Reproductive coercion in college health clinic patients: Risk factors, care seeking and perpetration.

AIMS: Reproductive coercion is associated with poor health outcomes in women. This study examined exposure to and use of reproductive coercion and care seeking among college students. DESIGN: A cross-sectional survey was administered to 2291 college students of all genders seeking care in college health and counselling centres as baseline data for a cluster-randomized controlled trial. METHODS: Online surveys were collected (9/2015-3/2017). Descriptive statistics, chi-square, Fisher's exact and t-tests were analysed. RESULTS: Among female participants, 3.1% experienced reproductive coercion in the prior 4 months. Experience was associated with older age (p = .041), younger age at first intercourse (p = .004), Black/African American race (p < .001), behaviourally bisexual (p = .005), more lifetime sexual partners (p < .001) and ever pregnant (p = .010). Sexually transmitted infection (p < .001), recent drug use or smoking (p = .018; p = .001), requiring special health equipment (p = .049), poor school performance (p < .001) and all categories of violence (p = <.001-.015) were associated with women's reproductive coercion experience. Participants who experienced reproductive coercion were more likely to seek care for both counselling and healthcare, (p = .022) and sexually transmitted infection (p = .004). Among males, 2.3% reported recent use of reproductive coercion; these participants reported sexual violence perpetration (p = .005), less condom use (p = .003) and more sexual partners than non-perpetrators (p < .001). CONCLUSION: Although reproductive coercion was reported infrequently among college students, those students experiencing it appear to be at risk for poor health and academic outcomes. Health and counselling centres are promising settings to address RC and related health behaviours.

Provider Screening and Counseling for Intimate Partner Violence: A Systematic Review of Practices and Influencing Factors.

BACKGROUND: Primary care providers have an important role in identifying survivors of intimate partner violence (IPV) and providing safety options. Routine screening rates by providers have been consistently low, indicating a need to better understand providers' practices to ensure the translation of policy into clinical practice. AIM: This systematic review examines common themes regarding provider screening practices and influencing factors on these practices. METHOD: A literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search focused on research articles which met the following criteria: (1) health-care providers as participants, (2) provider reports on screening and counseling practices for IPV, and (3) were in English or Spanish. RESULTS: A total of 35 studies were included in the review. Across studies, providers commonly acknowledged the importance of IPV screening yet often used only selective screening. Influencing factors on clinic, provider, and patient levels shaped the process and outcomes of provider screening practices. Overall, a great deal of variability exists in regard to provider screening practices. This variability may be due to a lack of clear system-level guidance for these practices and a lack of research regarding best practices. CONCLUSIONS: These findings suggest the necessity of more facilitative, clearly defined, and perhaps mandatory strategies to fulfill policy requirements. Future research directions are outlined to assist with these goals.