Academic Safety Planning: Intervening to Improve the Educational Outcomes of Collegiate Survivors of Interpersonal Violence

Washington University in St. Louis

Demonstrated impacts of intimate partner violence (IPV) and sexual assault (SA) for college students include negative outcomes related to mental, physical, emotional, and academic well-being. As a result of increasing awareness of the long-standing epidemic of IPV and SA on college campuses, Institutions of Higher Education (IHEs) are expanding the services provided to survivors of IPV and SA, including campus-based advocacy services that are adapted from community models. Like community advocacy, campusbased advocacy services focus on empowerment, support, resource provision, and addressing safety needs. However, the unique context of higher education produces specific student-centered needs, including an increased focus on educational goals, academic accommodations, and safety planning. The current study seeks to shed new light on the specific foci and tasks of advocacy in the context of IHEs, related to what we call “academic safety planning,” and to highlight the experience of student service recipients utilizing these forms of advocacy. Thematic analysis of 48 qualitative interviews with advocates (n = 23) and service users (n = 25) from five programs at three universities was used to discover practices applied by campus-based advocates and to understand student-survivor needs and preferences within academic safety planning. Findings reveal the core components of academic safety planning, which are: (a) Advocating for emotional and physical safety in the university context, (b) Assessing and identifying needed academic accommodations, and (c) rebuilding connections and institutional trust at school. These interviews reveal that academic safety planning has the potential to enhance the academic outcomes of survivors, which in turn could lead to important improvements in long-term personal safety, wellbeing, and economic security for student-survivors.

Publication
Journal of Interpersonal Violence
Publication Year
2020

Individual and Social Network Correlates of Sexual Health Communication Among Youth Experiencing Homelessness

University of Denver

Despite the potential for sexual health communication to be leveraged for HIV prevention among youth experiencing homelessness (YEH), there has yet to be a rigorous examination of individual and network or relational characteristics associated with sexual health communication in this group of young people. Cross-sectional survey and social network data from 1014 YEH aged 14–25 recruited in Los Angeles, California, were utilized to assess individual and network or relational characteristics associated with communication regarding condom use and HIV testing among YEH. Results suggest that social networks are key to understanding sexual health communication; YEH’s engagement in sexual health communication was significantly related to the composition of their networks. To increase testing and decrease new HIV cases, a prudent strategy would be to train existing social network members (e.g., staff members, home-based peers, or partners) as agents of change in naturally occurring social networks of YEH.

Publication
AIDS and Behavior
Publication Year
2020

Using the Life Story Book With Mentally Alert Residents of Nursing Homes

University of Houston

Depression and lack of meaning in life (MIL) are common among residents of nursing homes (NHs) and contribute to a reduction in overall health and well-being. Life Story Book (LSB), a reminiscence intervention, is designed to provide a person with the opportunity to review their past and capture their life stories and photographs into a book. LSB has demonstrated positive outcomes for residents of NHs with dementia, yet little is known for residents without dementia. A switching replication design was used to examine the effects of LSB among 21 mentally alert residents from two NHs (NH-A and NH-B) in Houston, Texas. Participants in NH-A received three weeks of the LSB intervention, while NH-B received three weeks of care-as-usual; the intervention was then switched. The GDS-12R and the MIL questionnaire (MLQ) were used to measure depressive symptoms and MIL respectively. Participants from NH-A (n =11) and NH-B (n = 10) had a mean age of 75 years (SD =11.34); 81% female; 52% non-Hispanic white and 33% African American. Results from a one-way MANCOVA found no statistically significant difference on the GDS-12R and MLQ (F(3, 14) = 2.50, p = .102; Wilks’ Lambda = .652; η2 = .35). Further analyses comparing the pre-intervention and post-intervention scores for the entire sample (N =21) found a significant reduction in depressive symptoms (M = 2.67; SD = 2.52) and (M =1.67, SD = 2.29); (t (20) = 2.21, p = 0.039). The potential benefits of LSB for mentally alert residents of NHs warrants further research.

Publication
Innovation in Aging
Publication Year
2020

Consensus Parameter: Research Methodologies to Evaluate Neurodevelopmental Effects of Pubertal Suppression in Transgender Youth

Children’s National Medical Center

Purpose: Pubertal suppression is standard of care for early pubertal transgender youth to prevent the development of undesired and distressing secondary sex characteristics incongruent with gender identity. Preliminary evidence suggests pubertal suppression improves mental health functioning. Given the widespread changes in brain and cognition that occur during puberty, a critical question is whether this treatment impacts neurodevelopment. Methods: A Delphi consensus procedure engaged 24 international experts in neurodevelopment, gender development, puberty/adolescence, neuroendocrinology, and statistics/psychometrics to identify priority research methodologies to address the empirical question: is pubertal suppression treatment associated with real-world neurocognitive sequelae? Recommended study approaches reaching 80% consensus were included in the consensus parameter. Results: The Delphi procedure identified 160 initial expert recommendations, 44 of which ultimately achieved consensus. Consensus study design elements include the following: a minimum of three measurement time points, pubertal staging at baseline, statistical modeling of sex in analyses, use of analytic approaches that account for heterogeneity, and use of multiple comparison groups to minimize the limitations of any one group. Consensus study comparison groups include untreated transgender youth matched on pubertal stage, cisgender (i.e., gender congruent) youth matched on pubertal stage, and an independent sample from a large-scale youth development database. The consensus domains for assessment includes: mental health, executive function/cognitive control, and social awareness/functioning. Conclusion: An international interdisciplinary team of experts achieved consensus around primary methods and domains for assessing neurodevelopmental effects (i.e., benefits and/or difficulties) of pubertal suppression treatment in transgender youth.

Publication
Transgender Health
Publication Year
2020

Occupational therapists need to be involved in developing and evaluating technological solutions to support remote working

University at Buffalo, State University of New York

COVID-19 has led to increased remote working for occupational therapists and other health and social care professionals. Despite the rapid move to video consultations during COVID, the impact and implications of remote working still need consideration. Prior to COVID, digitisation was already recognised as essential, given the demands on health and social care (NHS, 2019). The National Health Service (NHS) long-term plan pledged to make digitally enabled care mainstream within the next decade (NHS, 2019). Technological innovation has the potential to improve care quality and cost savings across health and social care (Maguire et al., 2018). Allied health professionals (AHPs) have been urged to lead digital health innovations and use new technologies for patient benefit (NHS England, 2019). Video consultations had already emerged as a service model, with potential for improved efficiency and patient experiences (Greenhalgh et al., 2018a).

Publication
British Journal of Occupational Therapy
Publication Year
2020

Hate Knows No Boundaries: Online Hate in Six Nations

Northeastern University

This paper examines cross-national commonalities and differences in online hate speech content, exposure, and emotional reaction. Using online surveys from 18 to 25-year-old respondents in six countries, we find a majority of respondents were exposed to online hate in the preceding 3 months. Commonalities across countries are the platform where the respondents were exposed and how they arrived at such content. Unique national cultures of hate speech also exist, including the common targets and respondents’ emotional reactions. A majority of respondents report feeling angry, sad, or ashamed, but most worrisome may be the substantial numbers who report feelings of hatred or pride after seeing online hate. Given the potential for repeated exposure and the recent increase in hate crimes in the US. and Europe, this finding should serve as a reminder of the dangers of online hate and its potential link to offline violence.

Publication
Deviant Behavior
Publication Year
2020

Modifiable risk and protective factors for anxiety disorders among adults: A systematic review

University of Nevada, Reno

Anxiety disorders are highly prevalent in the general population and associated with high rates of impairment and disability. This burden highlights the need to identify risk factors that individuals can modify without professional intervention. A systematic review was conducted to identify studies that examined modifiable risk and protective factors for anxiety disorders among adults in the general population. Searches were conducted in PubMed, PsycINFO and MEDLINE using medical subject headings and text words related to risk factors, protective factors, and each anxiety disorder. Screening, data extraction, and quality assessment were performed by three study authors. Modifiable risk and protective factors from 19 studies across seven countries were identified. Risk factors identified included cigarette smoking, alcohol use, cannabis use, negative appraisals of life events, avoidance, and occupational factors. Protective factors included social support, coping, and physical activity. Cigarette smoking was the most studied risk factor. Support was found for cigarette smoking as a risk factor for agoraphobia and panic disorder. Mixed results were found for generalized anxiety disorder and specific phobia. Across disorders, smoking frequency was associated with greater risk. Results indicate an important gap in the literature in that few studies have examined modifiable risk factors for anxiety disorders.

Publication
Psychiatry Research
Publication Year
2020

Accountable policing: Policies to advance the personal safety of Black boys and young men (Race and Opportunity Lab Brief Report No. 3)

Washington University in St. Louis

The policies and practices that perpetuate the continual, unjust murder of Black males by the nation’s law-enforcement professionals have gone unchanged for far too long. While this pattern is most dangerous for Black men (Ross, 2015), the consequences of this system reach communities far and wide. HomeGrown StL is issuing this Brief Report to provide local, state, and federal policymakers with concrete, evidence-based policy recommendations for building an equitable, transparent, and ac- countable public-safety approach that will serve and protect all U.S. residents, not just a select few. Our review of local, state, and federal law-enforcement policies demonstrates that, although a handful have been implemented to reduce police violence, evidence-based solutions have been neglected in favor of ineffective approaches or of complete inaction. It is time for policymakers, especially leaders in the St. Louis region, to acknowledge their responsibility for putting an end to this abhorrent injustice.

Publication
Center for Social Development
Publication Year
2020

System involvement among young adults experiencing homelessness: Characteristics of four system-involved subgroups and relationship to risk outcomes

University of Denver

Young adults experiencing homelessness (YAEH) have been found to have high rates of prior involvement with foster care and juvenile justice, but little is known about whether YAEH differ in their risk behaviors based on exposure to different systems. This study used a dataset of 1426 YAEH from 7 different US cities to examine the historical risk and resilience characteristics of those involved in foster care alone, juvenile justice alone, both systems (dual status), and no system involvement. Logistic regression was used to examine whether different types of childhood system involvement predicted risk behaviors in young adulthood including substance use, trade sex, suicide attempts, unplanned pregnancy, and involvement in the adult criminal justice system. Notably, 57% of youth had been exposed to one of the systems – 20% foster care only (n = 291), 18% juvenile justice only (n = 254), and 18% dual status (n = 261). YAEH without a history of system involvement had significantly lower childhood trauma scores and lower rates of lifetime mental health diagnoses compared to all three system involved groups, with dual status youth having the highest rates of both. In relation to risk outcomes, youth with dual status histories had higher odds of trading sex and those with juvenile justice involvement, either alone or as dual status, had higher odds of being arrested after age 18 and of problematic substance use. Results suggest YAEH with prior involvement in child-serving systems have unique risk characteristics that vary by type of system involvement, with dual-system involved youth at particularly high risk. Findings highlight the need for foster care and juvenile justice systems to work collaboratively in providing preventive interventions prior to system exit.

Publication
Children and Youth Services Review
Publication Year
2020

Time well spent: Home learning activities and gains in children’s academic skills in the prekindergarten year

New York University

Parental engagement in home-based learning activities is linked to children’s academic skills. Yet, interventions that try to enhance parental engagement—sometimes targeted to families with low levels of education—have small effects. This study aimed to inform supports for families by examining how different types of home-based learning activities influence academic skills during prekindergarten. We created four measures that assessed the frequency with which parents (N = 307) engaged in unconstrained and constrained language/literacy and math activities at home. Unconstrained language activities predicted gains in children’s language skills, and unconstrained math activities were associated with gains in math skills. Both associations were larger for families with lower versus higher levels of parental education. Engagement in constrained activities did not predict gains in skills. Implications for practice and research are discussed.

Publication
Developmental Psychology
Publication Year
2020

Street-Level Bureaucrats and Ethical Conflicts in Service Provision to Sex Workers

The University of Chicago

Social workers and other service providers are the agents that often have initial contact with sex workers, a highly stigmatised population that has a fraught history with the social work profession. In this paper, I use Lipsky’s theory of street-level bureaucracy and show how social workers use professional discretion when working with this population, even as it might conflict with their personal ethics. Specifically, I focus on the dual service technologies of abstinence and harm reduction, and how service providers have negotiated these technologies in their work with sex workers. In regards to these technologies, I focus on how the emotional and moral discourse surrounding sex work has shaped the response of street-level bureaucrats (SLBs) that work with this population. Using qualitative data from interviews with 29 frontline service providers in a midwestern US state, I argue that these frontline workers use interpersonal modes of discretion to understand ethical conflicts in working with sex trade-involved persons, conflicting with both agency and field-level policy. Implications of this project show how frontline service providers negotiate their responsibilities to this population amidst conflicting personal ethics and service technologies.

Publication
Ethics and Social Welfare
Publication Year
2020

Experiences With Help Seeking Among Non-Service- Engaged Survivors of IPV: Survivors’ Recommendations for Service Providers

Washington University in St. Louis

Engaging with formal intimate partner violence (IPV) services can buffer the impacts of violence and reduce future risk. Many survivors do not access or engage with such services. However, much of our knowledge related to the experiences and perspectives of IPV survivors comes from samples drawn from those seeking formal services. Qualitative interviews with 23 survivors of violence who are not currently engaged with formal IPV services were conducted, focused on the process and outcomes of choosing to seek help. Themes emerged within the categories of formal help-seeking experiences, informal help seeking, and recommendations for providers. Keywords service engagement, help seeking, intimate partner violence, access An estimated 22.3% of American women and 14% of American men have experienced severe physical intimate partner violence (IPV; Breiding et al., 2014).

Publication
Violence Against Women
Publication Year
2020

Relationships Between Parenting and Dangerous Substance Use Behaviors Among Youth Experiencing Homelessness

University of Denver

Objective: Understanding patterns of dangerous and illicit substance use among young parents who are homeless may provide insight into how best to support this highly vulnerable group and their children. This study examines the relationship between having a biological child and drug use among youth experiencing homelessness. Method: We used 4 waves of cross-sectional data from 1,010 youths ages 14–26 at 3 drop-in agencies serving youth experiencing homeless in Los Angeles, CA. Among participants, 23.8% of males and 28.9% of females had a biological child. We conducted multivariate logistic regression models for males and females on 4 substance use behaviors in the past month: binge drinking, using hard/illicit drugs, prescription drug misuse, and injection drug use. Results: Fathers had greater odds of hard drug use, prescription drug misuse, and injection drug use than males without children. There was no significant relationship between having a child and any of the four substance use behaviors for females. Conclusions: Findings suggest that having a child is not associated with higher risk of dangerous or illicit substance use for females. Results highlight the need to proactively engage young males in pregnancy prevention, parenting programs, and substance use treatment and prevention.

Publication
Journal of the Society for Social Work and Research
Publication Year
2020

Determinants of Fall Prevention Guideline Implementation in the Home- and Community-Based Service Setting

The Ohio State University

Home- and community-based service (HCBS) recipients often possess multiple fall risk factors, suggesting that the implementation of evidence-based fall prevention guidelines may be appropriate for the HCBS setting. The purpose of this exploratory study was to examine the determinants of fall prevention guideline implementation and the potential strategies that can support implementation in HCBS organizations. Semistructured interview and focus group data were collected from 26 HCBS professionals representing the home-delivered meals, personal care, and wellness programs. Qualitative codes were mapped to the Consolidated Framework for Implementation Research by means of directed content analysis. The Consolidated Criteria for Reporting Qualitative research checklist was used to report the findings of this study. We identified 7 major determinants of guideline implementation: recipient needs and resources, cosmopolitanism, external policy and incentives, networks and communication, compatibility, available resources, and knowledge/beliefs. Strategies to support guideline implementation included the involvement of recipient and caregiver feedback, building fall prevention networks, and conducting educational meetings for HCBS staff. Falls and fall-related injuries will continue to plague the older adult community unless innovative approaches to fall prevention are developed and adopted. The implementation of fall prevention guidelines in the HCBS setting can help mitigate fall risk among a highly vulnerable older adult population and may be facilitated through the application of multifaceted implementation strategies.

Publication
The Gerontologist
Publication Year
2020

Parent-child concordance on the Pubertal Development Scale in typically developing and autistic youth

Children’s National Medical Center

Background: Characterizing puberty in autism spectrum disorder (ASD) is critical given the direct impacts of pubertal progression on neural, cognitive, and physical maturation. Limited information is available about the utility and parent-child concordance of the self-report and parent-report Pubertal Development Scale (PDS) in ASD, an economical and easily administered measure. Method: The primary aim of this study was to examine the concordance between self-report and parent-report PDS ratings in autistic males and females ages 8–17y compared to typically developing (TD) youth, including using the PDS to derive informant-based estimates of adrenal and gonadal development. We hypothesized that there would be greater parent-youth discrepancies in pubertal ratings among autistic males. Our second aim was exploratory; we examined whether individual characteristics impact PDS concordance and hypothesized that lower intellectual and adaptive skills, higher autistic traits, and reduced self-awareness/monitoring would correlate with lower concordance. Results: There were no significant diagnostic group differences in parent-youth concordance for overall PDS scores among males and females. Autistic males had significantly lower inter-item agreement with their parents than TD males and had lower agreement for both adrenal and gonadal aspects of pubertal maturation (adrenal κ = .48; gonadal κ = .55). Conclusions: The PDS is a feasible measure in ASD. Greater parent-youth discrepancies in autistic males may be due to reduced parental awareness or reduced insight into pubertal maturation among autistic males. Future research is needed to further elucidate individual and/or environmental characteristics that influence youth- and parent-reported PDS scores, including differences in self-perception and insight.

Publication
Research in Autism Spectrum Disorders
Publication Year
2020

Drinking Motives as Moderators of In‐the‐Moment Drinking Risks in Response to Trauma‐Related Distress

University at Buffalo, State University of New York

Background: Trauma exposure and posttraumatic stress disorder (PTSD) symptomatology are linked to increased risk for problematic drinking, yet the factors that increase such risk remain largely unknown. Theoretical models suggest that affectively oriented drinking motives may be central to trauma‐related drinking. Specifically, individual‐level motivations to drink to regulate affect may be important for moderating drinking urges that occur acutely in response to trauma cues. Further, elevated distress associated with PTSD symptomatology may increase any affectively motivated, momentary drinking risks. However, research has yet to examine these dynamic affective processes. In a large experimental sample, the current study tested whether affective (i.e., coping and enhancement) drinking motives and PTSD symptomatology moderated individuals’ drinking urge in response to a trauma cue in a laboratory cue reactivity paradigm. Methods: College drinkers (n = 611, 53% female) were recruited and selected across levels of trauma exposure and PTSD symptomatology by a structured clinical interview. Participants were randomized to a personalized trauma or neutral cue, reporting on their urge to drink alcohol before and after cue exposure. Drinking motives were assessed at the end of the experimental session. Results: Trauma cue associations with drinking urge were moderated by coping, but not enhancement, motives. Specifically, stronger coping motives were associated with increases in urge to drink alcohol following exposure to a trauma but not neutral cue. PTSD classification did not significantly moderate these associations. Conclusions: Coping motives may increase drinking urge immediately following exposure to trauma cues and may differentiate individuals most at risk for problematic drinking during trauma‐associated distress. Findings support momentary negative affect processes driving dynamic, immediate trauma‐related drinking risks.

Publication
Alcoholism: Clinical and Experimental Research
Publication Year
2020

Associations between childhood exposure to community violence, child maltreatment and school outcomes

Simmons College

This study examined whether physical abuse and community violence exposure (CVE) at age 5 were independently associated with academic performance at age 9, whether these effects were mediated by externalizing and internalizing behaviors, and whether the effects of CVE on mental health and academic performance were observed after accounting for the effects of physical abuse. Data were drawn from the Fragile Families and Child Wellbeing Study. Bayesian factor analysis was conducted in Mplus to form latent factors for internalizing behavior, externalizing behavior, and academic performance. Path analysis was then used to examine direct and indirect associations between CVE, internalizing and externalizing behaviors, and academic performance. CVE at age 5 was independently negatively associated with academic performance at age 9. Physical abuse at age 5 was not independently associated with academic performance at age 9. The effects of CVE and physical abuse on academic performance were mediated by externalizing behavior, and not internalizing behavior. CVE, externalizing behavior, and internalizing behavior all had a direct negative association with academic performance, after accounting for the effects of physical abuse on externalizing behavior. The findings confirmed that community violence has a negative impact on school performance above and beyond the effects of interpersonal violence. These findings reinforce the need for communitywide prevention programs that reduce violence. These findings suggest that more attention needs to be paid to how younger children are impacted by CVE and physical abuse, both through their own experiences or the experiences of their caregivers.

Publication
Child Abuse & Neglect
Publication Year
2020

A Primary Care Prevention System for Behavioral Health: The Behavioral Health Annual Wellness Checkup

University of Nevada, Reno

Behavioral health problems are involved in the majority of primary care visits. These behavior disorders (e.g., depression, anxiety, smoking, insomnia, etc.) are costly, burdensome to both the patient and the healthcare system, and result in greater medical utilization/cost and poorer future health outcomes. Integrated behavioral healthcare has been proposed as a model for more efficiently addressing the burden of behavioral health problems. While this model has demonstrated some promise in the treatment of behavioral health problems, as well as in the reduction in costs and improvement in healthcare outcomes, the primary prevention of behavioral health problems in this delivery model has been relatively neglected. The present paper discusses the potential value of incorporating the prevention of behavioral health problems into the annual physical/wellness checkup and proposes a detailed system for how this might be accomplished. Limitations, future research, and costs associated with increased prevention in a primary care context are discussed.

Publication
Journal of Clinical Psychology in Medical Settings
Publication Year
2020

Psychometric properties of the Italian version of the Interpersonal Needs Questionnaire‐15 (INQ‐15‐I)

Florida State University

Objective: The Interpersonal Needs Questionnaire (INQ‐15) is a self‐report measure of thwarted belongingness and perceived burdensomeness, two constructs associated with suicidal ideation. The objective of the current study was to translate the INQ‐15 from English to Italian (INQ‐15‐I) and to test its factor structure, reliability, and validity in Italian samples. Method: We examined (a) whether the components of the hypothesized two‐factor measurement model are invariant across a community sample (N = 510) and a clinical sample (N = 259); (b) the relations between the INQ‐15‐I factors and measures of depression (Beck Depression Inventory‐II), hopelessness (Beck Hopelessness Scale), and suicidal ideation (Beck Scale for Suicide Ideation); (c) the reliability and psychometric properties of the INQ‐15‐I. Results: Results from multigroup confirmatory factor analyses supported the adequacy of the two‐factor model to represent thwarted belongingness and perceived burdensomeness. The model is invariant across community and clinical groups, showing excellent fit. The two INQ‐15‐I scales measure highly intercorrelated constructs. Both significantly correlate with depression, hopelessness, and suicidal ideation, and correlations are high in the clinical sample. Conclusion: The INQ‐15‐I is a valid and reliable measure of thwarted belongingness and perceived burdensomeness. Implications for research, assessment, and intervention in suicidal ideation are discussed.

Publication
Journal of Clinical Psychology
Publication Year
2020

Exposure to community-based violence on social media among black male emerging adults involved with the criminal justice system

Washington University in St. Louis

The prevalence of community-based violence (CBV) exposure among black American male emerging adults ages 18 to 25 with a history of involvement with the criminal justice system is a major public health concern. Although exposure (whether as victim or witness) to CBV is linked with negative outcomes, empirical research examining black men’s negative emotional responses to seeing videos of real-life incidents of CBV on social media is scant. To address these identified concerns and make recommendations for future research, the present study examines the relationship between seeing videos of CBV on social media and three types of negative emotional responses (that is, feeling sad, angry, and fearful) prior to incarceration among a sample of 101 black men detained in a midwestern jail. Social media use and seeing videos of CBV on social media were moderately high for study participants. Seeing a video involving police violence was significantly associated with an increase in the odds of feeling sad, angry, and fearful. Social media research is an emerging area that has the potential to advance our understanding of the impact of seeing social media videos of police violence on the well-being of black men and factors that mediate or moderate this relationship.

Publication
Social Work Research
Publication Year
2020