatal Care
Jo Spangaro1, Jeannette Walsh2, Kim Spurway3, Kelsey Hegarty4, and Jane Koziol-McLain5
1University of Wollongong, Wollongong, New South Wales, Australia
2University of New South Wales, Sydney, New South Wales, Australia
3Western Sydney University, Sydney, New South Wales, Australia
4The University of Melbourne and Royal Hospital for Women, Melbourne, Victoria, Australia
5Auckland University of Technology, Auckland, New Zealand
Non-Fatal Strangulation: What Do We Know and What Are We Missing to Prevent Sexual Violence?
Amanda St Ivany1, Donna L. Schminkey2, Michelle L. Munro-Kramer3, Lindsay M. Cannon3, and Cindy Pierce4
1Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
2James Madison University, Harrisonburg, Virginia, USA
3University of Michigan, Ann Arbor, Michigan, USA
4Independent Author, Social Sexuality Educator and Speaker
Sexual Harassment in Tanzania—An Exploratory Study
Heidi Stöckl1, Joyce Wamoyi2, and Meghna Ranganathan2
1London School of Hygiene & Tropical Medicine, London, United Kingdom
2National Institute for Medical Research, Mwanza, Tanzania
The ground-breaking anti-sexual assault and harassment movements, Time’s Up and #MeToo, elevated global awareness of the offending actions that women encounter in their daily personal and working lives. Their ambitious aims are crucial for meeting the world’s sustainable development goals. However, there is no clear understanding of women’s range of experiences of sexual harassment globally. The few studies conducted on sexual harassment come primarily from Europe and North America with little attention to harassment in developing countries. Our study offers a first step toward understanding how these abuses occur and how they are perceived by and affect women in the Global South. For this study, we have conducted 90 in-depth interviews and nine focus group discussions with women and men, girls and boys, and policy makers in Mwanza, Tanzania. Interviews were conducted on sexual harassment in educational settings, public spaces, and in the workplace. The findings of our study suggest that sexual harassment is a normative occurrence across the discourse in the different settings, with both men and women and boys and girls being able to relate to experiences of it. For example, in educational settings, stories of sexual harassment focused on sexual comments by teachers toward female students. These were both in the classroom and in other places at the schools and indicated existing pressures of entering into sexual relationships. What became apparent in all the interviews was that sexual harassment was not only confined to the three settings investigated but went beyond, including sexual harassment by family members and neighbors. Women related to several strategies they engaged in to prevent and reduce sexual harassment that showed the impact it had on their daily activities, as well as their emotional well-being. Sexual harassment remains a concept that still warrants a clear definition to make it measurable across different settings. From the narratives obtained in our study, we know that it is highly prevalent in Mwanza, Tanzania, and that acknowledging and preventing it can have a positive impact on women’s lives.
The Multiple Facets of Violence—A Qualitative Study From Tanzania
Heidi Stöckl1, Joyce Wamoyi2, and Meghan Ranganathan2
1London School of Hygiene & Tropical Medicine, London, United Kingdom
2National Institute for Medical Research, Mwanza, Tanzania
Intimate partner violence is still often only perceived to be physical or sexual, with a fair level of international agreement on its definition and measurement. While emotional abuse and controlling behavior have received increased attention, there is a lack of clarity on what acts constitute it and whether women perceive them as abusive. Even with sexual violence, in cultures where husbands are believed to have a right to have sex, there is a lack of clarity what constitutes sexual violence. Our study aimed to address this gap by interviewing 18 women in depth about their relationship and their experiences and perceptions about intimate partner violence. The 18 women were purposively sampled based on their participation in the MAISHA longitudinal study and because they have indicated a change in their experience of sexual intimate partner violence between the first two rounds of their quantitative surveys. Interviewers specifically probed about what kind of behavior women found acceptable in their relationship, what kind of behavior made them uncomfortable, and what they clearly considered violence and abuse. While specific acts were queried, the focus of the interviews was to encourage women to speak about the experiences of violence and abuse that were most important and pressing for them. Women spoke about a multiple set of violence experiences from their partner, with a strong focus on economic abuse that were linked to economic hardships they and their families suffered. Beyond acts that are commonly captured under economic abuse, such as taking earnings and not allowing a woman to make decisions over her own income, women also perceived the inability of men to provide for the household as a form of abuse. Regarding sexual violence, women also raised being asked about anal and oral sex, sex taking too long, or being denied sexual pleasure as experiences they would consider violence and abuse. The findings of this study showed that women consider a broad range of experiences as violence and that they have a wider sense of what is abusive than what is currently captured in existing screening tools that offer a range of acts considered to be violence but which are not necessarily holistic and consider the context sufficiently.
The Feminism Welcoming Women With Disability in Women’s Shelters and the First Italian Observatory on Multiple Discrimination
Rosalba Taddeini1
1Differenza Donna NGO, Roma, Italy
Our paper will introduce the innovative practice to welcome and host women with disabilities (WWD) victims of violence at the Women’s Shelters and the actions we have designed, the obstacles we found and overcame, in order that it could be a valuable contribution and a moment of reflection for all the women of the Nursing Network on Violence Against Women International. Differenza Donna has been the first nongovernmental organization (NGO) in Italy overcoming that gap which had never included WWD into feminism, creating and launching a National Observatory on Gender-Based Violence on WWD. Through this Observatory, we report inefficient services, unable to decode situations of violence and to intervene in public policy, which too often does not take into account such discrimination, not including, for example, indicators capable of bringing to light the gender and disability perspectives in an organic way. The way in which gender-based violence is perpetrated on women with disabilities is similar to that on women without disabilities, but it starts from different roots. The assumption is that the former are not represented as a sexual object by patriarchal culture but they are seen as eternal girls or angels, unlike women with cognitive/intellectual disabilities who are perceived as hypersexualized in the collective imagination. This topic also emerged from a research we conducted with the University of Kent in 2016. Thanks to Focus Groups with WWD on issues of women’s rights, on sexuality, and gender-based violence, it turned out that 97% of them had suffered violence and sexual abuse at least once in their lifetime. We believe that the subject of the inaccessibility of Shelters by WWD is not tied exclusively to the physical place, but it starts from a culture of body objectification, which women without disabilities always have fought, not including WWD. The awareness of the violence suffered and of access to Shelters is not a foregone conclusion to WWD. Since 2014, we have met 120 WWD and we found different strategies to respond to the needs of women who overcome violence: We provide nursing assistance service inside the Shelter for WWD; we work as experts called by the Criminal Court to ensure the reliability of the violence reported by WWD.
Shedding Light on the Role of Gender Attitudes and Alcohol Abuse in Preventing and Reducing the Cycle of Intimate Partner Violence: A Multi-Country Analysis of Male Perpetration
Angela Taft1, Anne-Marie Laslett1, Sandra Kuntsche1, Emma Fulu2, Ingrid Wilson1,3,4, and Kathryn Graham5,6,7,8,9
1La Trobe University, Melbourne, Victoria, Australia
2The Equality Institute, Melbourne, Victoria, Australia
3Singapore Institute of Technology, Singapore
4University of Liverpool in Singapore, Singapore
5Centre for Addiction and Mental Health, Toronto, Ontario, Canada
6Dalla Lana School of Public Health, Toronto, Ontario, Canada
7Deakin University, Melbourne, Victoria, Australia
8Curtin University, Perth, Western Australia, Australia
9Western University, London, Ontario, Canada
An Interpretive Descriptive Study About the Mental Health Impact of Cumulative Lifetime Violence in Men: Interviews From a Sample in the Men’s Violence, Gender, and Health Study, New Brunswick, Canada
Petrea Taylor1, Sue O’Donnell1, Judith Wuest1, Jeannie Malcolm1, and Charlene Vincent1
1University of New Brunswick, Fredericton, New Brunswick, Canada
Men experience mental health (MH) problems differently than women. Men are three times more likely to die by suicide and are less likely to seek help for their MH; however, gender is often neglected within MH research and service delivery. While a biomedical approach has not accounted for these differences, social determinants of health (SDOHs), including gender, are important in the understanding of men’s MH. Another SDOH, violence, intersects with gender and contributes to poor MH; however, its impact is misunderstood within research. Violence is misrepresented as associating with health based on singular “types” of violence that occur in isolation, failing to capture the effect of cumulative lifetime violence (CLV). For these reasons, we sought to understand how gender and having experienced CLV as a victim and/or perpetrator affect men’s MH. We interviewed 32 men from a larger sample of 586 men in New Brunswick, Canada, for The Men’s Violence, Gender, and Health Study (MVGHS) in 2016–2017. Interview transcripts were analyzed using an interpretive descriptive approach with a grounded theory lens. Data were coded for themes and categories, while relationships were established between the concepts. Meaning was derived from men’s descriptions using an interpretative process situated in a gendered perspective of “what it means to be a man” and the ongoing effects of CLV on MH. Findings revealed that the crux of men’s MH problems were realized through their relationships. Relational Distortion emerged as the basic social problem and is managed by Rectifying My Stance With Others, the basic social process. Rectifying occurs while Disengaging and Inserting My Will, subprocesses that are guided by differing levels of personal and relational understanding. Trauma- and violence-informed practices that draw awareness of gender role expectations and relational power dynamics will support capacity to manage their difficulties with day-to-day functioning in men with CLV histories.
Disparities in Health Care Experiences and Outcomes for African American Survivors of Violence
Elizabeth Tomlinson1
1North Carolina Central University, Durham, North Carolina, USA
Whether and to what extent they show elevated inflammatory biomarkers (i.e., C-reactive protein; interleukin-6);
Their trauma exposure, psychological symptoms, and discriminatory experiences;
Descriptions of health care discrimination they have experienced; and
Strategies they use to navigate difficult and/or discriminatory health care experiences.
Female Genital Mutilation Survivors in Media—Pictures That Empower
Elisabeth Ubbe1
1eubbe press, Stockholm, Sweden
Using a Delphi Method for Adapting the Contents of the Women Abuse Screening Tool for Thai Women
Tipparat Udmuangpia1,2, Supawadee Thaewpia1, Wacharee Amornrojawutthi1, Prapatsri Shawong1, Yaowaret Kamanat3, Pilin Nisatea4, and Tina Bloom2
1Boromarajonani College of Nursing, Khon Kaen, Thailand
2University of Missouri, Columbia, Missouri, USA
3Khon Kaen Hospital, Khon Kaen, Thailand
4Sakon Nakhon Hospital, Sakon Nakhon, Thailand
A Mixed-Methods Research Predicting Intentions and Perceptions About Intimate Partner Violence Screening Among Nursing Students and Educators in Thailand
Tipparat Udmuangpia1 and Tina Bloom2
1Boromarajonani College of Nursing, Khon Kaen, Thailand
2University of Missouri, Columbia, Missouri, USA
Implementing Trauma- and Violence-Informed Care in Diverse Contexts
Colleen Varcoe1, Victoria (Vicky) Bungay1, and Nadine Wathen2
1University of British Columbia, Vancouver, British Columbia, Canada
2University of Western Ontario, London, Ontario, Canada
Trauma- and violence-informed care (TVIC), a universal approach, aims to provide safe care mindful of the circumstances of peoples’ lives. Rather than “screening” for violence, TVIC assumes that anyone coming to services may be experiencing, or have experienced, violence. Our approach is relational and multilevel: Intra-personally, providers need to consider how their own experiences of privilege and oppression shape their biases and assumptions; interpersonally, we need to be mindful of how each individual (providers and recipients) influences the other; contextually, we all operate in diverse policy, historical, and economic environments. TVIC requires significant shifts away from individualist approaches. This symposium invites participants to consider how to achieve such shifts. We open with an overview of TVIC as an equity-oriented concept, and consider how tools we’ve developed might be useful or adapted to participants’ own contexts (opening activity). Three papers then detail implementation of TVIC approaches in diverse contexts. We share the change process in which we are engaged in Emergency Departments, and in a woman-led model of outreach with women experiencing systemic inequities and severe interpersonal violence. Finally, presenting findings from an evaluation of TVIC workshops, we examine whether the TVIC approach is resonating with diverse service providers and leaders. Participants will be asked to consider how they might take up this equity-oriented approach, and how they could contribute to local and global TVIC efforts (closing activity).
Paper 1: TVIC in Emergency Departments (EDs).
EQUIP is an evidence-informed, complex intervention integrating equity-oriented health care (EOHC) in diverse service contexts. Based on promising outcomes in primary health care, we have refined and are testing the intervention in EDs. A key dimension of EOHC is TVIC. Given the relationships among racism, colonialism, violence, and trauma in Canada, particularly against Indigenous people, a second key dimension is Cultural Safety; reflecting the relationship between these and substance use, harm reduction is the third dimension. We share our approach and preliminary results integrating TVIC in EDs, including use of “equity readiness” and “Front Line Ownership.”
Paper 2: Women-Led or Women Centered? Re-Imagining TVIC in an Outreach Context
This paper considers “outreach” as a strategy to engage with women affected by violence, especially those regularly missing from services/programs. Women’s “absence” is associated with myriad circumstances including experiences of discrimination in care settings, siloed and disconnected services, competing demands necessary for survival (e.g., income generation, securing shelter), control by violent partners, and knowledge gaps concerning service navigation. TVIC approaches to outreach are critical to building trust and establishing sustained relationships that enhance women’s capacity to engage with and receive life-sustaining services. We share our TVIC approach fostering a women-led outreach initiative illustrating TVIC implementation in this context, and the associated benefits for women’s agency and engagement with services.
Paper 3: Uptake and Impact of TVIC Education in Diverse Service Contexts
We’ve delivered TVIC educational workshops in diverse contexts, including public health, primary care, and domestic violence services, since 2016. Pre–post evaluations indicate knowledge changes; however, uptake into practice remains unknown. We will report on follow-up evaluation of workshop impact. To date, 47 participants from 12 different sessions have responded to an online survey asking about impacts on their own practice, and on their organization. Based on responses, eight to 12 participants are being interviewed to explore these impacts, or lack of impacts. We will report on all data available at the time of presentation, to begin answering the question: Does TVIC education make a difference?
Hiding in Plain Sight: A Discourse Analysis of Registered Nurses Capacity to Care for Female Intimate Partner Violence Presentations to the Emergency Department
Vijeta Venkataraman1,2, Jane Currie3, and Trudy Rudge3
1Women’s Health Service, Canberra, Australian Capital Territory, Australia
2Canberra Sexual Health Canberra, Australian Capital Territory, Australia
3University of Sydney, Sydney, New South Wales, Australia
“We Need to Reach Them”: Child and Family Health Nurses Working With Women Experiencing Intimate Partner Violence
Jeannette Walsh1 and Jo Spangaro2
1University of New South Wales, Sydney, New South Wales, Australia
2University of Wollongong, Wollongong, New South Wales, Australia
Gender-Based Violence: Myths, Misrepresentations, and What to Do About Them
C. Nadine Wathen1,2, Eugenia Canas1, and Najibullah Naeemzadah1
1Western University, London, Ontario, Canada
2Centre for Research & Education on Violence Against Women & Children, London, Ontario, Canada
Gender-based violence (GBV) is a “wicked” social problem: prevalent, costly, harmful, and defying easy solution. Its causes are as much, or more, about what we believe and tolerate as a society, as they are about individual actions. We argue that two types of problematic beliefs about GBV exist. The first are myths and misunderstandings—beliefs based on outdated or mis-information, and/or ignorance of the scope and impact of GBV. The second stem from intentional messages to devalue and demean women and gender diverse people and are a feature of so-called men’s rights advocacy. We describe two inter-related studies designed to start shifting our shared narratives. News media play a significant role in the public’s understanding of GBV, with framing impacting support for funding, safe houses, legal sanctions for perpetrators, protection for victims, and so on. A gendered understanding of how the news media frames these issues is crucial. In Project 1, and with federal government partners, we use a nationally representative sample of online Canadian newspapers published over the last 30 years to examine one form of GBV: intimate partner violence (IPV). We conduct (a) a qualitative inductive framing analysis to capture emerging framings of IPV and (b) a quantitative deductive framing analysis to compare the differences in news media’s portrayal of IPV across genders. Project 2 describes how the results of Project 1, and related sources or knowledge, are being used in a deliberative dialogue process with Federal government policy partners to prioritize analysis of data collected in a new Canadian population–based survey using the Composite Abuse Scale (Revised)–Short Form. These priorities are intended to inform the staging and framing of forthcoming analyses to best address those narratives (of either or both types) found to be most problematic and in need of immediate attention. We will provide findings to date from the media analysis, and learnings from the formative part of the deliberative dialogue process. These new Canadian data provide a unique opportunity to create compelling evidence-based narratives to dispel existing myths, and, importantly, to push back against malicious and hateful messages designed to sow confusion and division.
What Are Australian Women’s Experience of Reproductive Coercion and Abuse?
Molly Wellington1, Laura Tarzia1, and Kelsey Hegarty1,2
1The University of Melbourne, Melbourne, Victoria, Australia
2The Royal Women’s Hospital, Melbourne, Victoria, Australia
Reproductive coercion (RC) and abuse are terms used to describe a set of controlling behaviors that take away women’s choices over their reproductive health. The behaviors that encompass RC include contraceptive sabotage (where contraceptives can be tampered with, or destroyed against a woman’s wishes), pregnancy pressure or coercion (where a woman is manipulated to become pregnant through coercion or threats), and controlling the outcome of a pregnancy (where a woman is forced to continue a pregnancy or terminate a pregnancy against her wishes). RC is associated with many negative health impacts, including poor mental health and sexually transmitted infections. Little is known about women’s experiences of RC and abuse and the impacts on their lives as well as their interactions with health professionals. To address this gap, this project aimed to answer the following research questions: “What are women’s experiences of RC and abuse?” “What do women experiencing RC and abuse want from their clinicians?” This qualitative research project involved recruiting women who had ever experienced someone trying to make them pregnant when they didn’t want to be, tried to force them to have an abortion or continue a pregnancy when they didn’t want to. Recruitment was done through social media and university student portals. Interviews were conducted either face to face or over the phone and were transcribed verbatim and de-identified. Interview transcripts were analyzed thematically to identify key themes. Transcripts were cross-coded by members of the research team to ensure rigor. The findings of this study highlighted the complexity of the issue of RC. Different to previous literature, this study captured experiences that included both behaviors of direct threats and abuse as well as more subtle coercion. Women interviewed were from diverse cultural backgrounds, with many experiencing RC in a country other than Australia and highlighted the need to understand this form of abuse with a cultural lens. Women believed that clinicians were well placed to have conversations and respond. This research has identified and explored a broader experience of RC than has been investigated before and could inform how we identify and measure it in the future.
WHO’s Curriculum Improves Timor-Leste Nursing and Midwifery Students’ Knowledge, Attitudes, and Confidence in Responding to Domestic and Sexual Violence
Kayli Wild1, Leesa Hooker1, Lidia Gomes2, Angelina Fernandes3, Luisa Marcal4, Guilhermina de Araujo1, and Angela Taft1
1La Trobe University, Melbourne, Victoria, Australia
2Universidade Nasional Timor Lorosa’e, Dili, Timor-Leste
3Instituto Superior Cristal, Dili, Timor-Leste
4Psychosocial Recovery and Development in East Timor (PRADET), Dili, Timor-Leste
All health providers are required to provide first-line support to survivors of violence, and these skills need to be embedded in their pre-service University training. This is of critical importance in countries such as Timor-Leste, where 47% of women have experienced physical or sexual violence from their partner in the past 12 months. The World Health Organization is developing a global curriculum for health providers responding to violence against women, and Timor-Leste is one of the first low-income countries to pilot it as pre-service training. This research examines what content and teaching methods work in low-resource settings, and what creates ownership and widespread uptake of the curriculum by Universities. The curriculum was adapted for the local context by a working group from one Australian University, two Timorese Universities, and a domestic violence advocacy service. Video-based learning materials were developed in the local language, based on formative research with 46 midwives and 28 survivors of violence. The curriculum was piloted three times with a total of 55 students. Pre- and post-training questionnaires assessed changes in students’ knowledge, attitudes, and self-confidence in responding to domestic and sexual violence. The evaluation also included class observation and qualitative interviews with students and lecturers. After each pilot, the proportional changes for each question were analyzed, and the working group improved the content in areas showing limited change. Overall mean score changes were assessed using a Mann–Whitney U test, with significance at p < .05. The results showed significant improvement in total knowledge scores, which increased progressively with each pilot. The largest change was observed in attitudes which tolerate violence. The qualitative findings highlight the need for videos, guest speakers, and role-plays to enhance student learning. This research demonstrates that significant change in students’ knowledge, attitudes, and confidence in responding to violence is possible, but requires careful attention to refining content based on evaluation results over successive pilots, and ongoing mentoring of lecturers. The widespread uptake of the curriculum by Universities in Timor-Leste illustrates the importance of ownership established through collaborative partnerships and building in time and resources to tailor global training packages to the local context.
Modeling the Pathways Between Interpersonal Trauma and Opioid Use
Jessica R. Williams1, Veronica Cole2, Susan Girdler1, and Martha Cromeens1
1University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
2Wake Forest University, Winston-Salem, North Carolina, USA
Building Sustainable Partnerships Between Community Health Centers and Domestic Violence Programs: Recommendations From a Community Engagement Forum
Jessica R. Williams1, Cassandra Rowe2, and Susannah Matthai1
1University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
2North Carolina Coalition Against Domestic Violence, Durham, North Carolina, USA
Promoting Safety and Health for Women and Youth Exposed to Violence: Advancing Health Practice, Education, Policy, and Research
Lindsay Williams1
1UCLA School of Nursing, Los Angeles, California, USA
Women Veterans are the largest Veteran population, yet have significant mental health disparities, greater than both civilian women and Veteran men. This is notably related to pervasive trauma before, during, and after military service, prompting the need for consistent mental health care in the outpatient setting. This study used constructivist Grounded Theory methods to explore women Veterans’ decision making to enter mental health outpatient services, and identify aspects of mental health outpatient services that are important to women Veterans. Twelve women Veterans revealed meaningful stories on their experiences of trauma and their use of mental health services. A significant precipitating factor to entry to mental health services is the “tipping point,” after which women Veterans use their peer networks to select a provider. “Trust and Time” can be used to characterize these relationships, because the clinicians’ expertise, consistency, and efforts to establish a partnership will result in positive relationships. Exploration into women Veterans’ perceptions of mental health outpatient care is critical for the creation of gender-specific mental health services. Women’s mental health must be understood within the context of their psychosocial, cultural, and biological circumstances to design interventions that address their unique needs.
“I Can See the Change in Him . . . ”: A Qualitative Study of Women’s Experience of Alcohol-Related Intimate Partner Violence
Ingrid M. Wilson1,2,3, Kathryn Graham4,5,6,7,8, and Angela Taft1
1La Trobe University, Melbourne, Victoria, Australia
2Singapore Institute of Technology, Singapore
3University of Liverpool in Singapore, Singapore
4Centre for Addiction and Mental Health, Toronto, Ontario, Canada
5Dalla Lana School of Public Health, Toronto, Ontario, Canada
6Deakin University, Melbourne, Victoria, Australia
7Curtin University, Perth, Western Australia, Australia
8Western University, London, Ontario, Canada
Indigenous Māori Women Keeping Safe in Unsafe Relationships Amid Structural Entrapment
Denise Wilson1, Alayne Hall1, Karina Cootes1, Juanita Sherwood2, and Debra Jackson3
1Auckland University of Technology, Auckland, New Zealand
2University of Sydney, Sydney, New South Wales, Australia
3University of Technology Sydney, Sydney, New South Wales, Australia