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Provider perspectives on implementing a student health and counseling center intervention for sexual violence.

ABSTRACT: Objective: To describe provider experiences with implementation of the GIFTSS (Giving Information for Trauma Support and Safety) intervention. Participants: Health and counseling center staff from participating campuses attended trainings between August 2015 and August 2016. Interviews were conducted between May and August 2017. Methods: Providers (n = 230) completed surveys prior to and six months following a 3-hour training on the intervention. Structured phone interviews were conducted with a purposively selected subset of 14 providers. Results: Overall, staff found the intervention acceptable. Implementation barriers noted were time and competing patient priorities. Providers noted variation based on patient and visit characteristics. Clinic commitment, particularly in adopting strategies for universal dissemination of the GIFTSS card, was seen as helpful. Conclusion: Implementation of a brief trauma-informed intervention in campus health and counseling centers was feasible and acceptable to most providers. Opportunities to change organizational culture regarding ensuring adequate time and safety for patients are discussed.

SUBMITTER: Anderson JC

PROVIDER: S-EPMC7855319 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Provider perspectives on implementing a student health and counseling center intervention for sexual violence.

Anderson Jocelyn C JC Feinstein Zoe Z Edwards Clare C Jones Kelley A KA Van Dusen Courtney C Kehr Vanessa V Burrell Carmen C Coulter Robert W S RWS Miller Elizabeth E Chugani Carla D CD

Journal of American college health : J of ACH 20200728 5

Objective: To describe provider experiences with implementation of the GIFTSS (Giving Information for Trauma Support and Safety) intervention. Participants: Health and counseling center staff from participating campuses attended trainings between August 2015 and August 2016. Interviews were conducted between May and August 2017. Methods: Providers (n = 230) completed surveys prior to and six months following a 3-hour training on the intervention. Structured phone inte ...[more]

PMID: 32721195

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Project description:IntroductionSexual violence, particularly in the context of drinking, is prevalent on college campuses. This study tested a brief intervention to prevent sexual violence among students receiving care from college health centers.Study designThis study was a two-arm, unblinded cluster RCT.Setting/participantsOn 28 campuses with health/counseling centers (1:1 randomization allocation; 12 intervention and 16 control), from September 2015 to March 2018, a total of 2,291 students seeking care at college health centers completed surveys before the appointment, immediately after, 4 months later, and 12 months later.InterventionIntervention college health center staff received training on delivering sexual violence education to all students seeking care. Control sites provided information about drinking responsibly.Main outcome measuresThe primary outcome was students' change in recognition of sexual violence. Additional outcomes included sexual violence disclosure and use of services among students with a history of sexual violence at baseline. Generalized linear mixed models accounting for campus-level clustering assessed intervention effects. Data were analyzed from September 2018 to June 2019.ResultsHalf (55%) of students seeking care at college health centers reported any history of sexual violence exposure. No between-group differences in primary (β=0.001, 95% CI= -0.04, 0.04) or secondary outcomes emerged between intervention and control students. Post-hoc analyses adjusting for the intensity of intervention delivery (intensity-adjusted) revealed an increase in self-efficacy to use harm reduction strategies (β=0.09, 95% CI=0.01, 0.18) among intervention participants. Among those who reported sexual violence at baseline, intervention students had increased odds of disclosing violence during the visit (AOR=4.47, 95% CI=2.25, 8.89) in intensity-adjusted analyses compared with control. No between-group differences emerged for remaining outcomes.ConclusionsSexual violence exposure is high among students seeking care in college health centers. A brief provider-delivered sexual violence intervention, when implemented with fidelity, was associated with improved self-efficacy to use harm reduction and increased disclosure of sexual violence during clinical encounters but no increased use of services. More interventions that are stronger in intensity are needed to connect students to sexual violence services.Trial registrationThis study is registered at www.clinicaltrials.gov NCT02355470.

Project description:BackgroundSexual dysfunction is prevalent among cancer survivors, significantly impacting patient and partner quality of life. Despite this, sexual health clinics (SHCs) remain rare in cancer centres across Canada. An innovative clinic was developed at Princess Margaret Cancer Centre in Toronto, Canada to address this significant gap in survivorship care. This study examines factors affecting the provision of sexual healthcare and the implementation of a sexual health clinic within a large urban centre.MethodsThe Quality Implementation Framework was used to explicate patient and provider experience and identify barriers and facilitators to integrating sexual healthcare into routine cancer care workflows. Healthcare providers and patients representing selected cancer types (prostate, cervical, ovarian, testicular, bladder, kidney, and head and neck cancer) participated in semi-structured interviews. Interviews were transcribed and analyzed using the Framework qualitative analysis protocol.ResultsThe analysis identified three organizing domains and ten themes that describe the unique aspects of the sexual healthcare experience and critical factors for sexual health implementation. Both patients and providers described a lack of sexual health support in the oncology setting and emphasized the need for comprehensive and personalized care. Limitations of current care provision included mutual silence between patients and providers due to discomfort in discussing sexual issues, insufficient provider confidence in delivering optimal sexual healthcare, and constraints related to space and time. Key Factors for implementing a sexual health clinic in oncology emphasized the importance of having a dedicated clinic, flexibility in service delivery, proactive patient engagement, and ongoing staff education.ConclusionsFindings highlight significant challenges in addressing sexual health in an oncology setting, underscoring the need for specialized sexual health clinics that are integrated with, but distinct from, routine oncology care. This study further emphasizes the need for incorporating sexual healthcare in survivorship programs as well as the necessity of conducting thorough implementation research, involving multiple stakeholders, prior to launching new programs.

Project description:BackgroundThe US Department of Veterans Affairs (VA) seeks to achieve interoperability with other organizations, including non-VA community and regional health information exchanges (HIEs).ObjectiveThis study aims to understand the perspectives of leaders involved in implementing information exchange between VA and non-VA providers via a community HIE.MethodsWe interviewed operational, clinical, and information technology leaders at one VA facility and its community HIE partner. Respondents discussed their experiences with VA-HIE, including barriers and facilitators to implementation, and the associated impact on health care providers. Transcribed interviews were coded and analyzed using immersion-crystallization methods.ResultsVA and community HIE leaders found training to be a key factor when implementing VA-HIE and worked cooperatively to provide several styles and locations of training. During recruitment, a high-touch approach was successfully used to enroll patients and overcome their resistance to opting in. Discussion with leaders revealed the high levels of complexity navigated by VA providers and staff to send and retrieve information. Part of the complexity stemmed from the interconnected web of information systems and human teams necessary to implement VA-HIE information sharing. These interrelationships must be effectively managed to guide organizational decision making.ConclusionsOrganizational leaders perceived information sharing to be of essential value in delivering high-quality, coordinated health care. The VA continues to increase access to outside care through the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act. Along with this increase in non-VA medical care, there is a need for greater information sharing between VA and non-VA health care organizations. Insights by leaders into barriers and facilitators to VA-HIE can be applied by other national and regional networks that seek to achieve interoperability across health care delivery systems.

Dataset Information

Provider perspectives on implementing a student health and counseling center intervention for sexual violence.

Publications

Provider perspectives on implementing a student health and counseling center intervention for sexual violence.

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