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"I think it's fuzzy": exploring definitions of consent and healthy relationships among college students with disabilities

Richter, Rachael (2019) "I think it's fuzzy": exploring definitions of consent and healthy relationships among college students with disabilities. Master's Thesis, University of Pittsburgh. (Unpublished)

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Background: Rates of sexual violence (SV) and intimate partner violence (IPV) remain high among young people in the United States and are even higher among college students with disabilities (SWDs). A first step in tailoring interventions aimed at reducing rates of SV/IPV for vulnerable populations is developing a nuanced understanding of how these individuals understand the concepts of consent and healthy relationships and relate them to their own experiences.

Methods: This qualitative study focused on participants, 18-24 years old, who reported a disability or health condition while in college (n=49) and used thematic analysis to examine their definitions of consent and healthy relationships within a semi-structured interview.

Results: Six themes were produced from the data: 1) Healthy relationships require both mutual care for one another through trust, respect, support, and communication, as well as care for one’s self as an individual through independence, self-confidence, and finding support outside the relationship; 2) Those experiencing unhealthy treatment by a partner may normalize the behaviors due to manipulation, denial, and their love for that person; 3) Dichotomous definitions of consent lead to misunderstandings and confusion about how to apply consent to real life experiences; 4) Within the context of a relationship, active consent can be facilitated through comfort and open communication but hindered by implied or assumed expectations and difficulty balancing one’s own discomfort with the possibility of their partner feeling rejected; 5) Students assume that when healthcare providers are asking about relationship health they are trying to elicit disclosure of abuse rather than facilitating a discussion of relationship health; and 6) Students are less likely to disclose abuse when they believe healthcare providers are fulfilling routine screening requirements rather than asking about their safety due to genuine concern, or, when they fear that disclosure will result in a loss of control over what happens next.

Conclusion: College SWDs have many of the same sexual and relationship understandings and experiences as other students, including some confusion about how to apply the concept of consent to their complex lived experiences and concerns about discussing abuse with healthcare providers. The public health significance of this study is in its implications for future SV/IPV prevention programming, healthcare provider interventions, and public health research related to consent and relationship health. Interventions that seek to reduce the high rates of SV/IPV in this population must address the complex nature of students’ real sexual and romantic relationships and healthcare providers addressing relationship health with students should do so in a confidential, open, and non-judgmental manner. Further research on students’ points of confusion around consent and relationship health is needed to inform future interventions.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Richter, Rachaelrar140@pitt.edurar140
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairHawk, Marymary.hawk@pitt.edumary.hawk
Committee MemberJames, Eganjee48@pitt.edujee48
Committee MemberCarla,
Committee MemberElizabeth,
Date: 19 June 2019
Date Type: Publication
Defense Date: 5 April 2019
Approval Date: 19 June 2019
Submission Date: 4 April 2019
Access Restriction: 4 year -- Restrict access to University of Pittsburgh for a period of 4 years.
Number of Pages: 70
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Behavioral and Community Health Sciences
Degree: MPH - Master of Public Health
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: sexual violence intimate partner violence dating violence consent healthy relationships disabilities college youth definition
Additional Information: An error was made in the upload stage of this record and an incorrect file was deposited. This has been resolved on 9/19/2021.
Date Deposited: 19 Jun 2019 22:04
Last Modified: 19 Jun 2023 05:15


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