A Multiple Streams Framework Approach to Access to Domestic Violence Services in an Indigenous Community.

This article focuses on access to domestic violence services within Belize. Using data from community asset mapping, interviews with key informants, and focus groups with community members, the multiple streams framework was used to identify potential areas for intervention to improve access and ameliorate the effects of family violence in Belize. Identified challenges to accessing limited domestic violence resources were mainly confidentiality concerns and mistrust. Existing laws and regulations, organizational structures, and policies and plans also influenced access. Women's groups, nongovernmental organizations, and the health department can play a crucial role in improving access to domestic violence services.

How Community and Individual Risk Factors Mutually Impact Youth's Perceived Safety: A Syndemic Analysis Using Structural Equation Modeling.

The purpose of this study was to evaluate the mutual impact of community and individual factors on youth's perceptions of community safety, using structural equation modeling (SEM) conceptualized by syndemic theory. This study used survey data collected from a county wide sample of middle and high school students (N=25,147) in West Central Florida in 2015. The outcome variable was youth's perceptions of community safety. Predictors were latent individual and community factors constructed from 14 observed variables including gun accessibility, substance use, depressive symptoms, and multiple neighborhood disadvantage questions. Three structural equation models were conceptualized based on syndemic theory and analyzed in Mplus 8 using weighted least squares (WLS) estimation. Each model's goodness of fit was assessed. Approximately seven percent of youth reported feeling unsafe in their community. After model modifications, the final model showed a good fit of the data and adhered to the theoretical assumption. In the final SEM model, an individual latent factor was implied by individual predictors measuring gun accessibility without adult's permission (ß=0.70), sadness and hopelessness (ß=0.52), alcohol use (ß=0.79), marijuana use (ß=0.94), and illegal drug use (ß=0.77). Meanwhile, a community latent factor was indicated by multiple community problems including public drinking (ß=0.88), drug addiction (ß=0.96), drug selling (ß=0.97), lack of money (ß=0.83), gang activities (ß=0.90), litter and trash (ß=0.79), graffiti (ß=0.91), deserted houses (ß=0.86), and shootings (ß=0.93). A second-order syndemic factor that represented the individual and community factors showed a very strong negative association with youth's safe perception (ß=-0.98). This study indicates that individual risk factors and disadvantaged community conditions interacted with each other and mutually affected youth's perceptions of community safety. To reduce these co-occurring effects and improve safe perceptions among youth, researchers and practitioners should develop and implement comprehensive strategies targeting both individual and community factors.

Christian Churches and the Prevention of Preadolescent Aggression and Violence in Puerto Rico: Regional Leaders' Perspective.

Preadolescents' involvement in religious congregations may serve as a distal protective factor against aggression. Interviews were conducted to explore Puerto Rico (PR) Christian church and faith-based organization (FBO) leaders' knowledge and perceptions about preadolescent violence, and the role of congregations in its prevention. Bullying was perceived as the most common type of aggression among PR preadolescents. Education, positive role modeling, and relationships with pro-social adults are considered important in its prevention. While willing to engage in violence prevention efforts, congregations may possess limited knowledge on the topic and its relevance. Findings can help inform the development of collaborative research and prevention efforts at the family and community levels.

Lactation Consultants' Perceived Barriers to Providing Professional Breastfeeding Support.

BACKGROUND: Addressing suboptimal breastfeeding initiation and duration rates is a priority in the United States. To address challenges to improving these rates, the voices of the providers who work with breastfeeding mothers should be heard. Research aim: The purpose of this study was to explore lactation consultants' perceived barriers to managing early breastfeeding problems. METHODS: This qualitative study was conducted with a grounded theory methodological approach. In-depth interviews were conducted with 30 International Board Certified Lactation Consultants across Florida. Lactation consultants were from a range of practice settings, including hospitals, Special Supplemental Nutrition Program for Women, Infants, and Children clinics, private practice, and pediatric offices. Data were digitally recorded, transcribed, and analyzed in Atlas.ti. RESULTS: A range of barriers was identified and grouped into the following categories/themes: indirect barriers (social norms, knowledge, attitudes); direct occupational barriers (institutional constraints, lack of coordination, poor service delivery); and direct individual barriers (social support, mother's self-efficacy). A model was developed illustrating the factors that influence the role enactment of lactation consultants in managing breastfeeding problems. CONCLUSION: Inadequate support for addressing early breastfeeding challenges is compounded by a lack of collaboration among various healthcare providers and the family. Findings provide insight into the professional management issues of early breastfeeding problems faced by lactation consultants. Team-based, interprofessional approaches to breastfeeding support for mothers and their families are needed; improving interdisciplinary collaboration could lead to better integration of lactation consultants who are educated and experienced in providing lactation support and management of breastfeeding problems.

Positives and negatives of online dating according to women 50.

To understand the positives and negatives of online dating according to the lived experience of older women, telephone interviews were conducted with 45 women ages 50+ who date online. Interviews were audio recorded, transcribed verbatim, and thematically team coded. The opportunity to expand one's social network for both friendships and romantic partners, the ability to control dating risks and pace of relationship formation, and knowing more about one's partner were significant reported benefits of online dating. Dating online also includes unique risks, such as pervasive lying, attempted financial exploitation in the form of scammers, and unwanted electronic sexual aggression.

Post-traumatic stress disorder following emergency peripartum hysterectomy.

PURPOSE: Our objective was to explore if women who experience emergency peripartum hysterectomy (EPH), a type of severe maternal morbidity, are more likely to screen positive for post-traumatic stress disorder (PTSD) compared to women who did not experience EPH. METHODS: Using a retrospective cohort design, women were sampled through online communities. Participants completed online screens for PTSD. Additionally, women provided sociodemographic, obstetric, psychiatric, and psychosocial information. We conducted bivariate and logistic regression analyses, then Monte Carlo simulation and propensity score matching to calculate the risk of screening positive for PTSD after EPH. RESULTS: 74 exposed women (experienced EPH) and 335 non-exposed women (did not experience EPH) completed the survey. EPH survivors were nearly two times more likely to screen positive for PTSD (aOR: 1.90; 95 % CI: 1.57, 2.30), and nearly 2.5 times more likely to screen positive for PTSD at 6 months postpartum compared to women who were not EPH survivors (aOR: 2.46; 95 % CI: 1.92, 3.16). CONCLUSION: The association of EPH and PTSD was statistically significant, indicating a need for further research, and the potential need for support services for these women following childbirth.

Depression in Women Who Have Left Violent Relationships: The Unique Impact of Frequent Emotional Abuse.

Intimate partner violence (IPV) exposure has been associated with poor mental health outcomes for victims, but fewer studies have examined the unique contributions of emotional abuse to mental health. This study explored the contextual relationships between the type and frequency of IPV, community factors, and emotional health. Data were collected from a community-based IPV intervention program. Logistic regression found an increased likelihood of depression for respondents who experienced emotional abuse more than once per week (odds ratio [OR] = 4.864) and were worried about contact by the abuser (OR = 5.898). Results indicate the need for specific policy and practice attention to this issue.

A preliminary investigation of risks for adverse outcomes of relationship seeking on social network sites (SNS): a descriptive study of women over 50 seeking relationships on MySpace in Hillsborough County, Florida.

In contrast to younger populations, little attention has been paid to the increase in seniors using Internet-based venues to find relationships and the potential risk for adverse outcomes this poses. This study examined data collected via an online survey from 45 ethnically diverse women aged 50+ "seeking relationships" on MySpace. The majority of women reported a relationship with someone they met online (85%). They also reported experiencing adverse events including financial exploitation (40%), threats (55%), and physical harm (38%) by someone they met online at levels greater than traditional relationship seeking in the general population. Directions for future research are explored.

Women's experiences, emotional responses, and perceptions of care after emergency peripartum hysterectomy: a qualitative survey of women from 6 months to 3 years postpartum.

BACKGROUND: Little is known of the experience and perceptions of care for survivors of emergency peripartum hysterectomy (EPH), an obstetric event that is increasing in incidence. We sought to explore women's experiences of EPH to make recommendations for care. METHODS: This qualitative study utilized purposive sampling through an online support group of women who experienced EPH. Eligible participants were at least 18 years old, had their hysterectomy at least 6 months but no more than 3 years before the interview, had a surviving infant associated with the delivery, and did not report suicidal ideation. In-depth, semi-structured telephone interviews were conducted and analyzed using Constant Comparative Analysis. Kappa statistics assessed interrater reliability for two independent coders. RESULTS: Fifteen women participated with a mean age of 32.5 years. Most had a cesarean section, with uterine atony as the most common indication for EPH. Kappa statistics indicated near-perfect interrater agreement between two coders, ranging from .82 to .89. Seven major themes were identified: fear; pain; death and dying; numbness or delay in emotional reaction; bonding with baby; communication; and the need for information. Psychological upset occurred postpartum and was often delayed. A major finding is the need for additional follow-up visits to address the emotional after-effects and to fill in gaps in women's understanding and memory of what had occurred. CONCLUSION: Understanding women's experiences with EPH can help practitioners address not only women's initial complications but provide needed long-term support.

Reducing domestic violence and other criminal recidivism: effectiveness of a multilevel batterers intervention program.

This study evaluated whether the use of a multilevel system of intervention based on batterer assessment resulted in lowered risk of re-arrests for both domestic violence and other crimes. The study conducted analysis of data from 1995 to 2004, including initial arrest and program placement information and re-arrest rates for 17,999 individual batterers. The study found that recidivism rates were substantially lower for participants who completed the programs when compared to those who did not and that the re-arrest rates were substantially lower than are generally found in the literature on batterer recidivism. The study provides guidance to batterers intervention programs in approaches to designing countywide programs that are most effective in reducing recidivism in domestic violence batterers.

Is adolescent sibling violence a precursor to college dating violence?

OBJECTIVE: To determine whether experiencing sibling violence in adolescence is a significant predictor for later dating violence. The influence of parent-to-child and parent-to-parent violence is also explored. METHODS: A modified version of the CTS2 was administered to community college students. The survey instrument used the CTS2 psychological and physical assault subscales. RESULTS: Adolescent sibling violence was a predictor for college dating violence. Males reported experiencing more sibling violence than females did, but females reported experiencing more dating violence, both as perpetrators and victims. CONCLUSION: Further research is needed to improve understanding of the reasons for and the long-term consequences of sibling violence.