Sexual and Reproductive Healthcare Needs of Refugee Women Exposed to Gender-Based Violence: The Case for Trauma-Informed Care in Resettlement Contexts.

This paper assesses literature regarding the sexual and reproductive healthcare (SRH) needs of resettled refugee women who experienced gender-based violence (GBV) and trauma-informed care (TIC) principles utilized among SRH service providers. A systematic search identified relevant studies published between 2000 and 2021; no articles found reflected both SRH and TIC principles among refugee women. The search was therefore separated into two aims: to review the literature about SRH needs for refugee women in resettlement countries who experienced GBV (Aim 1) and to examine the use of TIC principles in SRH care among women who experienced GBV (Aim 2). Thematic analysis of the articles identified key themes. Twenty-six articles were included in the analysis across both aims (Aim 1 = 8, Aim 2 = 18). Aim 1 articles shared three factors shaping the SRH needs of resettled refugee women: the centrality of violence and trauma; structural barriers to SRH care; and actions, practices, and resources for service providers. Aim 2 articles illustrated seven key principles of TIC used in SRH service provision, such as empowerment; trauma-specific services and integrated care; connection; safety; collaboration; identity culture and context; and trustworthiness. Resettled refugee women's experiences of violence necessitate trauma-informed SRH health care. While there is limited peer-reviewed literature regarding TIC-SRH care for refugee women, the findings regarding the SRH needs of refugee women and the findings regarding the implementation of TIC in SRH collectively frame recommendations for how SRH can be infused with TIC. An example from practice, in the form of the Refugee Women's Health Clinic, is included as an exemplar of TIC SRH principles in action for the health of resettled refugee women who have survived gendered violence.

A qualitative exploration of caregivers' experiences with the Attachment and Biobehavioral Catch-up (ABC) parenting program.

In the face of childhood adversity, services and interventions can improve a child's life trajectory by promoting healthy development, enhancing protective factors, and building resilience through stable and supportive relationships. One such service, a specific and highly researched home visiting intervention, Attachment and Biobehavioral Catch-up (ABC), is often provided to families through home visiting service programs. This qualitative descriptive study examines the experiences of caregivers (N = 18) who received ABC as part of a statewide early childhood initiative in one midwestern state. Participants provided insight into the context of their lives before and during the intervention. They described their perspectives of the utility of the program and its influence on their family's behaviors and interactions. Findings demonstrate that coaching support bolstered caregivers' confidence in effective strategies and guided them through caregiving challenges. Caregivers observed growth in their caregiving practices, their infants' and young children's social and emotional skills, and their dyadic caregiver-child relationships, demonstrating the benefits of participating in and completing the ABC intervention.

Ante las circunstancias adversas en la niñez, los servicios e intervenciones pueden mejorar la trayectoria de vida de un niño promoviendo un desarrollo saludable, mejorando los factores de protección y generando fortaleza a través de relaciones estables y de apoyo. Uno de tales servicios, una intervención específica de visita a casa, bien investigada, el Alcance de la Bio-Conducta de Afectividad (ABC), se les proporciona a menudo a familias a través de programas que prestan el servicio de visitas a casa. Este descriptivo estudio cualitativo examina las experiencias de quienes prestan el cuidado (N = 18) que recibieron el ABC como parte de una iniciativa estatal sobre la temprana niñez en un estado del medio oeste. Los participantes aportaron ideas en cuanto al contexto de sus vidas antes y durante la intervención. Describieron sus perspectivas acerca de la utilidad del programa y las influencias de este sobre los comportamientos e interacciones de sus familias. Los resultados demuestran que el apoyo de entrenamiento reforzó la confianza de quienes prestan el cuidado en estrategias eficaces y los guió a través de los retos en la prestación del cuidado. Los cuidadores notaron crecimiento en sus prácticas de prestación del cuidado, las habilidades sociales y emocionales de sus niños, así como en las relaciones diádicas entre cuidador y niño, lo cual demuestra los beneficios de participar y completar la intervención ABC.

Face à l'adversité de l'enfance, les services et les interventions peuvent améliorer la trajectoire de vie d'un enfant en promouvant un développement sain, en améliorant les facteurs de protection, et en construisant une résilience au travers de relations stables et favorables. Un de ces services, une intervention à domicile spécifiques et ayant fait l'objet de nombreuses recherches, le Rattrapage Biocomportemental d'Attachement (soit en anglais Attachment Biobehavioral Catchup ici abrégé ABC), est souvent offert aux familles au travers de programmes de visite à domicile. Cette étude descriptive qualitative examine les expériences de personnes prenant soin d'enfant (N = 18) qui ont reçu l'ABC parce qu'il fait partie d'une initiative d'enfance précoce dans un état, dans un état du centre des Etats-Unis d'Amérique. Les participant(2)s ont donné un aperçu du contexte de leurs vies avant et durant l'intervention. Ils ont décrit leurs perspectives quant à l'utilité du programme et son influence sur les comportements et les interactions de leur famille. Les résultats démontrent que le soutien d'un coach a renforcé leur confiance en des stratégies efficaces et les ont guidés au travers des défis qu'il y a à prendre soin d'un enfant. Les participant(e)s ont observé une croissance dans leurs pratiques de soin, dans les compétences sociales et émotionnelles des enfants et dans leur relation dyadique personne prenant soin de l'enfant-enfant, prouvant ainsi les bénéfices qu'il y a à participer et à terminer l'intervention ABC.

Cervical Cancer Screening and Prevention among Survivors of Intimate Partner Violence.

Women who experience intimate partner violence are an underserved population at risk for cervical cancer, precipitated by their heightened risk for human papilloma virus (HPV) and underutilization of gynecological care. This pilot study describes the self-reported behaviors, levels of knowledge, and perceived self-efficacy with cervical cancer screening (i.e., Pap testing) and prevention (i.e., HPV vaccination) among survivors (N = 30) recruited from two domestic violence shelter organizations in the midwestern United States. Survey results indicate a need for increased knowledge and awareness about cervical cancer and prevention strategies among this population; only 23 percent (n = 7) participants reported an up-to-date Pap test and 17 percent (n = 5) participants reported HPV vaccination. Findings also indicate how theoretical constructs from the health belief model, together with feminist understandings of coercive control and empowerment, might explain survivors' proactive cervical health behaviors and offer insights for intervention.

"We've Already Endured the Trauma, Who is Going to Either End that Cycle or Continue to Feed It?": The Influence of Family and Legal Systems on Native American Women's Intimate Partner Violence Experiences.

Native American (NA) women experience higher rates of intimate partner violence (IPV) compared to other U.S. racial/ethnic groups, yet previous research has not sufficiently examined the complex determinants shaping their IPV experiences. This research explores the interplay of family networks and legal systems influencing NA women's IPV experiences. Data were collected through in-depth individual and group interviews with 42 NA survivors and 41 health/social service providers from July 2016 to June 2017 in NA communities from three different U.S. regions. We used Grounded Theory to develop emergent themes from the data, focusing on system-level risk and protective factors of women's of IPV experiences. In terms of family systems, participants indicated that NA communities were comprised of highly influential and interwoven family systems, making them powerful sources of support for both survivors and their partners who use violence. Participants described how intergenerational violence exposures contributed to the normalization of violence. In terms of legal systems, participants described inconsistent consequences for abusers of NA women, insufficient protection from legal systems, and manipulation of jurisdictional complexities. Interactions between family and legal systems influenced decision-making and outcomes. Family and community-based approaches, and the incorporation of traditional language and cultures, are needed to promote healing. Our findings reflect the complex ways that family and legal systems shape NA women's IPV experiences. Results provide insight into how NA women interact with and navigate these systems when experiencing IPV and how these systems impact decision-making and the ability to be safe from IPV. Research is needed to advance understanding of the inter-relationships between intergenerational trauma, family systems, and legal systems on IPV survivors' mental health and wellness. To make meaningful change, further research examining IPV from an interdisciplinary perspective that explores the interplay of social determinants of health inequities is needed.

Patterns of Help-seeking Strategies in Response to Intimate Partner Violence: A Latent Class Analysis.

Women engage in multiple strategies to cope with the impact of intimate partner violence (IPV). Prior research has focused predominantly on women's service utilization and help seeking as individual acts, yet it is likely that women engage in distinct patterns of multiple help-seeking strategies to achieve safety. As such, the current article examines patterns of service-related help-seeking strategies survivors employ. This article also investigates demographic factors, relationship characteristics, and mental and physical health effects of IPV associated with patterns of help seeking. Using a web-based survey, data were collected from service-engaged adult female IPV survivors (n = 369) in the Southwest region of the United States. Latent class analysis (LCA), a person-centered analytical approach, was used to identify survivors' patterns of help seeking. A 3-class LCA model was determined to be the best fit for the data. Among the sample, 50% of women broadly engaged formal and informal networks, 15% primarily engaged informal networks, and 35% broadly engaged networks but avoided legal systems while seeking other formal services. Findings indicated varying and significant associations between class membership and race/ethnicity, foreign-born status, number of children, IPV severity, and mental health symptoms. The findings reinforce the need for practitioners to be aware of the varied ways women choose or avoid seeking help and explore women's preferences. Comprehensive and collaborative service networks are necessary for early detection and holistic care. Addressing structural factors is imperative for expanding the range of viable support options available to IPV survivors, particularly women of color.

Abnormal Pap Follow-Up among Criminal-Legal Involved Women in Three U.S. Cities.

Criminal-legal involved women experience significant barriers to preventive cervical care, and consequently there is a higher incidence of cervical cancer in this population. The purpose of this study is to identify variables that may facilitate abnormal Pap follow-up among criminal-legal involved women living in community settings. The study included n = 510 women with criminal-legal histories, from three U.S. cities-Birmingham, AL; Kansas City, KS/MO; Oakland, CA. Participants completed a 288-item survey, with questions related to demographics, social advantages, provider communication, and reasons for missing follow-up care. There were n = 58 women who reported abnormal Pap testing, and n = 40 (69%) received follow-up care. Most women received either repeat Pap/HPV testing (n = 15, 38%), or colposcopy and/or biopsy (n = 14, 35%). Women who did not follow-up (n = 15, 26%) cited that they forgot (n = 8, 53%), were uninsured (n = 3, 20%), or were reincarcerated (n = 3, 20%). In a multivariate analysis, both having a primary care provider (OR 4.6, 95% CI 1.3-16.0) and receiving specific provider communication about follow-up (OR 3.8, 95% CI 1.1-13.2) were independent predictors for abnormal Pap follow-up. Interventions that offer linkages to providers in the community or ensure abnormal Pap care plans are communicated effectively may mitigate the disparate incidence of cervical cancer among criminal-legal involved women.

Women's Reproductive Coercion and Pregnancy Avoidance: Associations With Homicide Risk, Sexual Violence, and Religious Abuse.

This survey study explores patterns of reproductive coercion (RC) and pregnancy avoidance (PA) among women recruited from domestic violence shelters in the southwestern United States (N = 661). Two logistic regression models assessed the demographic, relationships, and violence characteristics associated with RC and PA. Younger, African American, and Hispanic women were more likely to experience RC. Homicide risk, sexual intimate partner violence (IPV), and religious abuse were associated with RC, and RC and homicide risk were associated with PA. We discuss implications of the associations between RC and PA and their links to religious abuse, sexual IPV, and homicide risk.

Women's Experiences of Sexual Violence in Intimate Relationships: Applying a New Taxonomy.

How do women describe their experiences of sexual violence in their intimate relationships? In answering this question, the present article builds upon a newly developed taxonomy of intimate partner sexual violence (IPSV). Women with past or present intimate partner violence experience (N = 28) were recruited from a domestic violence program and the community at large. Data were collected with semistructured, in-person interviews, audio recorded, and transcribed. As defined by the taxonomy, 27 women (96%) experienced intimate partner sexual abuse; 19 (68%) experienced intimate partner sexual coercion; 14 (50%) experienced intimate partner sexual assault; and two (7%) experienced intimate partner-forced sexual activity. Intimate partner sexual abuse was central to women's experiences of IPSV. Common categories of sexual abuse were having sex outside of the relationship, controlling reproductive decisions, degrading with sexual criticism and insults, refusing communication, denying pleasure, and withholding sex. The types of IPSV did not typically occur in isolation; the taxonomy revealed a grouping pattern, with intimate partner sexual assault and intimate partner sexual coercion co-occurring with sexual abuse. Understanding the different types of IPSV as a comprehensive mechanism of sexual control is a meaningful way to conceptualize sexual violence in intimate relationships. The expanded taxonomy provides a useful therapeutic tool in helping women share and heal from these experiences.

How Intimate Partner Violence and Intersectional Identities Converge to Influence Women's Sexual Health across Environmental Contexts.

In this qualitative study, authors examine women's sexual risk and protective factors based on their experiences of intimate partner violence (IPV) and positioning within society relative to power. This analysis examines sexual risk and protective factors across intersectional identities-including gender, race, socioeconomic conditions, and age-among women survivors of IPV. The sample (N = 28) included women of diverse ages (range = 22-60 years) and races (57 percent White, 14 percent African American, 11 percent Hispanic, 7 percent Native American, 7 percent multiracial, and 4 percent South Asian). Findings demonstrated that IPV experiences differentially affect women's sexual health according to intersectional identities and across various levels of environmental context by influencing the (in)stability of their lives and their experiences of (dis)empowerment. This analysis offers a nuanced understanding of how social workers can support women in planning for their own sexual health and safety and shows how an intersectional feminist framework enriches our understanding of the grand challenge to "build healthy relationships to end violence."

Safety and services for survivors of intimate partner violence: A researcher-practitioner dialogue on the impact of COVID-19.

This commentary offers a dialogue between a researcher and practitioner on the potential benefits of collaborative research to benefit survivors of intimate partner violence (IPV), a population exposed to high levels of violence and trauma. The dialogue occurred in a written, back-and-forth exchange, with the researcher and practitioner taking turns asking and responding to questions. The questions posed and answered in this commentary include: How are clients at an emergency domestic violence shelter experiencing the pandemic? How do you think a researcher or community member can help during a time like this? What should a researcher consider when engaging in collaborative research partnerships with service providers during this time? The answers offer insights into the importance of developing strong researcher-practitioner partnerships to improve services for trauma survivors during a global crisis. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Women's Healing Journey From Intimate Partner Violence: Establishing Positive Sexuality.

Survivors of intimate partner violence (IPV) have an elevated risk for negative sexual health outcomes, including HIV and sexually transmitted infection (STI). Given the unique risk contexts for survivors, there is a need for effective sexual health interventions that take into account the imbalances of power for women who are survivors of IPV. Toward the aim of informing contextually relevant intervention approaches, this article describes women's strategies toward maintaining their sexual health in the context of violent, controlling relationships. Strategies are examined across women's healing process. Data were collected through semi-structured, in-person interviews with women who had experienced IPV ( N = 28). Participants had a wide range of negative sexual health outcomes and commonly used an analogy of a journey to describe their healing. Throughout these journeys, women gained more confidence and ownership over their sexuality. Themes centered around enhanced self-acceptance, ownership of personal sexuality, and readiness for desirable sexual partnerships.

Promotion of Latina Health: Intersectionality of IPV and Risk for HIV/AIDS.

Latina women in the United States are vulnerable to two intersecting public health concerns: intimate partner violence (IPV) and subsequent risk for HIV/AIDS infection. Examination of the cultural and contextual life factors of this understudied population is crucial to developing culturally relevant HIV interventions. Focus groups with Latinas (15 monolingual; 10 bilingual) who have experienced IPV were conducted. Monolingual and bilingual Latinas endorsed that they were concerned about HIV infection, naming partner infidelity and experiences of forced and coerced sex as primary reasons for their concern. However, monolingual participants had lower levels of HIV knowledge, spending much time discussing myths of HIV infection, whereas bilingual participants spent more time discussing specific prevention techniques, including challenges related to the violence in their relationships. These findings suggest that HIV/AIDS prevention programs for Latinas need to pay close attention to the different historical, contextual, and cultural experiences of this at-risk group of women.

The State of Intimate Partner Violence Intervention: Progress and Continuing Challenges.

Over the past 40 years, intimate partner violence (IPV) has evolved from an emerging social problem to a socially unacceptable crime. The Violence Against Women Act of 1994 encourages state policies that focus on criminal justice intervention, including mandatory arrest and prosecution. Services offered to victim-survivors of IPV are often tied to criminal justice intervention, or otherwise encourage separation. These interventions have been seen as effectively using the authority of the state to enhance women's power relative to that of abusive men. However, these interventions do not serve the needs of women who, for cultural or personal reasons, want to remain in their relationship, or marginalized women who fear the power of the state due to institutionalized violence, heterosexism, and racism. The one-size-fits-all approach that encourages prosecution and batterer intervention programs for offenders and shelter and advocacy for victim-survivors fails to adhere to the social work value of client self-determination and the practice principle of meeting clients where they are. It is imperative that social workers in all areas of practice are aware of IPV policies, services, and laws. Social workers' challenge moving forward is to develop innovative and evidence-based interventions that serve all victim-survivors of IPV

Intimate Partner Sexual Violence: A Review of Terms, Definitions, and Prevalence.

Intimate partner sexual violence (IPSV) is a significant aspect of intimate partner violence (IPV). While intimate partners commit one third of sexual assaults, IPSV is often overlooked in studies about IPV and in research on sexual violence. There are difficulties identifying, defining, and measuring IPSV, and research lacks consistency in terminology and measurement. The purpose of this article is to review the terms, definitions, and measurements associated with IPSV. Academic journals and nonscholarly documents from the United States were searched for articles and reports associated with the study of sexual violence and IPV. Forty-nine documents met the criteria for inclusion. A four-part taxonomy defining IPSV was developed, which included IPSV, intimate partner sexual coercion, intimate partner sexual abuse, and intimate partner forced sexual activity. The average weighted prevalence rates of these various forms of IPSV were calculated across included research studies. However, the measurements generally used to assess IPV do not adequately measure IPSV. Future research should consist terms to ensure consistent conceptualization and measurement of IPSV and to inform practice with survivors.