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Background: This study examines the role of Adverse Childhood Experiences (ACEs) as predictors of intimate partner violence (IPV) and sexual victimization (SV) in a college aged sample in southern Appalachia. Methods: Data were obtained from a health behavior questionnaire administered online at a university in southern Appalachia from July-December 2014. The sample included 992 participants who self-reported on ACEs and adult experiences of IPV and SV. Descriptive statistics were completed for age, race, sex, ACEs (emotional, physical, or sexual abuse experiences as a child or witnessing IPV), IPV, and SV. Multiple logistic regression models were used to predict IPV and SV in separate models. Results: The sample was mostly female (69.3%), Caucasian (84.2%), and had an average age of 20 years old (M=20.1, SD= 4.05). IPV was reported by 10.5% of participants and SV by 14.1%. Predictors of IPV were: female (OR: 2.85, CI: 1.44- 5.65), emotional abuse (OR: 2.06, CI: 1.14- 3.70), sexual abuse (OR: 2.52, CI: 1.40-4.53) and age (OR: 1.10, CI: 1.06-1.15). Predictors of SV were female (OR: 3.22 CI: 1.70- 6.08), emotional abuse (OR: 2.53, CI: 1.48-4.33), sexual abuse (OR: 7.45, CI: 4.40-12.60) and age (OR: 1.06, CI: 1.02-1.12). Conclusions: Emotional and sexual abuse experiences during childhood were the greatest predictors of IPV and SV in adulthood in this college aged sample. This illustrates that children who were victims of emotional or sexual abuse have an increased risk of further abuse and/or re- victimization as adults. Females had a greater odds of experiencing IPV and SV compared to their male counterparts. Although this pilot study is limited in that looked at college students at one university, this provides a foundation for future research on predictors of IPV and SV in young adults. Further, a better understanding of ACEs and their role in adult health outcomes will allow more targeted interventions in high risk groups.

BACKGROUND: This study examines characteristics and correlates of physical and emotional IPV in a college sample in southern Appalachia and further explores differences in the effect of correlates on perpetration and victimization. METHODS: Data were obtained from a health behavior questionnaire administered online at a university in southern Appalachia from July- December 2014. Sample included 992 participants who answered five questions on physical and emotional IPV; two on perpetration and three on victimization. Descriptive statistics were completed for age, race, sex, college year, rurality/ urbanicity, nine sexual risk behaviors, relationship status, sexual preference and IPV. Logistic regression models used gender, college year and sexual risk behaviors to predict IPV. RESULTS: The sample was mostly female (69.3%), Caucasian (84.2%), freshmen (56.9%), unmarried (94.7%) and heterosexual (92.6%) with average age 20 years (M=20.1, SD= 4.05). Population involved in IPV as either victim or perpetrator was 37.3%. There was no association between rurality/urbanicity and victimization or perpetration (χ2 = .13, p= .94: χ2 = .51, p= .77 respectively). Predictors of perpetration were: female (OR: 3.01, CI: 1.61- 5.65), college junior (OR: 2.96, CI: 1.61- 5.43), early sexual debut (OR: 2.19, CI: 1.35 -3.55) and illicit drug use during sex (OR: 1.92, CI: 1.144- 3.22). IPV victims were female (OR: 1.96 CI: 1.36- 2.83) with early sexual debut (OR: 1.50, CI: 1.05-2.14) using alcohol during sex (OR: 1.50, CI: 1.04- 2.16) and whose previous partner had multiple sexual partners (OR: 1.61, CI: 1.06-2.44). CONCLUSIONS: The risk of IPV victimization or perpetration in this sample was significantly increased by being female and involvement in sexual risk behaviors. Seniority in college increased the risk of perpetration. IPV awareness programs should integrate sexual risk behavior modules and be conducted in the early college years to be maximally effective.

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Adverse Childhood Experiences (ACEs) such as exposure to abuse, household dysfunction, and neglect have been shown to negatively impact adult health outcomes. The Behavioral Risk Factor Surveillance System (BRFSS) captures nationally representative data on behavioral risk factors and chronic disease in the United States and has included ACE items on the survey since 2009. The purpose of this study was to determine whether primary exposure to violence (experiencing physical abuse) and/or secondary exposure to violence (witnessing interpersonal violence in the home) during childhood predicted poor reported health status as an adult. METHODS: BRFSS data from 2009-2012 were included in the study. All analyses were performed using SPSS and SAS. A total of 3,060 individuals were including in the analyses. Descriptive statistics were completed for primary and secondary exposure to violence, race, gender, and health status. Univariate and multivariate logistic regression analyses predicting poor health were completed for the following predictor variables: race, gender, primary and secondary exposure to violence. Age, race, and gender were controlled for in the final model. Odds ratios and 95% confidence intervals were reported. RESULTS: Poor health was reported by 24% of the sample, 25.2% of the sample reported exposure to primary violence, and 27.3% reported exposure to secondary violence. Individuals who were exposed to primary violence were 79% (OR: 1.79, CI: 1.45-2.20) more likely to report poor health status and those exposed to secondary violence were 48% (OR: 1.48, CI: 1.20-1.81) more likely to report poor health compared to those who were not exposed to these types of violence. Individuals exposed to primary and secondary violence during childhood were over 2.5 times more likely to report poor health (OR: 2.52, CI: 2.00-3.17).CONCLUSIONS: These data suggest that exposure to violence during childhood negatively impacts health status in adulthood.

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•Identify the relation between domestic and global health. •Recognize prevalent cross-cultural and underserved issues. •Illustrate how learned knowledge can be applied locally and globally.

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This was a retrospective study that aimed to determine the treatment outcome of patients seen in the trauma unit of the Johnson City Medical Center (JCMC). The study included 2844 patients in the trauma registry and evaluated age, sex, injury severity score (ISS), length of stay (LOS) in the intensive care unit (ICU), overall hospital lengths of stay (LOS), ventilator days, discharge disposition, and complications between one group managed by extenders only and the second managed by both residents and extenders. The sample size of the two groups was similar (group one = 1446 and group two = 1398) and the proportions of males and females in the two groups were identical (males = 65%, females = 35%). Both groups had similar mechanisms of injury, although group one had a higher percentage of falls (32.9% vs. 22.03%) and group two had a higher proportion of motor vehicle crash (MVC) traumas (40.41% vs 30%). There was no significant difference in those discharged home and deaths between the two groups. (χ(1, N = 2258) = 0.04, p = 0.82). Complications showed statistical significance when looking at extenders vs. residents plus extenders for all complications (χ(7, N = 196) = 38.73, p ≤ 0.0001). It is possible that having extenders only versus both extenders and residents had no significant difference among the patient outcomes based on the variables age, sex, ISS, ICU days, overall hospital LOS, and ventilator days; however, when observing complications between the two groups, it is possible that patients are more likely to have complications due to overall hospital LOS in the residents plus extenders group.

Dr. Megan Quinn, an assistant professor in the Department of Biostatistics and Epidemiology in the College of Public Health, will discuss “Raising Awareness about Cervical Cancer in Nicaragua: Working with Health Promoters to Increase Pap Smear Uptake” in the second of five “Women on Wednesdays” lectures sponsored this spring by the Women’s Studies Program. A light lunch will be provided. The lecture series promotes the research, scholarship and community engagement of women at ETSU; provides a venue where women on campus and in the community can discuss and support each other’s work; and gives students an opportunity to meet faculty who could become mentors for their studies.