Under item response theory, three types of limited information goodness-of-fit test statistics – M2, Mord, and C2 – have been proposed to assess model-data fit when data are sparse. However, the evaluation of the performance of these GOF statistics under multidimensional item response theory (MIRT) models with polytomous data is limited. The current study showed that M2 and C2 were well-calibrated under true model conditions and were powerful under misspecified model conditions. Mord were not well-calibrated when the number of response categories was more than three. RMSEA2 and RMSEAC2 are good tools to evaluate approximate fit. The second study aimed to evaluate the psychometric properties of the Religious Commitment Inventory-10 (RCI-10; Worthington et al., 2003) within the IRT framework and estimate C2 and its RMSEA to assess global model-fit. Results showed that the RCI-10 was best represented by a bifactor model. The scores from the RCI-10 could be scored as unidimensional notwithstanding the presence of multidimensionality. Two-factor correlational solution should not be used. Study two also showed that religious commitment is a risk factor of intimate partner violence, whereas spirituality was a protecting factor from the violence. More alcohol was related with more abusive behaviors. Implications of the two studies were discussed.

This three-paper dissertation quantitatively identifies and examines three different substantive areas using data from the American College Health Association’s Fall of 2016 National College Health Assessment (ACHA-NCHA). Specific areas of inquiry include, marginalized populations and college campus sexual assault, intersectional analyses of risk factors for college campus sexual assault, and drinking protective behavioral strategies as prevention tools for college campus sexual assault. Paper one, titled, “College Campus Sexual Assault and Students with Disabilities,” explores a particular marginalized group of students that have been largely left out of college campus sexual assault studies: female college students with disabilities. The logistic regression analyses find that having any disability increases risk for any type of college campus sexual assault more than other commonly cited risk factors such as binge drinking, or Greek affiliation. Moreover, the study indicates that odds for female students with disabilities are varied depending on the type of assault, completed, attempted, or relationship, as well as the specific type of disability. Results are discussed, and policy implications, limitations, and opportunities for future research are delineated. Paper two, titled, “College Campus Sexual Assault: Moving Toward a More Intersectional Quantitative Analysis,” is guided by an intersectional theoretical framework. The study employs classification and regression tree analyses (CART) to identify more specific groups of students that are at disproportionate risk for sexual assault beyond singular variables or even interaction effects. Unlike traditional regression techniques, CART does not assume a linear relationship, and can simultaneously account for independent variables relationship to one another while determining which variables have the most explanatory power for the dependent variable and for which unique groups of students. The study discusses results of analyses in relationship to intersectional research both theoretically and methodologically, as well as future research, and policy implications. Alcohol consumption, particularly binge drinking, has been consistently linked to greater risk for college campus sexual assault victimization. However, there is a lack of college campus violence prevention and intervention programming that addresses alcohol consumption in relation to campus sexual assault. As such, paper three, titled, “Drinking Protective Behavioral Strategies and College Campus Sexual Assault,” uses logistic regression to explore whether or not the use of drinking protective behavioral strategies (PBS) lowers risk for sexual assault in female college students that drink alcohol. The study examines both the main effects of drinking PBS on sexual assault risk, as well as whether or not the use of drinking PBS moderates the risk of frequent alcohol consumption, and binge drinking on college campus sexual assault. The paper discusses findings, limitations, policy implications, and avenues for future research.

The purpose of this study was to examine factors influencing the decision of lesbian victims of domestic violence to call or not to call the police.

Sexual assault is a growing concern across college campuses in the United States. According to the Sexual Victimization of College Women study, the victimization rate is 27.7 rapes per 1,000 ­­­­women students (Fisher, Cullen, & Turner, 2000). In response to the high prevalence of sexual assault, college campuses are now mandated to implement various forms of sexual assault prevention programming. Sexual assault prevention programming is intended to promote awareness of sexual assault and reduce the prevalence of sexual assault on college campuses. Numerous studies have examined the short term effectiveness of sexual assault prevention programs (e.g., Anderson & Whiston, 2005). However, few studies have explored the effectiveness of repeated, annual prevention program participation on rape supportive beliefs. In addition, studies that have explored the efficacy of prevention programs have tended to rely exclusively on self-report measures and some have only focused on outcomes among men or women groups only. The purpose of the present study was to examine the impact of level of participation and gender in sexual assault prevention training on rape myth acceptance (RMA) and response latency to a hypothetical date rape scenario among a sample of Western college students. Results revealed no significant relationships between higher levels of sexual assault prevention programming participation and RMA scores and latency times. Additionally, there were no gender differences on IRMA scores or response latency. Findings have important implications for future sexual assault prevention programming efforts on college campuses and community settings.

Background: Pregnancy induced hypertension (PIH) is the leading cause of maternal mortality and a major contributor to preterm birth and neonatal mortality. Literature suggests that several modifiable psychosocial and health behavioral factors may play significant roles in the development of PIH. However, interrelationships among these factors and their collective impact on PIH are not well understood. Objectives: This study aims to: 1) Examine the relationship between pre-pregnancy physical activity and risk of PIH, 2) Determine the association between prepregnancy depression and PIH and the role of race/ethnicity in this association, 3) Evaluate the association between intimate partner violence (IPV) in women before and/or during pregnancy and PIH, and the role of utilization of prenatal care (PNC) as a mediator in this association. Methods: This study utilized the national Pregnancy Risk Assessment Monitoring System survey data (years 2009-2015). The outcome variable PIH was defined as a dichotomized variable (Yes; No) utilizing a birth certificate variable data. Domain-adjusted multiple logistic regression, multiple logistic regression with stratification, and structural equation modeling analyses were used to investigate the study aims. Results: No significant reduced risk of PIH was observed in women who were physically active prior to pregnancy compared to sedentary women. However, women with prepregnancy depression were more likely to have PIH compared to women without prepregnancy depression and this association was significant for non-Hispanic White women when stratified by race/ethnicity. Further, PNC utilization was a significant mediator in the association between IPV before and/or during pregnancy and PIH. However, IPV had no direct or total effect on PIH in this study. Conclusions: Public health professionals and health care providers should be aware of the relationships between prepregnancy depression, race/ethnicity, IPV, and prenatal care utilization, and PIH, and utilize the information in risk profiling, screening, early detection and intervention in women at risk of PIH.

The cost of domestic and intimate partner violence (DIPV) exceeded $8 billion annually on a national level, and North Carolina spent $307 million on DIPV and DIPV-related mental health care. Studies have shown a correlation between DIPV, mental illness, and substance abuse. North Carolina was found to have higher than normal risk factors for DIPV. In response, the Centers for Disease Control and Prevention partnered with the North Carolina Coalition Against Domestic Violence (NCCADV) to develop the NCCADV 10-year primary prevention plan. This study investigated clinicians' perceptions of the effectiveness of the plan. Phenomenological thought served as the conceptual framework. A purposive sample of 10 clinicians who worked in the region with DIPV clients in the preceding 12 months responded to semistructured interview questions that investigated their perceptions of whether the 10-year plan had a positive influence on victims and if the plan could potentially impact victims' future mental health and substance use behaviors. Interview data were transcribed, open coded, and thematically analyzed with the aid of qualitative software. Study results indicated that these clinicians believed the plan did not impact DIPV clients' current behaviors and was unlikely to have a future impact. A policy recommendation in the form of a position paper resulted from the findings, which recommended the use of mass media that encompass old and new technologies to promote primary prevention efforts by stakeholders and practitioners for the general public. This study has implications for positive social change in that it may provide knowledge to clinicians and stakeholders at the study site that aids them in understanding and preventing DIPV, in addition to promoting an overall increase in public awareness of the negative effects of DIPV.

The purpose of this project was to improve support for victims of domestic violence. To that end, this project developed an evidence-based program to provide information about domestic violence including safe and confidential ways to seek assistance, rights as cohabiting intimate partners, and the resources available to community members. Several approaches were used to develop, validate, and plan for implementation and evaluation of this program, which was developed for 3 sites in Broward and Miami-Dade counties where the project is situated. The program logic model and the social ecological model, including the individual, relationship, community, and societal levels, were used to guide this project. In addition, scholarly works from 2000 to 2013 were selected from ProQuest, CINAHL, Ebscohost, Medline, and Ovid Nursing Journals to develop this program in collaboration with an interdisciplinary team of 7 community stakeholders including a physician, advanced practice nurse, law enforcement officer, pastor, and 3 recovery center directors with knowledge in these areas. Content validation involved incorporating feedback from the project team. The target population for the project includes women and men aged 18 or higher who have experienced domestic violence, homelessness, and drug addiction. Community operationalization of the initiative will be facilitated by implementation and evaluation plans developed as part of this project. The project includes community education that may help organize events and campaigns, increase domestic violence awareness among community members, and influence policy regarding issues pertaining to domestic violence.

Background: Intimate partner violence is a major human rights problem, that affects all sexes of all ages in all societies. Men are the primary perpetrators, and women are more likely to get injured since the violence against women also tends to be more severe. The majority of the perpetrators of violence are in an intimate relationship and in many of the cases, alcohol is a significant contributor to the abuse. Aim: To investigate which societal factors drive and maintain the alcohol-related violence towards women and what coping strategies these women use to handle this form of violence in Livingstone, Zambia. Methods: A qualitative study using semi-structured interviews with 16 Zambian women who had experienced violence by alcohol abusive male partners was conducted. Thematic analysis was used to analyze the data. Results: The results in this study shows that poverty is the source of this form of violence. It is not only the absence of money but also the presence thereof and the way in which this challenges the traditional gender roles. These traditional gender roles are changing because men do not take their responsibilities as providers. Women used emotion-focused and problem-focused strategies to cope with these stressful situations. Conclusion: This study concludes that poverty and the challenging of traditional gender roles perpetuate violence. These women, who are exposed to this violence are reaching out for help but are not getting the help they need, which is partly due to the society’s view of the importance of marriage.

Introducción: Diversos estudios transversales han demostrado el impacto negativo quela violencia de pareja tiene en la salud mental, en la salud física y en el funcionamientode los sistemas fisiológicos de las mujeres. Si bien, han sido pocos los estudioslongitudinales realizados para establecer la evolución de dicho impacto en la salud delas mujeres a lo largo del tiempo. Objetivos: En este estudio se pretendió, en primerlugar, determinar la evolución del estado de salud física y del funcionamiento delsistema inmune de las mujeres víctimas de violencia de pareja y, en segundo lugar,establecer los factores personales y sociales que contribuyen a la recuperación de lasalud o la perjudican. Métodos: Las mujeres (n=91) que participaron en un estudiotransversal previo (T-1) fueron evaluadas tres años después (T-2): mujeres víctimas deviolencia psicológica (n=23), mujeres víctimas de violencia física/psicológica (n=33) ymujeres control en cuya relación de pareja no existía violencia (n=35). Tanto en elestudio transversal (T-1) como en el estudio longitudinal (T-2) se llevaron a caboentrevistas estructuradas a través de las cuales se recogió información sobrecaracterísticas sociodemográficas, relaciones de pareja, características de la violencia depareja, historial de victimización, salud física, apoyo social y acontecimientos vitales. Elestado de salud física de las mujeres se midió a través de tres indicadores: incidencia desíntomas físicos, incidencia de enfermedades físicas y utilización de servicios de salud.Finalmente, en ambos momentos temporales se recogieron muestras de saliva paraevaluar el control del sistema inmune sobre el virus Herpes simple tipo 1 (HS-1) através de tres medidas: neutralización del virus HS-1, cantidad de inmunoglobulina A(IgA) específica contra el virus HS-1 (IgA HS-1) y cantidad total de IgA en la saliva(IgA total). Resultados: La incidencia de síntomas físicos disminuyó significativamentea lo largo del tiempo en ambos grupos de mujeres víctimas de violencia de pareja,psicológica y física/psicológica, si bien se observó una mayor disminución en lasmujeres víctimas de violencia física/psicológica. Los factores que contribuyeron a estarecuperación fueron el estado de salud física de las mujeres en T-1, el grado de apoyosocial percibido y el cese de la violencia física. Por el contrario, los factoresperjudiciales para su recuperación fueron el consumo de psicofármacos, la convivenciacon el agresor, las experiencias de victimización en la edad adulta durante T-2, lapercepción negativa de los acontecimientos vitales y el mantenimiento de la violenciapsicológica. Por otro lado, en las mujeres víctimas de violencia física/psicológica seprodujo una disminución a lo largo del tiempo en la cantidad total de enfermedadesagudas padecidas, así como en el número de veces que utilizaron los servicios deurgencia por motivos de violencia. En cuanto al funcionamiento del sistema inmune a lolargo del tiempo, las mujeres víctimas de violencia física/psicológica mostraron unaumento tanto en la capacidad para neutralizar el virus HS-1 como en los niveles de IgAHS-1. El cese de la violencia física fue el principal factor predictor de dicharecuperación. Conclusiones: Este estudio muestra que es posible la recuperación de lasalud física previamente deteriorada en mujeres que han sido víctimas de violencia depareja, psicológica o física/psicológica. Además, indica que es posible la recuperacióndel control inmune sobre el virus HS-1 en mujeres que han estado expuestas a violenciafísica/psicológica a pesar de su baja capacidad antiviral inicial. Son necesarios otrosestudios longitudinales para determinar los factores que mejor predicen la recuperaciónde la salud de las mujeres con la finalidad de diseñar programas de intervención máseficaces. / Introduction: Several cross-sectional studies have demonstrated the negative impactthat intimate partner violence (IPV) has on women's health. However, few longitudinalstudies have been carried out to establish the course of this impact over time.Objectives: This study pretended to determine the course of the physical health and theimmune system function on women victims of IPV and to establish the factors thatcontribute or impair to its recovery. Methods: Women (n=91) who took part in aprevious cross-sectional study (T-1) were evaluated three years later (T-2): victims ofpsychological IPV (n=23), victims of physical/psychological IPV (n=33) and controlwomen (n=35). Information about characteristics of IPV, physical health and lifestylevariables was obtained by structured interviews. Finally, saliva samples were collectedto assess the immune system control over Herpes simplex virus type 1 (HSV-1).Results: The incidence of physical symptoms decreased in time in both groups ofwomen, psychological and physical/psychological victims of IPV. Factors thatcontributed to this recovery were the women's health condition in T-1, the socialsupport and the physical IPV cessation. On the contrary, factors that impaired thisrecovery were the psychopharmacological treatment, the cohabitation with theaggressor, the experiences of victimization during T-2, the negative perception of lifeevents and the continuation of psychological IPV. Furthermore, the amount of acutediseases suffered by women and the visits to emergency rooms because of violencereasons decreased in time in physical/psychological IPV victims. With regard to thecourse of immune system over time, women who were victims ofphysical/psychological IPV had a significant improvement in both the capacity toneutralize HSV-1 and HSV-sIgA levels. Physical IPV cessation was the main predictorof this recovery. Conclusions: This study shows that physical health recovery ispossible in women that have been IPV victims. Furthermore, it shows that recovery ofimmune control over HSV-1 is possible in women who have been exposed tophysical/psychological IPV. Other longitudinal studies are needed to determine whichfactors best predict the restoration of health in order to design effective interventionprograms.

The purpose of this study was to describe and analyze IntimatePartner Violence (IPV). How does contemporary science illustrate men as victimsand women as perpetrators in these relationships? Ten articles were presentedand analyzed in a systematic literature study. The results show that men beingabused by their female intimate partner, do exist and that they in many ways doconform to abused women. There are many underlying causes to the violence inclose relationships. There are also many shapes and degrees in violence and inIntimate Partner Violence (IPV). Furthermore, Intimate Partner Violence (IPV) exhibitssymmetry in socio-demographic characteristics, such as gender and ethnicity. Thefindings also points out that Common Couple Violence (CCV) are a much morecommon form of violence than Intimate Terrorism (IT) and that both forms areused by men and women. Finally, violence is ambiguous, includes many aspectsand is not easy to explain among cultural values, norms and social contexts.Still, violence is a universal human issue which demands social interventions.