Examining the Implementation of the National Protocol for Sexual Assault Medical Forensic Examinations.

ABSTRACT: The National Protocol for Sexual Assault Medical Forensic Examinations, Adult/Adolescent, 2nd edition, or SAFE Protocol, is a voluntary guide that assists local and state jurisdictions with their responses to sexual assault by institutionalizing best practices around survivor care and evidence collection, particularly for sexual assault nurse examiners (SANEs) completing medical forensic examinations. We examined the uptake of the SAFE Protocol in communities across the United States by analyzing data from a set of national surveys of forensic nursing programs and victim advocates within the same communities. We studied four implementation outcomes: the acceptability, adoption, reach, and sustainability of the SAFE Protocol. SANEs and advocates reported that stakeholders responding to sexual assault-including forensic nurses, advocates, law enforcement, and prosecutors-have high implementation of the Protocol, which indicates how important individual stakeholder engagement is in actively facilitating the adoption of it. However, when information from SANEs and advocates from the same community are compared, the extent to which the SAFE Protocol is reported to be implemented with fidelity across U.S. jurisdictions is mixed.

Do Substance Use, Psychosocial Adjustment, and Sexual Experiences Vary for Dating Violence Victims Based on Type of Violent Relationships?

BACKGROUND: We examined whether substance use, psychosocial adjustment, and sexual experiences vary for teen dating violence victims by the type of violence in their relationships. We compared dating youth who reported no victimization in their relationships to those who reported being victims of intimate terrorism (dating violence involving one physically violent and controlling perpetrator) and those who reported experiencing situational couple violence (physical dating violence absent the dynamics of power and control). METHODS: This was a cross-sectional survey of 3745 dating youth from 10 middle and high schools in the northeastern United States, one third of whom reported physical dating violence. RESULTS: In general, teens experiencing no dating violence reported less frequent substance use, higher psychosocial adjustment, and less sexual activity than victims of either intimate terrorism or situational couple violence. In addition, victims of intimate terrorism reported higher levels of depression, anxiety, and anger/hostility compared to situational couple violence victims; they also were more likely to report having sex, and earlier sexual initiation. CONCLUSIONS: Youth who experienced physical violence in their dating relationships, coupled with controlling behaviors from their partner/perpetrator, reported the most psychosocial adjustment issues and the earliest sexual activity.

The co-occurrence of physical and cyber dating violence and bullying among teens.

This study examined the overlap in teen dating violence and bullying perpetration and victimization, with regard to acts of physical violence, psychological abuse, and-for the first time ever-digitally perpetrated cyber abuse. A total of 5,647 youth (51% female, 74% White) from 10 schools participated in a cross-sectional anonymous survey. Results indicated substantial co-occurrence of all types of teen dating violence and bullying. Youth who perpetrated and/or experienced physical, psychological, and cyber bullying were likely to have also perpetrated/experienced physical and sexual dating violence, and psychological and cyber dating abuse.

Correlates of cyber dating abuse among teens.

Recent advancements in technology (e.g., social networking, texting) have created new ways for dating youth to relate to one another, including in abusive ways via "cyber dating abuse." Cyber dating abuse is a form of teen dating violence that overlaps with other types of abuse (e.g., psychological) but also has several unique characteristics. Given the phenomenon's limited presence in dating violence literature, we focus on identifying how experiencing cyber dating abuse relates to youths' individual behaviors and experiences (e.g., substance use, sexual activity), psychosocial adjustment, school connection, family relationships, and partner relationships. A total of 3,745 youth (52% female, 74% White) in three northeastern states participated in the survey and reported currently being in a dating relationship or having been in one during the prior year. We found that experiences of cyber dating abuse were most significantly correlated with being female, committing a greater variety of delinquent behaviors, having had sexual activity in one's lifetime, having higher levels of depressive symptoms, and having higher levels of anger/hostility. Further, cyber dating abuse appeared somewhat more strongly related to depressive symptoms and delinquency than did other forms of teen dating violence and abuse.

Dating violence experiences of lesbian, gay, bisexual, and transgender youth.

Media attention and the literature on lesbian, gay, and bisexual youth overwhelmingly focus on violence involving hate crimes and bullying, while ignoring the fact that vulnerable youth also may be at increased risk of violence in their dating relationships. In this study, we examine physical, psychological, sexual, and cyber dating violence experiences among lesbian, gay, and bisexual youth--as compared to those of heterosexual youth, and we explore variations in the likelihood of help-seeking behavior and the presence of particular risk factors among both types of dating violence victims. A total of 5,647 youth (51 % female, 74 % White) from 10 schools participated in a cross-sectional anonymous survey, of which 3,745 reported currently being in a dating relationship or having been in one during the prior year. Results indicated that lesbian, gay, and bisexual youth are at higher risk for all types of dating violence victimization (and nearly all types of dating violence perpetration), compared to heterosexual youth. Further, when looking at gender identity, transgender and female youth are at highest risk of most types of victimization, and are the most likely perpetrators of all forms of dating violence but sexual coercion, which begs further exploration. The findings support the development of dating violence prevention programs that specifically target the needs and vulnerabilities of lesbian, gay, and bisexual youth, in addition to those of female and transgender youth.

The rate of cyber dating abuse among teens and how it relates to other forms of teen dating violence.

To date, little research has documented how teens might misuse technology to harass, control, and abuse their dating partners. This study examined the extent of cyber dating abuse-abuse via technology and new media-in youth relationships and how it relates to other forms of teen dating violence. A total of 5,647 youth from ten schools in three northeastern states participated in the survey, of which 3,745 reported currently being in a dating relationship or having been in one during the prior year (52 % were female; 74 % White). Just over a quarter of youth in a current or recent relationship said that they experienced some form of cyber dating abuse victimization in the prior year, with females reporting more cyber dating abuse victimization than males (particularly sexual cyber dating abuse). One out of ten youth said that they had perpetrated cyber dating abuse, with females reporting greater levels of non-sexual cyber dating abuse perpetration than males; by contrast, male youth were significantly more likely to report perpetrating sexual cyber dating abuse. Victims of sexual cyber dating abuse were seven times more likely to have also experienced sexual coercion (55 vs. 8 %) than were non-victims, and perpetrators of sexual cyber dating abuse were 17 times more likely to have also perpetrated sexual coercion (34 vs. 2 %) than were non-perpetrators. Implications for practice and future research are discussed.

Recent victimization experiences and continued criminal behaviors: what are the links for adult drug-involved offenders?

Using data from the multi-site adult drug court evaluation (MADCE), we examined the relationship between recent victimization experiences and the likelihood of subsequent criminal behavior among a sample of adult drug-involved offenders. The MADCE data used in this study involved interviews with 674 men and 284 women at baseline and then, 18 months later. Multilevel modeling showed that physical victimizations in the year before baseline, but not sexual victimization experiences, were associated with self-reported criminal offending behavior 18 months later. All relationships held true despite controlling for respondents' demographic, criminal history, prior drug-related characteristics, and their participation in a drug court or comparison site program.

Does recent physical and sexual victimization affect further substance use for adult drug-involved offenders?

This study examined whether physical and sexual victimization experiences were related to further substance use for a sample of drug-involved adult offenders and whether this increase could be attributed to depression experienced after the victimization occurred. A total of 674 men and 284 women from the longitudinal Multisite Adult Drug Court Evaluation (MADCE) were included in analyses. The study included 23 drug court and 6 comparison sites. Study participants completed three interviews: at baseline enrollment and then at 6 and 18 months after baseline. Multilevel path modeling showed that physical and sexual victimization experiences during the year before the baseline interview were associated with further substance use at 18 months and that this relationship was mediated by depression. All relationships held for both men and women, and beyond the contribution of several control variables, including drug court program participation. Public health and criminal justice personnel working with substance-using offenders should screen individuals for victimization-related trauma and, if identified, provide assistance to evaluate and improve such individuals' mental health and, subsequently, decrease their likelihood of using substances.

Sexual assault within intimate partner violence: impact on helpseeking in a national sample.

Within intimate partner violence (IPV), sexual assault is often subsumed under the heading of physical abuse, but evidence suggests qualitative differences in outcomes when both types of abuse occur. This study explores the cumulative effect of sexual assault and physical abuse by a current or former intimate partner on helpseeking. Using a dataset of 1,072 IPV victims from 8 states, we found that women who had experienced sexual assault in addition to physical abuse (44%) used more help, but were also more likely to say that they did not seek help when they needed it. Among those who were aware of services, fear was the greatest obstacle to reaching out for help. Implications include the need for information on best practices in addressing the sequelae of both physical and sexual assault in victim service agencies.

Predicting women's perceptions of domestic violence and sexual assault agency helpfulness: what matters to program clients?

Study goals were to assess if community agency interactions, the characteristics of services provided by staff, and the combinations of services received can predict women's perceptions of victim service helpfulness around domestic violence and sexual assault. Data were collected from agency representatives in 26 communities, and both women who used services and others living in the community (n = 1,509 women). Women found nonprofit victim services more helpful based on staff behavior in those agencies and the extent to which women felt control when working with staff; helpfulness of services was enhanced when agencies interacted with the legal system and other community agencies.

Impacts of agency coordination on nonprofit domestic violence and sexual assault programs in communities with STOP formula grant funding.

The goals of the current study are (a) to understand the community and state context in which STOP(Services* Training* Officers* Prosecutors)-funded victim service (VS) programs operate, (b) to assess the degree to which receipt of STOP funding for VS programs and the degree of state-level STOP agency support for collaboration among community agencies have led to improved program services and community interaction, and (c) to assess the degree to which improved interaction between community agencies leads to improvements for VS programs. The results show that community interaction between VS programs and other community agencies can improve VS program services as reported by service providers. In addition, the higher the pre-STOP levels of activity around violence against women issues in communities, the more agencies can enhance their service system with STOP funding. Also, STOP funding has facilitated greater levels of change for communities whose pre-STOP attention to violence against women was lower.

Predicting adolescent profiles of risk: looking beyond demographics.

PURPOSE: To identify vulnerability and protective factors related to profiles of risk encapsulating the co-occurrence of health risk behaviors. METHODS: The current sample includes 12,578 high school students from the National Longitudinal Study of Adolescent Health, a nationally representative sample. Four profiles of risk behaviors (sexual activity, general alcohol use, binge-drinking, cigarette use, marijuana use, other illicit drug use, fighting, and suicide) were compared separately by gender for factors in four domains: psychosocial adjustment, daily activities, school, and family. Data were analyzed using ordinary least-squares regression with follow-up contrast statements and multinomial logit regression. RESULTS: Results indicate that profiles are related to factors in the psychosocial adjustment, school, and family domains. Students in the lowest risk profiles reported consistently higher levels of protective factors and lower levels of vulnerability factors than students in any other profiles. Likewise, students in the highest risk profiles reported consistently lower levels of protective factors and higher levels of vulnerability factors than those in any other profiles. Students in profiles of risk distinguished by higher levels of suicidal thoughts and behaviors reported similar levels of vulnerability and protection as the highest risk profiles. Students in profiles consisting of sexually active, substance-using teens reported higher levels of protective factors and lower levels of vulnerability factors than both the highest risk profiles and the profiles distinguished by suicidal thoughts and behaviors. CONCLUSION: Program staff and policymakers should recognize that different profiles of risk behaviors are related to varying levels of vulnerability and protective factors which have potential implications for preventive interventions.