A Multilevel Exploration of the Role of Student Health Centers in Addressing Campus Sexual Violence

The prevalence of sexual violence (SV) within the college population is alarmingly high. Experiences of SV may lead to numerous negative academic, physical, and psychological consequences. Recent calls to action emphasize the importance that universities address this serious public health concern. The overall purpose of this dissertation is to explore the role of student health centers (SHCs) in addressing campus SV. This dissertation has three main aims: (1) to examine current research literature on SV in the college undergraduate student population with a specific focus on student disclosure and campus resources and services, (2) to describe SV practices of SHCs located on university campuses in the state of Florida, and (3) to explore students’ perspectives of SHCs’ role in addressing campus SV. Aim 1 was addressed through a systematic review of the literature. Then, Aims 2 and 3 were addressed by conducting a two-phase study with multiple study designs. To address aim 1, studies were identified through systematic searches of PubMed, CINAHL, and PsycInfo of articles published between January 2010 and February 2015. After screening, 16 articles were included in this review. Results demonstrated a lack of consistency in how SV was referred to and measured. Research on college student SV disclosure was found to have been primarily conducted in six areas: (1) informal disclosure, (2) formal disclosure, (3) friends’ perceptions of disclosure, (4) process/effects of disclosure on the survivor, (5) barriers to disclosure, and (6) social support in the disclosure process. Research related to campus SV resources and services primarily focused on: (1) students’ knowledge, (2) students’ utilization, and (3) students’ suggestions. To address aim 2, a cross-sectional, observational study design was used. Institutional level data was collected from 33 SHCs from November 2015 through January 2016. Data was collected from SHC representatives through use of a telephone administered survey. The majority of SHCs screen for SV. Not all use effective screening strategies. Further, the majority of screening questions used are not specific to SV, but rather focus on general abuse and/or intimate partner violence (IPV). Finally, to address aim 3, a qualitative, descriptive research design was used. Data were collected from thirty-seven female undergraduate students in March 2016. Four focus groups were conducted and analyzed using thematic analysis techniques. Three themes emerged: (1) supports and barriers to using SHCs for SV; (2) SHCs’ responsibility to educate students about SV; and (3) SHCs’ responsibility to use campus-wide, comprehensive SV efforts. This dissertation follows the three manuscript option. Chapter One provides an overview of the issue of campus SV and introduces this dissertation’s purpose, aims, and methodology. Chapters Two through Four consist of publication-ready manuscripts presenting the results for Aims 1, 2, and 3, respectively. Finally, Chapter Five presents a summary, introduces additional findings, and integrates main findings. Taken together, findings of this dissertation recognize the key role that SHCs have in assisting universities with addressing SV. Nurses are often present within these facilities and, therefore, have an important role in assisting universities with addressing SV. Synthesized findings and recommendations for nursing research, practice, and education are presented