Kristie A. Thomas

Intersections of Harm and Health A Qualitative Study of Intimate Partner Violence in Women's Lives

Eight focus groups of women with recent exposure to intimate partner violence (IPV) were conducted to elicit womens descriptions of how IPV affects their health. Their shared narratives reveal a complex relationship with three main points of intersection between IPV and health: IPV leading to adverse health effects; IPV worsening already compromised health; and womens illness or disability increasing dependency on abusive partners, thereby lengthening the duration of IPV exposure. Women describe bidirectional and cyclical ways through which IPV and health intersect over time. Service providers, including physicians, need to better understand the myriad ways that abuse affects womens health.

Intimate Versus Nonintimate Partner Murder A Comparison of Offender and Situational Characteristics

To explore whether homicide of intimate partners is distinct from homicide of nonintimates, we compared sociodemographic, legal, family, clinical, and situational characteristics of men who murdered an intimate partner (n = 71) to those of men who murdered a nonintimate (n = 363). Bivariate findings suggest that intimate murder offenders are more socially bonded and conforming regarding employment and relationship patterns and use fatal violence to meet emotional rather than instrumental needs compared to nonintimate offenders. Multivariate findings indicate marital status, history of severe mental illness, and motive are important factors that differentiate men who murder intimates from those who murder nonintimates. Homicide prevention efforts must be tailored to account for factors that differentiate these two offender types.

“Do You Know What It Feels Like to Drown?” Strangulation as Coercive Control in Intimate Relationships

Strangulation is a unique and particularly gendered form of nonfatal intimate partner violence, affecting 10 times as many women as men. Medical research documents multiple negative health outcomes of such victimization, and in the past decade nearly 30 U.S. states have enacted laws making nonfatal strangulation a felony. We extended prior work by using grounded theory in a qualitative study to explore women’s experiences of, thoughts about, and reactions to being strangled. Each of the 17 mostly well-educated and African American domestic violence shelter residents had been strangled at least once by an intimate partner; most had survived multiple strangulations. Despite other severe abuse and a high level of fear, all were shocked that their partner strangled them. Participants reported an intense sense of vulnerability when they recognized during the assault how easily they could be killed by their partner. Nonetheless, they seemed to think of strangulation, not as a failed murder attempt, but as a way to exert power. Efforts to extricate themselves from a “choking” largely failed and resistance resulted in an escalation of the violence. Moreover, strangulation is difficult to detect which, as participants observed, makes it especially useful to the abuser. The aftereffects permeated the relationship such that strangulation need not be repeated in order for her to be compliant and submissive, thus creating a context of coercive control.

Survivor-Defined Practice in Domestic Violence Work Measure Development and Preliminary Evidence of Link to Empowerment

Survivor-defined practice, characterized by an emphasis on client choice, partnership, and sensitivity to the unique needs, contexts, and coping strategies of individual survivors, is an aspirational goal of the domestic violence (DV) movement, assumed to be a key contributor to empowerment and other positive outcomes among survivors. Despite its central role in DV program philosophy, training, and practice, however, our ability to assess its presence and its presumed link to well-being has been hampered by the absence of a way to measure it from survivors’ perspectives. As part of a larger university–community collaboration, this study had two aims: (a) to develop a measure of survivor-defined practice from the perspective of participants, and (b) to assess its relationship to safety-related empowerment after controlling for other contributors to survivor well-being (e.g., financial stability and social support). Results supported the reliability and validity of the Survivor-Defined Practice Scale (SDPS), a nine-item measure that assesses participants’ perception of the degree to which their advocates help them achieve goals they set for themselves, facilitate a spirit of partnership, and show sensitivity to their individual needs and styles. The items combined to form one factor indicating that the three theoretical aspects of survivor-defined practice may be different manifestations of one underlying construct. Results also support the hypothesized link between survivor-defined practice and safety-related empowerment. The SDPS offers DV programs a mechanism for process evaluation that is rigorous and rooted in the feminist empowerment philosophy that so many programs espouse.

Bringing Community Based Participatory Research to Domestic Violence Scholarship: an Online Toolkit

In the absence of ongoing involvement in the communities that are the subjects of research, even well-intentioned researchers can develop questions that are not relevant to community needs, employ methods that hurt community members, or disseminate findings in ways that are inaccessible to those most affected. Recognizing these harms, a growing number of domestic violence (DV) researchers have embraced community-based participatory research (CBPR), an approach in which researchers and community members share power at every level of the research process, co-creating knowledge that can be applied to enhance community well-being. Despite growing interest in this approach, however, there are insufficient opportunities for interested researchers to learn how to actually engage in it, especially in the DV context. To remedy this gap, the authors of this paper collaborated to develop an online toolkit for emerging researchers interested in CPBR. This brief report frames the need for CBPR in DV research using short vignettes that come from our own research experience; introduces Power Through Partnerships: A CBPR Toolkit for Domestic Violence Researchers; and presents recommendations for developing, promoting, and disseminating future CBPR research. We chose to announce the development and availability of this toolkit in an academic journal in order to highlight its scholarly and practical relevance for researcher audiences who might be less familiar with the CBPR approach.

“No Sacred Cows or Bulls”: The Story of the Domestic Violence Program Evaluation and Research Collaborative (DVPERC)

The Domestic Violence Program Evaluation and Research Collaborative (DVPERC) was formed in Massachusetts in 2011 as an effort to connect research and practice. Initially, we consisted of a few programs and researchers, but we quickly evolved into a regional collaboration spanning several states. From the outset, we have followed community-based participatory research values, including co-learning, power sharing, and relationship-building. Several aspects of DVPERC make it unique. Our collaboration is informal, ongoing, and comprised of an array of programs, practitioners, and researchers. Although we are abundant in number, we are regional in scope, which allows for regular, in-person meetings. In this article, we describe the history of DVPERC, the five elements of the DVPERC model, and the model’s inherent benefits and limitations. Throughout, we infuse our practitioner and researcher perspectives on DVPERC involvement. We hope our honest description of DVPERC assists others interested in launching their own CBPR practitioner-researcher partnerships.

A systematic review of community-based research interventions for domestic violence survivors.

Objectives: Community-based research is a broad approach in which researchers work closely with practitioners and community members to enhance the understanding of a given phenomenon and promote positive outcomes. In the domestic violence (DV) field, community-based research is a particularly useful strategy to develop and evaluate interventions that address unique community needs. Despite the potential benefits of this approach, to our knowledge, no systematic review has synthesized DV-focused interventions and evaluations designed using a community-based research approach. This study aimed to fill that gap. Method: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review of the literature, retrieving articles that described the collaborative development and evaluation of interventions for DV survivors residing in the United States. Articles were identified from peer-reviewed databases, bibliographies, and experts. Twenty of the 199 articles assessed for eligibility were included. Results: Interventions primarily consisted of small-group sessions focusing on survivors’ mental health and safety needs. Evaluations focused on process metrics, although approximately half reported changes in survivors’ outcomes. Collaboration generally occurred between DV advocates and applied health care academic teams. Authors described the promotion of collaboration in multiple ways and to varying degrees. Common examples included shared decision-making, recognizing and addressing potential power imbalances, longitudinal relationship building, changing programs based on stakeholder feedback, and co-owned project outputs including coauthorship of manuscripts. Conclusions: This is the first systematic review of interventions to support DV survivors, developed using a community-based research approach. Implications include promoting community-based outcome evaluations and developing guidelines for teams publishing community-based research in the peer-reviewed literature.

“Consent is Good, Joyous, Sexy”: A banner campaign to market consent to college students

ABSTRACT Objective: This study assessed the recall of, reaction to, and understanding of a brief campus banner campaign promoting consent in sexual relationships, and determined whether campaign exposure was associated with subsequent engagement in activities related to sexual assault education, awareness, and prevention. Participants: A stratified random sample of 1,200 undergraduates was recruited during fall of 2010; 628 (52.3%) participated. Methods: To account for history and maturation, an experimental research design was employed with an online survey. Results: Direct and indirect campaign exposure was associated with increased action. Students expressed primarily positive reactions to and appeared to understand the consent message. The campaign appealed to and was associated with increased activity among a wide range of students with one exception: a negative effect was observed for business students. Conclusions: Colorful banners with pithy, upbeat messages hold promise for engaging undergraduates in conversations and proactive activities related to sexual assault prevention.

Coercive Control in Intimate Partner Violence: Relationship With Women’s Experience of Violence, Use of Violence, and Danger.

Objective: The objective of this study was to better understand the experience of coercive control as a type of intimate partner violence (IPV) by examining associations between coercive control and women’s experiences of particular forms of violence, use of violence, and risk of future violence. Method: As part of a larger research study, data were collected from 553 women patients at 2 hospital emergency departments who had experienced recent IPV and unhealthy drinking. Baseline assessments, including measures of coercive control, danger, and experience and use of psychological, physical, and sexual forms of IPV in the previous 3 months, were analyzed. Results: Women experiencing coercive control reported higher frequency of each form of IPV, and higher levels of danger, compared with women IPV survivors who were not experiencing coercive control. There was no statistically significant association between experience of coercive control and women’s use of psychological or sexual IPV; women who experienced coercive control were more likely to report using physical IPV than women who were not experiencing coercive control. Conclusions: Findings contribute to knowledge on the relationship between coercive control and specific forms of violence against intimate partners. A primary contribution is the identification that women who experience coercive control may also use violence, indicating that a woman’s use of violence does not necessarily mean that she is not experiencing severe and dangerous violence as well as coercive control. In fact, experience of coercive control may increase victims’ use of physical violence as a survival strategy.

A Comparison of Intimate Partner Violence Strangulation Between Same-Sex and Different-Sex Couples

Strangulation is a common and dangerous form of intimate partner violence (IPV). Nonfatal strangulation is a risk factor for homicide; can lead to severe, long-term physical and mental health sequelae; and can be an effective strategy of coercion and control. To date, research has not examined strangulation within same-sex couples. The objective of this cross-sectional, observational research is to identify whether and to what extent the detection of strangulation and coercive control differs between same-sex and different-sex couples in police reports of IPV. Data ( n = 2,207) were obtained from a single police department in the southwest United States (2011-2013). Bivariate analyses examined differences in victim and offender demographics, victim injury, violence, and coercive controlling behaviors between same-sex (male-male and female-female) and different-sex couples (female victim-male offender). Logistic regression was used to examine associations between strangulation, victim and offender demographics, coercive controlling behaviors, and couple configuration. Strangulation was reported significantly more often in different-sex (9.8%) than in female and male same-sex couple cases (5.2% and 5.3%, respectively; p < .05). Injury, however, was reported more frequently in same-sex than in different-sex couples ( p < .05). Couple configuration ( p < .05), coercive control ( p < .05), and injury ( p < .05) significantly predict strangulation. Findings suggest that nonfatal strangulation occurs within at least a minority of same-sex couples; it is possible that underdetection by law enforcement makes it appear less common than it actually is. Regardless of couple configuration, timely identification of strangulation and subsequent referral to medical and social service providers is essential for preventing repeated strangulation, life-threatening injury, and the long-term health effects of strangulation.