Unwanted Sex Common Among Teens

According to a new study published in the June, 2006 issue of Archives of Pediatrics and Adolescent Medicine, 40.9% of girls experienced unwanted sex and 1 out of 10 girls reported forced sex by a dating partner. The fact that these statistics are 3-month incidence rates as opposed to lifetime prevalence rates emphasizes the exceedingly high risk of sexual victimization throughout adolescence.
Sexual coercion is linked to several risk behaviors including younger age at sexual initiation, more lifetime sexual partners, unplanned pregnancies, and sexually transmitted diseases (STIs). Dr. Margaret J. Blythe and colleagues conducted a longitudinal study of female adolescents receiving health care at three primary care clinics in Indianapolis. Data were collected from face-to-face interviews asking a series of questions about relationships and sexual experiences in the past three months. The definition of unwanted sex was limited to unwanted penile-intercourse. STI testing was also done at each clinic visit.
A total of 279 female adolescents (mean age=15.9 years; 88.5% African American) participated in the interviews. Among the 40.9% teens who disclosed unwanted sex at least once in the past three months, the most common reason was “fear that their partner would get angry if denied sex” (37.6%). Sex for money or gifts was disclosed by 4.7% of study participants. Girls who experienced unwanted sex with a dating partner in the past three months were 4 times more likely to have a baby with that partner, nearly two times more likely to report lack of sexual control with that partner, and were twice as likely to have sex without using a condom. Girls who disclosed that their partner used marijuana before sex were more likely to report unwanted sex.
The high incidence rates of unwanted and forced sex occurring in a relatively short period of time make a strong case for routine assessment in the health care setting and counseling teens on healthy relationships and sexual behaviors. Research findings from other studies suggest that some teens perceived unwanted sex as a normal part of dating relationships. Educating teens on effective communication, negotiation strategies, and risk behaviors such as substance abuse that are associated with coerced sex are important steps towards reducing the incidence of nonconsensual sex among this at-risk population.
Article available online at: Archives of Pediatric and Adolescent Medicine. 2006. Volume 160:591-595. Available online at http://archpedi.ama-assn.org/

Seizing the 9-Month Moment: Addressing Behavioral Risks in Prenatal Patients

Opportunities to reduce or stop smoking, alcohol use, illicit drug use, and the risk of domestic violence with prenatal patients were explored through a series of six focus groups with OB/GYN physicians, nurse practitioners, and certified nurse midwives. Three major themes were identified: 1) specific risk-prevention tactics or strategies exist that are useful during pregnancy; 2) some providers address patients’ isolation or depression; and 3) providers can adopt a policy of “just chipping away” at risks.
Pregnancy was identified as a “teachable moment” and described a number of tactics to address risk behaviors with prenatal patients. The importance of normalizing risk prevention by letting patients know that risk assessment and intervention is a routine part of prenatal care was an important starting point to help patients feel comfortable. Providers described strategies to make questions less threatening such as asking about behaviors prior to pregnancy, using extreme amounts in assessment questions to reduce the stigma of disclosing a risk behavior (“Would you say six drinks a day?”), and opening with more general questions. A wide range of counseling practices were employed by prenatal health care providers to take advantage of follow-up visits to monitor progress on an issue and to use the maternal instinct to protect the baby as a motivator to change risk behaviors. Isolation and depression were noted as key factors that exacerbated substance abuse and domestic violence. Creating a group setting for discussion and support with pregnant women was an effective and efficient strategy used for domestic violence and smoking cessation. Pregnancy provides a ongoing window of opportunity to assess for risk behaviors, give supportive, risk-reduction messages, involve patients in problem-solving interventions such as motivational interviewing and the “5 As” (Ask, Advise, Assess, Assist, Arrange), and to employ a strategy of “chipping away” at risk prevention during prenatal care.
For more information please see: Patient Education and Counseling. 2006. Volume 61:228-235 or go online to http://www.sciencedirect.com/science/journal/07383991.

Continuing Medical Education on Bullying Available Online for Pediatricians

An article by Dr. Karen Gouze in the spring, 2006 issue of The Child’s Doctor, is part of a seven article series on pediatricians’ role in the identification and prevention of bullying. Dr. Gouze noted that bullying often starts in elementary school, affects nearly 1 out of 3 (30%) students, and can lead to many of the same physical and mental health consequences that domestic violence victims experience. Pediatricians can receive 2 Category 1 credits for reviewing the series of articles and completing the quizzes. Key topics covered in the articles include recognizing high-risk children, how to do effective screening and referral, assertiveness training for children particularly those at higher risk such as children with disabilities, and strategies for parents to detect warning signs and prevent long-term victimization. Online bullying, the more severe problems associated with bully-victims, and implications of ADHD and bullying are addressed in this continuing medical education.
For full report go to: http://www.childrensmemorial.org/cme/online/article.asp?articleID=151&previewmode=review

Intimate Partner Violence, PTSD, and Adverse Health Outcomes

An article published in the June, 2006 issue of the American Journal of Preventive Medicine evaluated the impact of intimate partner violence (IPV) on women’s health. Dr. Amy Bonomi and colleagues analyzed survey data from a random sample of more than 3400 adult women who belonged to a large HMO in the Pacific Northwest. Comparisons were made between physical and non-physical IPV, recent (in the past 5 years) and remote abuse (not in the past 5 years), and by the duration of the abuse. A wide range of health-related outcomes were examined including physical health and symptoms, depression, tobacco use, substance abuse, sexual risk behaviors, and social connectedness. The authors observed two important trends between IPV and health---the effects were more pronounced for recent IPV compared to remote IPV and for longer exposure to IPV. Other findings included: • Women who experienced IPV at some point in their lives were more likely to be current or former smokers • Heavy or binge drinking, recreational drug use, and engaging in sexual risk behaviors were significantly higher among women who disclosed recent and remote IPV • Women with a history of IPV had rates of depression (2.6 for physical and 2.0 for nonphysical) that were higher or comparable to patients with diabetes or a recent diagnosis of heart disease • Women with recent physical and/or sexual IPV were 4.0 times more likely to report severe depression symptoms compared to never-abused women
See Full article in: American Journal of Preventive Medicine. 2006. Volume 30(6):458-466 or online at http://www.sciencedirect.com/science/journal/07493797

Efficacy of an HIV Prevention Program Among Female Adolescents Experiencing Gender-Based Violence

The efficacy of an HIV prevention program was evaluated with a random sample of African American female adolescents who reported a history of gender-based violence. The intervention, which emphasized ethnic and gender pride, provided information on HIV, condom attitudes, healthy relationships, communication, and condom use skills. Adolescents who received the intervention reported more safe sex practices including using condoms more consistently, reduced incidents of unprotected vaginal sex, more likely to have used a condom during their most recent intercourse, less likely to have a new sexual partner, less likely to have a sexually transmitted disease, and more proficient condom practices compared to adolescents who did not receive the intervention.
See full article at American Journal of Public Health. June, 2006. Volume 96(6):1085-90 or online at www.ajph.org

Missed Opportunities: Emergency Department Visits by Police-Identified Victims of Intimate Partner Violence

While police-identified victims of intimate partner violence (IPV) frequently utilized emergency department (ED) services, documentation of IPV status and linkage to community-based victim services was sporadic according to a study published in the February, 2006 issue of Annals of Emergency Medicine. The authors, Drs. Catherine Kothari and Karin Rhodes, conducted a retrospective review of ED visits for female victims that were identified in a prosecutor’s database of IPV cases. Two-thirds (n=616) of IPV victims had received care in at least one ED during the year that the index assault case occurred. The proportion of victims visiting at least one ED increased to 82.7% during the three-year study period with a median of 4 visits per victim. Most ED visits (71.2%) by IPV victims were for noninjury-related problems. IPV screening was documented in less than one-third (30.3%) of ED visits and the initial positive screen rate was only 5.8%. The positive screen rate increased over the study period to 23.0% because victims presented to the ED so many times. ED staff need to routinely identify, document, and address IPV with patients seeking care for injury-related as well as non-injury related complaints.
See full article at Annals of Internal Medicine. February, 2006. Volume 47(2):190-199 or online at: www.annemergmed.com/

Assessment for Intimate Partner Violence: Where Do We Stand?

In this commentary by Janssen, Dascal-Weichhendler & McGregor, the authors examined the challenging interface between systematic evidence reviews that have led to recommendations that there is insufficient evidence to support IPV screening and the reality that IPV is a leading health indicator with major implications for quality of care. Noting the distinction between “insufficient evidence” and “evidence supporting lack of efficacy,” the authors noted that evidence-based interventions for IPV exist. Public health strategies and the potential of patient-centered interviewing were emphasized as key strategies to enhance the safety of victims and their children.
See full article at Journal of the American Board of Family Medicine. 2006. Volume 19:413-415 or online at: www.jabfm.org

ANNOUNCEMENTS and NEW RESOURCES

Primary prevention of sexual and intimate partner violence - 2 new publications

Sexual Violence and the Spectrum of Prevention: Towards a Community Solution
What would the world look like without sexual violence? Sexual Violence and the Spectrum of Prevention emphasizes the importance of primary prevention to change norms and reshape environments - including homes, neighborhoods, schools and workplaces - to prevent sexual violence. This new NSVRC ( www.nsvrc.org) publication, written by Prevention Institute, highlights the Spectrum of Prevention, a tool for developing a comprehensive prevention strategy, and details effective primary prevention activities at all six Spectrum levels, including innovative examples from throughout the country. http://www.preventioninstitute.org/SVspectrum.html

Before It Occurs: Primary Prevention of Intimate Partner Violence and Abuse
The updated and expanded version of The Physician's Guide To Intimate Partner Violence and Abuse features a chapter co-authored by Prevention Institute and Corinne Graffunder, Branch Chief, Division of Violence Prevention, CDC. Focusing on primary prevention and applying lessons learned from past successes, Before It Occurs: Primary Prevention of Intimate Partner Violence and Abuse, presents a framework for meaningful health sector involvement in initiating the environmental change necessary to stop intimate partner violence and abuse before it occurs. http://www.preventioninstitute.org/physiciansguide.html

A Tool for Measuring Physician Readiness to Manage Intimate Partner Violence

Dr. Lynn Short and colleagues have developed a 15-minute survey called PREMIS (Physician Readiness to Manage Intimate Partner Violence Survey). Expert consensus and previous surveys were used to develop this updated tool. Evaluation results from testing the PREMIS tool with physicians indicates that PREMIS provides a reliable measure of a wide range of self-reported behaviors. The self-assessment tool assesses IPV knowledge, opinions, and practice issues. Opinion scales were constructed to examine preparation, legal requirements, workplace issues, self-efficacy, alcohol/drugs, victim understanding, constraints, and victim autonomy. This tool is publicly available and can be used to measure the effectiveness of IPV educational programs.
For the full article go to American Journal of Preventive Medicine. 2006. Volume 30(2):173-180 or online at: http://www.sciencedirect.com/science/journal/07493797

Handbook on Reaching and Serving Teen Victims

The Healthy People 2010 National Initiative to Improve Adolescent health by 2010 released a new Guide for States and Communities. The guide takes a youth development approach and practitioners and policy makers are urged to have a focus on the strengths and developmental needs of adolescents rather than just their risks and health adverse behaviors. State-funded programs can find relevancy in the paper although it is specific to addressing youth development in state adolescent programs.
See full paper: http://www.forumfyi.org/Files/AdolescentHealth.pdf

INTERNSHIPS, REQUEST FOR PROPOSALS and MANUSCRIPTS

Mary Byron Grants for Innovative DV Programs

Mary Byron Foundation to Honor Innovative Programs that Demonstrate Promise in Breaking the Cycle of Domestic Violence:
The Mary Byron Foundation ( http://www.marybyronfoundation.org ), a public grantmaking charity based in Louisville, Kentucky, funds programs throughout the United States that are working to stop domestic violence. The foundation is accepting nominations for its Celebrating Solutions Awards program, a $10,000 cash prize to institutions that demonstrate an innovative approach to confronting and solving domestic violence. Recipients are not required to render any further services as a condition of receiving a Celebrating Solutions Award. In general, the Mary Byron Foundation chooses four winners each year, but reserves the right to choose fewer. Institutions that have applied in previous years are welcome to do so again. The awards are open to nonprofit or government-based programs that have been operating for a minimum of three years and specifically address the issue of domestic violence. Consideration for the award requires submission of a nomination form and a program outline. Any staff member, board member, volunteer, or community supporter may nominate a qualifying institution for a Celebrating Solutions Award. Nomination materials are available on the foundation's Web site.
Deadline: September 22, 2006
RFP Link: http://fconline.foundationcenter.org/pnd/10003421/marybyronfoundation For additional RFPs in Human Services, visit: http://foundationcenter.org/pnd/rfp/cat_human_services.jhtml

WHO Foundation: Women Helping Others Accepting Grant Applications

Grants are provided to organizations serving women and/or children in the United States and Puerto Rico. Specific projects and programs addressing health, education, and social service needs are the foundation's priority. The foundation recognizes the value of new programs created to respond to changing needs and will consider funding projects of an original or pioneering nature within an existing organization. In order to qualify for funding, organizations must have 501(c)(3) nonprofit status under the U.S. Internal Revenue Code and be qualified to receive deductible charitable contributions. Organizations that have received a WHO Foundation grant in the past should wait three years before applying again.
Deadline: September 12, 2006
For more information go to: http://fconline.foundationcenter.org/pnd/10002943/whofoundation
For additional RFPs in Women, visit: http://foundationcenter.org/pnd/rfp/cat_women.jhtml

OVC Professional Development Scholarships are available!

Scholarships provide up to $1,000 for individuals and up to $5,000 for multidisciplinary teams of victim service professionals seeking continuing education opportunities. To determine whether you or your team are eligible for a scholarship, visit the OVC.
For more information go to: http://www.ovcttac.org/calendar/training.cfm.

EVENTS/CONFERENCES

DATE HAS CHANGED! 2007 National Conference on Health and Domestic Violence- Abstract Submission Deadline: July 28th, 2006

Pre-conference Institutes: March 15, 2007
Conference: March 16 - March 17, 2007
Now Accepting Abstracts! Deadline for Abstract Submission: July 28, 2006
Registration Opens Online: September 30, 2006 at http://www.endabuse.org/ Location: Grand Hyatt San Francisco, California, USA

The 4th Biennial National Conference on Health and Domestic Violence aims to advance the health care system's response to domestic violence. The conference attracts the nation's leading medical, public health and family violence experts from across the U.S. with increased international participation. Workshops and plenary sessions highlight the latest research and most innovative clinical responses to domestic violence, with a focus on the work being done by physicians, physician assistants, dentists, nurses, nurse midwives, mental and behavioral health providers, social workers, domestic violence experts, and others. To submit an abstract online click here. We strongly encourage all applicants submit abstracts online, however if you do not have internet access, proposals may be sent by U.S. mail once confirmed. For more information, please contact Julie Varghese at Julie@endabuse.org, phone (415) 252-8900.

Violence Prevention: Promoting Health Communities: Morehouse School of Medicine

Morehouse School of Medicine (MSM) and the Hamilton Fish Institute are proud to announce a conference entitled Violence Prevention: Promoting Health Communities to be held from September 25- 26th, 2006 in Atlanta, Georgia. The Hamilton Fish Institute on School and Community Violence is a national resource for the research and development of school violence prevention strategies. The conference aims to provide training and increase awareness among practitioners and community stakeholders about violence prevention and the new strategies that are rapidly growing in programs across the United States. Local and national leaders will be present to talk about successful activities and programs in their communities to deter violence.
For more information go to: http://www.msm.edu/ViolenceConference/Violence.htm or call Dr. Katherine Erwin for additional information at (404) 756-5278 or Dr. Kisha Braithwaite at (404) 756-8923, Monday through Friday, between the hours of 9:00 am and 5:00.

Mental Health Response to Mass Violence and Trauma: Office for Victims of Crime

Every year the Office for Victims of Crime (OVC) sponsors training workshops for victim service professionals. From October 3-5, 2006 they will host a workshop entitled "Mental Health Response to Mass Violence and Trauma" in Phoenix, Arizona. Workshops are designed to build practical technical skills and enhance knowledge of victim service issues. The Fall/Winter schedule offers several new workshops as well as favorites from years past.
For more information go to: http://www.ovcttac.org/calendar/training.cfm

Bridging the Gap: Reaching Across Cultures and Disciplines: Colorado Coalition Against Sexual Assault

"Bridging the Gap: Reaching Across Cultures and Disciplines" will be held on September 5-7th, 2006 in Denver, CO. The focus for the 2006 Sexual Assault Conference is two-fold; 1) reaching underserved victims with prevention and effective intervention and 2) how to create a sustainable inclusive organizations. This can include, but is not limited to, trafficking, people with disabilities, elderly, rural communities, bi- and monolingual communities, the homeless, LGBTQ, immigrant populations, incarcerated individuals, sex workers, etc.
For more information, go to: http://www.ojp.usdoj.gov/nij/events/nij_conference2006.html

Health e-News is a monthly electronic news digest focusing on health care and domestic violence policy, research, prevention and advocacy. Health e-News is available in both text and html formats. To subscribe Click Here.

We encourage you to use Health e-News to share news, views, and experiences concerning your projects and activities on addressing domestic violence as a health care issue. To post an announcement or ask a question, send an e-mail to HealthE-News@endabuse.org. The digest is facilitated by Julie Varghese, julie@endabuse.org, with the Family Violence Prevention Fund.

Thank you for your ongoing commitment to end domestic violence!

Be sure to visit our website http://endabuse.org/health to learn more about our programs, products, and campaigns!