Objective
To illustrate the process of developing and sustaining an academic‐public health partnership for behavioral health integration through an expansion of the Aligning Systems for Health (ASfH) ...framework.
Study Setting
Practice‐informed primary data (2017–2023) from the Holistic Opportunity Program for Everyone (HOPE) Initiative based in Charlotte, NC.
Study Design
The unit of analysis in this descriptive case study is inter‐organizational, specifically focusing on an academic‐public health relationship. We illustrate the partnership process across the ASfH four core areas, including key challenges and insights.
Data Collection
Utilized a Critical Moments Reflection methodology and review of HOPE program data.
Principal Findings
(1) Formal partnership structures and processes are essential to monitoring the four ASfH core components for on‐going system alignment. (2) Aligning systems for health principally involves two ecologies: (i) the health program and (ii) the partnership. The vitality and sustainability of both ecologies require continuous attention and resource investment. (3) Relationships rest at the heart of aligning systems. (4) With comparative advantages in research methods, the academic sector is especially poised to collaborate with healthcare systems and human service organizations to study, develop, implement, and scale evidence‐based health interventions.
Conclusions
The academic sector shares overlapping purposes with the public health, healthcare, and social services sectors while providing complementary value. It is a critical sectoral partner in advancing population health and health equity.
Disclosure of interpersonal violence (i.e., sexual violence, sexual harassment, dating violence, and stalking) is often the first step toward receiving social and systemic support. Research ...demonstrates that sexual assault and dating violence survivors on college campuses are more likely to disclosure to informal sources (i.e., friends and family) than formal sources (e.g., police, Title IX, counseling centers). However, there is limited research examining disclosure rates after other forms of violence (i.e., stalking, sexual harassment), and little is known about the impact of the survivors' identities on disclosure. Utilizing four academic years (2016-2019) of aggregated campus climate data from a large Southeastern university, the current study examined rates of disclosure across experiences of sexual violence, sexual harassment, dating violence, and stalking while identifying whether the prevalence and type of disclosure (formal versus informal-only) differed by gender, sexual orientation, and/or race/ethnicity. Of 8,017 participants, 4.6% reported sexual violence, 18.9% reported sexual harassment, 12.3% reported dating violence, and 11.3% reported stalking in the past academic year. Results of multinomial logistic regression indicated that, across all four types of violence, men (as compared to women) had lower odds of disclosing both informally-only and formally. Bisexual as compared to heterosexual students had higher odds of formal disclosure of sexual harassment and stalking while gay/lesbian students had higher odds of formally disclosing sexual harassment. Individuals of another race/ethnicity (compared to White students) had lower odds of informal-only disclosure of dating violence. Findings underscore the need to implement programs to improve the social reactions of friends and family members receiving disclosures, and to increase culturally-tailored service provision.
The COVID-19 pandemic has exacted a physical and mental health toll on health care and hospital workers (HHWs). To provide COVID-19 care, HHWs expected health care institutions to support equipment ...and resources, ensure safety for patients and providers, and advocate for employees' needs. Failure to do these acts has been defined as institutional betrayal. Using a mixed-methods approach, this study aimed to explore the experience of institutional betrayal in HHWs serving COVID-19 patients and the associations between self-reported institutional betrayal and both burnout and career choice regret. Between July 2020 and January 2021, HHWs working in an urban U.S. health care system participated in an online survey (n = 1,189) and semistructured interview (n = 67). Among 1,075 quantitative participants, 57.8% endorsed institutional betrayal. Qualitative participants described frustration when the institution did not prioritize their safety while reporting they perceived receiving inadequate compensation from the system and felt that leadership did not sufficiently respond to their needs. Participants who endorsed prolonged breaches of trust reported more burnout and stronger intent to quit their job. Quantitatively, institutional betrayal endorsement was associated with 3-fold higher odds of burnout, aOR = 2.94, 95% CI 2.22, 3.89, and 4-fold higher odds of career choice regret, aOR = 4.31, 95% CI 3.15, 5.89, compared to no endorsement. Developing strategies to prevent, address, and repair institutional betrayal in HHWs may be critical to prevent and reduce burnout and increase motivation to work during and after public health emergencies.
Attitudes about violence and sex in dating relationships were related to psychological, physical, and sexual teen dating abuse perpetration and victimization. Data from Wave 4 of the national, ...randomly selected, Growing up with Media cohort (n = 876 adolescents aged 14‐19 years), collected in 2011, were analyzed. Dating youth perceived more peer pressure to have sex and were more accepting of sex in brief or nonmarital relationships than pre‐dating youth. Boys had higher levels of rape‐supportive attitudes than girls. Among dating youth, the relative odds of involvement in teen dating abuse as a perpetrator or a victim were generally associated with greater acceptance of relationship violence, perceived peer pressure to have sex, and acceptance of sex in brief and/or nonmarital relationships. Rape‐supportive attitudes were not significantly associated with any type of teen dating abuse involvement. Programs aimed at preventing dating abuse might benefit from targeting attitudes associated with sexual activity as well as relationship violence.
Aims
A mixed‐methods study details a multidisciplinary team's efforts to assess and transform police response to sexual assault in a mid‐size community.
Method
A police department‐wide survey (n = ...331) determined baseline levels of officer exposure to trauma‐informed training, rape myth acceptance, and awareness of community and nationwide sexual assault movements to understand officer attitudes towards factors influencing sexual assault investigations. These data, in conjunction with SAMHSA's (2012) trauma‐informed assumptions, were leveraged to develop and adopt trauma‐informed policies that would enhance the police department's response to sexual assault.
Results
At baseline, few officers reported receiving trauma‐informed interviewing training (21.8%) or having knowledge of local SAK, #MeToo, or #TimesUp movements (10.0%, 7.2%, 3.9%, respectively). Chi‐square analyses suggested officer knowledge of community SAK movement, personal investment in learning about sexual assault, and understanding of trauma were higher in officers with versus without training; of concern, officers with more sexual assaults on their caseload were more likely to endorse rape myths. Training understanding was related to lower rape myth acceptance.
Conclusions
Policy changes, including adding trauma‐informed training to the Police Academy, were implemented by the MDT to promote a system‐wide trauma‐informed approach to sexual assault and ensure community safety.
Teen dating violence (TDV) is a public health concern impacting more than half of U.S. adolescents aged 12 to 18. Sexual minority youth (i.e., adolescents who are not exclusively heterosexual) ...experience disproportionately high rates of TDV. Yet, measures of TDV such as the Conflict in Adolescent Dating Relationships Inventory (CADRI) have been developed without considering sexual identity with items and instructions frequently anchored in heterosexual romantic relationships. Examination of measurement equivalence across heterosexual and sexual minority youth has only begun recently with existing research examining the CADRI’s victimization scale measurement invariance providing empirical support for invariance across heterosexual and sexual minority youth. However, no prior research has examined the measurement invariance of the CADRI perpetration scales across heterosexual and sexual minority youth. The current study fills this gap by examining the CADRI perpetration scale measurement invariance across heterosexual and sexual minority youth. Using multigroup confirmatory factor analysis responses from 1,143 adolescents (Mage = 15.88, SD = 2.49) to the CADRI perpetration items were examined across heterosexual (n = 922) and sexual minority youth (n = 218). Results confirmed the five-factor structure of the CADRI perpetration scales, providing empirical support for the appropriateness of the use of the CADRI perpetration scale’s scores across heterosexual and sexual minority youth broadly. However, findings of partial scalar measurement invariance on the emotional/verbal abuse perpetration scale raise questions about the appropriateness of mean-score comparisons on this particular subscale. Areas of potential revisions of the emotional/verbal abuse perpetration scale are discussed to facilitate meaningful comparisons among heterosexual and sexual minority youth and to substantiate program evaluation results by groups.
This study considered whether experiencing cybervictimization is associated with increased recognition of cybervictimization intervention opportunities (i.e., witnessing others’ cybervictimization), ...as well as greater engagement in self-protective (e.g., changing usernames and privacy settings) and other-protective cybervictimization bystander response behaviors. We collected cross-sectional self-report data from an age-diverse (M = 46.29 years, SD = 19.14, range = 15–93) national sample (n = 3002). We hypothesized that: (1) personal experiences with cybervictimization would be associated with increased reports of witnessing opportunities to intervene when others are cybervictimized, greater self-reported use of active bystander behaviors in witnessed situations, and greater use of self-protective strategies; (2) We also expected that engagement in self-protective behaviors would be positively associated with engagement in other-protective bystander behaviors in response to witnessed cybervictimization. To test our hypotheses, we estimated a structural equation model wherein four latent variables were constructed: cybervictimization experienced, witnessed opportunities to intervene, engagement in self-protective behaviors, and engagement in other-protective cybervictimization bystander behaviors. As hypothesized, cybervictimization was associated with witnessing more opportunities to intervene in other’s cybervictimization, greater self-reported use of active cyber bystander behaviors, and greater engagement in self-protective strategies. However, the strength of two associations was moderated by age, with stronger relationships between cybervictimization and witnessing opportunities to intervene as well as engaging in bystander behavior for older as compared to younger participants. Contrary to hypothesis, there were no significant associations between use of self and other protective behaviors. Furthermore, greater witnessing of cybervictimization was associated with less engagement in bystander behavior in the final model. The implications for existing bystander intervention programs are described. Longitudinal studies of these associations in multiple age groups and among different cultural groups remain necessary.
Federally Qualified Health Centers (FQHCs) are a fast‐growing source of healthcare for women with intersectional identities, or those most frequently exposed to and negatively impacted by ...interpersonal trauma. According to the “3 E” conceptualization of trauma, certain Event‐ and Experience‐related characteristics of a trauma predict victims’ physical and mental health Effects. The “3 Es” have yet to be studied in female FQHC patients. The current study examined the prevalence of interpersonal trauma and interrelationships among traumatic Event‐related factors (e.g., cumulative trauma by victim‐perpetrator relationship), Experience‐related factors (e.g., betrayal, resilience), and Effects (e.g., somatic symptoms, posttraumatic stress (PTS), anxiety/depression, mistrust, reduced sense of safety) among 138 predominantly Black (89.1%) women receiving care at an FQHC in the southeastern U.S. Roughly 65% of participants (n = 86) endorsed exposure to at least one type of interpersonal trauma. More cumulative trauma was significantly correlated with more somatic, PTS, and anxious/depressive symptoms, and a reduced sense of safety. Experiences of betrayal and/or resilience were better predictors of PTS and anxious/depressive symptoms and lack of safety than Event‐related factors. Findings support the need for the implementation of trauma‐informed care within community‐based health centers. Healthcare providers should consider women's subjective experience of trauma when screening for exposure and providing trauma‐sensitive care.
Technology-facilitated intimate partner violence (T-IPV), including social media surveillance (SMS) and cyber dating abuse (CDA), are increasingly common post-breakup experiences among college ...students. Although a large body of research has focused on identifying risk factors for both types of T-IPV, perpetrators of T-IPV may differ in their pattern of risk factors. Using the I3 model as a guiding framework, the current study sought to identify typologies of college students engaging in post-breakup SMS and CDA. Specifically, 710 college students’ responses on self-report measures were examined for similarities in known risk factors, namely attachment anxiety, impulse control difficulties, lack of emotion regulation strategies, intolerance of uncertainty, distress tolerance, and problematic alcohol use. Three distinct perpetrator profiles emerged with attachment anxiety, alcohol use, and intolerance of uncertainty presenting as distinguishing features. Problematic alcohol use was evident in the moderate and high levels of SMS and CDA perpetration profiles. Contrary to what was expected, there appeared to be little variability in emotional regulation and impulse control abilities across the three profiles such that individuals belonging to low and high perpetration profiles did not differ in the degree to which they were able to control their impulses or access emotion regulation strategies. Results highlight the potential importance of tailoring interventions, while reducing transdiagnostic risk factors, to account for the heterogeneity in risk factors among T-IPV perpetrators.
Cyber dating abuse (CDA) is a growing public health concern among college students. CDA includes monitoring and abusive behaviors perpetrated toward an ex-partner via technology. Little is known ...about the predictors of CDA, particularly among sexual minority (SM) college students. Some theorized but relatively untested predictors include break-up characteristics, emotional regulation deficits, and alcohol use. The current study investigates what factors are associated with an increased risk for CDA toward an ex-partner (i.e., break-up characteristics, emotional dysregulation, and alcohol use) and the differences in associations with CDA between heterosexual and SM college students. Participants (N = 661) self-reported their CDA perpetration following their worst romantic break-up. They also answered questions about the break-up, their emotional regulation skills, and their current alcohol use. While SM students (n = 191) reported greater emotion regulation difficulties and alcohol use, they did not significantly differ from heterosexual participants (n = 470) in their reported CDA perpetration post-break-up. Hierarchical regressions were conducted to determine the impact of break-up characteristics and individual factors on CDA perpetration. Break-up characteristics, emotional dysregulation, and alcohol use significantly predicted heterosexual participants’ CDA perpetration and accounted for 17% of the variance. Conversely, for SM students, only alcohol use was predictive of CDA, accounting for 5% of the variance. Although SM students report similar break-up experiences and levels of CDA as heterosexual students, additional, unmeasured factors may drive perpetration. However, given the generally high rates of alcohol use and CDA, and their robust association, interventions targeting alcohol reduction and healthy relationship dissolution strategies may be beneficial.
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