"It Happens to Girls All the Time": Examining Sexual Assault Survivors' Reasons for Not Using Campus Supports

"In the End You Keep Silent": Help-Seeking Behavior Upon Sexual Victimization in Older Adults

Sexual violence is considered a prominent mental health problem. Exposure to sexual victimization during lifetime has been linked to mental health problems in old age. Research in adult victims has shown that they experience many barriers for disclosure and seeking professional help upon sexual victimization. However, information on help-seeking behavior in older victims of sexual violence is non-existent. With this study we aim for a better understanding of help-seeking behavior upon sexual violence in older adults. We used a mixed methods approach with an explanatory sequential design. Data were collected through structured face-to-face interviews with a random sample of 227 sexual violence victims of 70 years and older living in Belgium. Quantitative data were triangulated with qualitative data from 15 in-depth interviews with older victims. We found that up to 60% of older sexual violence victims never disclosed their experiences and 94% never sought professional help. Help-seeking is a complex process comprising several phases, which are affected by strong feelings of shame and self-blame, ageist premises and taboos about sexuality. In the end, most victims choose to cope on their own. Occasional disclosure only happens decades after the sexual violence took place. Older victims do not spontaneously disclose to healthcare workers but expect professionals to initiate the conversation. In conclusion, few older victims disclose or seek professional help upon sexual victimization. Healthcare professionals working with older adults need capacity building through training, screening tools, and care procedures to initiate conversation on sexual violence, and to detect signs, prevent, mitigate and respond to sexual victimization in older adults.

Trauma of the Shared Environment: A Qualitative Analysis of the Experiences of Survivors of College Campus Sexual Assault

Survivors of campus sexual assault are often tasked with healing while sharing an environment with their perpetrators. However, little is known about the effects of a shared environment on survivor well-being. A qualitative thematic analysis design was employed to address this gap. We conducted semi-structured interviews with nine female survivors who identified their perpetrators as fellow students at a large state university in the southeastern U.S. The five themes that emerged are situated within an ecological framework, which is also used to guide our recommendations for supporting survivors' well-being within higher education.

"They Don't See Us": Asian Students' Perceptions of Sexual Violence and Sexual Harassment on Three California Public University Campuses

Sexual violence and sexual harassment (SVSH) are prevalent among college and university students; however, the experiences of ethnic minority students, especially Asians, are understudied. This study aimed to reduce this gap by exploring Asian students' perceptions of SVSH on three public university campuses in Southern California. We examined their perceptions about the campus environment related to SVSH, attitudes, and behaviors toward help seeking, and utilization of on-campus resources. A total of 23 in-depth interviews were conducted with Asian students enrolled at the three University of California campuses. Thematic coding was conducted to generate main themes and subthemes. Five main themes emerged: (a) SVSH is considered a "taboo" topic in Asian culture and family systems, and Asian student survivors are often reluctant to disclose incidents or seek support services. (b) Students did not feel their campus environments were tailored to understand or meet the sociocultural realities and needs of Asian student survivors. (c) Campus SVSH services and reporting processes were seen as non-transparent. (d) Peers were the major source of support and SVSH information, as opposed to official campus-based resources and training. (e) Survivors often conduct an internal cost-benefit analysis evaluating their decision about whether to report. This study highlights the lack of conversation surrounding SVSH in Asian families, and how the cultural stigma of sex and sexual violence prevented Asian students from receiving knowledge and resources about these topics in their families. Instead of relying on formal campus resources (e.g., Title IX and confidential advocacy services, mental health services), many students turn to their peers for support. Thus, facilitating peer support groups, training university students to support each other through SVSH incidents, and tailoring campus services to the diverse cultural backgrounds of students are key considerations to foster a safe campus environment and prevent SVSH.

Evaluating cognitive and affective abilities among medical students: behavioural and medicolegal perspectives

Medical students attending university for the first time experience a new environment, full of significant social, cultural, and intellectual challenges. Moreover, drug abuse and bullying among university students are major global concerns. The aim of the current study was to assess the impact of medicolegal issues on undergraduate and postgraduate students. It is a cross-sectional survey-based study, with each set of questions investigating cognitive functions, aggression, personality, and exposure to medicolegal issues. Males and those with a chronic disease have been significantly exposed to medicolegal issues; exposed students were significantly older than nonexposed ones. The scores of aggression were significantly higher among exposed and male students. The cognitive scores were higher for the students from rural areas than in urban areas, and females were more neurotic than males. The current study recommends conducting campaigns to educate university students on the importance of formally disclosing unethical behaviors and listening to the victims to facilitate overcoming their negative feelings. As many victims feel comfortable disclosing victimization to their friends, we recommend conducting peer educational programs to help friends support their colleagues regarding unethical misconduct.

"I'm not going to do it alone": A qualitative study of barriers to sexual assault service-seeking among college students

Objective: To understand barriers to seeking post-sexual assault services for students of color and lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ+) students. Methods: Qualitative interviews about campus and community resources for sexual and relationship violence were conducted with 29 undergraduate and graduate students who held diverse sexual, gender, and racial identities (n = 15 disclosed violence-related service-seeking). Results: Organized within trauma-informed care pillars, thematic coding revealed aspects of campus environment/culture that prevent students from accessing support including challenges identifying experiences as violence; limited cultural and identity-affirming care; limited clarity about resources; confidentiality concerns; difficulty accessing resources; and navigating resources alone. Suggestions to address concerns included regular prevention training; better coordinated care and systems with increased accountability, increased survivor support and peer support, and heightened transparency on websites/trainings about processes and confidentiality. Conclusions: Findings suggest promising avenues to improve support, particularly for minoritized survivors of violence, at this campus.

A Strengths and Needs Assessment of Campus Sexual Assault Response

BACKGROUND

Sexual violence and sexual assault (SA) disproportionately affect the young adult population aged 18-24 years, half of which are enrolled in higher education. Campuses are tasked with providing a safe space for students and enacting an appropriate response to campus SA (CSA).

AIMS

As part of a grant-funded program to strengthen SA nurse examiner (SANE) services to those who experience SA on college campuses, we conducted a campus needs assessment and a campus website review for key messaging and analyzed the responses to identify strengths and gaps in campus resources related to CSA. These findings were the basis of individualized Campus Community Summary reports shared with participants from each campus.

METHODS

Guided qualitative interviews with interdisciplinary stakeholders across seven campus communities and campus website reviews were used to identify campus resource strengths, gaps, and recommendations for improvement.

RESULTS

Common strengths included awareness of campus programs and community services, leadership support for CSA activities, and community CSA response. Identified opportunities for improvement included strengthening interdisciplinary collaboration, solving transportation issues to obtain care, mental healthcare and advocacy services, awareness and resource messaging, and fighting stigma and bias. Campus websites reviews indicated gaps in key information about SANE care and how to access SANE services.

CONCLUSIONS

Numerous gaps and opportunities to strengthen campus SA awareness and coordination and access to a timely response to SA were identified. Addressing these gaps is essential to ensure quality care and services for individuals who experience SA on college campuses.

Women Higher Education Students' Experiences of Sexual Violence: A Scoping Review and Thematic Synthesis of Qualitative Studies

Sexual violence (SV) against women is common in higher education settings, causing serious harm to the health, well-being, and academic outcomes of victim/survivors. There have been numerous systematic reviews of the quantitative evidence on this topic, highlighting the prevalence, health impacts, and barriers and facilitators to help-seeking after SV. To date, however, qualitative research exploring the lived experience of women higher education students has not been synthesized. This scoping review and thematic synthesis of qualitative studies aims to map the global evidence on women higher education students' experiences of SV and explore how they understand and make sense of their experiences. We searched five databases (CinAHL, Academic Search Complete, Medline, PsychInfo, and SocIndex) in January 2023 for relevant articles. Eligible articles needed to be published in English and describe qualitative or mixed-methods primary research on the lived experiences of women higher education students who were victim/survivors of SV. In all, 34 articles describing 32 studies met these inclusion criteria. Thematic analysis of data extracted from the included studies suggests that, for women higher education students, the experience of SV is characterized by profound shame, with often-irreversible impacts on hopes and plans for the future. Yet, at the same time, SV is normalized and expected as a part of the "student experience." Furthermore, an imagined "specter" of "real violence" is held up as a constant comparison that serves to minimize and trivialize their experiences. These findings have important implications for higher education providers seeking to improve programs to address SV.

Timing of Sexual Assault Disclosure: A Study of College Women

The present study examined correlates of immediate (within 48 h) and delayed (after 48 h) sexual assault disclosure among a sample of 83 college women who experienced sexual victimization since age 14. The use of physical resistance and experiencing a "freeze response" was positively associated with delayed disclosure. Identifying the perpetrator as a friend/acquaintance, compared to a was a romantic partner, increased the likelihood of immediate disclosure. Other individual characteristics (i.e., assault characteristics, a history of childhood sexual abuse, attitudes towards seeking help, and sexual assertiveness) and microsystem-level characteristics (i.e., perceived social support) did not impact the timing of disclosure.

How Many Terms Does It Take to Define Sexual Assault? Inconsistencies in U.S. Higher Education Sexual Misconduct Policies

Campus sexual misconduct policies (SMPs) outline prohibited conduct. We sought to document the range of terms used to refer to forms of nonconsensual sexual contact in SMPs and to analyze the content of definitions provided for the term "sexual assault." We coded the 2016-2017 SMPs from a sample of 381 U.S. schools. We identified 125 unique terms and documented both a terminological and conceptual morass around sexual assault. Policy language may have implications for students' and administrators' evaluation of experiences and reports of sexual assault.

"Sometimes It Seems Easier to Push It Away": A Study Into the Barriers to Help-Seeking for Victims of Sexual Violence

Experiencing sexual violence may have serious long-term consequences for victims. Seeking help may decrease the chances of developing long-term physical and psychosocial problems. Still not every victim seeks help, and especially with victimization of sexual violence, there may be several reasons as to why. The barriers to help-seeking are diverse and may depend on several contextual factors. This study, as part of a larger research project, aimed to determine the barriers that victims of sexual violence experience in their decision to seek help in a non-college setting. This mixed-methods study included an online survey (N = 133) and open-ended survey (N = 207) amongst victims of 18 years and older. The online survey data were analyzed using chi-square tests for independence and t-tests; the open-ended survey data were analyzed using a descriptive approach. The online survey data showed that minimization of the incident was higher for non-help-seekers, whilst distrust toward support providers and issues with the accessibility of help were higher for help-seekers. No further significant associations were found between the decision to seek help and the barriers to help-seeking. From the open-ended survey data, three categories of barriers were distinguished: (a) individual barriers, such as feelings of shame, (b) interpersonal barriers, such as the fear of negative social reactions and (c) sociocultural barriers, such as societal stereotypes regarding sexual violence. The findings suggest that victims experience various, but primarily individual, barriers to help-seeking and that these barriers do not strongly differ between help-seekers and non-help-seekers. This study highlights the importance of addressing barriers to help-seeking on an organizational and societal level to encourage help-seeking.

Comprehensive policies for victims of sexual assault returning to the campus classroom: Lessons from university sports-related concussion policies

ObjectiveThe current paper presents a comparison of university policies and health and academic accommodations offered to undergraduate students following sexual assault (SA) and sports-related concussions (SRC). Procedures and protocols for universities to consider adapting from their SRC policies to their SA policies are detailed.Participants: The SRC and SA policies at the 50 United States public flagship universities were analyzed.Methods: The research team coded for a number of policy details including health referrals, academic and financial accommodations, and requirements for follow-up with university personnel.Results: Compared to SA polices, SRC policies at the public flagship universities offer more comprehensive academic accommodations and physical and mental health resources. Conclusions: Comprehensive policies for student SA survivors, like those available for students who suffer SRCs, would improve student health and academic outcomes and increase SA survivors' likelihood of graduating college, thereby reducing individual and societal human capital loses.

Sexual and Gender Minority Victimization: Base Rates of Assault in College Students Across Sexual and Gender Identities

Past findings have indicated that sexual and gender minority (SGM) individuals experience disproportionate rates of emotional, physical, and sexual assault compared to their heterosexual/cisgender counterparts. While these findings are robust, many studies report homogenous groupings of SGM participants. This practice likely masks important between-group differences. We sought to address this issue by examining reported base rates of emotional, physical, and sexual assault within 12 months of data collection, split across specific sexual (heterosexual, gay/lesbian, bisexual, questioning, queer, pansexual, asexual, and demisexual) and gender (cisgender men, cisgender women, gender nonconforming female assigned at birth [FAB], and gender nonconforming male assigned at birth) identity groups. Our data came from 2020 to 2021 Healthy Minds Study, a large survey of college students living in the United States (N = 119,181). Results indicated most forms of assault were higher in SGM groups compared to heterosexual and cisgender individuals, both on univariate and multivariate (e.g., one or more type of assault) levels. Demisexual individuals reported the highest base rates for emotional assault (45.7%), whereas pansexual individuals reported highest rates of physical assault (12.5%) and sexual assault (17.3%). Demisexual individuals reported the highest multivariate base rate of experiencing at least one form of assault (49.5%), and pansexual individuals reported the highest multivariate base rate of experiencing all three forms of assault (4.7%) within the past 12 months. Gender nonconforming FAB individuals reported the highest univariate and multivariate base rates across assault types compared to all other gender identity groups. With few exceptions, compared to heterosexual and cisgender men (referents), all other sexual and gender identity groups reported significantly higher adjusted odds of experiencing each assault type. These data suggest SGM individuals experience disproportionate levels of assault.

Alcohol Use Before Sexual Violence and Cognitive Appraisals: Differential Associations With Barriers to Help-Seeking

The current study examined two cognitive appraisals-labeling (identifying an unwanted sexual experience as sexual violence) and self-blame-as potential mechanisms between survivor alcohol use before sexual violence and three help-seeking barriers (minimization, negative treatment, and social-emotional barriers) among non-service-seeking sexual violence survivors. Participants were 141 undergraduate women who completed self-report measures. Three parallel mediation models were tested. Survivors who were drinking were more likely to label their victimization as sexual violence and, in turn, perceived fewer minimization and greater social-emotional barriers. Further, survivors who were drinking blamed themselves more and, in turn, perceived greater negative treatment and social-emotional barriers.

Policy impacts on contraceptive access in the United States: a scoping review

Contraceptive access is influenced by policy decisions, which can expand and constrict the contraceptive options available. This study explored the impact of recent US federal policies on contraceptive access by identifying and reviewing empirical literature, which is then presented and discussed using Levesque et al.’s (2013) healthcare access framework. A scoping review was conducted to identify empirical studies (N = 96) examining the impact of recent federal policy (passed from 2009 to 2019) on contraceptive access. Most identified studies examined the role of the Affordable Care Act (n = 53) and Title X of the Public Health Service Act (n = 25), showing many benefits of both policies for contraceptive access, particularly through improved affordability, availability, and appropriateness of contraceptive care. Other identified studies examined the impact of policies funding abstinence-only sex education (n = 2) and the Teen Pregnancy Prevention Program (n = 3), military policies related to the availability of contraception (n = 1), guidelines for quality contraceptive care (n = 3), Title IX of the Education Amendments (n = 4), the Violence Against Women Act (n = 1), and the Veterans Access, Choice, and Accountability Act (n = 4). Through increased outreach efforts, normalising of care, availability of services, cost subsidies, and provider competencies, recent federal policy has, overall, enhanced contraceptive access across the dimensions of healthcare access. Numerous policy and practice gaps and needs are identified, and future directions for research, policy, and practice are suggested.

Policy impacts on contraceptive access in the United States: a scoping review

Contraceptive access is influenced by policy decisions, which can expand and constrict the contraceptive options available. This study explored the impact of recent US federal policies on contraceptive access by identifying and reviewing empirical literature, which is then presented and discussed using Levesque et al.’s (2013) healthcare access framework. A scoping review was conducted to identify empirical studies (N = 96) examining the impact of recent federal policy (passed from 2009 to 2019) on contraceptive access. Most identified studies examined the role of the Affordable Care Act (n = 53) and Title X of the Public Health Service Act (n = 25), showing many benefits of both policies for contraceptive access, particularly through improved affordability, availability, and appropriateness of contraceptive care. Other identified studies examined the impact of policies funding abstinence-only sex education (n = 2) and the Teen Pregnancy Prevention Program (n = 3), military policies related to the availability of contraception (n = 1), guidelines for quality contraceptive care (n = 3), Title IX of the Education Amendments (n = 4), the Violence Against Women Act (n = 1), and the Veterans Access, Choice, and Accountability Act (n = 4). Through increased outreach efforts, normalising of care, availability of services, cost subsidies, and provider competencies, recent federal policy has, overall, enhanced contraceptive access across the dimensions of healthcare access. Numerous policy and practice gaps and needs are identified, and future directions for research, policy, and practice are suggested.

Rape myth acceptance among students attending a historically black college (HBCU): implications for intervention design

OBJECTIVE

This study examines rape myth acceptance among students attending a Historically Black College (HBCU).

PARTICIPANTS

One hundred and thirty two students participated in the study. Methods: A survey consisting of demographic questions and the Updated Illinois Rape Myth Acceptance Scale (IRMA) was distributed using an anonymous paper questionnaire to students on campus.

RESULTS

Analysis of the scale indicate a moderate to high rejection of rape myths regardless of gender, with the highest acceptance in both genders of the "She Lied" subscale. Both male and female students were likely to agree that a girl would lie about being raped to get even with a guy or after a sexual encounter that she regretted. Gender differences were found in the "She asked for it" subscale, with men having a statistically significant higher acceptance than women.

CONCLUSIONS

These results have implications for the design and implementation of targeted sexual assault interventions on HBCU campuses.

Increasing knowledge and campus trust in reporting sexual and interpersonal violence: The role of the Title IX coordinator

Objective: The present study explores the influence of Title IX awareness on systematic barriers to reporting sexual and interpersonal violence among college students. Participants: The study surveyed undergraduate and graduate students from a public Northeastern institution (n = 10,615). The study also used a sub-sample of those that did not report their experience of violence (n = 6,319). Methods: The relationship between Title IX awareness and non-reporting was examined using the total sample (n = 10,615) and the relationship between Title IX awareness and systematic barriers was examined using the sub-sample of non-reporting participants (n = 6,319). Analysis was conducted using chi-square tests and logistic regression modeling. Results: Students who could identify their Title IX Coordinator were more likely to report their experience of sexual and interpersonal violence and less likely to identify the systematic barriers. Conclusions: The Title IX Coordinator may play a crucial role in increasing reporting knowledge and improving the campus climate.

Reflecting and rejuvenating our work, together: One team's consideration of AJCP publications on gender-based violence

Community psychology has long valued reflexive praxis as a critical part advancing our research and action. In this Virtual Special Issue (VSI), we, a group of community psychologists and gender-based violence (GBV) researchers at many different points in our careers, reflected on GBV publications that have appeared in AJCP. We examine the ways in which community psychology broadly and articles in AJCP more specifically have conceptualized GBV as a sociocultural issue, how GBV intersects with other oppressions and forms of violence, the tension when systems that aspire to support survivors are inequitable and focused on ameliorative change, and the importance of interventions being locally informed and locally driven. By highlighting selected GBV-focused articles published in AJCP, this VSI discusses (a) understanding and transforming culture via robust research and local partnerships, (b) targeting effective interventions for survivors, (c) invoking systems and targeting change in institutional environments, and (d) making connections between local efforts and broader social movements. To continue to move forward, we conclude we must reflect, embrace methodological plurality, partner, and push for structural change. Reflective questions regarding research and action are offered, to address gender-based violence.

Campus Sexual Violence Prevention and Response: Lessons from a Pandemic to Inform Future Efforts

The COVID-19 pandemic forced institutions of higher education to transition and work in ways that were new and innovative. Even though most colleges and universities transitioned to a virtual platform, the issues that students face continued, including sexual violence (SV). For many campus prevention and response professionals, reaching students during the pandemic posed unique challenges. The COVID-19 pandemic began when the project team was 18-months into a 4-year grant to administer and evaluate the efficacy of a SV prevention and response app, uSafeUS®, at 15 4-year colleges. In this paper, we describe the transition of engaging students with the app in traditional in-person settings to remote and hybrid learning settings. The project team, in collaboration with the campus partners, devised new ways to use the app to support victims of SV and their allies, along with campus professionals in their efforts to support students. These efforts included changes to collaboration (e.g., virtual platforms) and student engagement strategies. We describe how the lessons learned from this transition are important for continuing to engage campus communities in SV prevention and response, even as campuses slowly transitioned back to hybrid and in-person activities. The knowledge gained from this transition are attributable to an ongoing and open collaboration between campus practitioners and the project team.

"It's Hard to Show Empathy in a Text": Developing a Web-based Sexual Assault Hotline in a College Setting

To increase access to counseling and advocacy services and respond to changes in communication preferences, many victim service programs are expanding their traditional telephone hotlines and adding web chat or text hotlines. However, there is little research available about these web and text-based hotlines. We examined program data collected in the first year of operation of a web-based crisis hotline for sexual assault survivors at a large Midwestern university in the United States as part of a larger evaluation project. We examined how often the web-based chat hotline was used and explored patterns of use by time of day and month, comparing to records from the phone hotline operated by the same campus-based victim service program. We also conducted interviews and two group discussions with volunteers and staff about their experiences with providing crisis intervention in a web-chat medium. Findings suggest that the web-based crisis hotline is being used frequently, nearly as often as the telephone hotline and doubling the total number of crisis contacts the organization had in the year prior to adding the web-based chat hotline. Staff and volunteers identified a number of advantages of a web-based hotline, including increased privacy and accessibility for survivors. Difficulty identifying and conveying emotions in the web-chat context was one of the primary challenges described by staff and volunteers. Operating the web-hotline, therefore, requires additional training for volunteers and staff on how to translate crisis intervention skills into a text-based medium. Suggestions for how to communicate effectively in text-based crisis intervention are discussed, along with other considerations for designing a web or text hotline.

Inconsistency is the Consistency: The Title IX Reporting Process for Sexual and Gender-Based Misconduct Within Maryland Public Universities

Title IX is a primary federal legal approach to address campus sexual and gender-based misconduct, yet few students utilize Title IX reporting as a formal campus support, and those that do frequently report negative experiences. In this study, we interviewed 11 student survivors at four Maryland public universities who engaged with the Title IX reporting and response process. Our aims were to (a) examine how Title IX functions in a state public education system with a robust Title IX policy; (b) describe commonalities and differences in experiences; and (c) use theories of institutional betrayal and support to understand aspects of the process most helpful or harmful for survivors, especially minoritized survivors. Results reflected several common themes, but also an inconsistent Title IX process both within and across institutions beholden to the same Title IX policy, representing potential policy deviations. Further, institutional betrayal was reflected in the experiences of minoritized survivors who described Title IX staff microaggressions and invalidations and survivors who unknowingly disclosed to mandatory reporters. Overall, experiences contributed to a perception of the Title IX office and reporting process as unhelpful and untrustworthy. Results identify the need to reduce inconsistencies in Title IX reporting and response processes to ameliorate process harms.

An Inherently Masculine Practice: Understanding the Sexual Victimization of Queer Women

Sexual violence is a widespread social issue, and sexual victimization is especially prevalent among queer-identified women. Still, there is little research on queer women's experiences of sexual violence or explanations for the high rate of victimization. This study uses data from 40 open-ended interviews to investigate queer women's experiences with sexual violence and those who perpetrate it. Respondents answered questions about the characteristics of their sexual assaults and perpetrators, as well as connections the survivors perceive between their sexual assaults and sexual identities. Findings indicate that the perpetrators of such sexual assaults invoke an expression of masculinity, regardless of the perpetrator's gender identity at the time of violence. To understand the nuanced role of masculinity in queer assailant's assaults, we develop the concept of "righteous masculinity," which refers to a traditional (and, in this case, violent) masculinity invoked by marginalized people in an attempt to reclaim power. We find that sexual violence against queer women is an especially powerful way to enact masculinity through drawing upon misogyny and homophobia simultaneously, providing an explanation for the high rates of sexual victimization among queer women. We argue that centering masculinity can help scholars and activists better challenge the sexual victimization of queer women and deepen understanding of the links between gender-based violence and masculinity.

Perceptions of campus authorities: Institutional responses, fairness, and bystander action

Objective: This study is an examination of college students' bystander behaviors in relation to several exosystem factors related to their institution, including trust in their college's support systems, perceived procedural justice by campus police, and perceived procedural justice by campus administrators. Participants: Online surveys were completed by 223 students at a mid-sized public institution in the Northeastern U.S. Methods: Responses were analyzed using an OLS multiple regression to examine bystander behaviors in relation to their perceptions of institutional exosystem factors. Results: Students who felt more favorably about both campus police and campus admin were more likely to have intervened in the past as a bystander; trust in school had no effect. Conclusions: Perceptions of institutional leaders and representatives are important to consider as influential motivators for bystander behavior. School personnel trainings and policies which increase visibility of staff as trustworthy and fair should be part of comprehensive campus antiviolence efforts.

Sexual Assault Among Women in College: Immediate and Long-Term Associations With Mental Health, Psychosocial Functioning, and Romantic Relationships

The current study sought to examine immediate and long-term consequences of college sexual assault (C-SA) among women with no prior sexual assault history. While much is known regarding the short-term negative impact of C-SA, the current study examines whether C-SA is associated with immediate academic and psychosocial consequences as well as long-term poorer mental health (depression, posttraumatic stress [PTS], anxiety) and interpersonal functioning (relationship quality, sexual and emotional intimacy). In addition, the current study explores potential moderators of these associations, including race, the nature of the assault, resulting injury, relation to perpetrator, and whether the assault was reported. A stratified design was used comparing women who experienced C-SA (n = 201) to women with no C-SA history (n = 203) controlling for age, education, race, and ethnicity. Results from a series of repeated-measures analyses of variance (ANOVAs) demonstrated that across race and ethnicity, women with a history of C-SA reported lower grade-point averages, more missed classes, and fewer serious romantic relationships in college following the assault. Furthermore, results from a series of linear and logistic regression revealed that approximately 9 years later, women who experienced C-SA reported greater symptoms of depression, anxiety, and PTS as well as lower emotional and sexual intimacy. These associations differed by a number of assault variables (assault type, relation to perpetrator, amount of fear reported, physical injuries sustained, whether the assault was reported, whether medical treatment was sought). The current study further confirms the significant and pervasive impact of C-SA associated with women's health and functioning, warranting further intervention to both reduce the incidence of C-SA and expand the reach of existing mental health interventions to survivors.

College student perceptions of institutional responses to sexual assault reporting and general help-seeking intentions

College students are a high-risk population for sexual assault exposure. This study examines 1) sociodemographic differences in student perceptions of institutions of higher education (IHEs) responses to sexual assault reporting and 2) the relationship between student perceptions, knowledge of campus sexual assault (CSA) services, and general help-seeking intentions. Participants: A sample of 1,648 college students completing an online survey during the 2016-2017 academic year. Methods: A secondary analysis of data from the Healthy Minds Study. Results: Transgender/nonconforming, sexual minority, and domestic students held more negative perceptions of IHEs. Positive perceptions were significantly associated with increased odds for both formal (odds ratio [OR] = 1.09, p < .05) and informal help-seeking intentions (OR = 1.05, p < .05). Knowledge of CSA services did not significantly moderate the relationship between perceptions of IHEs' responses and help-seeking intentions. Conclusions: Student perceptions of their IHEs vary based on aspects of identity and may contribute to general help-seeking.

Walking the Walk: Testing a Theory-Derived Measure of Campus Sexual Assault Policy Implementation

Institutional Theory posits that organizations sometimes engage in practices that are inconsistent with their stated policies-a process called "decoupling"-due to three types of legitimacy pressures: normative, coercive, and mimetic. Limited previous research suggests that such decoupling between policy and practice may be occurring in institutions of higher education (IHEs) when addressing sexual assault. The objective of this study was to test a measure designed to assess sexual assault policy implementation using the constructs of Institutional Theory. The measure was tested with a national sample of 210 staff and faculty at IHEs who work on sexual assault prevention and response on their campuses. This study assessed (a) the reliability of the measure; (b) the degree to which the measure identified legitimacy pressures and decoupling in the sample; (c) the degree to which legitimacy pressures were linked to decoupling in the sample, as the theory suggests; and (d) the degree to which campuses and individual characteristics were differentially associated with decoupling and legitimacy pressures. Principal factor analysis resulted in a factor structure that conformed reasonably well to the existing constructs of Institutional Theory, with the addition of a new construct reflecting an institution's stated commitment to addressing sexual assault. Regression analyses found that only normative legitimacy pressures significantly predicted decoupling and commitment. Higher decoupling scores were found for public campuses and larger institutions. Campus-based victim advocates reported significantly higher rates of decoupling than Title IX coordinators. The findings suggest that the process of policy implementation may vary across campus types and that further research is needed to better understand the impact of campus sexual assault regulatory attention.

Exploring Help Seeking Patterns for Emerging Adult Victims Using the National Intimate Partner and Sexual Violence Survey

Emerging adulthood is a critical developmental period and a particularly important one for studying responses to interpersonal victimization as they can shape future coping patterns. This study focuses on non-college-attending emerging adults to explore their use of help seeking and satisfaction with resources. Comparisons are made with their college-attending counterparts. The findings highlight (a) the importance of friends across gender and education levels as a common resource and one perceived as helpful and (b) the large proportion of victims of interpersonal violence who do not seek any help. These results are discussed in connection with future research and policy implications.

Campus Service Use Among Students With Disabilities Who Have Experienced Sexual Violence: A Conceptual Model

Students with disabilities are one student group with elevated risk of sexual violence. Although they would benefit from streamlined access to campus support, little is known about their patterns of campus service use. This qualitative analysis includes data from semi-structured interviews with 51 students with disabilities who experienced sexual violence focused on service use across campus. The resultant conceptual model shows that greater accessibility is associated with positive experiences, and lower accessibility is associated with negative experiences. Students with disabilities who experienced or expected negative reactions (e.g., judgment) were less likely to use services and were less satisfied. Advocacy and support in connecting students with disability or sexual violence services was associated with positive experiences and increased accessibility. These findings highlight key facilitators and barriers to campus service use for students with disabilities with sexual violence histories and suggest key intervention points for increasing accessibility, reducing stigma, and improving student experiences with campus providers, staff, and faculty.

A Socioecological Model of Risk Associated With Campus Sexual Assault in a Representative Sample of Liberal Arts College Students

Campus sexual assault (CSA) is a growing area of research and public health concern, yet little research has considered the sociocultural context in which CSA occurs or the effect of sociocultural factors on the posttraumatic stress disorder (PTSD) symptoms of CSA survivors. This study describes the results of a web-based census survey administered to students at a liberal arts college. Of the 1,611 students who completed the survey (74% female; 71.4% White, 4.3% African American, 12% Hispanic), 13.5% reported experiencing at least one type of completed or attempted CSA. Female students, participants in Greek life, and students who reported victimization prior to college were more likely to report having experienced CSA. CSA was positively correlated with PTSD symptoms, and this relationship was stronger for racial/ethnic minorities, those who reported less sense of community, and those who were more aware of campus services to address CSA. This study demonstrates multiple levels of sociocultural influence on the mental health of college students who have experienced CSA and may suggest ways for improving prevention and intervention strategies to address CSA and its consequences.

Moaning and Eye Contact: Men's Use of Ambiguous Signals in Attributions of Consent to Their Partners

In recent years, there has been increasing pressure on men to prevent sexual violence. This study uses data from 25 semi-structured interviews to explore how heterosexual undergraduate men have responded to cultural and organizational pressure to seek consent. Participants answered questions about their recent sexual experiences and attitudes toward campus sexual consent policies. Findings indicate that while participants condone key elements of sexual consent, they do not consistently apply reliable strategies to seek consent. Instead, they use ambiguous social cues that are common in both consensual and nonconsensual sexual interactions, which reinforce the notion that consent is unclear.

Sexual assault reporting amongst users of online sexual health services

Sexual assault (SA) survivors often attend sexual health clinics (SHC) for care relating to their assault. Reported rates of SA amongst SHC attendees can be high. Online sexual health services are becoming increasingly popular. Sexual Health London (SHL) is a large online sexual transmitted infection (STI) screening service. Between 1.1.20– 8.2.20, 0.5% (242/45841) (54% female, 45.6% male) of adults disclosed a recent SA when ordering an online STI testing kit. 79% (192/242) users engaged in a call back discussion initiated by the SHL team: 45% (87/192) users confirmed a SA had occurred and 53% (101/242) users denied an assault (particularly men) stating they had reported this in error. 18% (16/87) users had already reported their SA to the police/sexual assault centre, and one user accepted an onward referral. This study found a low reporting rate of SA amongst SHL users, but despite a high response rate to call backs, >50% cited they reported in error, 25% (22/87) didn’t want to discuss their SA and few accepted onward referrals. Using e-triage to screen for SA followed by service-initiated telephonic support to everyone who discloses, may not be acceptable or offer utility to all. Further evaluation of ways to engage these individuals is required.

Campus Support Providers' Discussion of Consent in Response to Sexual Assault Disclosure Situations: Understanding of Consent Linked to Resource Referrals

College sexual assault is a widespread issue and the responses of support providers can greatly affect sexual assault survivors' wellbeing after a disclosure. Although "consent" (or, more precisely, the lack thereof) is the defining feature of sexual assault, little is known about how support providers understand consent and draw from this knowledge in their responses to disclosures. This is particularly important in the wake of evolving consent policies in institutions of higher education. University resident assistants (RAs) are an important source of support for students in crisis, functioning as a "first responder" and providing support. Using a sample of 305 RAs, the current study employs a critical discourse analysis to examine how RAs engage with the concept of consent in response to sexual assault disclosure situations. Four types of consent discourses were identified: (a) affirming nonconsent, (b) validating right to consent, (c) questioning nonconsent, and (d) dictating how to consent. Findings provide a novel examination of how consent is understood, communicated, and reinforced in the campus community, and the implications of these discourses for survivors. Results suggest there may be benefit in additional training for support providers around the conceptualization of consent and how to discuss consent with survivors.

Barriers in seeking support: Perspectives of service providers who are survivors of sexual violence

Research with survivors of sexual violence suggests that most do not seek supportive services from community organizations. The purpose of this study is to understand the unique barriers that service providers, who are also survivors of sexual violence, may experience and how it informs their work with survivors. We conducted semi-structured interviews with 19 female, trans, and nonbinary survivors of sexual violence who are also employed as domestic violence or sexual assault advocates, community organizers, therapists, health care providers, educators, or substance abuse counselors, and had worked with survivors of sexual violence in their current positions. We coded the data using a multistep strategy derived from grounded theory. Participants indicated sensitivity to community-level barriers including where services are offered, perceived cost of services, and taking time off of work. Internalized blame, shame, minimization of their experiences, and trauma were also mentioned as significant barriers for themselves and impacted their work with survivors. Our findings suggest a need for trauma-informed intervention in community practice and policy.

Widening the Lens: An Ecological Review of Campus Sexual Assault

Varying prevalence rates of sexual violence across colleges and universities indicate the need to understand institutional factors underlying such variation; however, research often focuses exclusively on individual risk and protective factors, which both under theorizes and under explains the phenomenon of campus sexual assault. In this review, we propose that broadening to include campus- and contextual-level factors is necessary to fully explain campus sexual assault. Using an ecological approach, we identify and synthesize research related to campus-level variation in sexual violence, including availability of campus services and resources for survivors, institutional risk factors such as alcohol and party culture, athletics, and fraternities, and the impact of policies at the state and federal levels. Suggestions are made for conducting additional research at the campus level and implications of reframing campus sexual assault from an institutional lens are discussed, including the importance of this approach for practice, evaluation, and policy.

Factors Associated With and Barriers to Disclosure of a Sexual Assault to Formal On-Campus Resources Among College Students

Sexual assault on college campuses occurs at high rates, but disclosure to formal on-campus resources remains low. This study used a mixed methodological survey to explore demographic and social characteristics of students who formally reported their assaults and those who did not and examined barriers to formal disclosure. Responses revealed that students who disclosed to formal on-campus resources suffered frequent polyvictimization, had high rates of physical and emotional consequences, and were mostly White women involved in campus organizations. Barriers to formal resource utilization were identified at the individual, interpersonal, organizational, and community levels.

"Call for Help Immediately": A Discourse Analysis of Resident Assistants' Responses to Sexual Assault Disclosures

Formal support providers can play a critical role in sexual assault survivors' well-being (e.g., providing resource referrals). In a university setting, resident assistants (RAs) are key support providers with a unique relationship to survivors based on their dual roles as help-provider and peer. We examined 305 RAs' responses to student sexual assault disclosure scenarios. Employing a critical discourse analysis, we identified four discourses used by RAs in their discussion of resources: controlling, gatekeeping, minimizing, and empowering. Due to power dynamics between RAs and residents, we conclude that empowering discourses would facilitate survivors' access to other resources (e.g., sexual assault center).

Leveraging Data to Strengthen Campus Sexual Assault Policies

The U.S. Department of Education recently announced that existing legislation and guidance on campus sexual assault (CSA) policies had created a "failed system" in institutions of higher education. This announcement raises the question of how CSA legislation and guidance should be evaluated and applied in practice. We believe researchers are well situated to not only leverage data and empirically evaluate the success (or failure) of CSA federal and university policies but also to facilitate development of improved, more effective CSA policy. This commentary first chronicles the pivotal role of federal policy and guidance in driving the collection of CSA data and increasing research efforts in this domain. Second, we present recommendations for increased collaboration among researchers, practitioners, and policy makers aimed at measuring the effectiveness of current CSA policies and promoting data-driven policy. These recommendations focus on (a) establishing a CSA data repository, (b) analyzing existing CSA data to gain knowledge and identify opportunities for improved data collection, and

Service seeking experiences of college-aged sexual and intimate partner violence victims with a mental health and/or behavioral disability

OBJECTIVE

To examine mental health service experiences following sexual violence (SV) and intimate partner violence (IPV) victimization among college women with a disability.

PARTICIPANTS

College women (n = 27, ages 19 to 24) with a disability who experienced at least one SV/IPV occurrence; interviewed July/August 2016.

METHODS

Qualitative study using in-depth interviews, with thematic analysis.

RESULTS

Women tended to wait several months (or did not seek care at all) following SV/IPV, because they downplayed their experience (e.g., not wanting to label an experience as "rape"). Those seeking services primarily did so because of escalating mental health concerns. Among service seekers, women were satisfied when professionals validated their experiences/concerns; and were dissatisfied when faced with extended wait time for care and/or professionals unskilled with SV/IPV and mental health. However, women still sought care following negative experiences.

CONCLUSIONS

Improved access to integrated care for SV/IPV and mental health, along with skilled professionals, is essential.

Campus sexual assault climate surveys: A brief exploration of publicly available reports

OBJECTIVE

Despite popularity of climate surveys as a tool produce accurate data on campus sexual assault, little is known about how campuses are administering these surveys, what they are assessing, and what they are finding.

PARTICIPANTS

A sample of 105 campus climate survey reports was located with an internet search during the 2015-2016 academic year.

METHODS

Review of climate survey reports assessed the methodology used, such as sampling method, use of incentives and sample size and response rate. Document review also assessed the topics included in the climate survey reports and key findings related to victimization, perpetration, and student knowledge of resources.

RESULTS

Most campuses reported victimization rates, but few reported perpetration rates. Students generally express confidence in their knowledge of campus resources, but reporting of sexual violence was low.

CONCLUSION

Climate surveys are inconsistent and do not always use scientifically sound measurement. Suggestions for improving climate surveys are discussed.

Public health nursing and the issue of trust in campus sexual assault

Public Health Nurses are the largest group of public health practitioners in both local and state health departments across the United States. Essential for the delivery of health services in the community, Public Health Nurses frequently provide care for underserved and vulnerable populations. Among these populations are the victims of campus sexual assault, a growing problem on college and university campuses. Both nationally and internationally, sexual assault has been described as a public health and human rights concern. With the signing of the Senate Bill 967 in California, affirmative consent, known as "yes means yes," requires both parties in a sexual encounter to give voluntary and affirmative consent. Many colleges and universities across the country have adopted similar standards. However, students may choose not to seek health care after an assault at the Student Health Center, preferring to obtain care in community clinics or health departments. Students must be able to be safe on and off campus, and must be able to trust they will be heard by campus authorities and the health care community, and be treated with respect. Public health nurses need to be prepared to work with victims of campus sexual assault and have a solid foundation in the issues surrounding assault, and the needs of the student to trust their caregivers. This paper presents an overview of the vulnerability and risk factors in sexual assault, presents legislation on campus and institutional responsibility, and provides a foundation for Public Health Nurses working with victims of sexual assault.