Communication Strategies to Intervene in Intimate Partner Violence Among Young Adult Couples

Intimate partner violence (IPV) is a social and behavioral health issue of importance among the young adult population (Cupp et al., 2015). IPV includes acts of physical violence, sexual violence, psychological aggression, and stalking enacted by an intimate partner (Smith, Zhang, Basile, Merrick, Wang, Kresnow, & Chen, 2018). In the United States., approximately one in three women and one in ten men experience IPV during their lifetime (Smith et al., 2018). Furthermore, over more than 70% of women who experience indicate that the first act occurred before the age of 25. One approach to preemptively address IPV on college campuses is through the implementation of bystander intervention campaigns and training. Although IPV can and does occur in private settings, approximately one-third of acts of IPV occur in the presence of individuals external to the couple, and these individuals have the opportunity to intervene (Planty, 2002). The overall objective of this dissertation study was two-fold: (a) examine college students’ attitudes, norms, and perceived behavioral control in the context of intervening in acts of IPV; and (b) assess college students’ intentions to intervene using different communicative strategies when presented with portrayals of IPV. The study was conducted in two phases. Phase One comprised an online, primarily qualitative questionnaire including (a) a pilot-test of the vignettes depicting acts of IPV with a small subset of young adults attending a university; and (b) an elicitation questionnaire to gather readily accessible beliefs for behavioral outcomes, normative referents, and control factors as they relate to the behavior of bystander intervention. Phase Two included online survey data collection. First, participants completed measures assessing their beliefs about IPV and their attitudes, normative beliefs, perceived behavioral control, and intentions to intervene using different communication strategies as a bystander in the context of IPV. Second, participants were presented with one of six written vignettes portraying three different types of IPV enacted by either a male or female partner and asked to identify how they would respond when presented with the scenario using four different communication strategies to intervene: direct, distract, delegate, delay; and the option to do nothing to intervene. The results of this dissertation evidence that bystander intervention is not a one-size-fits all approach in the context of IPV. The findings provide a basis to inform future messages for campaigns, interventions, and programmatic materials developed to improve young adult college students’ awareness and understanding of IPV and tools to help them become active bystanders. The data sheds light on theoretical mechanisms that may increase young adults’ intentions to intervene, the types of IPV for which young adult college students are most inclined to intervene, and what communication strategies students find to be most accessible when confronted with IPV as a bystander. This information is crucial because bystander intervention efforts should be continually adapted over time to more effectively influence their target audiences. This dissertation seeks to make interdisciplinary contributions, spanning the fields of health communication, health promotion, and violence prevention

Patients’ Attitudes Toward Deprescribing and Their Experiences Communicating with Clinicians and Pharmacists

Purpose: Developing effective deprescribing interventions relies on understanding attitudes, beliefs, and communication challenges of those involved in the deprescribing decision-making process, including the patient, the primary care clinician, and the pharmacist. The objective of this study was to assess patients’ beliefs and attitudes and identify facilitators of and barriers to deprescribing. Methods: As part of a larger study, we recruited patients ⩾18years of age taking ⩾3 chronic medications. Participants were recruited from retail pharmacies associated with the University of Kentucky HealthCare system. They completed an electronic survey that included demographic information, questions about communication with their primary care clinician and pharmacists, and the revised Patients’ Attitudes Toward Deprescribing (rPATD) questionnaire. Results: Our analyses included 103 participants (n=65 identified as female and n=74 as White/Caucasian) with a mean age of 50.4years [standard deviation (SD)=15.5]. Participants reported taking an average of 8.4 daily medications (SD=6.1). Most participants reported effective communication with clinicians and pharmacists (66.9%) and expressed willingness to stop one of their medications if their clinician said it was possible (83.5%). Predictors of willingness to accept deprescribing were older age [odds ratio (OR)=2.99, 95% confidence interval (CI)=1.45–6.2], college/graduate degree (OR=55.25, 95% CI=5.74–531.4), perceiving medications as less appropriate (OR=8.99, 95% CI=1.1–73.62), and perceived effectiveness of communication with the clinician or pharmacist (OR=4.56, 95% CI=0.85–24.35). Conclusion: Adults taking ⩾3 chronic medications expressed high willingness to accept deprescribing of medications when their doctor said it was possible. Targeted strategies to facilitate communication within the patient–primary care clinician–pharmacist triad that consider patient characteristics such as age and education level may be necessary ingredients for developing successful deprescribing interventions