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Miyamoto S, Wright EN, Thiede E, Perkins DF, Bittner C, Dorn L. Multidisciplinary Perspectives on the Implementation of a Comprehensive Sexual Assault Telehealth Program in Rural Communities: A Qualitative Study. Violence Against Women 2024; 30:2674-2696. [PMID: 36913738 PMCID: PMC11292964 DOI: 10.1177/10778012231159413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
Access to quality sexual assault (SA) care in rural communities is limited by challenges surrounding building and sustaining a skilled SA nurse examiner workforce. Telehealth can facilitate access to expert care while cultivating a local sexual assault response. The Sexual Assault Forensic Examination Telehealth (SAFE-T) Center aims to decrease disparities in SA care by providing expert, live, interactive mentoring, quality assurance, and evidence-based training via telehealth. This study examines multidisciplinary perceptions of pre-implementation barriers and SAFE-T program impact using qualitative methods. Implications for the implementation of telehealth programs to support access to quality SA care are considered.
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Affiliation(s)
- Sheridan Miyamoto
- College of Nursing, The Pennsylvania State University, University Park, PA, USA
| | - Elizabeth N. Wright
- College of Nursing, The Pennsylvania State University, University Park, PA, USA
| | - Elizabeth Thiede
- College of Nursing, The Pennsylvania State University, University Park, PA, USA
| | - Daniel F. Perkins
- Department of Agricultural Economics, Sociology and Education, The Pennsylvania State University, University Park, PA, USA
| | - Cynthia Bittner
- College of Nursing, The Pennsylvania State University, University Park, PA, USA
| | - Lorah Dorn
- College of Nursing, The Pennsylvania State University, University Park, PA, USA
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Franklin CA, Bouffard LA, Goodson A, Garza AD. Police Decisions in a Rape Scenario: The Effect of Trauma Response, Forensic Evidence, Stranger-Perpetrators, and Rape Mythology. Violence Against Women 2023; 29:3024-3049. [PMID: 37709270 DOI: 10.1177/10778012231197556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
This study examined the direct effect of "classic rape" characteristics, and how they were moderated by rape myth endorsement, on the likelihood of arrest, perceived district attorney charge acceptance, and perceived suspect conviction using a formal rape disclosure among a sample of 468 police participants from a sizeable municipal law enforcement agency in one of the fifth largest and most diverse U.S. cities. A randomly assigned, between-subjects factorial vignette design was employed. Manipulations included stereotypical trauma response, forensic medical exam, and perpetrator type. Path modeling revealed statistically significant relations between stereotypical trauma response, forensic medical exam, perpetrator type, and the three outcome variables. Rape myth endorsement moderated the effect of manipulations on the dependent variables. Implications for research and policy are discussed.
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Affiliation(s)
- Cortney A Franklin
- Division of Governmental Studies and Services, Washington State University, Pullman, WA, USA
| | | | - Amanda Goodson
- Department of Criminal Justice, University of Texas at El Paso, El Paso, TX, USA
| | - Alondra D Garza
- Department of Criminal Justice, University of Central Florida, Orlando, FL, USA
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Allison MK, Curran G, Walsh WA, Dworkin ER, Zielinski MJ. Factors Affecting Telemedicine Implementation in Emergency Departments and Nurses' Perceptions of Virtual Sexual Assault Nurse Examiner Consultation for Sexual Assault Survivors. JOURNAL OF FORENSIC NURSING 2023; 19:41-49. [PMID: 36812373 PMCID: PMC9971634 DOI: 10.1097/jfn.0000000000000385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Emergency department (ED) nurses play a critical role in caring for sexual assault patients, but many have not received training on how to conduct a proper sexual assault forensic medical examination. Live or real-time sexual assault nurse examiner (SANE) consultation provided via telemedicine (known as "teleSANE") during sexual assault examinations is a promising new practice to address this issue. PURPOSE The purpose of this study was to assess ED nurses' perceptions of influences on telemedicine use, as well as the utility and feasibility of teleSANE, and identify potential influences on teleSANE implementation in EDs. METHODS Guided by the Consolidated Framework for Implementation Research, this developmental evaluation involved semistructured qualitative interviews with 15 ED nurses from 13 EDs. RESULTS Interviews revealed facilitators and barriers to current telemedicine use across Consolidated Framework for Implementation Research levels. Facilitators included state-level grant funding and technical assistance. Barriers included clinician discomfort being on video and access to ongoing training. Participants believed teleSANE consultation would improve patient care and forensic evidence collection but had concerns for patient privacy and acceptability. Most participants worked in EDs that have the information technology support and telemedicine equipment needed to support teleSANE implementation, although many requested ongoing education and trainings on teleSANE and sexual assault care to improve clinician confidence and account for high staff turnover. DISCUSSION Findings highlight the unique needs of sexual assault survivors receiving telemedicine services in EDs, particularly those in rural communities with heightened privacy concerns and limited access to specialty care.
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Affiliation(s)
- M. Kathryn Allison
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Geoffrey Curran
- Center for Health Services Research, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Center for Implementation Research, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Central Arkansas Veterans Healthcare System, USA
| | | | | | - Melissa J. Zielinski
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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Shaw J, Feeney H, Meunier‐Sham J, Hazard K, Plante P, Petricone R. An evaluation of a rapid conversion to teleSANE in response to COVID-19. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 70:458-474. [PMID: 35901455 PMCID: PMC9353418 DOI: 10.1002/ajcp.12619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/16/2022] [Accepted: 06/30/2022] [Indexed: 06/15/2023]
Abstract
Sexual Assault Nurse Examiners (SANEs) provide expert, comprehensive medical forensic care to patients who present for services following a sexual assault. Because SANEs are not consistently available, telehealth technology is being explored as a means to provide access to this expert care (i.e., teleSANE). During the COVID-19 pandemic, teleSANE offered additional potential benefits by reducing the length of time spent and number of providers in patient exam rooms, the need for personal protective equipment that was in high demand and short supply, and provider anxiety related to providing in-person care. In the summer of 2020, the Massachusetts SANE program rapidly and temporarily converted five hospitals from in-person SANE care to teleSANE. An evaluation team interviewed 23 providers using a rapid research and evaluation methods approach to assess the temporary model and inform the future of SANE care. Evaluation findings reveal it is possible to rapidly and temporarily convert hospitals from in-person to teleSANE care in a time of broad uncertainty, and that such a change requires intensive and thoughtful planning; a shared commitment to being supportive, flexible, and responsive; and specific experience and expertise. Considerations for communities exploring how best to ensure consistent, equitable access to SANEs are discussed.
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Affiliation(s)
- Jessica Shaw
- Department of PsychologyUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | | | - Joan Meunier‐Sham
- Massachusetts Department of Public Health Sexual Assault Nurse Examiner ProgramBostonMassachusettsUSA
| | - Karen Hazard
- Massachusetts Department of Public Health Sexual Assault Nurse Examiner ProgramBostonMassachusettsUSA
| | - Pamela Plante
- Massachusetts Department of Public Health Sexual Assault Nurse Examiner ProgramBostonMassachusettsUSA
| | - Randi Petricone
- Massachusetts Department of Public Health Sexual Assault Nurse Examiner ProgramBostonMassachusettsUSA
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Lapsey DS, Campbell BA, Plumlee BT. Focal Concerns and Police Decision Making in Sexual Assault Cases: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2022; 23:1220-1234. [PMID: 33583357 DOI: 10.1177/1524838021991285] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Sexual assault and case attrition at the arrest stage are serious problems in the United States. Focal concerns have increasingly been used to explain police decision making in sexual assault cases. Because of the popularity of the focal concerns perspective and potential to inform evidence-based training, a systematic review and meta-analysis are needed to condense the literature. In this study, we assess the overall strength of the relationship between focal concerns variables and police decisions to arrest in cases of sexual assault. Our assessment of the effects of focal concerns variables on arrest decision making in sexual assault cases followed the systematic review protocols provided by the Campbell Collaboration of Systematic Reviews. Specifically, we used the Campbell Collaboration recommendations to search empirical literature and used meta-analysis to evaluate the size, direction, and strength of the impact of focal concerns variables on arrest decisions. Our search strategy detected 14 eligible studies and 79 effect sizes. The meta-analysis found several robust and statistically significant correlates of arrest. In fact, each focal concerns concept produced at least one robust arrest correlate. Overall, focal concerns offers a strong approach for explaining police decisions in sexual assault cases. Although practical concerns and resource constraints produced the strongest arrest correlates, results show the importance of additional case characteristics in officers' decision to arrest.
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Miyamoto S, Thiede E, Richardson C, Wright EN, Bittner C. Pathway to Healing and Recovery: Alleviation of Survivor Worries in Sexual Assault Nurse Examiner-Led Sexual Assault Telehealth Examinations. J Emerg Nurs 2022; 48:709-718. [PMID: 35970605 DOI: 10.1016/j.jen.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The purpose of this study is to understand the pre-examination worries of individuals who experience sexual assault, and whether those worries were experienced or resolved during a telehealth-enabled, sexual assault nurse examiner-led sexual assault examination. METHODS Patient surveys were administered to understand pre-examination worries, whether those worries were ultimately experienced during the consultation, and patient perceptions of care quality, telehealth consultation, and whether the examination helped individuals feel better. Data analysis was conducted using descriptive statistics and binomial proportion tests. RESULTS Surveys were collected from 74 adolescents and adults who obtained sexual assault care at 6 rural and 2 suburban hospitals. Study findings showed individuals overcome substantial worries to access care, with 66% having at least 1 worry and 41% endorsing 3 or more pre-examination worries. Most participants felt believed (83%) and did not feel judged (88%) or blamed (85%) during their examination. Analysis of pre-examination worries and worry resolution during the examination showed 88% to 100% resolution of worries related to being believed, judged, blamed or lacking control. Participants highly rated the quality of care received (92%) and 84% stated the examination helped them feel better, suggesting a sexual assault nurse examiner-led examination is an important step toward recovery and healing. DISCUSSION These findings have implications for emergency department support for sexual assault nurse examiner-led care and public health messaging to demystify sexual assault care, allay fears, and highlight care benefits.
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Morris A, Goletz S, Friona J. Indiana Sexual Assault Nurse Examiner Training Initiative: Positive Impacts for Medical Forensic Care. JOURNAL OF FORENSIC NURSING 2022; 18:146-155. [PMID: 35271529 DOI: 10.1097/jfn.0000000000000383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Indiana ranks among the highest in the nation for child abuse and neglect reports. Already facing a persistent shortage of sexual assault nurse examiners (SANEs) to serve patients across the life span, residents with medical forensic needs were often being referred to other hospitals across the state for care or simply were not receiving medical forensic examinations because of lack of access to trained examiners. The Indiana SANE Training Project was established to evaluate the forensic nursing workforce throughout Indiana and work to expand access to qualified SANEs through training and collaboration with stakeholders, with a focus on rural and underserved areas of the state. METHODS The Project gathered information from nurses who participated in activities during the first Project year. This information was evaluated for service gaps and ongoing training needs. The project coordinator then convened a workgroup of stakeholders and subject matter experts to evaluate and respond to the most immediate need-limited access to pediatric medical forensic providers. RESULTS From September 2018 to December 2019, nurses were trained by the Project ( n = 160). Of those, 86% indicated that their hospital did not provide medical forensic examinations to pediatric patients. The Pediatric SANE Intensive was launched in October 2020 and trained pediatric SANEs ( n = 28). Upon completion, participants reported 47% increase in confidence and 56% increase in competence related to caring for pediatric patients. DISCUSSION Statewide collaboration is a critical component of establishing a consistent approach to care, strengthening multidisciplinary partnerships, increasing access to medical forensic services across the life span and in rural and underserved areas, and promoting the Indiana Guidelines for Medical Forensic Examination of Pediatric Sexual Abuse Patients.
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Affiliation(s)
| | | | - Jane Friona
- Author Affiliations: University of Southern Indiana
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Petersilge CA, McDonald J, Bishop M, Yudkovitch L, Treuting C, Towbin AJ. Visible Light Imaging: Clinical Aspects with an Emphasis on Medical Photography-a HIMSS-SIIM Enterprise Imaging Community Whitepaper. J Digit Imaging 2022; 35:385-395. [PMID: 35146611 PMCID: PMC9156602 DOI: 10.1007/s10278-022-00584-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 12/29/2021] [Accepted: 12/31/2021] [Indexed: 12/15/2022] Open
Abstract
Photodocumentation is a subset of visible light imaging and is an important growing segment of enterprise imaging. Medical videography is another subset of visible light imaging that shares many of the challenges of photodocumentation. Medical photographs are used to document clinical conditions, support diagnosis, guide, and document procedures and to enable collaboration among colleagues. They also play a significant role in patient engagement and are a mechanism for patients to share information with their provider without the need for a clinical office visit. The content of medical photographs raises issues for acquisition, management, storage, and access. Medical photographs may contain protected health information, and these images benefit from the standardized, secure processes inherent in any enterprise imaging program. The ability to securely acquire images on mobile, and sometimes personally owned devices, is a necessity. In addition to containing protected health information, photograph content can be sensitive or gruesome or the images may be used for forensic purposes. These types of images require additional protections. Access to these images should be role-based and auditable. To properly identify photographs and to convey information about their acquisition parameters new metadata requirements and mechanisms for its association with the imaging files are evolving. Institutional policies need to be developed to define the organization's requirements for medical photography, including consent processes. Existing policies such as those defining the designated record set and legal health record should address the management of medical photography.
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Affiliation(s)
- Cheryl A Petersilge
- UPMC Department of Radiology, 200 Lothrop Street, UPMC Montefiore, Room NE 538, PA, Pittsburgh, 15213, USA.
| | | | - Matthew Bishop
- Enterprise Solutions Architect - Imaging, UnityPoint Health, Bettendorf, IA, USA
| | | | - Caitlin Treuting
- Clinical Photography, Cincinnati Children's Hospital, 3333 Burnet Avenue, MLC 5013, Cincinnati, OH, 45229, USA
| | - Alexander J Towbin
- Department of Radiology, Cincinnati Children's Hospital, University of Cincinnati College of Medicine, 3333 Burnet Avenue, MLC 5013, OH, 45229, Cincinnati, USA
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Tiry E, Zweig J, Walsh K, Farrell L, Yu L. Beyond Forensic Evidence: Examining Sexual Assault Medical Forensic Exam Mechanisms that Influence Sexual Assault Case Outcomes. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP5693-NP5727. [PMID: 32990160 DOI: 10.1177/0886260520961870] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Despite the widespread use of sexual assault medical forensic exams (SAMFEs), practitioners and researchers continue to debate the role of SAMFEs and the evidence they provide in the investigation and prosecution of sexual assault cases. Using data from a review of sexual assault cases reported to police between 2015 and 2017 in two jurisdictions (n = 534), we use logistic regression examine whether the presence of a SAMFE predicts the likelihood of achieving criminal case processing outcomes and whether the relationship of the SAMFE with criminal case processing outcomes is moderated by other legal and extralegal case characteristics. We did not find evidence that the presence of a SAMFE in a case significantly predicts whether a suspect will be identified, arrested, or convicted overall, but we did find evidence of the SAMFE's injury documentation value for arrest. Researchers and practitioners should account for the multiple ways SAMFEs can influence decision-making in future research and policymaking.
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Affiliation(s)
- Emily Tiry
- Urban Institute, Washington, DC, United States
| | | | - Kelly Walsh
- Urban Institute, Washington, DC, United States
| | | | - Lilly Yu
- Harvard University, Cambridge, MA, United States
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Downing NR, Adams M, Bogue RJ. Factors Associated With Law Enforcement Reporting in Patients Presenting for Medical Forensic Examinations. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP3269-NP3292. [PMID: 32779504 DOI: 10.1177/0886260520948518] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Law enforcement reporting following sexual assault is lower than for other violent crimes. Sexual assault nurse examiners (SANEs) provide care for patients in the acute period following sexual assault and are well-positioned to identify and address barriers to reporting. We examined data from medical forensic examination records documented by SANEs for a 5-year period (2011-2015). We examined 347 records of women 18 and older to identify factors associated with law enforcement reporting at the time of the exam using binomial logistic regression to construct odds ratios (OR). A total of 56.5% of patients in the sample reported to law enforcement. Patients who did not voluntarily consume alcohol were more likely to report than those who did (OR = 4.45; p = .001). Patients who were not students were more likely to report than students (OR = 3.24; p = .002). Patients who had a medical forensic exam within 32 hr of the assault were more likely to report than those having exams after 32 hr (OR = 2.68; p = .007). Patients who had anogenital and/or bodily injuries were more likely to report than those who had no injuries (OR = 2.50; p = .008). Patients who were penetrated (vaginally, orally, and/or anally) were more likely to report than those who were not penetrated (OR = 2.50; p = .056). Knowing the assailant, having multiple assailants, and patient and assailant race/ethnicity were not associated with different likelihood of reporting to law enforcement. SANEs and others who work with victims of sexual assault can use data to understand and address barriers to reporting.
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Abstract
BACKGROUND Forensic nursing is a specialty deployed in patient care areas, including emergency departments, intensive care units, labor and delivery suites, and psychiatric units treating persons who have suffered trauma from a violent or criminal act. The recognition of violence-related injuries in patients presenting to health care facilities is critical to an appropriate care trajectory. These patients require specialized resources beyond the treatment of physical injuries to include psychosocial and legal care that supports patient recovery and pursuit of criminal justice. OBJECTIVE The purpose of this study is to obtain a broad view of current forensic knowledge and training for emergency nurses working in U.S. emergency departments and to identify gaps in nursing skills and practice such that appropriate education can be developed for this nursing specialty. METHODS The study was conducted using a quantitative exploratory, descriptive approach via an emailed cross-sectional survey sent to a convenience sample of U.S. emergency nurses. RESULTS A total of 43,775 emails were sent out to members of the Emergency Nurses Association. Of that group, 2,493 recipients opened the email, and 1,824 completed the survey, resulting in a total response rate of 4% and a 73% response rate from those who opened the email. Few respondents self-reported competence in the care of patients who experienced child abuse (13.1%), elder abuse (12.4%), interpersonal violence (17.6%), sexual assault (19.2%), human trafficking (7.4%), developmental challenges (7.2%), strangulation (12.5%), or who were suspected of committing a violent crime (11.4%). CONCLUSIONS There is a compelling need to expand forensic education to advance knowledge and skill acquisition in emergency nursing practice and provide staff with additional resources that support a holistic trauma-informed approach to patient care.
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Colbert AM, Sekula LK. A Major Investment in the United States Sexual Assault Nurse Examiner Workforce. JOURNAL OF FORENSIC NURSING 2022; 18:1-3. [PMID: 35170880 DOI: 10.1097/jfn.0000000000000375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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Bracewell TE, Greenwood LM. Child Sexual Assault Nurse Examinations and Prosecutorial Decisions to Accept or Reject Cases of Child Sexual Abuse. JOURNAL OF FORENSIC NURSING 2021; 17:E10-E17. [PMID: 34432403 DOI: 10.1097/jfn.0000000000000328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Prosecution of child sexual abuse (CSA) cases provides safety for communities and justice for victims. Prosecutorial decisions are multifactorial and include the presence of a structured coordinated community response to outcries and access to skilled healthcare providers. This study examines the impact forensic nurse sexual assault examinations (SAEs) have on prosecution in a population of children seen at a child advocacy center (CAC). METHODS The authors examined case data from 553 cases of reported CSA, seen by a forensic nurse in a CAC. RESULTS Statistical analysis focused on prosecution decisions with and without SAE, with and without physical findings. Logistic regression determined prosecution occurred more often when SAE had been conducted (p = 0.026, OR = 1.732, 95% CI [1.068, 2.808]), regardless of examination findings. LIMITATIONS The limitations include a single location for data and the multifactorial reasons for prosecution of cases. DISCUSSION The multifactorial elements contributing to prosecutorial decisions are diverse. The formalized approaches in CACs historically show increased prosecution. Teasing out the impact of an SAE in a CAC may be reflective of positive CAC approaches. Regardless, a statistically significant finding of association uniquely with the SAE, with or without findings, implies more studies are needed to support the role of the forensic nurse in successful prosecutions of CSA cases.
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Lechner M, Bell K, Short NA, Martin SL, Black J, Buchanan JA, Reese R, Ho JD, Reed GD, Platt M, Riviello R, Rossi C, Nouhan P, Phillips C, Bollen KA, McLean SA. Perceived Care Quality Among Women Receiving Sexual Assault Nurse Examiner Care: Results From a 1-Week Postexamination Survey in a Large Multisite Prospective Study. J Emerg Nurs 2021; 47:449-458. [PMID: 33516463 DOI: 10.1016/j.jen.2020.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 11/04/2020] [Accepted: 11/24/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION This study examined the perspectives of female patients who had been sexually assaulted regarding the quality of care provided by sexual assault nurse examiners, including whether the patients' perspectives varied by their demographic characteristics and health status before the assault. METHODS A total of 695 female patients who received care from sexual assault nurse examiners at 13 United States emergency care centers and community-based programs completed standardized surveys 1 week after receiving sexual assault nurse examiners' care for sexual assault. RESULTS Most patients strongly agreed that the sexual assault nurse examiners provided high-quality care, including taking patients' needs/concerns seriously, not acting as though the assault was the patient's fault, showing care/compassion, explaining the sexual assault examination, and providing follow-up information. The perceptions did not vary by the patients' demographic characteristics or preassault health status. DISCUSSION Female patients who had been sexually assaulted and who were evaluated at 13 widely geographically distributed sexual assault nurse examiners' programs consistently reported that the sexual assault nurse examiners provided high-quality, compassionate care.
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Baert S, Gilles C, Van Belle S, Bicanic I, Roelens K, Keygnaert I. Piloting sexual assault care centres in Belgium: who do they reach and what care is offered? Eur J Psychotraumatol 2021; 12:1935592. [PMID: 34367523 PMCID: PMC8317926 DOI: 10.1080/20008198.2021.1935592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sexual assault (SA) is highly prevalent in Belgium. In order to mitigate the negative consequences for victims of acute SA, Sexual Assault Care Centres (SACCs) were piloted from October 2017 to October 2018 in three Belgian hospitals. SACCs offer medical and psychological care, forensic examination and the possibility to report to the police at the SACC. OBJECTIVE Aiming to improve SACC services, we quantitatively assessed the number and characteristics of victims attending the SACC, the SA they experienced, and the care they received over 12 months upon admission. METHOD Data on victims presenting at the SACC were routinely collected in electronic patient files by the SACC personnel between 25 October 2017 and 31 October 2019. These data were analysed in IBM SPSS Statistics 25. RESULTS Within the first year 931 victims attended the SACCs. Mean age was 24.5 years (SD = 12.8), and one-third were under 18. The majority were female (90.5%) and 63.1% presented for rape. About one-third of the victims were considered vulnerable due to previous SA (35.6%), prior psychiatric consultation (38.7%) or disability (8.5%). The assailant was known to the victim in 59.2% of the cases. Of all SACC presentations, 35.2% self-referred to the SACC while 40.9% were referred by the police. Two out of three victims attended the SACC within 72 h post-assault. Respectively 74.7% of victims received medical care, 60.6% a forensic examination, 50.2% psychological care, and 68.7% reported to the police. CONCLUSION Despite the absence of promotion campaigns, the SACCs received a high number of victims during the pilot year. Use of acute and follow-up services was high, although new approaches to offer more accessible psychological support should be explored. The big proportion of vulnerable victims warrants careful monitoring and adaptation of care pathways.
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Affiliation(s)
- Saar Baert
- Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Christine Gilles
- Department of Obstetrics and Gynecology, Saint-Pierre University Hospital Brussels, Brussels, Belgium
| | - Sara Van Belle
- Department of Public Health, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Iva Bicanic
- National Psychotrauma Center for Children and Youth, University Medical Center, Utrecht, The Netherlands
| | - Kristien Roelens
- Department of Human Structure and Repair, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Ines Keygnaert
- Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent University, Ghent, Belgium
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Abstract
PURPOSE Sexual assault care provided by sexual assault nurse examiners (SANEs) is associated with improved health and prosecutorial outcomes. Upon completion of SANE training, nurses can demonstrate their experience and expertise by obtaining SANE certification. Availability of nurses with SANE training or certification is often limited in rural areas, and no studies of rural certified SANEs exist. The purpose of this study is to describe rural SANE availability. METHODS We analyze both county-level and hospital-level data to comprehensively examine SANE availability. We first describe the geographic distribution of certified SANEs across rural and nonrural (ie, urban or suburban) Pennsylvania counties. We then analyze hospital-level data from semistructured interviews with rural hospital emergency department administrators using qualitative content analysis. FINDINGS We identified 49 certified SANEs across Pennsylvania, with 24.5% (n = 12) located in 8 (16.7%) of Pennsylvania's 48 rural counties. The remaining 37 certified SANEs (75.5%) were located in 13 (68.4%) of Pennsylvania's 19 nonrural counties. Interview data were collected from 63.9% of all eligible rural Pennsylvania hospitals (n = 63) and show that 72.5% (n = 29) have SANEs. Of these, 20.7% (n = 6) have any certified SANE availability. A minority of hospitals (42.5%; n = 17) have continuous SANE coverage. CONCLUSIONS Very few SANEs in rural Pennsylvania have certification, suggesting barriers to certification may exist for rural SANEs. Though a majority of hospitals have SANEs, availability of SANEs was limited by inconsistent coverage. A lack of certified SANEs and inconsistent SANE coverage may place rural sexual assault victims at risk of receiving lower quality sexual assault care.
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Affiliation(s)
- Elizabeth Thiede
- College of Nursing, Pennsylvania State University, University Park, Pennsylvania
| | - Sheridan Miyamoto
- College of Nursing, Pennsylvania State University, University Park, Pennsylvania
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Nathan S, Ferrara M. An Innovative Trauma-Informed Curriculum for Sexual Assault Care. J Nurs Educ 2020; 59:336-340. [DOI: 10.3928/01484834-20200520-07] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 01/17/2020] [Indexed: 11/20/2022]
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Garza AD, Franklin CA. The Effect of Rape Myth Endorsement on Police Response to Sexual Assault Survivors. Violence Against Women 2020; 27:552-573. [PMID: 32241227 DOI: 10.1177/1077801220911460] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The current study used a purposive sample of 517 surveys administered to police officers at one of the five largest and most diverse U.S. cities to assess police adherence to rape myths, while considering demographic, occupational, and neurocognitive predictors. This study also examined rape myth endorsement and self-reported levels of preparedness in responding to sexual assault calls for service. Officer sex and impulsivity were significant predictors of rape myth endorsement. In addition, rape myth endorsement decreased preparedness, whereas prior specialized sexual assault training increased preparedness. Implications for policy, practice, and future research are discussed.
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Chandramani A, Dussault N, Parameswaran R, Rodriguez J, Novack J, Ahn J, Oyola S, Carter K. A Needs Assessment and Educational Intervention Addressing the Care of Sexual Assault Patients in the Emergency Department. JOURNAL OF FORENSIC NURSING 2020; 16:73-82. [PMID: 32433191 PMCID: PMC7868113 DOI: 10.1097/jfn.0000000000000290] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Emergency department (ED) providers serve as the primary point-of-contact for many survivors of sexual assault but are often ill-prepared to address their unique treatment needs. Sexual assault nurse examiners (SANEs) are therefore an important resource for training other ED providers. The objective of this project was to create a SANE-led educational intervention addressing this training gap. We achieved this objective by (a) conducting a needs assessment of ED providers' self-reported knowledge of, and comfort with, sexual assault patient care at an urban academic adult ED and, (b) using these results to create and implement a SANE-led educational intervention to improve emergency medicine residents' ability to provide sexual assault patient care. From the needs assessment survey, ED providers reported confidence in medical management but not in providing trauma-informed care, conducting forensic examinations, or understanding hospital policies or state laws. Less than half of the respondents felt confident in their ability to avoid retraumatizing sexual assault patients, and only 29% felt comfortable conducting a forensic examination. On the basis of these results, a SANE-led educational intervention was developed for emergency medicine residents, consisting of a didactic lecture, two standardized patient cases, and a forensic pelvic examination simulation. Preintervention and postintervention surveys showed an increase in respondents' self-perceived ability to avoid retraumatizing patients, comfort with conducting forensic examinations, and understanding of laws and policies. These results show the value of an interprofessional collaboration between physicians and SANEs to train ED providers on sexual assault patient care.
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Affiliation(s)
- Ayushi Chandramani
- Pritzker School of Medicine, University of Chicago
- Emergency Medicine Residency, Icahn School of Medicine at Mount Sinai
| | | | - Ramya Parameswaran
- Pritzker School of Medicine, University of Chicago
- Medical Scientist Training Program, University of Chicago
| | | | | | - James Ahn
- Department of Medicine, University of Chicago
| | - Sonia Oyola
- Pritzker School of Medicine, University of Chicago
- Department of Family Medicine, University of Chicago
| | - Keme Carter
- Pritzker School of Medicine, University of Chicago
- Department of Medicine, University of Chicago
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Henninger AL, Iwasaki M, Carlucci ME, Lating JM. Reporting Sexual Assault: Survivors' Satisfaction With Sexual Assault Response Personnel. Violence Against Women 2019; 26:1362-1382. [PMID: 31339469 DOI: 10.1177/1077801219857831] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although jurisdictions have attempted to improve their response procedures, sexual assault cases are often insufficiently investigated. This study examines the survey responses of 460 female sexual assault survivors regarding their experiences with response personnel. Overall satisfaction with response services was 66.1%. Victim advocates and forensic nurses received higher satisfaction ratings than did patrol officers, detectives, and State's Attorney's Office staff. The present study also found that 65% of the variance in overall satisfaction was accounted for by four personnel behaviors: respectful treatment, clearly explained procedures, believed their stories, and demonstrated cultural sensitivity. Policy implications and suggestions for future research are discussed.
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Hegarty K, Tarzia L. Identification and Management of Domestic and Sexual Violence in Primary Care in the #MeToo Era: an Update. Curr Psychiatry Rep 2019; 21:12. [PMID: 30734100 DOI: 10.1007/s11920-019-0991-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE OF REVIEW We discuss recent evidence around the identification and response to domestic and sexual violence in primary care for perpetrators and victims, in the context of feminist social media movements such as #MeToo. RECENT FINDINGS There is no recent research on identification and response to perpetrators in health settings. There is some limited recent evidence for how health settings can address domestic and sexual violence for female victims and their children. Recent studies of mixed quality focus on advocacy and empowerment, integrated interventions (with alcohol and drug misuse) and couples counselling for domestic violence and cognitive behavioural or processing therapy for sexual violence. Further research on perpetrator interventions in primary care is urgent. Larger sample sizes and a focus on sexual violence are needed to develop the evidence base for female survivors. Clinicians need to ask about violence and provide a first-line response depending on the patient's needs.
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Affiliation(s)
- Kelsey Hegarty
- Department of General Practice, The University of Melbourne, 200 Berkeley Street, Carlton, Victoria, 3058, Australia. .,Centre for Family Violence Prevention, The Royal Women's Hospital, Parkville, Australia.
| | - Laura Tarzia
- Department of General Practice, The University of Melbourne, 200 Berkeley Street, Carlton, Victoria, 3058, Australia.,Centre for Family Violence Prevention, The Royal Women's Hospital, Parkville, Australia
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Trentin D, Vargas MADO, Lino MM, Leal SMC, Ferreira ML, Saioron I. Women care in situations of sexual violence: an integrative literature review. ESCOLA ANNA NERY 2019. [DOI: 10.1590/2177-9465-ean-2018-0324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Objective: to identify Brazilian and international scientific evidence about women in situation of sexual violence service by a multidisciplinary health team. Method: an integrative literature review carried out in four databases and in a digital library, with the following inclusion criteria: type of study, language and temporal cut. The final sample consisted of 34 studies. Results: nine categories emerged: service network; teamwork; health professional in the service network; qualification and training; comprehensiveness; protocols; services; access to services and support from managers. They were organized into potentialities, demands and weaknesses, constituting elements necessary for assistance effectiveness by the multidisciplinary team to women in situation of sexual violence. Conclusion an Implications for practice: despite the potential of providing women care in situations of sexual violence, weaknesses stand out as an incipient and inexistent articulation of the intersectoral care network, generating demands for the networks’ construction, articulation and sustainability. In addition, professional qualification and support of managers in the performance of public policies make possible care comprehensiveness, updates and service evidence.
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Meunier-Sham J, Preiss RM, Petricone R, Re C, Gillen L. Laying the Foundation for the National TeleNursing Center: Integration of the Quality-Caring Model Into TeleSANE Practice. JOURNAL OF FORENSIC NURSING 2019; 15:143-151. [PMID: 31436682 DOI: 10.1097/jfn.0000000000000252] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In 2012, the Massachusetts Department of Public Health Sexual Assault Nurse Examiner (SANE) Program was awarded a grant from the Department of Justice, Office for Victims of Crime, to pilot the use of telemedicine technology to extend the reach of SANE expertise to six diverse communities across the United States. To meet the goals of this project, the National TeleNursing Center (NTC) developed a three-phase professional practice model integrating the Quality-Caring Model (QCM) to support the delivery of NTC teleSANE services. Using the QCM as a foundation for teleSANE practice ensures that patients experiencing a recent sexual assault who participate in teleSANE encounters receive quality forensic nursing care. In this article, we briefly review elements of the QCM, describe the application of the model to the NTC Professional Practice Model, and detail how teleSANEs integrate the QCM Caring Behaviors into all three phases of its model. The NTC Professional Practice Model provides a quality-based teleSANE model that may be translatable to other areas of telenursing practice.
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Affiliation(s)
- Joan Meunier-Sham
- Author Affiliations: The National TeleNursing Center, Newton Wellesley Hospital
- Massachusetts Department of Public Health Sexual Assault Nurse Examiner Program
| | - Rachel M Preiss
- Author Affiliations: The National TeleNursing Center, Newton Wellesley Hospital
- Massachusetts Department of Public Health Sexual Assault Nurse Examiner Program
| | - Randi Petricone
- Author Affiliations: The National TeleNursing Center, Newton Wellesley Hospital
- Massachusetts Department of Public Health Sexual Assault Nurse Examiner Program
| | - Cheryl Re
- Author Affiliations: The National TeleNursing Center, Newton Wellesley Hospital
- Massachusetts Department of Public Health Sexual Assault Nurse Examiner Program
| | - Leah Gillen
- Author Affiliations: The National TeleNursing Center, Newton Wellesley Hospital
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Walsh WA, Meunier-Sham J, Re C. Using Telehealth for Sexual Assault Forensic Examinations: A Process Evaluation of a National Pilot Project. JOURNAL OF FORENSIC NURSING 2019; 15:152-162. [PMID: 31436683 DOI: 10.1097/jfn.0000000000000254] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
INTRODUCTION This project describes the first time live sexual assault nurse examiner (SANE) services were provided via telehealth to support site clinicians conducting sexual assault forensic medical examinations for adult and adolescent patients. It involved six sites in three states, including rural, tribal, military, and community hospitals. The purpose of this process evaluation was to determine the extent to which patients consent to telehealth technology, examine how the technology worked, and explore the types of assistance. METHODS We reviewed information for sexual assault patients who presented at emergency departments (N = 215) and conducted telephone and online surveys with 178 clinicians who provided or received telehealth services. RESULTS Between May 1, 2015, and March 31, 2018, 129 patients and site clinicians received services via telehealth and an additional 86 site clinicians received consultation advice via telehealth. Most patients consented and accepted SANE services via telehealth (86% overall and 97% in non-U.S. Navy sites). No significant technology problems were experienced for most interactions (92%). The assistance provided remotely by SANEs to site clinicians included guiding clinicians through history taking and documentation, forensic examination and evidence collection techniques, identifying and documenting injuries, and guiding clinical practice. Site clinicians reported, on average, a positive impact of the assistance on their confidence in providing an effective examination, their ability to provide their patient with the best care, and their sense of feeling supported. IMPLICATION Results of this pilot suggest that using live telehealth services for sexual assault forensic examinations is a promising practice.
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Affiliation(s)
- Wendy A Walsh
- Author Affiliations: Crimes Against Children Research Center, University of New Hampshire
| | | | - Cheryl Re
- Massachusetts SANE Program, MA Department of Public Health
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Hansen NB, Hansen M, Campbell R, Elklit A, Hansen OI, Bramsen RH. Are rape cases closed because of rape stereotypes? Results from a Danish police district. NORDIC PSYCHOLOGY 2018. [DOI: 10.1080/19012276.2018.1470552] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- N. B. Hansen
- National Centre for Psychotraumatology, ThRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - M. Hansen
- ThRIVE, Department of Psychology, University of Southern Denmark, Odense, MI, Denmark
| | - R. Campbell
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - A. Elklit
- National Centre for Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - O. I. Hansen
- Institute of Forensic Medicine, Section of Clinical Forensic Medicine, University of Aarhus, Aarhus, Denmark
- The Sexual Assault Centre, Aarhus University Hospital, Aarhus, Denmark
| | - R. H. Bramsen
- ThRIVE, Department of Psychology, University of Southern Denmark, Odense, MI, Denmark
- The Sexual Assault Centre, Aarhus University Hospital, Aarhus, Denmark
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26
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Affiliation(s)
- Lisa Long
- The Haven Camberwell; King's College Hospital; London SE5 9RS UK
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27
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McGilloway C, Smith D, Galvin R. Barriers faced by adults with intellectual disabilities who experience sexual assault: A systematic review and meta‐synthesis. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018. [DOI: 10.1111/jar.12445] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Connie McGilloway
- Donegal Sexual Assault Treatment Unit Letterkenny University Hospital Donegal Ireland
| | - David Smith
- Department of General Practice Royal College of Surgeons in Ireland Dublin Ireland
| | - Rose Galvin
- Faculty of Education and Health Sciences School of Allied Health Health Research Institute University of Limerick Limerick Ireland
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McNair KT, Fantasia HC, Harris AL. Sexual Misconduct Policies at Institutes of Higher Education: An Integrative Review. JOURNAL OF FORENSIC NURSING 2018; 14:238-247. [PMID: 30433911 DOI: 10.1097/jfn.0000000000000216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Although federal legislation designed to advance sexual misconduct policies at institutes of higher education (IHEs) has been in effect for decades, recent national attention has put more pressure on IHEs to combat sexual violence on their campuses. Thus, the past few years have yielded significant research that examines federal compliance, dissemination, and perception of IHE sexual misconduct policies. This integrative review was conducted to assess sexual misconduct policies in the United States and the potential to prevent and combat sexual violence at IHEs through these policies. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and using a quality assessment tool to ensure rigor, eight studies were synthesized. Findings indicate that IHE sexual misconduct policies vary widely and that most IHEs lack transparent, legislation-compliant policies. There remains a need for research examining the association between sexual misconduct policy, campus climate, and students' behavior, so as to better inform future sexual misconduct interventions and IHE policies. Forensic nurses may be key stakeholders in policy development that is currently missing from the literature.
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Affiliation(s)
| | - Heidi Collins Fantasia
- Zuckerberg College of Health Sciences, Susan and Alan Solomont School of Nursing, University of Massachusetts Lowell
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Shaw J, Campbell R, Cain D. The View from Inside the System: How Police Explain Their Response to Sexual Assault. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2016; 58:446-462. [PMID: 27753117 PMCID: PMC6585754 DOI: 10.1002/ajcp.12096] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Prior research has documented the problematic community response to sexual assault: the majority of sexual assaults reported to police are never prosecuted. Social dominance theory suggests that this response is a form of institutional discrimination, intended to maintain existing social structures, and that police personnel likely draw upon shared ideologies to justify their decision-making in sexual assault case investigations. This study drew upon social dominance theory to examine how police justified their investigatory decisions to identify potential leverage points for change. The study revealed that the likelihood of a case referral to the prosecutor increased with each additional investigative step completed; of the different types of justifications provided by police for a less-than-thorough investigative response and stalled case, blaming the victim for the poor police investigation proved to be the most damaging to case progression; and the type of explanation provided by police was impacted by specific case variables. As suggested by social dominance theory, the study demonstrates that police rely on several different mechanisms to justify their response to sexual assault; implementing criminal justice system policies that target and interrupt these mechanisms has the potential to improve this response, regardless of specific case factors.
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Affiliation(s)
- Jessica Shaw
- Boston College School of Social WorkChestnut HillMAUSA
| | - Rebecca Campbell
- Department of PsychologyMichigan State UniversityEast LansingMIUSA
| | - Debi Cain
- Michigan Domestic and Sexual Violence Prevention and Treatment BoardLansingMIUSA
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30
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Nathanson D, Woolfenden S, Zwi K. Is there a role for paediatric Sexual Assault Nurse Examiners in the management of child sexual assault in Australia? CHILD ABUSE & NEGLECT 2016; 59:13-25. [PMID: 27490516 DOI: 10.1016/j.chiabu.2016.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 06/01/2016] [Accepted: 07/18/2016] [Indexed: 06/06/2023]
Abstract
In Australia, paediatricians and Child Protection Specialists provide the medical and forensic examinations of child victims of sexual assault. There are workforce challenges in the recruitment and retention of doctors to undertake child sexual assault (CSA) work particularly in remote and rural areas. Pediatric Sexual Assault Nurse Examiner (PSANE) programs have existed in the USA and the UK for many years. Using Rapid Evidence Assessment (REA) methodology, a systematic search of the literature was performed to ascertain what is known about SANE programs, to evaluate the evidence for their effectiveness across a number of domains (accessibility, health and legal outcomes and cost effectiveness) and to inform policy on models of care and elements of best practice which may be appropriate for local implementation in Australia. This review showed that despite the limited evidence available and significant gaps in the evidence, SANEs provide a high standard of medical care and are not detrimental to the legal process. By providing recommendations regarding the potential value, effectiveness and feasibility of establishing a PSANE program in Australia, this article may be of interest to other high income countries facing similar workforce challenges in meeting the needs of children with alleged sexual assault.
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Affiliation(s)
- Dania Nathanson
- Sydney Children's Hospitals Network, c/o Department of Community Child Health, Sydney Children's Hospital, Cnr Avoca and Barker Streets, Randwick, NSW 2031, Australia.
| | - Susan Woolfenden
- Sydney Children's Hospitals Network, c/o Department of Community Child Health, Sydney Children's Hospital, Cnr Avoca and Barker Streets, Randwick, NSW 2031, Australia; UNSW School of Women's and Children's Health, c/o Department of Community Child Health, Sydney Children's Hospital, Cnr Avoca and Barker Streets, Randwick, NSW 2031, Australia.
| | - Karen Zwi
- Sydney Children's Hospitals Network, c/o Department of Community Child Health, Sydney Children's Hospital, Cnr Avoca and Barker Streets, Randwick, NSW 2031, Australia; UNSW School of Women's and Children's Health, c/o Department of Community Child Health, Sydney Children's Hospital, Cnr Avoca and Barker Streets, Randwick, NSW 2031, Australia.
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31
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Valentine JL, Shaw J, Lark A, Campbell R. Now We Know: Assessing Sexual Assault Criminal Justice Case Processing in an Urban Community Using the Sexual Assault Nurse Practitioner Evaluation Toolkit. JOURNAL OF FORENSIC NURSING 2016; 12:133-140. [PMID: 27496646 DOI: 10.1097/jfn.0000000000000115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Campbell and colleagues developed an evaluation Toolkit for use by sexual assault nurse examiners (SANEs) to assess criminal case outcomes in adult sexual assault cases seen by SANE programs (Campbell, Townsend, Shaw, Karim, & Markowitz, 2014; Campbell, Bybee, et al., 2014). The Toolkit provides step-by-step directions and an easy-to-use statistical program. This study describes implementation of the Toolkit in Salt Lake County, the first site outside the pilot sites to utilize the program. The Toolkit revealed that, in Salt Lake County from 2003 to 2011, only 6% of adult sexual assault cases were successfully prosecuted. These findings prompted multiple community discussions, media attention, and a call to action to improve the investigation and prosecution of adult sexual assault cases. The primary purpose of this case report is to encourage other SANE teams and communities to use the Toolkit by sharing the successful experience of Salt Lake County in implementing the Toolkit.Video Abstract available for additional insights from Dr. Valentine (see Supplemental Digital Content 1, http://links.lww.com/JFN/A19).
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Affiliation(s)
- Julie L Valentine
- Author Affiliations:1Brigham Young University College of Nursing, Duquesne University School of Nursing; 2Boston College School of Social Work; 3Salt Lake Sexual Assault Nurse Examiners; and 4Department of Psychology, Michigan State University
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Campbell R, Townsend SM, Shaw J, Karim N, Markowitz J. Can a workbook work? Examining whether a practitioner evaluation toolkit can promote instrumental use. EVALUATION AND PROGRAM PLANNING 2015; 52:107-117. [PMID: 25996627 DOI: 10.1016/j.evalprogplan.2015.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Revised: 04/24/2015] [Accepted: 04/29/2015] [Indexed: 06/04/2023]
Abstract
In large-scale, multi-site contexts, developing and disseminating practitioner-oriented evaluation toolkits are an increasingly common strategy for building evaluation capacity. Toolkits explain the evaluation process, present evaluation design choices, and offer step-by-step guidance to practitioners. To date, there has been limited research on whether such resources truly foster the successful design, implementation, and use of evaluation findings. In this paper, we describe a multi-site project in which we developed a practitioner evaluation toolkit and then studied the extent to which the toolkit and accompanying technical assistance was effective in promoting successful completion of local-level evaluations and fostering instrumental use of the findings (i.e., whether programs directly used their findings to improve practice, see Patton, 2008). Forensic nurse practitioners from six geographically dispersed service programs completed methodologically rigorous evaluations; furthermore, all six programs used the findings to create programmatic and community-level changes to improve local practice. Implications for evaluation capacity building are discussed.
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Affiliation(s)
- Rebecca Campbell
- Department of Psychology, Michigan State University, 127 C Psychology Building, East Lansing, MI 48824-1116, United States.
| | - Stephanie M Townsend
- Townsend Consulting & Evaluation, 8 Locke Drive, Pittsford, NY 14534, United States.
| | | | - Nidal Karim
- CARE USA, 151 Ellis Street, NE, Atlanta, GA 30303, United States.
| | - Jenifer Markowitz
- Forensic Nurse Consultant, 2308 Mt. Vernon Avenue, Suite 238, Alexandria, VA 22301, United States.
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33
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Golding JM, Wasarhaley NE, Lynch KR, Lippert A, Magyarics CL. Improving the Credibility of Child Sexual Assault Victims in Court: The Impact of a Sexual Assault Nurse Examiner. BEHAVIORAL SCIENCES & THE LAW 2015; 33:493-507. [PMID: 26294384 DOI: 10.1002/bsl.2188] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The present study investigated the influence of a sexual assault nurse examiner's (SANE's) testimony on mock juror perceptions of a child or adolescent victim of child sexual assault. Community members (N = 252, 156 females) read a fictional criminal trial summary of a child sexual assault case in which the victim was 6 or 15 years old and the prosecution presented medical testimony from a SANE or a traditional registered nurse (RN), or did not present medical testimony. Mock jurors were more likely to render guilty verdicts when a SANE testified compared with the other two testimony conditions. In addition, pro-victim judgments (e.g., sympathy toward the victim) and negative defendant judgments (e.g., anger toward the defendant) mediated this relation. Finally, cognitive network representations of the case demonstrated that the RN and no-medical-testimony groups were similar and the SANE group was distinct from the other two conditions. We discuss these results in terms of the implications of SANE testimony in child sexual assault court cases.
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Affiliation(s)
- Jonathan M Golding
- Department of Psychology, University of Kentucky, Kentucky, KY, United States
| | - Nesa E Wasarhaley
- Department of Psychology, University of Kentucky, Kentucky, KY, United States
| | - Kellie R Lynch
- Department of Psychology, University of Kentucky, Kentucky, KY, United States
| | - Anne Lippert
- Department of Psychology, University of Kentucky, Kentucky, KY, United States
| | - Casey L Magyarics
- Department of Psychology, University of Kentucky, Kentucky, KY, United States
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