"He gets mad that I'm sober": Experiences of substance use coercion among postpartum women in recovery.

PURPOSE: The number of women with substance use disorders (SUDs) is growing in the U.S. Many women with SUDs are of childbearing age, and studies show that women who abstain from substance use during pregnancy often relapse in the postpartum period. Given the high overlap between substance use and intimate partner violence, these women may be in relationships that make recovery more challenging. This study aimed to better understand how substance abuse coercion in intimate relationships may affect substance use and to identify and describe the presence of substance use coercion in postpartum women. METHODS: The study conducted qualitative interviews with 30 women with substance use disorders who had given birth within the past six months. Researchers recruited women from a larger intervention study providing home visit support to postpartum women in substance use recovery. Thematic analysis was then identified overarching themes in the interview data. RESULTS: Analysis of the impact of IPV on substance use revealed four themes: 1) sabotaging sobriety, 2) making substance use a condition of the relationship, 3) portraying her as a "bad mom," and 4) furthering social isolation. CONCLUSIONS: Findings showed that women with SUDs have specific vulnerabilities that partners may exploit as a way of exerting control. Implications for practice with postpartum women who are working toward recovery are discussed.

Trapped in housing insecurity: Socioecological barriers to housing access experienced by intimate partner violence survivors from marginalized communities.

Homelessness and intimate partner violence (IPV) do not impact all communities equally. Survivors from marginalized communities-that is communities that have been historically and structurally excluded from social, economic, and political resources-face additional challenges weathering IPV and housing crises. Understanding the housing experiences of marginalized survivors is necessary to achieve housing equity for all survivors. Community-based participatory research methods were utilized to convene 14 listening sessions (7 primary/7 validation) with Black and Latinx IPV survivors with intersectional identities (n = 92). Listening sessions were held in community-based locations including a church, health clinic, social service agency, and private residence. The last five validation sessions were conducted virtually on Zoom due to COVID pandemic protocols. All listening sessions were digitally recorded and transcribed verbatim. Latinx population listening sessions were conducted in Spanish and were implemented and translated with attention to linguistic justice principles. The research team used a modified constructivist grounded theory approach for data analysis. Four overarching themes (and seven subthemes) related to survivors' housing experiences emerged: (1) safety and healing challenges, including living in unhealthy physical environments, not being safe in their homes, and contending with community violence, sexual exploitation threats, and eviction fears; (2) formal service fragmentation/bureaucracy that hampered access to housing resource information and resources; (3) resource scarcity associated with limited affordable housing stock; and (4) systemic oppression resulting from discriminatory treatment and gentrification. Comprehensive multileveled approaches are needed to disrupt the cycle of housing insecurity for IPV survivors from marginalized communities.

"We're Constantly Learning": Identifying and Disrupting White Supremacy Within a Victim Services Organization.

Many victim service organizations are seeking to realign service delivery around principles of racial equity. Dismantling institutional racism is a complex, intensive, and long-term process. Therefore, despite this imperative from the field, our knowledge about how social service organizations can effectively advance anti-oppressive practice is limited. This study examined victim advocate perspectives on the role institutional racism played within their work and the supports needed to undo institutional racism within their organization. Six focus groups were conducted with a meaningful cross section of staff members (n = 53) across the organization. Semi-structured interview guides included questions in four domains: (1) racism within client work, (2) challenges to addressing racism, (3) effective solutions, and (4) helpful organizational supports. Transcripts were thematically analyzed using modified constructivist grounded theory methods. Two overarching themes, Identifying Institutional Racism in the Workplace and Advancing Anti-racist Practice, and six subthemes emerged from the analysis. Advocates identified that naming and becoming comfortable talking about race was essential. Further, they believed it was important to acknowledge the ways in which that racism was implicitly built into helping systems at large. Advocates explored how internalized racial stereotypes influenced interactions between black, indigenous, and people of color (BIPOC) and white advocates and their clients in complex ways. Advocates highlighted organizational efforts that supported ongoing personal reflection, the creation of an accountable community, and staff empowerment within the organization as being critical to advancing anti-racist practice. Some advocates also wanted to see the organization move further in the direction of standing with BIPOC communities, particularly around criminal justice concerns. Findings provide important timely insights into how institutional racism manifests within victim service organizations and what organizational actions encourage anti-oppressive practices and culture.

Individual and community socioeconomic factors related to the quality of antenatal care: a multilevel analysis of West and Central Africa.

Antenatal care (ANC) can improve maternal health. We examined associations of individual and community socioeconomic status (SES) with the quality of ANC in West and Central Africa. Data were from the 2009-2011 UNICEF Multiple Indicator Cluster Surveys for women in seven countries (n = 24,718). Individual SES variables included women's education and wealth; community SES was defined as low or high poverty index. ANC quality was defined as receiving six services: blood pressure monitoring, blood tests, urine tests, malaria prophylaxis, tetanus vaccine, and HIV screening, and coded low or high. We used multilevel logistic regression to estimate fixed and random effects of individual and community SES on ANC quality. Less than one-fourth of women received high-quality ANC. Only small percentages of women had malaria prophylaxis and were counseled and tested for HIV. In adjusted country-stratified results, living in a poor community was associated with reduced odds of receiving high-quality ANC in six countries (Central African Republic: odds ratio, OR = 0.76; 95% confidence interval, CI:0.58-0.98; Chad: OR = 0.48; CI:0.32-0.74; Ghana: OR = 0.86; CI:0.61-0.97; Nigeria: OR = 0.74; CI:0.61-0.92; Sierra Leone: OR = 0.71; CI:0.57-0.91; and Togo: OR = 0.80; CI:0.47-0.91). The health system may be missing important opportunities to provide high-quality ANC and, thereby, improve pregnancy outcomes in these settings.

"I feel like their relationship is based on the media": Relationship Between Media Representation and Adolescents' Relationship Knowledge and Expectations.

Teen dating violence (TDV) is a serious public health issue associated with negative physical and behavior outcomes that disproportionately impact African-American adolescents. Despite the emergence of effective TDV prevention strategies, more knowledge is needed about how African American adolescents understand healthy and unhealthy relationships. Adolescents' analysis of media representations can provide important insight into social norms around adolescent romantic relationships, which can inform the development of TDV prevention strategies. We conducted nine focus groups (n = 86) to explore perceptions of healthy and unhealthy relationships and the influence of media representations on romantic relationships. We transcribed focus group interviews verbatim and coded them line by line. Participants were primarily African American (90%), female (67%), and high school aged (13-17 years). Consistent with other studies, participants reported significant engagement across traditional and social media platforms that exposed them to a wide variety of fictional, celebrity, and peer relationships. A modified constructivist grounded theory analytic approach produced four major relationship themes: commitment, authenticity, privacy, and maturity. These themes captured participants' reflections about romantic relationships and how the media interact with relationship processes and perceptions. Results show that adolescents are using media representations of romantic couples to clarify their own romantic relationship expectations and desires. Future prevention strategies should support youths' use of critical thinking, perspective taking, and analysis to help align their relationship choices and expectations with their own values and preferences.

Intimate Partner Violence in the Workplace: Exploring Gender Differences in Current Health-Related Quality of Life.

Workplace restraint and interference (WRI) behaviors represent a distinct form of intimate partner violence (IPV) that undermines survivors' employment. This study explored relationships between WRI, gender, and health-related quality of life. Eight linear regressions tested the relationship between WRI and health-related quality of life measures within a large corporate sample. Overall, female employees reported poorer outcomes on all health-related quality of life domains compared with males. WRI experiences uniquely contributed to female employees' anxious moods, sleep disruptions, and reduced vitality, as well as male employee pain, beyond other factors. Helping employees, supervisors, and co-workers to understand WRI as IPV increases opportunities to enhance employee safety, health, and well-being. Future research, including WRI measurement development, can deepen our understanding WRI experiences on specific health outcomes.

Examining the relationship between Latinas' perceptions about what constitutes domestic violence and domestic violence victimization.

Domestic violence is a serious issue for U.S. Latinas. Better understanding of the potential risk or protection that cultural perceptions about what constitutes domestic violence may convey can help strengthen interventions. Therefore, a convenience sample of 93 Latinas was surveyed about their current levels of domestic violence victimization, acculturation, and demographics, as well as about whether 5 behavioral scenarios constituted domestic violence. Hierarchical multiple regressions were performed to examine the relationships between the 5 perception items and domestic violence victimization. After adjusting for established risk factors, only viewing male partner stalking and female verbal aggression as domestic violence were significantly associated with decreased domestic violence victimization. Findings can be integrated into the development and implementation of culturally competent interventions targeting Latinas.

Back to basics: essential qualities of services for survivors of intimate partner violence.

Survivor voice is essential to effectively implement survivor-focused IPV (intimate partner violence) services. In this focus group study, domestic violence survivors (n = 30) shared detailed perspectives as service seekers and recipients, whereas national hotline advocates (n = 24) explored relationships between service providers and survivors based on their interactions with both. Four thematic categories related to enhancing IPV services emerged: providing empathy, supporting empowerment, individualizing care, and maintaining ethical boundaries. Advocates identified additional factors that interfered with quality services, including the following: inadequate organizational resources, staff burnout, lack of training, and poor integration with other community resources. Respectful, empowering relationships are the centerpiece for quality IPV services.

Sexual victimization and family violence among urban African American adolescent women: do violence cluster profiles predict partner violence victimization and sex trade exposure?

Guided by an intersectional feminist perspective, we examined sexual victimization, witnessing intimate partner violence (IPV) in the family, and familial physical abuse among a sample of 180 urban African American adolescent women. We used cluster analysis to better understand the profiles of cumulative victimization, and the relationships between profiles and IPV victimization and personal exposure to the sex trade. Just under one third of the sample reported sexual victimization, with cooccurrence with both forms of family violence common. The cluster profile with high levels of severe family violence was associated with the highest rate of IPV victimization and sex trade exposure.