College students' preferences for health care providers when accessing sexual health resources.

OBJECTIVE: Many emerging adults (18-25 year olds) report unmet health needs and disproportionately experience problems such as sexually transmitted infections. This study was conducted to examine college students' perceptions of health care providers, specifically in the context of accessing sexual health resources. DESIGN AND SAMPLE: Students (N = 52) were recruited from five diverse colleges in one state to participate in a one-to-one interview that involved walking and virtually exploring resources on and near campus. Interviews were conducted from May to November 2010. MEASURES: Open-ended one-to-one interview questions. RESULTS: Inductive qualitative analysis yielded six themes summarizing students' perceptions of provider characteristics, health care resources, the role of their peers, and students' suggestions for strengthening health care services. Importantly, students consider a variety of staff-and their student peers-to be resources for sexual health information and services. CONCLUSIONS: Findings emphasize the importance of collaboration between health service staff and broader campus staff because students often turn to campus staff initially. Postsecondary students welcome opportunities to know a provider through interactive websites that include details about providers on campus; their decisions to seek sexual health care services are influenced by their perceptions of providers' characteristics and interpersonal skills.

Sexual Violence in Virtual Reality: A Scoping Review.

BACKGROUND: One in four Americans report experiencing harassment online via social media and interactive gaming, which includes physical threats, stalking, sexual harassment, and sustained harassment. OBJECTIVE: The aim of this study was to gain understanding of the state of the science surrounding young adults and sexual violence/harassment harms in virtual reality (VR) as well as possible uses of VR to heal and intervene. METHODS: A scoping review was conducted in early 2023 using the Ovid Synthesis Clinical Evidence Manager and the MEDLINE database. Forty-seven articles met inclusion criteria. RESULTS: Our review found a growing body of evidence exploring incidents, effects, possible predictors, and initial strategies to prevent sexual violence in VR and to use the modality to positively intervene. Limited research addresses the effects of harms incurred in VR on (re)traumatization of survivors as well as the development and testing of VR tools used to educate, deliver bystander interventions, transform biases and perceptions via embodiment, and promote healing among survivors. CONCLUSION: Research addressing sexual violence in VR is needed and should build on the existing peripheral science on gaming and social media environments. Forensic nursing is well positioned to advance strategies of health and safety in VR, just as in the physical world. Incorporating forensic nursing avatars in VR and deploying diverse resources targeted for college-age young adults to prevent harms in VR should be explored safely and ethically. Forensic nurses are also positioned to assess for VR-related harms among patients and to work with private and government sectors to influence regulations and policies.

A Trauma-Informed Mentoring Framework for Forensic Nurses: An Overview of STEERR-Structure, Process, and Evaluation.

ABSTRACT: The STEERR Mentoring Framework, grounded in decolonized and feminist mentorship approaches, integrates foundational principles of mentoring with the unique and complex characteristics of the role of the forensic nurse. The primary objective of the program is to support a competent, sustainable, and resilient forensic nursing workforce. In this article, we describe the development process, framework structure, and evaluation approach implemented within a 1-year pilot initiative focused on forensic nurses in the sexual assault nurse examiner role. We reflect on strategies for broader application and replication in forensic nursing programs across the United States.

Health care reform and young adults' access to sexual health care: an exploration of potential confidentiality implications of the affordable care act.

One provision of the 2010 Affordable Care Act is extension of dependent coverage for young adults aged up to 26 years on their parent's private insurance plan. This change, meant to increase insurance coverage for young adults, might yield unintended consequences. Confidentiality concerns may be triggered by coverage through parental insurance, particularly regarding sexual health. The existing literature and our original research suggest that actual or perceived limits to confidentiality could influence the decisions of young adults about whether, and where, to seek care for sexual health issues. Further research is needed on the scope and outcomes of these concerns. Possible remedial actions include enhanced policies to protect confidentiality in billing and mechanisms to communicate confidentiality protections to young adults.

Characterizing sexual health resources on college campuses.

This observational study describes the development of the college resources and sexual health inventory, the profile of sexual health promotion resources at participating colleges, and comparisons of resources across several college characteristics. 28 diverse college campuses in one Midwestern state participated. 10 domains were assessed, including characteristics of campus health services (e.g. convenience), condom programs, sexual health information, communication about resources, sexual violence resources and gay/lesbian/bisexual student resources. Scores for each measure reflected the presence or extent of each resource. Summary scores were created for the overall level of sexual health resources and for each domain. T tests and ANOVAs were used to compare resources at 2-year versus 4-year colleges, public versus private sectors, metro versus non-metro locations, and across enrollment size. Inventory scores ranged from 6 to 53. 4-year colleges offered significantly more resources than 2-year; resource levels were statistically similar across location and enrollment size. Subsequent analyses comparing campuses with and without a health center indicated that several resources which were not inherently tied to a clinic nonetheless differed significantly with having a health center. Colleges without this resource could position sexual health resources in other offices or departments or provide referrals to sexual health resources in the broader community.

Conducting go-along interviews to understand context and promote health.

Go-along interviewing is an innovative approach to obtaining contextualized perspectives by conducting mobile interviews in which the participant acts as a navigational guide of the real or virtual space within which he or she lives. In this study, we used go-along interviews to obtain college students' contextualized perceptions of sexual health resources. Seventy-eight undergraduate students showed and described the resources on and near five campuses in a Midwestern state. In this article, we focus on the methodology of go-along interviews. The go-along, a relatively new methodology in health research, is a format in which participants take an active role in shaping the interview, and it facilitates identification of resources that might be overlooked using traditional interview formats. The go-along methodology is promising for researchers wanting to ground health-promotion efforts in the context of environmental or community-based strengths and needs.

College students' sexual health: personal responsibility or the responsibility of the college?

OBJECTIVE: This article examines students' perceptions of individual and institutional responsibility for sexual health so that institutions can better provide for the needs of their students to increase academic success and healthy relationship outcomes. PARTICIPANTS: Students from 2- and 4-year colleges in 1 state (N=78). METHODS: From May through November 2010, the authors used go-along interviews to examine students' perceptions of resources for sexual health on their campuses. RESULTS: Participants believed that it is the college's responsibility to provide resources and the responsibility of students to access resources. Participants at 2-year schools wanted referrals to resources, whereas participants at 4-year schools expected resources to be available and emphasized the importance of a supportive community. CONCLUSIONS: Students at 2- and 4-year colleges have different expectations of their institutions; by making resources and referrals for sexual health available, colleges can better serve their students, which will result in improved health outcomes.

Sexual health resources at Minnesota colleges: associations with students' sexual health behaviors.

CONTEXT: Sexual risk behaviors are common among college students, and research examining the environmental context of these behaviors is important for prevention. The presence of college sexual health resources is a potentially important part of that context. METHODS: In a 2010-2011 survey, 6,318 undergraduates from 28 two- and four-year Minnesota college campuses provided data on their sexual health behaviors. In addition, a specially designed inventory was used to assess the sexual health resources available on each campus. Multilevel regression was used to test the associations of four types of resources with students' condom use, birth control use, STD or HIV testing, and unplanned pregnancy. RESULTS: In models that controlled for students' personal and demographic characteristics, the higher the level of sexual health resources at a college, the lower the likelihood that students had had intercourse without birth control, intercourse without a condom and involvement in unplanned pregnancy. For example, students attending colleges with the maximum number of general clinic resources had a lower predicted probability of reporting nonuse of reliable birth control at last intercourse than students attending colleges with no resources (7% vs. 14%). After college characteristics were adjusted for, most measures of resources remained significant, although associations were reduced; two measures became significant in unexpected directions. CONCLUSIONS: Colleges' provision of sexual health resources may be associated with students' sexual health behaviors. Research using quasi-experimental or experimental designs is needed to assess the mechanisms underlying these associations; such work could lead to interventions that might help reduce students' risky behaviors.

Preventing sexual violence instead of just responding to it: students' perceptions of sexual violence resources on campus.

Rates of sexual assault of college students are higher than the national rates. Colleges are uniquely positioned to offer preventive education and support services to a high-risk group. This qualitative study examines students' perceptions of sexual violence resources and services. Seventy-eight female and male students, between 18 and 24 years old, belonging to various demographic groups, participated in one-to-one walking interviews on five diverse Midwest 2- and 4-year postsecondary campuses. Findings suggest that students are concerned with safety--students want more education regarding sexual violence--and they value services that offer protection from incidents of sexual violence on campus. Participants expressed mixed reactions to prevention education that combined sexual violence prevention with alcohol and drug use. Students shared positive views of the security measures on campus. They emphasized the importance of using varied mechanisms for sexual violence-related resource messaging and advised moving away from the pamphlet toward posters and online resources. Recommendations are offered to strengthen existing resources, such as prevention education and postassault interventions including sexual assault nurse examiner services, and to minimize barriers to access of sexual violence resources.