Kathryn J. Holland

Condom Negotiation Strategies as a Mediator of the Relationship between Self-Efficacy and Condom Use

College students are a group at high risk of sexually transmitted infections due to inconsistent condom use and engaging in other risky sexual behaviors. This study examined whether condom use self-efficacy predicted the use of condom negotiation strategies (i.e., condom influence strategies) and whether condom influence strategies mediated the relationship between condom use self-efficacy and condom use within this population, as well as whether gender moderated the mediation model. Results showed a strong relationship between condom use self-efficacy and condom influence strategies. Additionally, condom influence strategies completely mediated the relationship between condom use self-efficacy and condom use. Although condom use self-efficacy was related to condom use, the ability to use condom negotiation strategies was the most important factor predicting condom use. The mediation model held across genders, except for the condom influence strategy withholding sex, where it was not significant for men. For women, condom use self-efficacy promoted the use of a very assertive negotiation strategy, withholding sex, and was consequently related to increased condom use. Overall, using assertive condom negotiation strategies (e.g., withholding sex and direct request) were found to be the most important aspects of increasing condom use for both women and men. Implications and suggestions for prevention programming are discussed.

Quality of life and metastatic breast cancer: the role of body image, disease site, and time since diagnosis

PurposeToo little is understood about the quality of life (QoL) concerns of patients diagnosed with advanced disease. While body image has been found to be consistently important for women with early-stage breast cancer, the impact of body image on women with metastatic breast cancer (MBC) is less frequently studied. This cross-sectional study aimed to identify factors affecting QoL in a sample of patients diagnosed with MBC, with particular attention to body image, disease site, and time since diagnosis.MethodsIn total, 113 women diagnosed with MBC completed two QoL scales (EORTC QLQ30; EORTC BR23) as part of a larger study. Clinical characteristics were obtained via medical record review. Demographics, disease characteristics, and clinical factors were examined.ResultsTime since diagnosis and location of metastases were found to affect patients’ QoL, and most strikingly, this effect often differed for those with higher and lower body image. Body image appears to remain highly influential even for those living with a shortened life expectancy.ConclusionsThese findings indicate that the development of QoL support should more carefully consider patients diagnosed with MBC and the unique sets of body concerns that affect this population.

When Sexism and Feminism Collide: The Sexual Harassment of Feminist Working Women

The current study examined how feminism relates to women’s experiences of sexual harassment—that is, unwanted sexual and sexist conduct in the workplace. We posited that feminism would have both costs (e.g., increasing exposure to harassment) and benefits (e.g., decreasing harassment-related outcomes). We assessed two indicators of feminism: self-identification as “feminist” and engagement in feminist activism. We also measured two subtypes of sexual harassment: sexual-advance and gender harassment. According to survey data from 424 working women, feminist identification predicted fewer gender harassment experiences; once harassed, however, feminist-identified women reported the greatest decrease in job satisfaction and increase in turnover intentions. In contrast, feminist activism related to greater experiences of both kinds of harassment, and activism attenuated some negative outcomes. We further found that (regardless of feminist identification or activism) women who had faced sexual-advance harassment were over 7 times more likely to attach the “sexual harassment” label to their experiences, compared to women who had experienced gender harassment alone. In light of our findings, we recommend that sexual harassment laws, policies, and trainings be broadened to encompass all varieties of sexual harassment, including non-stereotypical, non-sexual conduct. Organizations would also benefit from interventions that reduce bias against undervalued persons, including feminists.

Sexual Assault Training in the Military: Evaluating Efforts to End the “Invisible War”

Sexual assault is an insidious problem in the United States military. In 2005 the Department of Defense (DoD) created the Sexual Assault Prevention and Response Office, which centralizes responsibility for sexual assault training. However, this training initiative has undergone little evaluation by outside researchers. Addressing this need, we analyzed responses from over 24,000 active duty personnel who completed the 2010 DoD Workplace and Gender Relations Survey. We assessed whether sexual assault training exposure (None, Minimal, Partial, or Comprehensive) predicted accurate knowledge of sexual assault resources and protocols. Using a social-ecological framework, we investigated whether institutional and individual factors influenced Service members’ training exposure and judgment of training effectiveness. According to our results, exposure to comprehensive training predicted lower sexual assault incidence and superior knowledge. However, comprehensive training differed as a function of military branch, rank, gender, and sexual assault history. Judgments of training effectiveness also varied across these dimensions. Our results highlight the importance of considering context, gender, and victimization history when evaluating institutional efforts to end sexual violence. The DoD’s 2010 annual report on military sexual assault concluded that “most Active Duty members receive effective training on sexual assault” (p. 104). Our results cast doubt on that assertion.

You, Me, or Her Leaders’ Perceptions of Responsibility for Increasing Gender Diversity in STEM Departments

We examined how university leaders described what and who needed to change in order to increase the representation of female faculty in science, technology, engineering, and math (STEM) departments. Thirty-one (28 men and 3 women) STEM departmental chairs and deans at a large, public university participated in semi-structured interviews. Data were examined using both qualitative and quantitative procedures. Analysis focused on participants’ descriptions of responsibility for changes related to gender equity. Using the distinction of high versus low responsibility, themes were examined for their qualitative characteristics as well as their frequency. Leaders who exhibited high personal responsibility most frequently saw themselves as needing to change and also named their male colleagues as concurrently responsible for diversity. Conversely, leaders who exhibited low personal responsibility most frequently described female faculty as responsible and described women’s attitudes and their “choice” to have a family as obstacles to gender diversity in STEM. We argue that the dimensions of high and low responsibility are useful additions to discussions of leadership, workplace diversity initiatives, and gender equity more broadly. To this end, we provide several methodological tools to examine these subtle, yet essential, aspects of how diversity and change efforts are imagined and discussed.

Sexual Harassment: Undermining the Wellbeing of Working Women

The past two decades have witnessed incredible strides in the understanding of workplace harassment based on sex and gender (a.k.a. “sexual harassment”). This chapter reviews sexual harassment definitions, laws, antecedents, and outcomes, focusing on the most recent and rigorous studies. We structure this chapter to answer the following questions: How is sexual harassment defined, legally and scientifically, both in the United States and in other nations? What is its prevalence and impact in the lives of working women? Finally, how do different features of context (e.g., power, organizational culture, policies, procedures, trainings) promote, prevent, and remedy harassment based on sex and gender?

Psychometric assessment of the Health Care Alliance Questionnaire with women in prenatal care.

The current study assessed the reliability and validity of the Health Care Alliance Questionnaire, which was developed using a Delphi process and embedded in an ongoing perinatal outcomes study. The Health Care Alliance Questionnaire exhibited content and face validity and high reliability. Results indicated concurrent validity in relation to satisfaction with practitioner and discriminant validity in relation to interpersonal sensitivity and posttraumatic stress disorder. The Health Care Alliance Questionnaire demonstrated predictive validity in relation to perceptions of practitioner’s care during labor and postpartum depression. Overall, results suggest that alliance may be an important factor in maternity care processes and outcomes. Further psychometric work is warranted.

The evolving landscape of Title IX: predicting mandatory reporters' responses to sexual assault disclosures

Approximately 1 in 4 women is sexually assaulted in college, a problem that federal law has attempted to address with recent changes. Under the evolving landscape of Title IX, and related law, universities nationwide have overhauled their sexual assault policies, procedures, and resources. Many of the new policies designate undergraduate resident assistants (RAs) as Responsible Employees—requiring them to provide assistance and report to the university if a fellow student discloses sexual assault. We investigated factors that predict the likelihood of RAs enacting their policy mandate, that is, reporting sexual assault disclosures to university authorities and referring survivors to sexual assault resources. Based on data from 305 Responsible Employee RAs, we found that likelihood to report and refer varied, depending on RAs’ knowledge of reporting procedures and resources, trust in these supports, and perceptions of mandatory reporting policy. Understanding mandatory reporter behavior is crucial, because help-providers’ responses can have serious implications for the recovery of sexual assault survivors. Our findings elucidate some effects of changes in the interpretation and implementation of Title IX, with potential to inform the development of more theoretically and empirically informed policies.

From distrust to distress: Associations among military sexual assault, organizational trust, and occupational health.

Objective: Workplace violence is underreported, in part due to lack of trust in the system—an organization’s ability to protect victims’ safety, confidentiality, and dignity. We focus on military sexual assault—a form of workplace violence—aiming to (a) identify factors that relate to employee trust in the organization’s sexual assault response system and (b) determine how trust in this system (or lack thereof) is associated with well-being. Method: Participants were drawn from a representative sample of U.S. military personnel (542 victims of past-year sexual assault and a random sample of 1,000 individuals who did not experience sexual assault in the past year). Results: Trust differed by personal and organizational characteristics. Notably, trust was higher among men (vs. women), nonvictims (vs. past-year victims of sexual assault), members of the air force (vs. other service branches), and personnel who recalled comprehensive training related to sexual assault prevention and response (vs. minimal or no training). Further, lower trust in the system predicted lower work satisfaction and coworker satisfaction, more negative health perceptions, more greater symptoms of depression and posttraumatic stress, and lower intent to remain on active duty. These negative outcomes emerged beyond the effects of past-year sexual assault and combat. Conclusions: Trust that an organization will protect employees’ safety, confidentiality, and dignity if they report violence is important to both mental and occupational health, for both victims and nonvictims alike. In short, workplace violence can be devastating and so can (non)responsiveness to violence by the larger institution.

Compelled Disclosure of College Sexual Assault.

Sexual assault is a widespread problem on college campuses. In response, many institutions are developing policies mandating that certain employees report any student disclosure of sexual assault to university officials (and, in some cases, to police), with or without the survivor’s consent. These policies, conceptualized here as compelled disclosure, have been prompted and shaped by federal law and guidance, including Title IX and The Clery Act. Proponents of compelled disclosure assert that it will increase reports—enabling universities to investigate and remedy more cases of sexual assault—and will benefit sexual assault survivors, university employees, and the institution. However, many questions remain unanswered. How broad (or narrowly tailored) are contemporary compelled disclosure mandates in higher education? Do any empirical data support assumptions about the benefits of these policies? Are there alternative approaches that should be considered, to provide rapid and appropriate responses to sexual violence while minimizing harm to students? The current article begins with an overview of federal law and guidance around compelled disclosure. Next, a content analysis of a stratified random sample of 150 university policies provides evidence that the great majority require most, if not all, employees to report student sexual assault disclosures. A review of the literature then suggests that these policies have been implemented despite limited evidence to support assumptions regarding their benefits and effectiveness. In fact, some findings suggest negative consequences for survivors, employees, and institutions. The article concludes with a call for survivor-centered reforms in institutional policies and practices surrounding sexual assault.