Sexual Assault Response Team Goals and Motivations for Development.

Sexual Assault Response Teams (SARTs) are community-based, multidisciplinary interventions that strive to coordinate the response to sexual assault. SARTs consist of sexual assault responders (e.g., rape crisis advocates, police, forensic examiners/Sexual Assault Nurse Examiners, and prosecutors) and seek to increase responder collaboration to improve survivors' help-seeking experiences. There is a lack of empirical research examining factors underlying SARTs' goals and what leads communities to form SARTs. Therefore, this study sought to examine the goals and motivations present in SART development using a multiple-methods approach with a national random sample of n = 172 SARTs. Exploratory factor analysis (EFA) was used to examine factors underlying SART goals, and qualitative thematic analysis was used to explore what motivators drove SART formation. Both qualitative and quantitative analyses underscored the importance of improving the accessibility and quality of services, improving the treatment of survivors, and increasing responder collaboration. The qualitative findings offered additional insight into the importance of community education and various community contextual factors (e.g., funding and policy requirements) that influence SARTs. Findings inform future research and practice on SART goals and functioning, such as how SART goals may relate to team structure, effectiveness, and capacity-building opportunities.

The Working Relationship Between Emergency Room Nurses and Medical Rape Victim Advocates: A Qualitative Examination of Nurses' Perceptions of the Influence of Nurse Training and Experience on Nurse-Advocate Interactions.

Nurses and medical advocates respond to sexual assault survivors seeking hospital services. Ideally, both providers work collaboratively. However, this does not always happen. Extant research on the nurse-advocate relationship focuses on Sexual Assault Nurse Examiners (SANEs). This study examines how ER nurses perceive their training and experience influence the working relationships between emergency room (ER) nurses (not exclusively SANEs) and medical advocates. Key findings indicate nurses perceive increased training improves (a) role understanding, (b) trust, (c) respect, (d) rapport, and (e) appreciation. Less training was associated with poorer role understanding and trust.

Rape Crisis Victim Advocacy: A Systematic Review.

While rape crisis center (RCC) advocacy is generally regarded as valuable, there are no prior systematic reviews of the advocacy literature. This review examined RCC advocacy service provision, perceptions and impact of advocacy, and challenges and facilitators to effective service provision. Databases related to health and social sciences were searched including Academic Search Complete, PsychINFO, PubMed, CINAHL, ProQuest, Science Direct, OAlster, WorldCat, and MEDLINE. Empirical articles written in English that examined RCC advocacy service provision and/or impact in the US were included. The researchers reviewed abstracts and titles, and then full texts. Forty-five articles met criteria, were summarized, and double checked. Findings demonstrate advocacy is multi-faceted, beneficial, and challenging. Advocates work directly with survivors and interact with other responders on behalf of survivors. Specifically, advocates provide emotional support, safety plan, support survivors in making decisions, and assist them in navigating other systems. While advocates are generally regarded positively by survivors and responders, some responders have concerns about advocates. In addition, advocates sometimes report victim-blaming and being ill-equipped to meet survivors' needs. Finally, advocates face specific challenges in their work with survivors and responders. Future research using diverse methodological approaches is needed to understand advocacy utilization and reach; survivors' perceptions of advocacy; marginalized survivors' experiences; connections between specific services, implementation, and outcomes; and effective strategies for advocates' interactions with other responders. Additional resources to help advocates serve all survivors effectively and equitably; to support evaluator-practitioner partnerships; and to share unpublished data on advocacy may help contribute to improvements in advocacy practice.

A Qualitative Examination of Collaborative Infrastructure within Sexual Assault Response Teams.

Sexual assault response teams (SARTs) are multidisciplinary interventions that seek to improve the response to sexual assault in their community. SARTs bring together relevant stakeholders (e.g., sexual assault advocates, medical/forensic examiners, police, prosecutors) to coordinate the response to sexual assault and improve survivors' help-seeking experiences. SARTs may adopt various infrastructures to guide their team (e.g., case review, subcommittees), but little is known about how infrastructure influences SART effectiveness. Therefore, this qualitative study examined the helpful versus challenging aspects of SART infrastructure. Interviews from a national random sample of 169 SART leaders revealed helpful versus challenging aspects of mission statements, formal protocols, subcommittees, team roles, trainings, meetings, and case review. Participants believed infrastructures have positive influences on interdisciplinary relationships, team efficiency, and creating improvements in responding to sexual assault. However, certain infrastructures were difficult to implement for some teams. Additionally, some infrastructures can have unintended consequences, such as exacerbating team conflict. Findings suggest that SARTs may benefit from first focusing on infrastructures that build trusting interdisciplinary relationships and widespread buy-in prior to implementing accountability-focused measures (e.g., protocols, case review).

Stressors of Rape Crisis Work From the Perspectives of Advocates With and Without Sexual Assault Victimization History.

Rape crisis centers largely rely on volunteers for delivering emergency room advocacy to survivors of sexual assault. Volunteer advocates bear witness to trauma as part of their role, such as when listening to details of sexual assault. This exposure may negatively affect advocates long term, which may lead to secondary traumatic stress and vicarious traumatization, and possibly reduce their ability to provide quality services and remain in their role. In addition, some advocates may be survivors of sexual assault themselves. Survivors may differentially experience the toll of advocacy work. The present qualitative study sought to identify stressors that advocates face within their role, aspects of stressors unique to survivors who advocate, and the effects of stressors on advocates. Semistructured interviews were conducted with 18 current volunteer advocates, 11 of whom identified as survivors, from three rape crisis centers. Findings demonstrated stressors associated with self-evaluation; rules or expectations of the role (including the crisis nature of the role); witnessing lack of client support; helplessness around sexual assault as a systems issue; identifying with the client; witnessing the physical and emotional impact on clients; and being reminded of their own assault. Results also revealed how these stressors and advocacy overall influenced advocates. Unique aspects of stressors to survivors arose in the way advocates experienced the stressors. In addition, survivors exclusively described being reminded of past trauma within advocacy work. Findings have implications for supporting advocate well-being by better understanding the stressors that may lead to negative outcomes and informing individual coping, training, and overall organizational support of advocates. Such measures may ensure retention of volunteers and maintain quality advocacy services.