Trauma-Informed Research With Emerging Adult Survivors of Sexual Violence

Health researchers have had increasing calls to include vulnerable populations in research to tailor inclusive evidence-based practice interventions. The inclusion of vulnerable populations in research is sensitive and complex. Sensitive topics such as dating and sexual violence are especially complex, with emerging adults the highest risk group for all forms of sexual violence and an especially hard-to-reach population for inclusion in research. Impacts of trauma, including physiological and psychological, complex needs of survivors, and potential for revictimization during interactions when participating in research must be considered. Researchers must be equipped with specialized, trauma-informed skills to safely and ethically conduct all aspects of research. Using the trauma-informed framework, the purpose of this paper is to discuss the complexities of conducting research with emerging adult survivors of sexual violence and to explore evidence-based approaches that can safely include this vulnerable population through the application of trauma-informed approaches. The use of evidence-based, trauma-informed research approaches tailored to engage this population in research can further help to develop effective interventions that are context-sensitive to emerging adults.

Past School Discipline Experiences: Perspectives of Disabled Adults

BACKGROUND

School discipline has potential life-long consequences for students. Disabled youth can be misunderstood and experience harsh discipline and are at increased risk for negative outcomes, yet little research includes their voices. The aim of this study was to explore past school discipline experiences among disabled adults.

METHODS

Disabled adult perspectives (N = 9) regarding past school discipline experiences were explored employing qualitative descriptive methodology framed by the Peace and Power Conceptual Model. Peace-Power versus Power-Over-Powers involve actions/behaviors reflecting critical emancipation or oppression of those in power.

RESULTS

Eight peace-power versus power-over themes emerged: "humiliating," "threatening," "escaping," "observing," "avoiding," "diverging," "isolating," and "failing."

IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY

Disabled students can experience oppressive power-over dynamics separating them from others because they are unable to meet rigid classroom expectations. Educators may lack awareness of structural biases shaping reactions warranting need for school policies and practices promoting restorative justice, social-emotional learning, and inclusion.

CONCLUSIONS

Classroom discipline can represent emancipatory peace-power or oppressive power-over powers. Not all teacher interactions represent 1 power or the other. Future research should focus on including disabled student voices informing school discipline practices. Educators' perspectives of their role fostering inclusive classrooms should also be considered.

Exploring Screening Practices for Child Sexual Abuse in School Settings: An Integrative Review

Child sexual abuse (CSA) is a pervasive public health problem. If left undetected, CSA can result in immediate and long-term health problems, which can be mitigated through early identification. Schools are an ideal environment to implement screening measures, and school nurses (SN) are uniquely poised to intervene and respond early. The aim of this review was to systematically examine and synthesize the international evidence related to screening for early identification of CSA in schools. Themes emerging from the analysis were SN behaviors relative to screening, potential instruments or approaches for screening, and SN and school professionals' beliefs about CSA screening practices. This review found little evidence that CSA screening is occurring in schools. However, SNs are aware that screening falls within their scope of practice and many SNs feel they should be screening for it. A constant proactive approach by SNs is necessary to improve early identification and subsequent intervention.

Confusing Terms: A Concept Analysis of Naming Youth Trafficking

Human trafficking is a growing population health problem. More than half of all persons experiencing trafficking are youth, with many in the United States unrecognized despite experiencing exploitation. Available peer-reviewed articles report a myriad of descriptions of trafficking, yet the concept and operational definition of youth trafficking, specifically, is lacking and unclear. Youth trafficking is described differently across multidisciplinary researchers and clinicians working with trafficked youth. Furthermore, labor trafficking of youth is largely excluded from the conversation surrounding trafficking. This article presents a concept analysis of naming trafficking of persons under the age of 18 years to clarify the concept specific to youth experiencing all forms of trafficking and approaches professionals can take with this specific subpopulation of trafficked persons and survivors.

Obtaining Exposure and Depth of Field: School Nurses "Seeing" Youth Vulnerability to Trafficking

Trafficking of youth is a growing phenomenon. How commercially exploited youth present in schools is multifaceted and poorly understood. Like other providers, school nurses are on the frontlines, yet can misunderstand youth who are commercially exploited. Using Grounded Theory, we employed theoretical sampling with school nurses and survivors of trafficking to generate a theory that explains (a) the factors that increase the risk of youth being trafficked and (b) how school nurses might identify youth at risk of being trafficked. The emerging theory developed from the data was Obtaining Exposure and Depth of Field: School Nurses "Seeing" Youth Vulnerability to Trafficking. Voices of school nurses and survivors illuminated the invisibility of youth in schools who are victims of trafficking and the magnified lens of exploiters who see their vulnerability. The lens of school nurses can be refocused to "see" youth who are victims of trafficking presenting at school.

Systematic Review of Human Trafficking Educational Interventions for Health Care Providers

Human trafficking is a global population health threat. Trafficking minors threatens the safety and well-being of youth. Limited studies measure health care providers’ awareness and attitudes toward trafficking. This systematic review synthesized retrospective and current knowledge and identified gaps in educational interventions aimed at increasing providers’ awareness and attitudes toward trafficking. A systematic search of four databases identified peer-reviewed published papers between January 1, 2000 and September 1, 2018. The Cochrane Collaboration’s Preferred Reporting Items for Systematic Reviews was followed. Study quality was assessed using the Downs and Black checklist. The Psychometric Grading Framework was used to assess the validity of instruments. Findings across studies ( N = 7) reveal providers (mostly social workers and physicians) have low awareness of trafficking and can have negative attitudes toward victims. Multiphase educational approaches and use of content experts, including survivors, in developing interventions enhanced sustainability of outcomes. Targeting multidisciplinary health care teams, including nurses, enhanced interventions.

Appreciating Recent Motherhood and Culture: A Systematic Review of Multimodal Postpartum Lifestyle Interventions to Reduce Diabetes Risk in Women with Prior Gestational Diabetes

Objectives Gestational diabetes mellitus (GDM) substantially increases a woman's lifetime risk of developing type 2 diabetes mellitus (DM). Lifestyle modification interventions have been effective in preventing DM in high-risk populations but present challenges in diverse, postpartum women. We systematically reviewed the literature to synthesize current knowledge and practices around tailoring multimodal, primarily home-based interventions for situational and cultural relevance to reduce DM risk in women with prior GDM. Methods We identified original research articles published from January 2000 through July 2015 describing randomized controlled trials testing multimodal interventions to reduce DM risk in women with prior GDM. We compared articles by study objective, delivery modes, intervention components, degree of individualization, theoretical basis, design, population, outcome variables, and findings. Results Ten studies met the inclusion criteria. Telephone and mailings (n = 7) and websites (n = 3) were the primary modes of participant contact in these primarily home-based interventions. These studies demonstrate that individualizing interventions may contribute to increased postpartum weight loss and improved dietary behaviors; however, researchers remain challenged to improve physical activity in this population. Additionally, even when testing primarily home-based interventions, recruitment rates were very low, underscoring challenges of engaging this population in lifestyle changes. Conclusions Postpartum interventions addressing the broader social-ecological dimensions of health behaviors should be tested in women with prior GDM. Researchers and clinicians must continue to explore ways to engage women, including women's families and communities, in interventions to adequately address the sociocultural determinants that affect women's lifestyle behaviors impacting their DM risk.

The Peace and Power Conceptual Model: An Assessment Guide for School Nurses Regarding Commercial Sexual Exploitation of Children

Human trafficking is a global problem; more than half of all victims are children. In the United States (US), at-risk youth continue to attend school. School nurses are on the frontlines, presenting a window of opportunity to identify and prevent exploitation. Available papers targeting school nurses report that school nurses may lack awareness of commercial sexual exploitation and may have attitudes and misperceptions about behaviors of school children at risk. This is a theoretical paper applying the Peace and Power Conceptual Model to understand the role of school nurses in commercial sexual exploitation of children.

Thoughts about the Name of Our Discipline

This essay addresses the name of our discipline. Discussion of the use of the term, nursology, focuses on the origin of the term, its use as a name for our discipline and its use as a research method and a practice methodology. Advantages and disadvantages of nursology as the name for our discipline are gleaned from PhD program students’ responses to a question posed by Reed (1997).