Service seeking experiences of college-aged sexual and intimate partner violence victims with a mental health and/or behavioral disability

Exploring Lived Experience of Family and Domestic Violence Against Women With Disability: A Scoping Review

This article reports on a scoping review exploring understandings of family and domestic violence (FDV) against women with disability (WWD) within the literature and constitutes the second article in a two-part series, the first critiquing the categorization and measurement of FDV and disability. We report findings from qualitative studies included in the review, predominantly interpretivist and critical in orientation. The scoping review included 43 articles, 15 of which are included here, as they draw upon data directly from the perspectives of WWD. Reflexive thematic analysis was conducted, utilizing both inductive and deductive coding, and consultation between the authors. The analysis highlighted experiences of disability-based abuse, the nexus of ableism and sexism within the everyday, and meanings of justice and resilience for WWD. Disability-based abuse was perpetrated primarily by intimate partners, including financial and physical disability-based abuse, and was used to exploit and perpetuate situations of isolation. Sexist and ableist expectations, assumptions, and attitudes converged in everyday encounters within the community, with workers and systems. However, WWD reported strategies of resistance, healing, coping, and moving on in the aftermath of FDV and indicated what can be done to promote justice, both personally and within systems. The findings were discussed drawing on Axel Honneth's theory of recognition to highlight the mechanisms by which recognition and respect can be enhanced to enable full access to citizenship, in particular, for WWD to live free from violence.

Labeling Victimization Experiences and Self as Predictors of Service Need Perceptions and Talking to Police

Theoretical frameworks suggest that how victims of violence against women (VAW) label their experiences and selves shapes their help-seeking intentions and behaviors. Quantitative studies assessing this relationship have focused on sexual assault and have neglected self-labels, thus this study adds to the research by including multiple forms of VAW and both experience-labels (e.g., "abuse") and self-labels (e.g., "victim"). Data came from a community-based sample of 1,284 adult, female victims of physical intimate partner violence, sexual assault, and/or stalking. These women participated in a state-wide phone survey in 2020 to determine victimization prevalence and were selected for the present analyses based on their victimization experiences. Bivariate analyses and multivariate logistic regression models were used to determine whether experience- and self-labels predicted the likelihood of perceiving the need for legal services, victim services, shelter or safe housing, and/or medical care, as well as talking to police. Both applying a label to one's experiences with VAW and applying a label to oneself in relation to those experiences approximately doubled the odds of perceiving a need for formal services. The significance of self-labels seemed to be driven by the "survivor" label, as using a "victim" label was not related to need perceptions, but a "survivor" label doubled or tripled the odds of perceiving a need for formal services. Applying a label to one's experiences with VAW almost doubled the odds of talking to the police, and, again, use of the "survivor" self-label significantly increased the odds of talking to the police. These findings confirm the importance of labeling one's victimization experiences and self, and indicate that greater attention be paid to the labels that victims use and how the use of labels might be improved so that they are more likely to seek and attain meaningful help and services.

College women with a disability and interpersonal violence: A call to action

ABSTRACT

Interpersonal violence is a serious public health issue, particularly in the young adult population. College women are more likely to experience interpersonal violence than the general population; college women with disabilities are at particularly high risk of victimization. Despite this reality, screening rates for interpersonal violence in college health centers remain low, and college women, both disabled and not, report unsatisfactory interactions with college health providers after an interpersonal violence experience. We provide suggestions for nurse practitioners working in college health which will assist them in their endeavors to screen college women, specifically college women with a disability, for interpersonal violence and to respond to the outcomes of those screenings using a trauma and disability-informed practice lens.

Measuring the Prevalence of Interpersonal Violence Victimization Experience- and Self-Labels: An Exploratory Study in an Alaskan Community-Based Sample

Purpose

How victims of violence against women (VAW) label their experiences and selves can be important for help-seeking, but descriptive research on the prevalence of experience- and self-labels among VAW victims is limited. This study sought to fill some of the gaps in this quantitative literature using new measurement tools.

Method

The current study used quantitative survey data from a weighted sample of 1694 community-based women in Alaska who had experienced VAW (determined using behaviorally specific items) to measure the prevalence of a variety of labels these victims could apply to their experiences and selves.

Results

Generally, victims of specific forms of violence had minimal agreement on the terms they used to label their experiences. The most commonly endorsed label was 28.5% of those who had experienced alcohol or drug involved sexual assault applying the label rape to their experiences. Across all victims, the most commonly endorsed self-label was survivor, with one-quarter to one-third endorsing this label, depending on the subsample. Roughly one-tenth used the self-label victim across all subsamples.

Conclusion

VAW service providers should consider labels used to promote services and how to increase awareness about which behaviors constitute VAW; policymakers should improve the accessibility of healthcare so that labeling oneself or one's experiences in a certain way is not a prerequisite of help-seeking; and researchers should continue exploring how to measure experience- and self-labels with minimal priming of participants and greater specificity to the actual experiences with violence.

Improving Access to Postassault Healthcare for College Students: Creating a Campus-Based Sexual Assault Nurse Examiner Program

National prevalence data indicate that college students are at a high risk for sexual assault, but most institutions of higher education do not provide postassault medical forensic examinations as part of student-facing healthcare services. College sexual assault patients might have access to sexual assault nurse examiners (SANEs) in local hospitals, if they are available where they are attending school, but unfortunately, many student victims do not have options for postassault health services. Creating campus-based SANE programs could address this gap in services and increase access to healthcare. In this article, we describe how we created a free-standing, campus-based SANE program at Michigan State University. We worked with a multidisciplinary community advisory board to identify core guiding principles to inform stakeholder engagement, program location decisions, program policies, training protocols, staffing plans, and collaborative partnerships with other disciplines (e.g., advocacy, law enforcement, prosecution, forensic sciences). We discuss how we navigated opening the program in the midst of the global COVID-19 pandemic and share lessons learned for creating campus-based SANE programs.

Help-Seeking and Barriers to Care in Intimate Partner Sexual Violence: A Systematic Review

Intimate partner sexual violence (IPSV) is a prevalent phenomenon, yet an under-researched topic. Due to the complex nature of balancing love and fear, individuals who experience IPSV have unique needs and face unique barriers to seeking care. The purpose of this systematic review was to examine the literature on help-seeking and barriers to care in IPSV. Articles were identified through PubMed, CINAHL, PsycINFO, and Web of Science. Search terms included terms related to IPSV, intimate partner violence (IPV), domestic violence, sexual assault, and rape. The review was limited to the United States, and articles that were included needed to specifically measure or identify sexual violence in an intimate relationship and analyze or discuss IPSV in relation to help-seeking behaviors or barriers to care. Of the 17 articles included in this review, 13 were quantitative studies and four were qualitative studies. Various definitions and measurements of IPSV across studies included in this review make drawing broad conclusions challenging. Findings suggest that experiencing IPSV compared to experiencing nonsexual IPV (i.e., physical or psychological IPV) may increase help-seeking for medical, legal, and social services while decreasing help-seeking for informal support. Help-seeking can also reduce risk of future IPSV and decrease poor mental health outcomes. Barriers to seeking care in IPSV included social stigma, fear, and difficulty for individuals in identifying IPSV behaviors in their relationships as abuse. More inclusive research is needed among different populations including men, non-White individuals, nonheterosexual, and transgender individuals. Suggestions for research, practice, and policies are discussed.

THEORETICAL-EXPLANATORY MODEL OF THE CARE PROVIDED TO WOMEN IN SITUATIONS OF VIOLENCE IN PRIMARY HEALTH CARE

ABSTRACT Objective: to develop a theoretical-explanatory model of the care provided to women in situations of intimate partner violence in the context of Primary Health Care. Method: a study with a qualitative approach, whose theoretical-methodological contribution adopted was the updated Straussian strand of the Grounded Theory. Between February and December 2019, individual interviews were conducted with 31 professionals who worked in Family Health Units in the Health District of a capital from northeastern Brazil, members of the minimum team (first sample group) and of the Expanded Family and Primary Care Health Center (second sample group). The data were organized using an analytical tool called Paradigmatic Model, consisting of three components: condition, action-interaction and consequences. Results: the theoretical-explanatory model of the phenomenon called “enabling the empowerment of women in situations of intimate partner violence” allowed understanding the meanings attributed by the professionals to the care offered to women in situations of intimate partner violence within the scope of the Family Health Strategy. Conclusion: the model of care provided to women in situations of intimate partner violence, based on identification of the problem and intervention in the cases, is limited due to the characteristics of the organization of the services. In this sense, the study points to the importance of managerial actions to achieve favorable outcomes for female empowerment and consequent confrontation of violence.

Campus Service Use Among Students With Disabilities Who Have Experienced Sexual Violence: A Conceptual Model

Students with disabilities are one student group with elevated risk of sexual violence. Although they would benefit from streamlined access to campus support, little is known about their patterns of campus service use. This qualitative analysis includes data from semi-structured interviews with 51 students with disabilities who experienced sexual violence focused on service use across campus. The resultant conceptual model shows that greater accessibility is associated with positive experiences, and lower accessibility is associated with negative experiences. Students with disabilities who experienced or expected negative reactions (e.g., judgment) were less likely to use services and were less satisfied. Advocacy and support in connecting students with disability or sexual violence services was associated with positive experiences and increased accessibility. These findings highlight key facilitators and barriers to campus service use for students with disabilities with sexual violence histories and suggest key intervention points for increasing accessibility, reducing stigma, and improving student experiences with campus providers, staff, and faculty.

Sexual behaviours and sexual health outcomes among young adults with limiting disabilities: findings from third British National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

OBJECTIVE

To explore whether the sexual behaviours and sexual health outcomes of young adults with self-reported disabilities that they perceive limit their activities ('limiting disability') differ from those without disability.

DESIGN

Complex survey analyses of cross-sectional probability sample survey data collected between September 2010 and August 2012 using computer-assisted personal interviewing and computer-assisted self-interview.

SETTING

British general population.

PARTICIPANTS

7435 women and men aged 17-34 years, resident in private households in Britain, interviewed for the third National Survey of Sexual Attitudes and Lifestyles.

MAIN OUTCOME MEASURES

Self-reported sexual behaviour and sexual health outcomes.

RESULTS

Approximately 1 in 10 participants reported having a limiting disability. Sexual behaviours were similar between those with limiting disability and those without, with a few exceptions. Women and men with limiting disability were less likely to report having sexual partner(s) (past year, adjusted ORs (AORs) for age and social class: AORs: 0.71, 0.75, respectively). Women with limiting disability were more likely to report having same-sex partner(s) in the past 5 years (AOR: 2.39). Differences were seen in sexual health outcomes, especially among women; those with limiting disability were more likely to report having experienced non-volitional sex (ever, AOR: 3.08), STI diagnoses (ever, AOR: 1.43) and sought help/advice regarding their sex life (past year, AOR: 1.56). Women with limiting disability were also more likely to feel distressed/worried about their sex life than those without limiting disability (AORs: 1.61). None of these associations were seen in men.

CONCLUSIONS

Young adults with limiting disability, especially women, are more likely to report adverse sexual health outcomes than those without, despite comparatively few behavioural differences. It is important to ensure that people with disabilities are included in sexual health promotion and service planning, and targeted policy and programme interventions are needed to address negative sexual health outcomes disproportionally experienced by people with disabilities.