Introduction Texas SB 1191 was enacted in 2013 with the intent of increasing access to medical forensic examinations for sexual assault victims by requiring every hospital with an emergency department to be prepared to provide a medical forensic examination if requested by a sexual assault victim. To realize that goal, the law also required basic forensic training for medical professionals before conducting a medical forensic examination as well as a requirement that hospitals develop a "plan to train personnel on sexual assault forensic evidence collection." Methods Interviews were conducted in 18 healthcare facilities (five with sexual assault nurse examiner [SANE] programs and 13 without SANE programs) in Dallas, Lubbock, and Austin to determine their awareness and compliance with SB 1191. Results The data suggest that the law had a little effect on actual practice, and sexual assault survivors still sought a SANE program for a medical forensic examination. Discussion Although SB 1191 is an important state level effort to make forensic examinations more readily available, it did not fully account for the challenges faced by smaller hospitals that do not see enough sexual assault victims to justify training staff to SANE standards and did not adequately address the training required by medical professionals to feel prepared to conduct a medical forensic examination.

Increasing the Accessibility of Sexual Assault Forensic Examinations: Evaluation of Texas Law SB 1191.

Abstract Objective To investigate the frequency and impact of contraceptive coercion in the Appalachian region of the United States. Data Sources and Study Setting In fall 2019, we collected primary survey data with participants in the Appalachian region. Study Design We conducted an online survey including patient‐centered measures of contraceptive care and behavior. Data Collection/Extraction Methods We used social media advertisements to recruit Appalachians of reproductive age who were assigned female at birth (N = 622). After exploring the frequency of upward coercion (pressure to use contraception) and downward coercion (pressure not to use contraception), we ran chi‐square and logistic regression analyses to explore the relationships between contraceptive coercion and preferred contraceptive use. Principal Findings Approximately one in four (23%, n = 143) participants reported that they were not using their preferred contraceptive method. More than one‐third of participants (37.0%, n = 230) reported ever experiencing coercion in their contraceptive care, with 15.8% reporting downward coercion and 29.6% reporting upward coercion. Chi‐square tests indicated that downward (χ2(1) = 23.337, p < 0.001) and upward coercion (χ2(1) = 24.481, p < 0.001) were both associated with a decreased likelihood of using the preferred contraceptive method. These relationships remained significant when controlling for sociodemographic factors in a logistic regression model (downward coercion: Marginal effect = −0.169, p = 0.001; upward coercion: Marginal effect = −0.121, p = 0.002). Conclusions This study utilized novel person‐centered measures to investigate contraceptive coercion in the Appalachian region. Findings highlight the negative impact of contraceptive coercion on patients' reproductive autonomy. Promoting contraceptive access, in Appalachia and beyond, requires comprehensive and unbiased contraceptive care.

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/1475-6773.14157

Health care provider bias in the Appalachian region: The frequency and impact of contraceptive coercion

Development of a Sexual Assault Support Group for Female Rape Victims by Ann Marie Willoughby MS, Walden University, 2015 BS, University of Dundee, 2013 Project Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University August 2018 Abstract Survivors of sexual assault struggle to cope with subsequent psychological disturbances. The project facility was a rural hospital in the southwestern United States in whichSurvivors of sexual assault struggle to cope with subsequent psychological disturbances. The project facility was a rural hospital in the southwestern United States in which postasault care was initially provided, but survivors later returned to the emergency department. Support groups can be a powerful tool to alleviate long-term consequences of assault by helping individuals cope and improving socialization. This project used the social-ecological theory to explore whether a sexual assault support group would impact the progress of survivors toward improved social interaction, improved socialization, and decreased psychological disturbance. The purpose of the quality improvement (QI) project was the development of a sexual assault support group, based on the International Association of Forensic Nurses guideline to improve and expand health care services for survivors of sexual assault. The QI development was accomplished in conjunction with a team of local experts consisting of law enforcement, social worker, nurse, victims advocate and, a victim of sexual assault, who provided process evaluation regarding their satisfaction with the planning process through the completion of an anonymous, 10question, Likert-type survey. A descriptive analysis of the data provided information that positively supported the development of the project. Project deliverables included the developed QI, a plan for later implementation, and plans for outcome evaluation through measurement of socialization, psychological disturbances, and emergency department visits. This project has the potential to achieve positive social change through improved quality of life for survivors of sexual assault Development of a Sexual Assault Support Group for Female Rape Victims by Ann Marie Willoughby MS, Walden University, 2015 BS, University of Dundee, 2013 Project Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University August 2018 Dedication I dedicate this project to the women who have suffered a sexual assault and has fought back to defy societal odds. Those who are struggling and those who need help in coping with the stresses of sexual victimization. Additional, all those who give willingly of themselves to support victims of sexual assault. Acknowledgments My husband and son have been a tower of strength throughout my educational journey. Upon graduating with my Masters, they pushed me into pursuing my doctoral studies. Reminding me of the dangers of delaying when it comes to adult learning. I cannot forget the nights my husband sleeps on the sofa as a means of supporting me while I sit at my desk doing schoolwork. Although he would go out to work and is tired, he never fails to prepare a hot meal while I study. To my son, for being patient and for the times I could not attend a tennis match because I am writing a paper, thank you for your understanding. I would like to thank my Chair; Dr. Cassandra Taylor, committee member Dr. Dana Leach and all Instructors at Walden University, who supported and guided me on my journey throughout the course.

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Development of a Sexual Assault Support Group for Female Rape Victims

We investigated the role of COVID-19 exposure and discrimination on depressive and posttraumatic stress symptoms among Latinx adults residing in the southeastern United States. Survey data were collected from 264 Latinx adults. Using structural equation modeling (SEM) procedures, we estimated a structural model for hypothesized direct and indirect relationships between the risk factors of COVID-19 exposure and discrimination, social support, and two mental health conditions: depression and posttraumatic stress. COVID-19 exposure and discrimination each had a significant and positive relationship with both depression and posttraumatic stress. Social support was found to have a significant and inverse relationship with depression and posttraumatic stress, as well as to mediate the relationship between discrimination and both mental health symptoms. Implications for service provision and program design are presented. Future studies should examine variation between southeastern states and consider the influence of documentation status among an immigrant-only sample. 

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Effects of COVID-19, Discrimination, and Social Support on Latinx Adult Mental Health

/pdf/different-effects-of-perceived-social-support-on-the-hqlyk93a.pdf

Different Effects of Perceived Social Support on the Relationship between Perceived Stress and Depression among University Students with Borderline Personality Disorder Symptoms: A Multigroup Mediation Analysis

Latinx, and especially Mexican and Central American, adults in the United States (U.S.) have been detrimentally impacted by policies under the Trump administration that instilled continual stress associated with immigration enforcement. Both native- and foreign-born adults are affected when either they or loved ones are deported, resulting in family disruption. Though research has established a connection between Trump-era exclusionary immigration policies and mental health status of Latinx community members, data are notably lacking for Mexicans and Central Americans in the southeastern U.S., where enforcement activity is particularly high.To inform service provision and policymaking, the current study was designed to investigate stress associated with policies under the Trump administration on two mental health outcomes (depression and anxiety) among Mexican and Central American adults in the southeastern U.S. Additionally, the mediating effect of social support on the relationship was examined. A sample of 264 Mexican and Central American adults in the southeast was surveyed via an online platform. Using structural equation modeling (SEM), we employed a two-step procedure to first test a measurement model to ensure that the latent variables were explained by the indicators. In the next step, we estimated a structural model for hypothesized direct and indirect relationships between Trump-era policy stress, social support, and two outcome variables: depression and anxiety.Findings suggest that Trump-era policy stress significantly and positively predicted depression and anxiety symptoms. In addition, policy stress predicted lower levels of social support, which in turn, predicted more symptoms of both depression and anxiety.Findings can inform service provision and policymaking for a vulnerable community that underutilizes mental health services. 

Policy stress and social support: Mental health impacts for Latinx Adults in the Southeast United States.

Purpose: This cross-sectional study was designed to examine the impacts of three risk factors (i.e., Trump-era policy stress, incidents of discrimination, and COVID-19 exposure) and two protective factors (i.e., resilience and social support) on mental health status. Methods: Data were collected via an online survey with first- and second-generation immigrant adults (n = 447). Hierarchical linear regression was employed to assess the risk and protective factors, in addition to demographic characteristics, on anxiety and depression scores. Results: Trump-era policy stress and discrimination predicted higher symptoms of both anxiety and depression. In terms of protective factors, resilience and social support each had a significant inverse relationship with anxiety and depression scores. Conclusion: Findings contribute to the knowledge base of risk and protective factors during a stringent immigration policy context and pandemic in the United States. Discussion: Implications for practice, research, and policymaking are presented. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

An Examination of Risk and Protective Factors on the Mental Health of First- and Second-generation Immigrant Adults during an Exclusionary Policy Context in the United States

Health and Well-Being: Texas Statewide Sexual Assault Prevalence Study

ABSTRACT This study utilized a social media post by a well-known social media influencer and the accompanying 63 responses to explore feelings and experiences related to abortion. This study employed qualitative thematic analysis and identified three themes related to reasons for abortion (i.e., relationship issues, not being ready for pregnancy, and other reasons) and one supplemental theme of bystander support. Findings highlight the efforts of many respondents to normalize abortion as an issue of women’s health and women’s rights. In fact, in response to the original post’s discussion regarding valid reasons for an abortion, most respondents remarked similarly that any reason is valid. While study limitations include concerns regarding generalizability, this study provides access to abortion experiences outside of a traditional health clinic survey and insight into the abortion beliefs of women, both who have and have not experienced an abortion. Findings are in line with previous studies which found that multiple reasons are cited for obtaining an abortion, but also revealed a more supportive climate than the divisive discourse typically portrayed in the media. This suggests the timing may be conducive for efforts aiming to normalize abortion and reduce stigma, including potential avenues for interventions (e.g., social networks and platforms). Lastly, the innovative use of social media to inform this study should be considered by others as they seek to understand and explore topics that can be challenging to study.

Melody Huslage

Papers

Policy stress and social support: Mental health impacts for Latinx Adults in the Southeast United States.

An Examination of Risk and Protective Factors on the Mental Health of First- and Second-generation Immigrant Adults during an Exclusionary Policy Context in the United States

Health and Well-Being: Texas Statewide Sexual Assault Prevalence Study

“Any Reason is Valid:” How an Unexpected Abortion Disclosure is Received by an Online Community

Effects of COVID-19, Discrimination, and Social Support on Latinx Adult Mental Health