Catherine L. Kothari

“I Didn’t Want To Put Them Through That”: The Influence Of Children on Victim Decision-making in Intimate Partner Violence Cases

For mothers, intimate partner violence (IPV) presents a concern not only for their own well-being but also for that of their children who are exposed to the violence and its aftermath. In focus groups with adult women (N = 39) across three jurisdictions who had experienced legal system intervention for IPV victimization, mothers raised unsolicited concerns about the negative effects of IPV exposure on their children. These comments were not prompted by the facilitator but were raised by women in all seven of the focus groups during discussions about motivations and barriers to participation in prosecution of their abusive partners. The overall message was that victims with children felt very conflicted. Children both facilitate and inhibit leaving the abusive relationship. Mothers wanted to spare their children from harmful effects of violence but also wanted to keep their families together and protect their children from potential agitation and instability caused by legal system involvement. Participants described how fears and threats of involvement from child protective services inhibited help-seeking while simultaneously voicing a desire for services that would help their children. More research is needed to help service providers understand the quagmire mothers who are victims of IPV encounter regarding their children’s wellbeing.

Using GIS and Secondary Data to Target Diabetes-Related Public Health Efforts:

Objectives. To efficiently help communities prevent and manage diabetes, health departments need to be able to target populations with high risk but low resources To aid in this process, we mapped county-level diabetes-related rates and resources/use using publicly available secondary data to identify Michigan counties with high diabetes prevalence and low or no medical and/or community resources. Methods. We collected county-level diabetes-related rates and resources from Web-based sources and mapped them using geographic information systems (GIS) software. Data included age-adjusted county diabetes rates, diabetes-related medical resource and resource use (i.e., the number of endocrinologists and percentage of Medicare patients with diabetes who received hemoglobin A1c testing in the past year), community resources (i.e., the number of certified diabetes self-management education and diabetes support groups), as well as population estimates and demographics (e.g., rural residence, education, poverty, and race/ethnicity). We created GIS maps highlighting areas that had higher-than-median rates of disease and lower-than-median resources. We also conducted linear, logistic, and Poisson regression analyses to confirm GIS findings. Results. There were clear regional trends in resource distribution across Michigan. The 15 counties in the Upper Peninsula were lacking in medical resources but higher in community resources compared with the 68 counties in the Lower Peninsula. There was little apparent association between need (diabetes prevalence) and diabetes-related resources/use. Specific counties with high diabetes prevalence and low resources were easily identified using GIS mapping. Conclusion. Using public data and mapping tools identified diabetes health-service shortage areas for targeted public health programming.

Protection Orders Protect Against Assault and Injury A Longitudinal Study of Police-Involved Women Victims of Intimate Partner Violence

The objective of this study was to measure the efficacy of protection orders (POs) in reducing assault and injury-related outcomes using a matched comparison group and tracking outcomes over time. This study was a retrospective review of police, emergency department, family court, and prosecutor administrative records for a cohort of police-involved female IPV victims; all events over a 4-year study period were abstracted. Victims who obtained POs were compared with a propensity-score-based match group without POs over three time periods: Before, During, and After the issuance of a PO. Having a PO in place was associated with significantly more calls to police for nonassaultive incidents and more police charging requests that were of multiple-count and felony-level. Comparing outcomes, PO victims had police incident rates that were more than double the matched group prior to the PO but dropped to the level of the matched group during and after the order. ED visits dropped over time for both groups. This study confirmed the protective effect of POs, which are associated with reduced police incidents and emergency department visits both during and after the order and reduced police incidents compared with a matched comparison group.

The Impact of Children on Legal Actions Taken by Women Victims of Intimate Partner Violence

Successful criminal or civil legal system response to assaults against intimate partners (intimate partner violence; IPV) usually rely on the victim’s participation in the legal process, including having contact with the prosecutor, filing charges, and/or applying for an order of personal protection. Using data abstracted from criminal and civil legal system records for a county-wide cohort of 990 female IPV victims over a 4-year period, we examine the impact of having children, and of specific child factors, on victims’ engagement with the criminal prosecution of their abusive partners and/or seeking a personal protection order (PPO) in the civil court system. Having children increased victim’s contact with the prosecutor and applications for PPOs, but did not increase her likelihood of wanting to file or drop charges. Findings support prior work suggesting both the importance and complexity of children on mothers’ decision-making. Policy makers and service providers may want to assess survivors’ thoughts about the role children play in their decision-making. Additionally, by offering survivors interventions to help their children address the impact of IPV exposure, survivors may be more willing to engage with services.

Improved birth weight for black infants: Outcomes of a healthy start program

OBJECTIVES We determined whether participation in Healthy Babies Healthy Start (HBHS), a maternal health program emphasizing racial equity and delivering services through case management home visitation, was associated with improved birth outcomes for Black women relative to White women. METHODS We used a matched-comparison posttest-only design in which we selected the comparison group using propensity score matching. Study data were generated through secondary analysis of Michigan state- and Kalamazoo County-level birth certificate records for 2008 to 2010. We completed statistical analyses, stratified by race, using a repeated-measures generalized linear model. RESULTS Despite their smoking rate being double that of their matched counterparts, Black HBHS participants delivered higher birth-weight infants than did Black nonparticipants (P = .05). White HBHS participants had significantly more prenatal care than did White nonparticipants, but they had similar birth outcomes (P = .7 for birth weight; P = .55 for gestation). CONCLUSIONS HBHS participation is associated with increased birth weights among Black women but not among White women, suggesting differential program gains for Black women.

Victim Participation in Intimate Partner Violence Prosecution Implications for Safety

Are intimate partner violence (IPV) victims safer if they use the criminal justice system? Concerns about perpetrator retaliation, in the face of data that protection orders can reduce future harm, make it important to understand how victim utilization (calling 911, talking to the prosecutor, and proceeding with prosecution) affects subsequent safety. We hypothesized participation would improve victims’ safety, measured by decreases in subsequent IPV-related 911 calls and/or emergency department visits. Findings support contact with the prosecutor’s office was associated with reduction in police-reported IPV, regardless of the victim’s wish to proceed. Policy implications support pro-prosecution strategies coupled with victim contact.

In Our Voice: Survivors’ Recommendations for Change

Seven focus groups with a diverse group of intimate partner violence (IPV) survivors (n = 39) explored how to improve survivor satisfaction, empowerment, and safety related to their court-based experiences. These occurred in three jurisdictions which all supported community coordinated responses to IPV. This paper contributes to the literature by asking survivors about existing service gaps and how helping professionals might enhance court operations. Analysis was conducted using a framework approach based on the socio-ecological model. Findings suggest four areas worthy of improvement: Logistics, Emotional Enhancements, Society’s Perception of IPV, and Court Procedures. The recommendations for change are neither expensive nor complicated; rather, modest changes may result in greater victim satisfaction with the courts.

Perinatal Status and Help-Seeking for Intimate Partner Violence

BACKGROUND Although there has been much research examining the relationship between pregnancy and abuse, this study is one of the few to investigate whether perinatal status (defined as pregnancy or early postpartum) impacts the help seeking of abused women. METHODS We retrospectively reviewed 3 years of prosecutor administrative records, police incident reports, and hospital medical records for a countywide population of adult females (n = 964) assaulted by an intimate partner in 2000. Perinatal and nonperinatal victims were compared using chi-square and a series of logistic regression models, controlling for all demographic and incident-related factors. RESULTS Compared with women across the county, abused women were twice as likely to become pregnant (p < 0.001). Perinatal status did not change the rate of help seeking from police (OR 1.1, p = 0.67) or emergency departments (ED) (OR 1.1, p = 0.94), but it did change the pattern of help seeking with higher ED use in the 6 months prior to the assault (p < 0.01) and a trend toward seeking help with fewer injuries (p = 0.10). CONCLUSIONS Abused women are more likely to become pregnant. Perinatal status impacts how victims seek help from criminal justice agencies and EDs.

Help-seeking patterns among women experiencing intimate partner violence: do they forgo the criminal justice system if their adjudication wishes are not met?

Following a criminal case disposition, an intimate partner violence (IPV) victim’s willingness to seek future police and prosecutorial assistance may depend on her prior experiences within the system. This longitudinal study examines the relationship between IPV victims’ future help-seeking based on past experiences. We hypothesized women would return to the criminal justice system if their adjudication wishes corresponded with prosecutors’ actions. Contrary to the hypothesis, results suggest women return to the criminal system and other venues even if prosecutors’ actions do not correspond to their earlier stated wishes. This has important policy implications given pro-prosecution protocols that encourage adjudication regardless of a woman’s participation.

Emergency Department Visits and Injury Hospitalizations for Female and Male Victims and Perpetrators of Intimate Partner Violence

Introduction. The potential for hospital-based interventions for male victims of intimate partner violence (IPV) as well as adult perpetrators of both genders has been largely unexplored despite early evidence of acute-care utilization that may be as high as female victims. The current investigation compared the emergency department (ED) and injury-related-hospitalization rates of IPV-involved individuals against standardized national norms, assessing differences by gender and victim/perpetrator-status. Methods. This cross-sectional study collected one-year ED and in-patient visit data from hospital records for individuals listed as victim or perpetrator in an IPV criminal charging request in a Midwestern county (). Expected rates were calculated based upon age-adjusted national norms. Results. The IPV-involved population generated ED rates 4.1 times higher than expected and injury-related-hospitalization rates that were 4.0 times higher than expected. Bi-directionally-violent individuals (both victim and perpetrator in IPV charges) consistently had the highest utilization rates (ED 8.4 RR, injury-hospitalization 22.5 RR). Victims, primarily female, had higher ED-visits than perpetrators, primarily male (victims = 4.6 RR, perpetrator = 3.1 RR). Perpetrators, though, had higher injury hospitalizations (victims = 0.8RR, perpetrators = 5.5 RR). Conclusions. Substantial opportunities exist within acute-care medical settings to intervene with IPV-involved women, men, victims, and perpetrators, although the magnitude of the opportunity varied by setting, gender and victim/perpetrator-status.