Post-Assault Health Care for Sexual Assault Survivors During COVID-19: A Mixed Methods Analysis of Service Rates in a Predominately African American Community

Mental Health Care Resource Utilization of Victims of Interpersonal Violence in the Novel Coronavirus Era

INTRODUCTION

Higher incidences of interpersonal violence were reported throughout the country during the coronavirus (COVID) time period. We aimed to compare health-care encounters and resource utilization related to interpersonal violence with mental health (MH) disorders before and during the pandemic within a year of the index visit for interpersonal violence.

METHODS

A retrospective analysis of the Delaware Healthcare Claims data of all patients aged ≥16 y who suffered interpersonal violence was performed. Patients were followed up for 1 y pre and post their index visit of interpersonal violence episode during the pre-COVID (March 2018 through December 2018) and the COVID (March 2020 through December 2020) period. Census tract information was used to assess social determinants of health.

RESULTS

There were 431 patients in the COVID period and 527 patients in the pre-COVID period with index violence claim encounters. African American patients were more likely to have a violence encounter during COVID (60.3% versus 47.2%, P < 0.001). Patients in the COVID period were more likely to live in a census tract with public assistance households (median 3.3% versus 2.2%, P = 0.005) and higher unemployment (7.5% versus 7.1%, P = 0.01). In the following year of index violence claim, the mean numbers of MH claim-days for COVID and pre-COVID patients were 19.5 (53.3) and 26.2 (66.2), (P = 0.51). The COVID group had fewer MH claim-days mostly in the second half of the year after the index encounter with an incidence rate ratio of 0.61, 95% CI (0.45-0.83).

CONCLUSIONS

Racial and socioeconomic disparities were amplified and MH resource utilization was lower during COVID. Further injury prevention efforts should be focused on MH in future pandemics or disasters.

Living in an Intimate Partner Violence Shelter During a Pandemic: Perspectives from Advocates and Survivors

PURPOSE

With state-wide quarantine policies during the COVID-19 pandemic like those implemented in the state of Texas, intimate partner violence (IPV) shelter staff were forced to incorporate new safety measures to keep survivors and advocates safe. To understand the impact of these adaptations fully, authors interviewed shelter staff and residents to capture both of their experiences living and working in the same shelter during the height of the coronavirus pandemic (summer 2020) to understand how changes in policy and procedure in shelters impacted survivors and advocates.

MATERIALS AND METHODS

A qualitative phenomenological design was utilized to collect and analyze data from 10 staff and 10 survivors to develop both a textual and a structural description of participant experiences living in an IPV shelter.

RESULTS

The current study captured the survivors' and advocates' perspectives related to the 1) vacillating views of shelter social distancing and quarantine policies, 2) shelter occupancy and staffing unpredictability, 3) the broader challenges related to environmental stressors and 4) mobility challenges.

DISCUSSION

Results of this study highlight factors related to interpersonal relationships within the shelter and structural factors of shelter which contributed to stress for participants.

CONCLUSION

The coronavirus is continuing to present challenges for shelters. Implications can be drawn from provider and client experiences that can inform policies and procedures for future health crises, including the need to mitigate environmental stress and transportation challenges, as well as considerations for maintaining social support should social distancing be necessary in future epidemics.

Presenting Methodological Resilience for Conducting Research with Vulnerable Populations During Current and Future Pandemics: A Case Study with IPV Shelters and Survivors in the United States

Purpose

In this brief report, we highlight the challenges that we experienced while attempting to conduct primary data collection with intimate partner violence (IPV) survivors living in an IPV emergency shelter throughout the prolonged COVID-19 pandemic and our strategies to overcome them.

Method

In the summer of 2021, we began collecting data on a study investigating maternal-child bonding while living in IPV emergency shelters. We proposed a 14-day electronic daily diary methodology with follow-up semi-structured interview. The purpose of the study was to understand what factors affect maternal-child bonding to support survivors' relationships with their children while living in an emergency shelter.

Results

We encountered two global obstacles to study implementation: the Institutional Review Board (IRB) pausing in-person data collection and low IPV shelter utilization. In what we term methodological resilience, we engaged in innovative and flexible team work to overcome these barriers. Specific strategies centered on creating an entirely remote data collection process and expanding our geographic area and participant eligibility criteria.

Conclusions

Implications for researchers include greater communication with IRB offices, planning for multi-state recruitment, triangulated recruitment methods, reminder texts for participants and incremental incentives to ensure continued engagement with the study.