Exploring Advocacy Practices for Interpersonal Violence Survivors on College Campuses: Approaches and Key Factors
Objective: The current study explores campus-based advocacy services for survivors of sexual assault and intimate partner violence, to increase understanding of how these supportive services are used on college campuses. Method: Semi-structured interviews with campus-based advocates and student survivors who used advocacy programs on 3 college campuses were conducted. The participating programs were diverse in setting and student population. Thematic analysis was used to identify program approaches and distinguishing features for advocacy in higher education. Results: Data from 48 participants were used to identify approaches guiding campus-based advocacy models. Campus-based advocacy models are trauma focused and student/survivor-centered similar to community programs with higher education-based applications. Campus-based advocacy is distinguished by attention to (a) developmental phase, (b) the university community experience, and (c) the role of the institution and institutional policy in services. Campus-based advocacy programs vary in service model and setting based on institutional structure and needs. Confidential advocacy services are critical to meeting student survivor needs. Conclusion: This study illustrates that similar to community approaches, campus-based advocacy models for survivors of sexual assault and intimate partner violence focus on empowerment, resource provision, and expanding social support during the college experience through a trauma informed lens. Campus-based advocacy programs provide potential benefit to student-survivors expressed needs, including prevention of further violence, enhanced well-being, increased academic outcomes, and support. Further research is needed to assess the outcome of campus-based advocacy and to guide program implementation as advocacy services in higher education grow.
The role of the internet in the grooming, exploitation, and exit of United States domestic minor sex trafficking victims
The Internet (e.g., social networking, online marketing, and encryption technologies) has been identified as a means to facilitate domestic minor sex trafficking (DMST; a.k.a., commercial sexual exploitation of children). At the same time, the Internet is increasingly being identified as a method of primary prevention and intervention for DMST among youth. However, to-date there are limited examinations of the role of the Internet in the lives of youth who experience DMST victimization. The current study aims to consider the role of the Internet in DMST grooming, exploitation, and exit. In-depth, semi-structured qualitative interviews were conducted with 20 service providers in North Carolina and Texas. Interviews were digitally recorded, transcribed verbatim, and coded line-by-line using a grounded theory approach. Results feature two overarching themes in service provider interviews: 1) Initial exploitation and 2) Exit from exploitation. Within each of these larger themes were subthemes including technology facilitated risk and prevention needs. Overall, these qualitative findings reveal the role of the Internet in: (1) Facilitating DMST, (2) Preventing Internet-facilitated DMST, and (3) Victim exit and survivorship. Implications for research and practice are discussed.
Evidence-Based Practice Implementation in Stroke Rehabilitation: A Scoping Review of Barriers and Facilitators
Importance: Despite advancements in stroke rehabilitation research, occupational therapy practitioners still face challenges with implementing research into routine practice. Although the development of evidence-based practices (EBPs) is one critical step along the knowledge translation continuum for the population of people with stroke, research is also needed to identify the most effective strategies for implementing EBPs with stroke survivors who are receiving occupational therapy services. Objective: To synthesize research related to occupational therapy practitioners’ implementation of EBPs in adult stroke rehabilitation. Data sources: We searched four electronic databases-CINAHL, MEDLINE, PubMed, and Academic Search Complete-and the peer-reviewed journal Implementation Science to identify relevant research studies. Study selection and data collection: Studies that met the following inclusion criteria were included in the scoping review: published between January 2003 and January 2018, addressed the adult stroke population, and examined the implementation of occupational therapy interventions. Data were abstracted on the basis of recommendations from the seminal review framework established by Arksey and O’Malley (2005). Thematic analysis identified themes that emerged from the included studies. Findings: Twenty-five articles satisfied our inclusion parameters. Our analyses yielded three overarching themes: barriers to implementation, facilitators of implementation, and implementation strategies. Implementation strategies often consisted of multimodal knowledge translation training programs. Conclusion and relevance: Although the stroke rehabilitation literature appears to have established the barriers to and facilitators of EBP implementation, greater attention to the identification of effective implementation strategies that promote the uptake of EBPs by occupational therapy practitioners is needed. What this article adds: This article summarizes the contextual factors and effective strategies that may influence practitioners’ implementation of stroke research findings in real-world practice.
A pilot study of a group-based perinatal depression intervention on reducing depressive symptoms and improving maternal-fetal attachment and maternal sensitivity
To conduct a pilot study of a group-based perinatal depression intervention, the Mothers and Babies Course, on depressive symptomatology, maternal-fetal attachment, and maternal sensitivity, 60 pregnant women with moderate to severe depressive symptomatology were randomized to a 6-week intervention or usual care group at their initial prenatal care visit. Measures of depressive symptomatology and maternal-fetal attachment were collected at baseline and 36 weeks gestation. At 12 weeks postpartum, participants completed a measure of depressive symptomatology, and an objective measure of maternal sensitivity was collected. Participants randomized to the intervention group completed an average of 5.2 sessions, and 70% of women completed all six sessions. Exploratory analyses showed that at 12 weeks postpartum, participants randomized to the intervention group had an 8.32-point decrease from baseline on the Edinburgh Postnatal Depression Scale (EPDS) as compared to a 4.59-point decrease among participants randomized to usual care. Participants randomized to the intervention group had a mean change score of 12.60 in maternal-fetal attachment via the Maternal Fetal Attachment Scale (MFAS) as compared to 4.60 among participants in usual care. Maternal sensitivity scores, assessed via the Nursing Child Assessment Satellite Training-Feeding Scale (NCAST-Feeding), were higher at 12 weeks postpartum for women in the intervention group as compared to women in usual care (59.2 and 51.8, respectively). Our pilot study findings provide preliminary support for the benefits of a perinatal depression intervention, delivered in a group setting, on reducing depressive symptomatology, and improving maternal-fetal attachment and maternal sensitivity. Further research, conducted with larger samples, is necessary to determine the effect of this intervention on indicators of maternal attachment.
Hopelessness, Interpersonal, and Emotion Dysregulation Perspectives on Suicidal Ideation: Tests in a Clinical Sample
Objective: The present study directly compared three perspectives of suicidality: Interpersonal Theory of Suicide (IPTS), Hopelessness Theory, and a perspective emphasizing emotion dysregulation. Method: 219 adults seeking outpatient psychological services completed questionnaires during intake between November 2015 and February 2019. Patients were included if they completed surveys related to thwarted belongingness (TB), perceived burdensomeness (PB), hopelessness, depressive symptoms, negative affect, and Borderline Personality Disorder (BPD) symptoms. Analyses tested the ability of TB, PB, depressive symptoms, hopelessness, and emotion dysregulation to relate to total scores on Beck Scale for Suicide Ideation. We employed Pearson’s correlations and linear regressions to investigate these relations. Results: Constructs related to emotion dysregulation—negative affect (r = 0.161, p < .05) and Borderline Personality Disorder symptoms (r = 0.284, p < .01)—were significantly correlated with suicidal ideation, as were those relevant to Hopelessness Theory—depressive symptoms (r = 0.46, p < .01) and hopelessness (r = 0.45, p < .01)— and IPTS—TB (r = 0.36, p < .01) and PB (r = 0.43, p < .01). Notably the combinations of constructs as proposed by theories were significantly associated with suicidal ideation, but did not improve upon single constructs. This indicated that theoretically relevant constructs alone were strongly associated with suicidal ideation, but were not bested by interactions. Conclusions: This project compared constructs relevant to three theories of suicidality among a sample of treatment seeking outpatients. Findings indicated that suicidal ideation assessment was similarly informed by Hopelessness Theory and IPTS, and to a lesser degree emotion dysregulation. The cross sectional nature of the data and the reliance upon self-report measures limit the inferences that can be made.
Characteristics of Dispensary Patients that Limit Alcohol after Initiating Cannabis
Many patients have reported that they decrease their use of opioids after starting medical cannabis (MC) but less is known for alcohol. The objective of this exploratory study was to identify any factors which differentiate alcohol abaters from those that do not modify their alcohol use after starting MC (non-abaters). Comparisons were made to identify any demographic, dosing, or health history characteristics which differentiated alcohol abaters (N = 47) from non-abaters (N = 65). Respondents selected from among a list of 37 diseases/health conditions (e.g. diabetes, sleep disorders). Abaters and non-abaters were indistinguishable in terms of sex, age, or prior drug history. A greater percentage of abaters (59.6%) than non-abaters (40.6%, p < .05) reported using MC two or more times per day. Abaters were more likely to be employed (68.1%) than non-abaters (51.1%, p < .05). Abaters also reported having significantly more health conditions and diseases (3.3 ± 2.0) than non-abaters (2.4 ± 1.4, p < .05). This small study offers some insights into the profile of patients whose self-reported alcohol intake decreased following initiation of MC. Additional prospective or controlled research into the alcohol abatement phenomenon following MC may be warranted.
Knowledge of objects’ physical properties implicitly guides attention during visual search
Our interactions with the world are guided by our understanding of objects’ physical properties. When packing groceries, we place fragile items on top of more durable ones and position sharp corners so they will not puncture the bags. However, physical properties are not always readily observable, and we often must rely on our knowledge of attributes such as weight, hardness, and slipperiness to guide our actions on familiar objects. Here, we asked whether our knowledge of physical properties not only shapes our actions but also guides our attention to the visual world. In a series of four visual search experiments, participants viewed arrays of everyday objects and were tasked with locating a specified object. The target was sometimes differentiated from the distractors based on its hardness, while a host of other visual and semantic attributes were controlled. We found that observers implicitly used the hardness distinction to locate the target more quickly, even though none reported being aware that hardness was relevant. This benefit arose from fixating fewer distractors overall and spending less time interrogating each distractor when the target was distinguished by hardness. Progressively more stringent stimulus controls showed that surface properties and curvature cues to hardness were not necessary for the benefit. Our findings show that observers implicitly recruit their knowledge of objects’ physical properties to guide how they attend to and engage with visual scenes.
Climate of Fear: Provider Perceptions of Latinx Immigrant Service Utilization
Latinx immigrants endure stressors throughout the immigration process that detrimentally impact their health and wellbeing. Yet, they also face substantial barriers to accessing and utilizing services. These barriers might be heightened under the Trump administration, which has implemented policies facilitating increased immigration enforcement and punitive immigration practices. This study utilizes data collected from providers who serve Latinx immigrants in the border state of Texas to better understand current immigrant service utilization behaviors. Individual interviews and focus groups were conducted shortly after the last presidential election to inquire about recruitment, retention, program completion, and resources to address key client risk factors. Applying grounded theory analysis strategies, interviews, and focus group recordings were coded for key themes. Data demonstrated central concerns held by providers serving immigrants, and especially those who are undocumented or in mixed-status families. Concerns were related to the following three themes: (1) undocumented immigrant stressors, (2) limited resources for undocumented immigrants, and (3) service utilization barriers. Lack of services for undocumented immigrants and fear related to service utilization were prominent subthemes. These findings extend our knowledge of stressors and barriers of access and utilization for immigrants during this time period of increased immigration enforcement which have valuable implications for practice and future research. Providers can take concrete actions to educate immigrants, regardless of documentation status, on how their clients’ identities will be protected. In addition, intentional trust-building strategies are essential to help overcome fear of utilizing services. Future research should ascertain perspectives of immigrant families, as this study drew perspectives only from providers.
Depression After Open Heart Surgery: Influences of Optimism, Sex, and Event-Related Medical Factors
Postoperative depression is a multifaceted condition that can limit quality of life and potentially decrease the survival benefits of open heart surgery (OHS). We postulated that sex, pre-event character strengths, medical, and certain surgery indicators would predict post-event/myocardial infarction depression. To identify predictors, we collected three-wave survey data from 481 OHS patients at a large academic referral institution (age, 62+; female, 42%) and included key medical and surgical information. The final model (F[7, N = 293] = 28.15, p < 0.001, R = 0.408) accounted for over two fifths of the variance in post-OHS depression. Pre-event/OHS optimism mitigated post-OHS depression. Being female, older, living alone, longer surgical perfusion time, absence of left main disease greater than 50%, and pre-OHS depression were associated with the increased likelihood of post-OHS depression. Our findings suggest that teaching optimism to OHS patients might be beneficial in reducing the risk of postoperative depression and that female patients should be monitored more closely for the development of depression through an interdisciplinary approach.
Body Image and Sexual Behavior Among Adult Men Who “Hook Up”
Understanding the psychosocial variables associated with sexual behavior is critical, particularly among high-risk individuals such as those who hook-up. It is possible body image is one of these variables. The current study aimed to examine the relationship between body appreciation and body image self-consciousness and three sexual health-related behaviors: 1) condom usage, 2) HIV screening, and 3) STI screening among a sample of adult men who have hooked up at least once in the past month (n = 243). We found that higher levels of body appreciation were related to being less likely to use condoms and higher levels of body image self-consciousness were related to being less likely to be screened for HIV and STIs. The conflicting results suggest additional research is warranted.
A House but Not a Home: How Surveillance in Subsidized Housing Exacerbates Poverty and Reinforces Marginalization
A robust literature has shown that surveillance disproportionately targets poor people of color through the criminal justice and welfare systems. However, little empirical research traces the mechanisms through which surveillance reproduces inequality in other domains, such as subsidized housing, where private actors including property owners and landlords do the work of surveilling tenants. In this article, I apply the theoretical lens of surveillance to the case of subsidized housing to explore the symbolic and material consequences of being monitored at home. Drawing on in-depth interviews with 67 low-income Black mothers in the Sunnyside neighborhood in Houston, Texas, I argue that the scrutiny mothers face in and around their homes reproduces inequality through two key mechanisms. First, surveillance creates a home environment devoid of privacy, that mothers liken to being in prison. Mothers interpret this scrutiny as an effort to control and contain them because of their race, reinforcing racialized notions of presumptive Black criminality. Second, surveillance heightens the material risk for mothers of being caught breaking rules, which paves the way for eventual eviction and exacerbates poverty. Although mothers develop strategies to counter and at times resist disciplinary monitoring, these efforts come with drawbacks that can make surviving poverty harder. Taken together, these findings suggest that being surveilled at home not only diminishes low-income Black mothers’ status in society, but also pushes them into deeper economic precarity. This research extends our understanding of the reach of surveillance into the lives of the poor even in spaces considered to be private.
Voluntary, Survivor-Centered Advocacy in Domestic Violence Agencies
Voluntary, survivor-centered advocacy is a model of practice used in domestic violence organizations; however, more information is needed from the perspective of survivors on how to best facilitate survivor-centered approaches in a voluntary service format. This qualitative study used a thematic analysis to uncover core advocacy approaches from 25 female-identified survivors dwelling in domestic violence emergency shelter and transitional housing programs in two states. Themes revealed that three core approaches aid a voluntary, survivor-centered advocacy model: 1) Establishing a safe base for support, 2) Facilitating access and connection, and 3) Collaboration. Advocacy approaches that emphasize safety, mutuality, and availability of support best engage survivors in voluntary services to address needs and meet goals. Use of a strengths-based approach, psychoeducation, and resource-building contributes to the social and emotional well-being of survivors. Findings indicate community DV advocates should use adaptable advocacy models aimed at service access, connection, and collaborative resource acquisition. Voluntary, survivor-centered models use principals of trauma-informed care, though more widespread use of trauma-informed care (TIC) in voluntary services are needed. Advocates need organizational support to meet survivor needs. Implications for research include the need for fidelity studies and longitudinal research.
Identity in the context of early psychosis: a review of recent research
Purpose: The emergence of psychosis most frequently occurs during adolescence and young adulthood, a period of development in which identity is developed and consolidated. The present narrative review surveyed and synthesized recent empirical contributions to the issue of identity in the context of early psychosis, to inform clinical and future research considerations. Materials and Methods: A systematic search obtained 983 reports pertaining to identity and psychosis among youth and young adults. After screening the abstracts, 81 studies were reviewed in full, yielding 17 that met inclusion criteria. Studies were reviewed with regard to major themes by authors. Results: Three major themes emerged, the majority of which employed qualitative methods. The first theme indicated a disruption to personal identity posed by psychosis symptoms and the diagnosis of mental illness. The second theme suggested that identity difficulties may confer additional emotional and behavioural risk among this population. Third, young people with psychosis indicated the importance of restoring their personal identity, as distinct from their experiences of psychosis, during the recovery process. Conclusions: Identity-related concerns are important aspects of young people’s experience in the early stages of psychosis. Research is needed to determine the potential for interventions to support and enhance identity within early psychosis care.
A Path Analysis Investigating the Relationships between Family Violence, Addictive Behaviors, and Trauma among Adolescents in China
Family violence is a public health concern in China. Exposure to family violence, including witnessing intimate partner violence (IPV) between parents and/or experiencing child abuse, has numerous deleterious effects on adolescent’s mental and behavioral health. This study examined specific mental and behavioral health outcomes of family violence exposure including trauma symptoms and addictive behaviors using a nationally representative sample of adolescents in China. Cross-sectional, self-report data were collected from 16,254 adolescents (M = 15.89 years of age, 47.69% female) using a self-administered survey. More than two-thirds of the sample reported having been exposed to child abuse or IPV at home. Adolescents who were exposed to child abuse and/or IPV were significantly more likely to misuse substances, engage in gambling activities and exhibited more trauma symptoms than their non-exposed peers. A multivariate path analysis revealed that child abuse had an indirect effect on severity of trauma symptoms through problem drinking, cigarette smoking, and gambling behavior. Witnessing IPV between parents had an indirect effect on trauma symptoms through problem drinking and cigarette smoking. An alternative pathway model suggested that child abuse and witnessing IPV between parents had indirect effects on a variety of substance misuse and gambling behavior through PTSD. Findings offer a unique insight into the effects of family violence exposure on adolescents in Greater China. Family violence awareness and intervention could be a meaningful intervention strategy to address substance use and behavioral health problems among adolescents in China.
Healthcare Providers’ Experiences with Gaps, Barriers, and Facilitators Faced by Family Caregivers of Children with Respiratory Diseases
Purpose: The purpose of this study was to identify healthcare providers’ experiences of the gaps in the healthcare system, barriers to obtaining care, and facilitators that promoted safe, quality care for family caregivers of children with respiratory diseases. Design and methods: A qualitative, descriptive design was used with 13 pediatric healthcare providers. Findings: Gaps included themes of 1) fragmented healthcare system and 2) lack of asthma management knowledge. Barriers included themes of 1) poor access to healthcare and medications, 2) non-adherence, and 3) linguistic diversity and poor health literacy. Facilitators of optimal respiratory management included themes of 1) education, 2) improved communication, and 3) peer support. Conclusions: Through better understanding the gaps, barriers, and facilitators, pediatric nurses will be able to more effectively anticipate and address the needs of the caregivers. Practice implications: The nurse is in a pivotal role to empower caregivers with the skills and resources to address challenges and connect them with providers for optimal respiratory management.
Probation Officers’ and Supervisors’ Perspectives on Critical Resources for Implementing Specialty Mental Health Probation
This paper presents the results of a qualitative study designed to explore and identify the resources that probation officers need to implement specialized mental health probation caseloads, a promising practice that enhances mental health treatment engagement and reduces recidivism among people with mental illnesses. Our research team conducted a directed content analysis guided by the Practical, Robust Implementation and Sustainability Model (PRISM) to analyze qualitative interviews with 16 specialty mental health probation officers and their supervising chiefs. Results indicated five components and resources related to multiple PRISM constructs: (1) meaningfully reduced caseload sizes (intervention design), (2) officers’ ability to build rapport and individualize probation (organizational staff characteristics), (3) specialized training that is offered regularly (implementation and sustainability infrastructure), (4) regular case staffing and consultation (implementation and sustainability infrastructure), and (5) communication and collaboration with community-based providers (external environment). Agencies implementing specialized mental health probation approaches should pay particular attention to selecting officers and chiefs and establishing the infrastructure to implement and sustain specialty mental health probation.
Does gender-bending help or hinder friending? The roles of gender and gender similarity in friendship dissolution
We explored how gender and gender similarity affects friendship dissolution following the transition to middle school. We predicted that both gender and gender similarity (measured by perceived similarity to own-gender and other-gender peers) explain dissolution trends and that less own-gender similarity or more other-gender similarity predicts more friendship dissolution. We considered gender and gender similarity at both the individual and dyad level (reflecting the discrepancy between friends). Participants were 198 students in Grade 6 (42% Latinx, 21% Caucasian, 10% Native American, 8% African American, 2% Asian American, and 17% mixed backgrounds; 77% qualified for free/reduced meals) in reciprocated same- or mixed-gender friendships followed from fall to spring of the academic year. Multilevel multimember logistic regression models, nesting friendships within each participating individual, demonstrated that girl–girl friendships were less likely to dissolve than boy–boy friendships, and mixed-gender friendships did not dissolve more than same-gender friendships. Feeling similar to one’s own gender predicted less dissolution, but feeling similar to the other gender did not increase friendship dissolution. There was no support for the hypothesis that feeling similar to both genders (i.e., androgyny) protected against friendship dissolution, nor was there any support for the hypothesis that dyad-level differences in gender similarity would predict dissolution. The discussion focuses on the importance of conducting individual and dyad-level analyses as well as including gender similarity constructs when studying gender differences in friendships and their trajectories over time.
Addressing Gaps in Pediatric Scientist Development: The Department Chair View of 2 AMSPDC-Sponsored Programs
Value-driven attentional capture is modulated by the contents of working memory: An EEG study
Attention and working memory (WM) have previously been shown to interact closely when sensory information is being maintained. However, when non-sensory information is maintained in WM, the relationship between WM and sensory attention may be less strong. In the current study, we used electroencephalography to evaluate whether value-driven attentional capture (i.e., allocation of attention to a task-irrelevant feature previously associated with a reward) and its effects on either sensory or non-sensory WM performance might be greater than the effects of salient, non-reward-associated stimuli. In a training phase, 19 participants learned to associate a color with reward. Then, participants were presented with squares and encoded their locations into WM. Participants were instructed to convert the spatial locations either to another type of sensory representation or to an abstract, relational type of representation. During the WM delay period, task-irrelevant distractors, either previously-rewarded or non-rewarded, were presented, with a novel color distractor in the other hemifield. The results revealed lower alpha power and larger N2pc amplitude over posterior electrode sides contralateral to the previously rewarded color, compared to ipsilateral. These effects were mainly found during relational WM, compared to sensory WM, and only for the previously rewarded distractor color, compared to a previous non-rewarded target color or novel color. These effects were associated with modulations of WM performance. These results appear to reflect less capture of attention during maintenance of specific location information, and suggest that value-driven attentional capture can be mitigated as a function of the type of information maintained in WM.
Social mobility: The necessary focus of St. Louis investment in Black males (Race and Opportunity Lab Brief Report No. 1)
The tragic killing of Michael Brown on August 9, 2014, at the hand of Darren Wilson, a Ferguson, Missouri, police officer, further highlighted the long-standing disparities in health, education, employment, and overall well-being disproportionately burdening Black boys and young men in the St. Louis region (city and county). Since Brown’s death, we have observed a continuous environment of civil unrest and weakened confidence in the region’s welfare and economic future. An examination of reports and media discussions following the incidents in Ferguson reveal actions that have rightly centered on attending to structural determinants, racism, and equity (U.S. Department of Justice, 2015). Notably absent, however, was a central focus on the economic opportunity and overall well-being of Black boys and young men in the St. Louis region.