Human Services Utilization Among Male IPV Perpetrators: Relationship to Timing and Completion of Batterer Intervention Programs.

Limited information exists on the extent to which male perpetrators of Intimate Partner Violence (IPV) are engaged in the use of human services for co-occuringpsychosocial and health issues. The current analysis uses administrative data from one batterer intervention program (BIP) and data from the local Department of Human Services to explore perpetrators' engagement with human services, and the relationship of that use to timing and completion of the BIP. Data for 330 adult male clients referred to the participating BIP from 2010 to 2015 were collected. A majority (63%) had engaged in at least one human service program. The most common kind of service was mental health (46%). The most specific service engagement was child welfare as a parent (41%). Engagement largely concluded prior to beginning the BIP. BIP completers had less service use overall. Future work should explore how these services could be utilized to improve the success of BIPs and reduce perpetration.

Hepatitis C Virus Knowledge Among Pregnant Women with Opioid Use Disorder.

Objectives To evaluate Hepatitis C virus (HCV) knowledge and awareness among pregnant women with opioid use disorder (OUD). Methods From May through November 2015, a one-time survey was distributed to a convenience sample of pregnant women with OUD to assess their knowledge and awareness of (a) risk factors for HCV infection, (b) HCV transmission prevention strategies, (c) hepatotoxic risk reduction and (d) perinatal transmission and neonatal implications of HCV infection. Chi square and Fisher's exact tests were used to compare demographic characteristics and HCV knowledge between participants who were HCV positive and negative. Results Of 179 pregnant women with OUD approached, 169 (94%) completed the survey. Of these, 153 (90.5%) reported at least one risk factor for HCV infection, 85 (50.3%) were HCV positive and 38 (44.7%) of HCV positive women were diagnosed with HCV for the first time during pregnancy. When HCV knowledge was evaluated, 114 (66.7%) responded that sharing eating utensils could transmit HCV, 69 (55.0%) responded that there is a vaccine to prevent HCV and 56 (32.7%) did not identify intranasal drug use as a risk factor for HCV transmission. Among HCV positive women, 61 (71.8%) associated breastfeeding with an increased risk for HCV transmission, 33 (38.1%) failed to identify the importance of pediatric follow-up for HCV-exposed children and 16 (18.8%) perceived the risk of HCV vertical transmission as "likely" or "very likely." Conclusions for Practice Gaps in HCV knowledge exist among a rapidly growing population of pregnant women with OUD. Healthcare providers have a unique opportunity to provide HCV education and counseling during pregnancy.

Partner Violent Men's Perspectives on the Factors That They Believe Contributed to Their Abusive Behaviors.

While research on perpetration of intimate partner violence (IPV) is growing, few studies have sought to explore perpetrators' perspectives on their abusive behaviors. Thus, much remains unknown regarding how perpetrators view their abuse. We conducted 34 semistructured, open-ended interviews with men convicted of an IPV crime in which we broadly explored their perspectives on contributors to abuse. A history of exposure to violence as children, experiences with other traumatic events, and other causes (e.g., drug abuse) were the most cited. Our findings highlight areas where intervention efforts need to be tailored to address the unmet needs of men who perpetrate.

Pregnant Victims of Intimate Partner Homicide in the National Violent Death Reporting System Database, 2003-2014: A Descriptive Analysis.

Intimate partner homicide (IPH) is a leading cause of maternal mortality in the United States. However, very little information exists as to the circumstantial factors associated with IPH during pregnancy. We conducted a descriptive study of the demographic characteristics, psychosocial service engagement, and crises experiences (i.e., life and relationship stressors) among pregnant and nonpregnant victims to understand what differences, if any, exist in their risk profile for IPH. Data from the Centers for Disease Control and Prevention's National Violent Death Reporting System (NVDRS) were used for this study. The NVDRS is a national opt-in tracking system of all violent deaths in the United States. Pregnant victims (N = 293) were significantly more likely to be 5 years younger than nonpregnant victims, African American, and never married. Pregnant victims were more likely to be seen in the emergency room following the fatal incident. Nonpregnant victims (N = 2,089) were significantly more likely to have suspected alcohol use at the time of their death. In strictly proportional terms, we also observed higher rates of mental health problems, a history of mental health treatment, and a reported history of intimate partner violence (IPV), crisis, or family problems among nonpregnant victims. A wider range of IPH-related risk factors (e.g. substance abuse) need to be included IPV assessments. Future studies should seek to develop effective interventions to prevent IPH, particularly among reproductive aged women.

Key Components of the Batterer Intervention Program Process: An Analysis of Observational Data From Two Community-Based BIPs.

Qualitative research on batterer intervention programs (BIPs) has primarily consisted of interview-based studies of clients and facilitators. To date, no research has utilized observational data to understand how BIPs "work," or the processes occurring in BIPs that promote prosocial behavioral change. Forty-four observations of BIP group sessions were conducted. Two key processes were found: "facilitator processes" (e.g., managing group dynamics and engaging clients in learning) and "client processes" (e.g., mutual aid, help-seeking, and support). More observational research on BIPs is needed to uncover the full range of processes occurring during BIPs and that can link group processes to client outcomes.

The Challenges of Working With Men Who Perpetrate Partner Violence: Perspectives and Observations of Experts Who Work With Batterer Intervention Programs.

Batterer intervention programs (BIPs) constitute the primary treatment for perpetrators of intimate partner violence (IPV). Systematic evaluations of BIPs, however, have yielded modest results in terms of these programs' ability to reduce perpetration. Descriptive studies, which can provide information on the contexts and process associated with BIPs, can provide insights into the underlying mechanisms that might promote change among BIP clients, and as such are important to improving efficacy measures for BIPs. To date, however, limited research exists on what challenges BIPs encounter in working with clients, and how those challenges present barriers to behavioral change among perpetrators at the intervention level. As part of a 2-year ethnographic study, we conducted 36 individual semistructured interviews with professionals working with BIPs. We identified six themes related to challenges to promoting behavioral change among men who perpetrate violence: (a) social acceptance of IPV, (b) hypermasculine attitudes, (c) emotional problems, (d) childhood exposure to violence, (e) co-morbid mental health issues, and (f) denial, minimization, and blame. Our results have implications for thinking about some of the contextual factors that may impede BIPs ability to produce desired outcomes and for identifying areas in which programs can be tailored to improve the overall client experience. Our results also point to the need for a more coordinated community response to IPV, and in particular to helping provide resources that support BIPs sustained, safe, and as effective as possible work.

Messages About Contraception and Condoms in Mother-Adolescent Dyadic Conversations: Knowledge, Risks, and Effectiveness.

STUDY OBJECTIVE: Little is known about the content of parental discussions with young adolescents about reproductive health topics. We sought to characterize the messages mothers share about contraception and condoms. DESIGN: Recruitment occurred between January 2012 and May 2013. Mothers and their 12- to 14-year-old adolescent son or daughter were invited to participate in a semistructured conversation about everyday issues and health topics, including reproductive health topics. Discussions were audio-recorded, transcribed, and a grounded theory approach to content analysis was performed. Content analysis was performed to characterize maternal messages regarding contraception and condoms. SETTING: Urban city in western Pennsylvania. PARTICIPANTS: Twenty-five dyads; 14 mother-daughter dyads and 11 mother-son dyads. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Maternal reproductive health messages during conversations with early adolescent children. RESULTS: Four key themes emerged. Theme 1 focused on general facts about condoms and contraceptive methods, how each works, and how to obtain them. Theme 2 emphasized the consequences of sexual behaviors and the advantages of safe sex. Theme 3 conveyed the effectiveness of condoms and contraceptive methods for preventing pregnancy and sexually transmitted infections. Theme 4 described where adolescents could get more information about condoms and contraception. CONCLUSION: Mothers convey a broad range of information about contraceptives and condoms to young adolescents.

Male Intimate Partner Violence Perpetrators' Perceptions of the Positives and Negatives of Peer Interactions in Group Batterer Intervention Programs.

Seventy-six adult male perpetrators of intimate partner violence enrolled in a batterer intervention program (BIP) were interviewed on their perspectives of the intra-BIP group peer interactions. A majority of participants endorsed positives aspects of working with peers in the group context. Only one negative aspect arose, namely, other group members who disrupted the BIP process in some way. More importantly, a minority of participants expressed indifference toward the group process. This study has implications for training of BIP facilitators and for future research on BIPs that helps to tailor the approaches these groups use to maximize client engagement.

The Operational Challenges for Batterer Intervention Programs: Results From a 2-Year Study.

Batterers intervention programs (BIPs) constitute a primary intervention for perpetrators of intimate partner violence (IPV). There is little understanding as to what operational, or program-level, challenges BIPs face that can impede their effectiveness and adherence to state standards. As part of a 2-year ethnographic study, we conducted 36 individual semistructured interviews with professionals working with BIPs and identified five themes related to program-level challenges for BIPs: (a) information barriers, (b) safety issues, (c) facilitator retention and training, (d) the need for monitoring, and (e) funding constraints. We conclude that continued work needs to be done at both the state and local level, and in coordination with community judicial, mental health, human services, and other agencies to help provide resources that support BIPs in sustained, safe, and as effective as possible work.

Identifying Strategies for Effective Telemedicine Use in Intensive Care Units: The ConnECCT Study Protocol.

Telemedicine, the use of audiovisual technology to provide health care from a remote location, is increasingly used in intensive care units (ICUs). However, studies evaluating the impact of ICU telemedicine show mixed results, with some studies demonstrating improved patient outcomes, while others show limited benefit or even harm. Little is known about the mechanisms that influence variation in ICU telemedicine effectiveness, leaving providers without guidance on how to best use this potentially transformative technology. The Contributors to Effective Critical Care Telemedicine (ConnECCT) study aims to fill this knowledge gap by identifying the clinical and organizational factors associated with variation in ICU telemedicine effectiveness, as well as exploring the clinical contexts and provider perceptions of ICU telemedicine use and its impact on patient outcomes, using a range of qualitative methods. In this report, we describe the study protocol, data collection methods, and planned future analyses of the ConnECCT study. Over the course of 1 year, the study team visited purposefully sampled health systems across the United States that have adopted telemedicine. Data collection methods included direct observations, interviews, focus groups, and artifact collection. Data were collected at the ICUs that provide in-person critical care as well as at the supporting telemedicine units. Iterative thematic content analysis will be used to identify and define key constructs related to telemedicine effectiveness and describe the relationship between them. Ultimately, the study results will provide a framework for more effective implementation of ICU telemedicine, leading to improved clinical outcomes for critically ill patients.