Developing and implementing survivor-centred approaches for college student-athletes: perspectives from athletic department, Title IX, and campus advocacy personnel.

ABSTRACTBackground: Sexual violence (SV) is a persistent issue on US college campuses, particularly among college student-athletes. Strategies to address SV are urgently needed. Yet, prior research shows that many university practices can be more harmful than helpful to SV survivors and necessitates a reimagination of how institutions support SV survivors. Survivor-centred approaches may be one way to effectively address SV for students, including student-athletes, across college campuses.Objective: This qualitative study explored campus personnel experiences with and perceptions of survivor-centred SV prevention and intervention policies and practices on college campuses and examined how these approaches serve SV survivors, including college student-athletes.Methods: As part of a larger study on campus SV and student-athletes across four institutions, semi-structured interviews with 22 representatives from athletic departments, campus advocacy, and Title IX were conducted. Guided by phenomenology, a thematic analysis approach was used to identify key patterns in survivor-centred SV prevention and intervention policies and practices. Participant demographic data were analysed descriptively.Results: Most participants identified as white (72.2%), heterosexual (63.6%), women (68.2%), and were an average of 41.8 years old (SD = 10.2). The majority were in positions associated with athletic departments (63.6%), and they had been in their role for an average of 5.6 years (SD = 6.6). Through thematic analysis, three main themes were identified: (1) education & accessibility; (2) interpersonal relationships & individual well-being; and (3) campus and societal norms.Conclusions: The findings from this study highlight clear policy and practice recommendations for survivor-centred SV prevention and intervention on college campuses, such as accessible, applicable SV training and the implementation of survivor-centred approaches. Further research is needed to understand existing survivor-centred practices and the facilitators and barriers to their implementation across institutions and within athletic departments.

Sexual violence is a persistent issue on US college campuses, particularly among college student-athletes. Strategies to address SV are urgently needed. Survivor-centred approaches may offer solutions to better serve survivors of sexual violence, including student-athletes.Through interviews with athletic department, Title IX, and campus advocacy personnel, three themes were identified related to developing and implementing survivor-centred approaches: (1) education & accessibility; (2) interpersonal relationships & individual well-being; and (3) campus and societal norms.Further research is needed to understand existing survivor-centred practices and the facilitators and barriers to their implementation across institutions, particularly for college student-athletes.

Examination of protective factors that promote prosocial skill development among children exposed to intimate partner violence.

This retrospective cohort study examined prosocial skills development in child welfare-involved children, how intimate partner violence (IPV) exposure explained heterogeneity in children's trajectories of prosocial skill development, and the degree to which protective factors across children's ecologies promoted prosocial skill development. Data were from 1,678 children from the National Survey of Child and Adolescent Well-being I, collected between 1999 and 2007. Cohort-sequential growth mixture models were estimated to identify patterns of prosocial skill development between the ages of 3 to 10 years. Four diverse pathways were identified, including two groups that started high (high subtle-decreasing; high decreasing-to-increasing) and two groups that started low (low stable; low increasing-to-decreasing). Children with prior history of child welfare involvement, preschool-age IPV exposure, school-age IPV exposure, or family income below the federal poverty level had higher odds of being in the high decreasing-to-increasing group compared with the high subtle-decreasing group. Children with a mother with greater than high school education or higher maternal responsiveness had higher odds of being in the low increasing-to-decreasing group compared with the low stable group. The importance of maternal responsiveness in fostering prosocial skill development underlines the need for further assessment and intervention. Recommendations for clinical assessment and parenting programs are provided.

3-month prevalence of unwanted sexual contact victimization in a national sample of college students: differences by race, gender identity, and sexual identity.

IMPORTANCE: Most unwanted sexual contact victimization (USCV) research utilizes predominantly white, cisgender, heterosexual college student samples. Estimates of USCV prevalence and demographic variation can determine the need for dedicated funding and culturally relevant campus services for students in high-risk groups. OBJECTIVE: To estimate the national prevalence and demographic variation in self-reported USCV within the first three months of college. DESIGN: Data are from the Sexual Assault Prevention for Undergrads (SAPU) (2020-2021) dataset. SAPU is an online intervention program administered to students on more than 600 college campuses in the United States (N = 250,359). Group differences were assessed by race/ethnicity, gender identity, and sexual identity, and then stratified by gender to assess within-gender group differences. SETTING: The SAPU dataset includes public and private institutions and 2-year and 4-year colleges with varying sizes of enrollment. PARTICIPANTS: The sample is demographically diverse, and consists of newly matriculated U.S. college students, most of whom complete the SAPU program within the first three months of enrollment. MAIN OUTCOMES AND MEASURES: The primary outcome measure is self-reported USCV within the first three months of college enrollment, analyzed for subgroup differences. We hypothesized that USCV would be higher among students from racial/ethnic, gender, and sexual minority populations. RESULTS: Nearly 8% of transgender men reported USCV, followed by 7.4% of transgender women, 7.4% of genderqueer/gender non-conforming students, 4.5% of women, and 1.5% of men. Several subgroups reported exceedingly high rates of USCV, including Black students who identified as transgender women (35.7%) and American Indian/Alaska Native/Native Hawaiian/Pacific Islander students who identified as trans men (55.6%) or genderqueer/gender non-conforming (41.7%). CONCLUSIONS AND RELEVANCE: Universal and targeted (selective and indicated) intervention programs are needed to lessen USCV, particularly among gender minority students who also identify as Black, Indigenous, other person of color, or as a sexual minority.

Illuminating the landscape of sibling relationship quality: An evidence and gap map.

This paper used an evidence and gap map (EGM) to advance the scientific understanding of sibling relationship quality among children aged 2 to 18 years by synthesizing literature on 277 empirical studies from 1985 to 2022 to delineate patterns of study design, sampling, and measurement. Most existing research has utilized majority of White, middle-to-upper class, and/or two-caregiver family samples. Nearly 85% (n = 235) of studies used quantitative methods to measure sibling relationship quality across eight domains: conflict, warmth/affection, quality, cohesion, hostility, power/control, positive engagement, and conflict management. A total of 122 studies used a measure of sibling relationship quality as a predictor of sibling behavior, social, psychological, cognitive, health, or physiological outcomes. Future directions for research are discussed.

Examining the Association Between Trauma Characteristics and Adult Depression and Anxiety: Analysis of Types, Variety, Repetition, and Timing of Past Trauma.

Past research has emphasized the impact of prior trauma on adult depression and anxiety rates. However, few studies have examined the simultaneous connection between various trauma characteristics (e.g., type, variety, repetition, timing) and symptoms of depression and anxiety in adults. Understanding how these different trauma characteristics relate to mental health issues can offer valuable insight into predicting the onset of such problems. We conducted a cross-sectional analysis with 356 adult participants to explore the associations between lifetime trauma history and depression/anxiety scores. Participants retrospectively reported on five different traumatic experiences from birth to the present, including childhood physical abuse, witnessing parental violence, lifetime experiences of rape, witnessing trauma to loved ones, and the unexpected death of loved ones. For each trauma type, participants indicated the timing of their first exposure and the frequency of subsequent occurrences. Depression and anxiety symptoms in the past 2 weeks were also self-reported. Multiple regression analyses with covariates were employed. On average, participants experienced two out of the five trauma types. Regardless of the type, having at least one traumatic experience was linked to higher depression and anxiety scores. Those who experienced all five trauma types reported the highest levels of depression and anxiety. Repeated instances of rape, witnessing trauma to loved ones, and the death of loved ones were significantly associated with elevated depression and anxiety scores. The timing of exposure to the unexpected death of loved ones predicted higher depression scores in childhood compared to adulthood, while no relationship between timing and anxiety scores was observed. Other trauma types did not show significant associations. Our study enhances knowledge of the link between trauma and depression/anxiety by elucidating how various trauma characteristics, such as type, variety, repetition, and timing of trauma, have differential influences on depression and anxiety scores.

Dating Abuse and Harassment Among Sexual and Gender Minority U.S. College Students.

Purpose: Sexual and relationship violence has devasting effects on the health and well-being of college students. This study assessed the prevalence of dating abuse victimization and harassment among sexual and gender minority (SGM) college students within the first 3 months of college enrollment and identified potential demographic differences in exposure. Methods: Data are from the 2020 to 2021 Sexual Assault Prevention for Undergraduates digital sexual assault prevention program (N = 250,359). Descriptive statistics were used to determine 3-month prevalence of dating abuse victimization and harassment among gender identity and sexual orientation subgroups and to examine within-group differences based on race and ethnicity. Results: Dating abuse victimization during college was reported by 6.5% of transgender women, 5.0% of transgender men, 5.0% of genderqueer/nonconforming students, 2.0% of "women," and 1.0% of "men." Harassment during college was reported by 13.7% of genderqueer/nonconforming students, 11.2% of transgender women, 8.9% of transgender men, 8.7% of "women," and 1.6% of "men." Students who identified with more than one sexual orientation identity reported the highest rates of dating abuse (3.9%) and harassment (14.9%) during college. SGM students with particular racial/ethnic identities (i.e., Indigenous, multiracial) reported disproportionately higher rates, particularly American Indian/Alaska Native/Native Hawaiian/Pacific Islander students who identified as transgender men (42.9%), transgender women (41.7%), genderqueer/nonconforming students (26.1%), queer/pansexual/questioning students (20%), and students with multiple sexual orientation identities (36.4%). Conclusion: Targeted intervention strategies and resources are needed on college campuses to support the needs and experiences of SGM students, including students who identify as Indigenous, multiracial, and other persons of color.

Materials and Methods for Recruiting Systematically Marginalized Youth and Families for Weight-Management Intervention Trials: Community Stakeholders' Perspectives.

Rates of overweight and obesity are problematic among systematically marginalized youth; however, these youth and their families are a hard-to-reach research population. The purpose of our study was to identify facilitators and barriers for recruiting systematically marginalized families in youth weight-management intervention research. This study built upon existing evidence through involvement of youth, parents, community agency workers, and school nurses, and an exploration of both recruitment materials and processes. Seven focus groups were conducted with 48 participants from 4 stakeholder groups (youth, parents, school nurses, and community agency workers). A codebook approach to thematic analysis was used to identify key facilitator and barrier themes related to recruitment materials and processes across the stakeholder groups. Ecological systems theory was applied to contextualize the facilitators and barriers identified. Participants reported the need to actively recruit youth in the study through engaging, fun recruitment materials and processes. Participants reported greater interest in recruitment at community-based events, as compared to recruitment through health care providers, underscoring the depth of distrust that this sample group has for the health care system. Recommendations for recruitment materials and processes for weight-management intervention research with systematically marginalized families are proposed.

Strategies to Engage Systematically Marginalized Youth and Their Families in Research Using High-Tech Methods.

The purpose of this study was to identify facilitators and barriers for engaging youth and families from a historically and systematically marginalized community in high-tech research. Adapting community-based participatory research principles, 4 focus groups were conducted with 13 youth and 12 parents. Using codebook thematic analysis, 5 facilitator themes (develop skills, ensure health, build understanding, promote safety, and help others, youth-initiated interest) and 4 barrier themes (anxiety and fear, skepticism, confusion, and unfamiliar/unknown experience) were identified. Youth and parent responses informed proposed guidelines for recruiting and engaging families in research using high-tech methods, particularly those from historically and systematically marginalized communities.

"Making Sure We Are All Okay": Healthcare Workers' Strategies for Emotional Connectedness During the COVID-19 Pandemic.

Healthcare workers have been on the front lines throughout the COVID-19 pandemic, treating affected patients and navigating overwhelmed healthcare systems. Emotional connection has been associated with resilient outcomes following collective trauma. This qualitative study examined how healthcare workers define emotional connectedness during the COVID-19 pandemic and their adaptive emotional connection strategies. Data were gathered through the first wave of the online COVID-19 Pandemic and Emotional Well-Being study, a prospective panel study of the psychological impact of COVID-19 on frontline workers and the general public. This study focused on three extended-response questions about definitions of and strategies for emotional connectedness. Data were analyzed using reflexive thematic analysis. Participants conceptualize emotional connectedness as having empathy and value, help and support, presence, and vulnerability. They also describe emotionally connected relationships as being characterized by mutuality and frequent contact. Participants identify current behavioral strategies for cultivating emotional connectedness, such as using technology, providing instrumental help or sending gifts via mail, and building quality time within their households. They also report challenges in maintaining these connections. Future research must contribute knowledge about effective interventions for essential healthcare workers in the aftermath of COVID-19. Specific recommendations for social work practitioners are also discussed.

Client Violence Against Youth Care Workers: Findings of an Exploratory Study of Workforce Issues in Residential Treatment.

Residential treatment centers (RTCs) for youth are plagued by high turnover of youth care workers who provide round-the-clock treatment and supervision to youth with severe affective and behavioral problems. This article presents findings from a 15-month ethnographic study of workforce issues in one RTC related to youth care workers' exposure to client violence (CV). Findings are based on 65 semistructured interviews and 490 hours of participant observation with consenting employees. Participants reported CV incidents, including punching, kicking, biting, hair pulling, choking, threats or assaults with a weapon, and other physical and sexualized violence. Workers viewed CV as an inevitable aspect of youth care work that could be reduced-though not eliminated-through proper use of de-escalation and behavior management techniques. Participants reported that exposure to CV sometimes resulted in serious physical injury and/or missed work, as well as substance abuse, anxiety, sleep disturbance, and memory loss. Participants reported that CV was the most difficult part of their jobs and cited it as a reason for leaving or wishing to leave youth care work. We conceptualize youth care workers in RTCs as a vulnerable class whose biopsychosocial well-being must be protected to better serve the vulnerable youth in their care. To that end, we suggest directions for future research on CV in residential treatment and propose measures RTCs can take immediately to better understand and prevent CV in their organizations.

An integrative review of adolescent trust in the healthcare provider relationship.

AIM: To conduct an integrative review of empirical studies examining factors affecting trust in the healthcare provider (HCP) relationship among adolescents. DESIGN: An integrative review was conducted. DATA SOURCES: The keywords adolescent, trust, healthcare provider and related words were searched in multiple online research databases. The results were limited to research published between 2004 and 2019. Seventeen primary sources were identified and synthesized in the final review. REVIEW METHOD: Guided by the Whittemore and Knafl integrative review method, a data-based convergent synthesis design was used to explore the key research question in both qualitative and quantitative research. RESULTS: This integrative review found that health care provider behaviours, such as confidentiality, honesty, respect, and empathy, promote adolescent's trust of the HCP. Notable gaps in the literature were also identified, including a lack of diversity among adolescent samples and HCP types and underdeveloped measures of adolescent trust of HCP. CONCLUSION: This integrative review informed the development of a new conceptual definition of adolescent trust of HCP, which embodies the key findings of the importance of HCP confidentiality, honesty, respect, and empathy. This definition can be used to develop instruments, interventions and policies that promote HCP trust among adolescents. Future research is needed to develop instruments to measure adolescents' trust of HCPs, evaluate trust of HCPs among diverse samples of adolescents and evaluate adolescent trust of HCPs with a variety of HCP types. IMPACT: The new conceptual definition of adolescent trust of HCP can be used to enhance nursing practice and design behavioural interventions to improve trust of HCP. To foster adolescent trust of HCP, policies should be enacted in healthcare institutions to explain confidentiality, provide notification of reporting mandates and formalize consent, assent and dissent for adolescents seeking health care.

A Paradigm Shift in Batterer Intervention Programming: A Need to Address Unresolved Trauma.

Intimate partner violence (IPV) is a significant public health problem affecting women, men, and children across the United States. Batterer intervention programs (BIPs) serve as the primary intervention for men who use violence, employing three primary modalities: psychoeducation, cognitive-behavioral therapy (CBT), and other forms of group therapy such as alcohol or drug treatment. However, research indicates that program effectiveness of the primary BIP modalities is limited, due, in part, to the theoretical underpinnings guiding intervention such as learned behavior (psychoeducation), patriarchy as the root cause (Duluth model), and "dysfunctional" thinking (CBT). Considering the mental, physical, and economic toll of IPV on families and the limited effectiveness of current intervention approaches, an assessment of the strengths and weaknesses of current modalities and an incorporation of the latest science addressing violence prevention and cessation are paramount. This article draws upon existing theories of trauma and the etiologies of violence perpetration and proposes an alternative model of care for men with IPV histories. Experiences of childhood adversity and trauma have well-established associations with a range of negative sequelae, including neurological, cognitive, behavioral, physical, and emotional outcomes. Childhood trauma is also associated with later violence and IPV perpetration. Thus, incorporating trauma-informed care principles and trauma interventions into programming for IPV perpetrators warrants further investigation. Practice and policy implications of a trauma interventions for men with IPV histories, as well as areas for future research, are discussed.

Moral People or Moral Projects? Worker Altruism in Youth Residential Treatment.

Paraprofessional youth care workers in residential treatment centers (RTCs) are responsible for the everyday care, supervision, and treatment of youth with serious behavioral and mental health challenges. Turnover rates among this poorly paid workforce are high, and it is not known why individuals seek and maintain youth care work despite its significant challenges. Following anthropologists who study morality as situated practice, we investigate the role of altruism in recruiting and retaining workers in RTCs. We ask: How do managers and youth care workers understand altruism and its role in youth care work and what are the consequences of those understandings? Through organizational ethnography of an RTC, we show that workers and management understood altruism differently. Managers viewed altruism as an inherent trait of some and attributed turnover to its lack. Although workers sometimes enacted this script, they understood themselves as engaged in far more complex situated moral projects in which altruism was only one part. We demonstrate political effects of these differing understandings of altruism, namely, that management deflected institutional critique by viewing it as a sign of workers' immorality. We offer modest recommendations for RTCs seeking to recruit and retain competent youth care workers and address potential new directions for moral anthropology of organizations.