South Asian Young Adults and Gender Roles: Expectations, Expressions, and Intimate Partner Violence Prevention.

The goals of the researchers who conducted this study were to explore South Asian young adults' (N = 30) perceptions of gender roles and intimate partner violence (IPV) prevention in South Asian communities in the United States. Three distinct themes (a) gender role socialization and expectations, (b) gender role expression/negotiation within own intimate relationship, family, and own community, and (c) IPV prevention were identified. Important implications include how socialization and acculturation processes, immigration, and other factors influence South Asian young adults' perceptions of IPV in the community.

Intimate Partner Violence in an Orthodox Jewish Community in the United States: A Qualitative Exploration of Community Members' Perspectives.

This study sought to understand the needs and priorities of the Orthodox Jewish community around intimate partner violence in a medium-sized midwestern city. Twelve Orthodox Jewish rabbis, Rebbetzins, and community members (including survivors) were recruited to participate in in-depth, semistructured interviews. Interviews were analyzed using Dedoose via a mixed content analysis approach. Interviews revealed four themes: (1) Orthodox Gender Norms and Socialization: Risk or Protective Factor? (2) Awareness of DV Services in the Community; (3) Barriers to help-seeking; and (4) Salience of Rabbis and Rebbetzins. Recommendations for culturally congruent programs and practices are discussed.

Crisis Work Embedded in a Global Crisis: The Early Phase Impact of COVID-19 on Survivors of Intimate Partner Violence and Service Provisions.

COVID-19, as a global pandemic, was a public health inflection point for individuals affected by intimate partner violence (IPV) and those who provide IPV services. Public health guidelines that were intended to reduce risk of exposure to the virus impacted vulnerability factors for IPV survivors and associated systems of services. We aimed to (1) explore the effect of COVID-19 on survivors of IPV; (2) assess the effect of COVID-19 on IPV-related service provisions and service providers; and (3) explore challenges and opportunities in the wake of COVID-19 on broader IPV services and advocacy. METHOD: Twelve directors of IPV shelter, criminal justice, and other advocacy services within a diverse, Midwestern metropolitan area were recruited to participate in in-depth, semi-structured interviews in June-August 2020. Interviews were transcribed verbatim and analyzed using Dedoose. Data were coded and analyzed through thematic analysis. RESULTS: Four major themes, contextualized by COVID-19 and racial injustice, emerged from the data analysis: (1) IPV-related trends; (2) impact on IPV survivors, services, and agency morale; (3) inter-agency collaborations; and (4) future opportunities for innovative service delivery. Gaps and opportunities for developing culturally congruent, trauma-informed services were identified. CONCLUSION: Findings suggest that responsive and accessible IPV resources and associated advocacy services can make the difference between life and death for survivors.

IPV and Health Consequences Among CPS-Involved Caregivers: A Fixed Effects Analysis Stratified by Race and Ethnicity.

Intimate partner violence (IPV) is a public health dilemma that disproportionately affects minority women in the United States. The present study utilized data from the National Survey of Child and Adolescent Well-Being (NSCAW II) to examine the longitudinal course of IPV outcomes reported by minority women involved with Child Protective Services (CPS). Our findings highlight the heterogeneity of the relationship between IPV and mental or physical health based on race/ethnicity. Nonetheless, additional research is necessary to investigate the impact of IPV severity on physical and mental health outcomes to ultimately facilitate race-specific interventions for women involved with CPS.

Documenting Behavioral Health Needs in an Urban Setting.

Most local communities lack the capacity to conduct behavioral health needs assessments. The purpose of this paper is to describe a mixed-methods approach to estimate the behavioral health needs in St. Louis, MO. Data were drawn from multiple sources including local and state government prevalence estimates, medical records, and key informant interviews. The most prevalent behavioral conditions were depression, alcohol, and drug abuse. Priority populations were residents with co-occurring disorders, youth transitioning into the adult behavioral system, and homeless individuals with behavioral health needs. Treatment rates for behavioral health conditions were low, relative to identified needs. There are significant provider shortages and high staff turnover, which extend wait times, diminish the quality of care, and contribute to the use of emergency departments for behavioral health care. The data and methods described in this paper could be helpful to other municipalities that are looking to conduct behavioral health needs assessments.

Coding of Sexual Assault by Emergency Physicians: A Nationally Representative Study.

INTRODUCTION: Sexual assault is a public health problem that affects many Americans and has multiple long-lasting effects on victims. Medical evaluation after sexual assault frequently occurs in the emergency department, and documentation of the visit plays a significant role in decisions regarding prosecution and outcomes of legal cases against perpetrators. The American College of Emergency Physicians recommends coding such visits as sexual assault rather than adding modifiers such as "alleged." METHODS: This study reviews factors associated with coding of visits as sexual assault compared to suspected sexual assault using the 2016 Nationwide Emergency Department Sample. RESULTS: Younger age, female gender, a larger number of procedure codes, urban hospital location, and lack of concurrent alcohol use are associated with coding for confirmed sexual assault. CONCLUSION: Implications of this coding are discussed.

Intimate partner violence among pregnant women reporting to the emergency department: findings from a nationwide sample.

OBJECTIVE: Intimate partner violence (IPV) describes physical violence, sexual violence, stalking, or psychological harm by a current or former partner or spouse. During pregnancy, IPV has substantial negative implications for maternal and child health. The aim of the present study was to better understand the prevalence and sociodemographic and psychiatric correlates of IPV among pregnant females in the emergency department (ED). METHODS: Using the 2016 Nationwide Emergency Department Sample (NEDS), logistic regression was employed to examine the relationship between IPV during pregnancy, sociodemographic factors, substance abuse and mental health disorders. RESULTS: Bivariate analyses indicated that approximately 0.06% of pregnant women who visited EDs in 2016 were coded as experiencing abuse by a spouse or partner. Pregnant women abused by a spouse or partner were more likely to have a diagnosis of each of the disorders coded as complicating pregnancy, childbirth and the puerperium examined in this study, including alcohol use (0.77%, aOR 8.38, 95% CI 2.80 to 29.50), drug use (2.26%, aOR 3.49, 95% CI 1.60 to 6.15), tobacco use (11.05%, aOR 1.90, 95% CI 1.34 to 2.54) and general mental disorders (4.13%, aOR 2.64, 95% CI 1.60 to 4.79). CONCLUSION: Screening for IPV in EDs, especially among at-risk women identified in this study, may lead to referrals and coordination of care that could reduce the violence and improve maternal and child health outcomes.

Dog bite injuries in the USA: prevalence, correlates and recent trends.

Dog bite-related injuries are associated with high medical costs. The aim of this study was to estimate the prevalence, correlates and recent trends in dog bite injuries among male and female individuals presenting to US emergency departments. The prevalence of dog bites was calculated for years 2010-2014 using the Nationwide Emergency Department Sample. Sex-stratified multivariate logistic regression analyses were conducted with 'dog bite' as the dependent variable and patient and hospital characteristics as independent variables. Overall, the prevalence of dog bite injuries decreased from 2010 to 2014. The prevalence is highest in this sample among male youth. Male individuals diagnosed with an externalising behaviour disorder were more likely to present with a dog bite (OR=1.21, 95% CI 1.27 to 1.30). While the prevalence of dog bites has decreased in recent years, this costly and largely preventable injury remains a concern, especially among youth.

Caregiver and pediatric provider perspectives on symptom-based inhaled corticosteroid therapy in asthma.

OBJECTIVES: Guidelines recommend that healthcare providers adjust the dose of inhaled corticosteroids (ICS) in asthma patients based on the degree of symptom severity and control. Symptom-based, intermittent ICS therapy (use of ICS together with short acting bronchodilators- symptom-based adjustment: SBA) has been demonstrated to be comparable to guideline-based management by providers in controlled clinical trials. We sought input from African American caregivers and pediatricians on the acceptability and barriers for this alternative management strategy. METHODS: Focus group interviews of caregivers and individual interviews with community providers of African-American children ages 6-17 years with mild-moderate persistent asthma were conducted by trained facilitators to assess perceptions of how asthma affects children and their caregivers, and of SBA as a management strategy. Interview data were transcribed and analyzed using inductive thematic based coding. RESULTS: Twenty-six parents participated in six focus groups. Fourteen pediatricians were interviewed. Caregivers reported facing financial burden and difficulty with tracking medications. Caregivers and pediatricians were favorable about SBA, citing its potential for decreased use of medications and cost and similarity to actual care provided. Some caregivers voiced concern that SBA would not be as effective as daily ICS. Caregivers suggested that education on symptom recognition and close communication between physician and patient would facilitate the implementation of SBA. CONCLUSIONS: SBA was generally viewed favorably by caregivers and providers of African American children. However, concerns regarding effectiveness of SBA were voiced by both caregivers and providers. Patient education and provider-patient communication is important in implementing this alternative asthma management strategy.

In-home Smoking in Households with Women of Reproductive Age in Nepal: Does Women's Empowerment Matter?

Authors examined the prevalence and predictors of in-home smoking in households with women of reproductive age. They analyzed data from 9,837 ever married women from 2011 Nepal Demographic Health Survey. About 17 percent of women and 66 percent of their husbands smoked and 58 percent of the women lived in homes that permitted in-home smoking. About 6 percent of the women were pregnant and 42 percent had given birth within the past five years. In-home tobacco use was equally prevalent in homes with and without young children and irrespective of women's pregnancy status. Husband's use of tobacco doubled the odds of in-home smoking (odds ratio [OR] = 2.36; 95% confidence interval [CI] = 1.52-3.69) and wife's use of tobacco quadrupled the odds of in-home smoking controlling for other factors (OR = 3.94; 95% CI = 3.30-4.70). In addition, employed women were 39 percent more likely to allow in-home smoking than their unemployed counterparts (OR = 1.39; 95% CI = 1.19-1.63). Protective factors against in-home smoking were women's education, intrahousehold decision-making ability, household wealth, and urban residence. To reduce in-home smoking, social workers should increase awareness about the adverse consequences of secondhand smoke by providing counseling services to male and female tobacco users.

From the Individual to the Community: Perspectives about Substance Abuse Services.

This paper argues that substance abuse interventions in distressed African-American communities must be culturally-tailored and incorporate a framework targeting changes in both individual behavior and the community. The current study employed Concept Mapping in conjunction with Community-Based Participatory Research (CBPR) principles to involve 100 community members, substance users, and service providers to examine the role of alcohol and other drugs in distressed African-American communities. Findings reveal the way participants understand the role of drugs and alcohol in their community and their perceptions of substance abuse services. The paper describes a collaborative approach to engage the community in addressing substance abuse.