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Examining Risk Factors and the Healthcare Response to Intimate Partner and Sexual Violence among Adolescents and Young Adults

Hill, Amber L (2020) Examining Risk Factors and the Healthcare Response to Intimate Partner and Sexual Violence among Adolescents and Young Adults. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Intimate partner violence (IPV) and sexual violence (SV) are prevalent in the United States and can negatively impact health and wellbeing. This dissertation sought to inform future prevention and response efforts by exploring risk factors associated with IPV and SV and examining how healthcare providers currently support IPV and SV survivors.

First, we used longitudinal structural equation modeling to investigate the association between SV victimization and alcohol use among college students. SV victimization significantly predicted future alcohol use when controlling for previous alcohol use behaviors. Alcohol use did not predict future SV victimization when controlling for previous SV experiences. Survivors may be using alcohol as a coping mechanism for trauma; SV response efforts need to integrate substance use assessment and counseling to provide ongoing support for survivors. Prevention efforts need to move beyond targeting binge drinking and alcohol use as a means to reduce SV and instead explore larger societal norms that condone violence.

Second, we psychometrically evaluated a scale designed to measure gender equitable attitudes among a diverse sample of adolescents. We derived an 11-item scale that demonstrated construct validity across a sample of predominantly Black adolescent boys (aged 13-19 years) and measurement invariance across gender and race. In the United States, most psychometric research on gender attitudes has been conducted among white adult male populations, therefore, our research provided insight into how this construct is defined among populations with different demographic characteristics. By validating measurement tools, we are better able to attribute shifts in gender inequitable attitudes to true differences as opposed to measurement error.

Finally, we used audio-recorded patient-provider encounters at family planning clinics to determine if and how healthcare providers discussed IPV and substance use with patients. We found that many clinicians were likely to discuss IPV, often asking screening questions followed by education through a wallet-sized safety card. Clinicians frequently asked about tobacco use, but not alcohol or drug use. Notably, there was only one integrated discussion about IPV and substance use, indicating a strong need for provider training on how these two phenomena can interact and potentially worsen health problems.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Hill, Amber LALH198@pitt.eduALH1980000-0002-6486-9181
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairSwitzer, Galengswitzer@pitt.edugswitzer
Thesis AdvisorMiller,
Committee MemberBorrero, Sonyaborrsp@UPMC.EDU
Committee MemberChang,
Committee ChairAbebe, Kaleabkza3@pitt.edukza3
Date: 4 May 2020
Date Type: Publication
Defense Date: 22 April 2020
Approval Date: 4 May 2020
Submission Date: 23 April 2020
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 93
Institution: University of Pittsburgh
Schools and Programs: School of Medicine > Clinical and Translational Science
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: intimate partner violence sexual violence substance use prevention psychometric evaluation
Date Deposited: 04 May 2020 12:10
Last Modified: 04 May 2022 05:15


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