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Background: Women living in Ohio Appalachia experience cervical cancer at disproportionately high rates. Intimate partner and sexual gender-based violence (GBV) and smoking are independent risk factors for cervical cancer and interact to heighten risk. Appalachian women smoke at higher rates than other Ohio women, but little is known about GBV exposure in the region. The purpose of this study was to establish prevalence of women's exposure to GBV in Ohio Appalachia and examine the association between GBV and smoking among women in the region. Methods: A two-phase address-based random sampling approach was used in three purposefully selected Ohio Appalachian counties to identify women to complete an interviewer administered cross-sectional survey ( n = 398). The primary exposure variable was GBV Index Score, a 4 level indices representing increasing exposure to eight abuse types. Correlation analysis and logistic regression were used to examine smoking correlations and risk. Results: Almost 57% of women in the three selected Ohio Appalachian counties experienced GBV, with rate increasing to 77.5% among current smokers. The distribution of the GBV Exposure Index Score was significantly different across smoking status ( p < = 0.0001), with exposure of GBV increasing when moving from never, to former, to current smokers. When controlling for depression, age, and adult socioeconomic position, GBV Exposure Index was significantly associated with current smoking behavior (OR:1.62, 95% CI [1.21-2.17]). Discussion: Professionals working to reduce disparate disease burden among women in Ohio Appalachia should consider the role GBV plays in health behavior and behavioral change interventions, including smoking and smoking cessation. [ABSTRACT FROM AUTHOR]

Background: No prior study has empirically characterized the association between health risks and reading popular fiction depicting violence against women. Fifty Shades-a blockbuster fiction series-depicts pervasive violence against women, perpetuating a broader social narrative that normalizes these types of risks and behaviors in women's lives. The present study characterized the association between health risks in women who read and did not read Fifty Shades; while our cross-sectional study design precluded causal determinations, an empirical representation of the health risks in women consuming the problematic messages in Fifty Shades is made. Methods: Females ages 18 to 24 ( n=715), who were enrolled in a large Midwestern university, completed a cross-sectional online survey about their health behaviors and Fifty Shades' readership. The analysis included 655 females (219 who read at least the first Fifty Shades novel and 436 who did not read any part of Fifty Shades). Age- and race-adjusted multivariable models characterized Fifty Shades' readers and nonreaders on intimate partner violence victimization (experiencing physical, sexual and psychological abuse, including cyber-abuse, at some point during their lifetime); binge drinking (consuming five or more alcoholic beverages on six or more days in the last month); sexual practices (having five or more intercourse partners and/or one or more anal sex partner during their lifetime); and using diet aids or fasting for 24 or more hours at some point during their lifetime. Results: One-third of subjects read Fifty Shades (18.6%, or 122/655, read all three novels, and 14.8%, or 97/655, read at least the first novel but not all three). In age- and race-adjusted models, compared with nonreaders, females who read at least the first novel (but not all three) were more likely than nonreaders to have had, during their lifetime, a partner who shouted, yelled, or swore at them (relative risk [RR]=1.25) and who delivered unwanted calls/text messages (RR=1.34); they were also more likely to report fasting (RR=1.80) and using diet aids (RR=1.77) at some point during their lifetime. Compared with nonreaders, females who read all three novels were more likely to report binge drinking in the last month (RR=1.65) and to report using diet aids (RR=1.65) and having five or more intercourse partners during their lifetime (RR=1.63). Conclusions: Problematic depictions of violence against women in popular culture-such as in film, novels, music, or pornography-create a broader social narrative that normalizes these risks and behaviors in women's lives. Our study showed strong correlations between health risks in women's lives-including violence victimization-and consumption of Fifty Shades, a fiction series that portrays violence against women. While our cross-sectional study cannot determine temporality, the order of the relationship may be inconsequential; for example, if women experienced adverse health behaviors first (e.g., disordered eating), reading Fifty Shades might reaffirm those experiences and potentially aggravate related trauma. Likewise, if women read Fifty Shades before experiencing the health behaviors assessed in our study, it is possible that the book influenced the onset of these behaviors by creating an underlying context for the behaviors. [ABSTRACT FROM AUTHOR]

Background: While intimate partner violence (IPV) affects 25% of women and impairs health, current societal conditions-including the normalization of abuse in popular culture such as novels, film, and music-create the context to support such violence. Fifty Shades of Grey, a best-selling novel, depicts a 'romantic' and 'erotic' relationship involving 28-year-old megamillionaire, Christian Grey, and a 22-year-old college student, Anastasia Steele. We argue that the relationship is characterized by IPV, which is harmful to Anastasia. Methods: All authors engaged in iterative readings of the text, and wrote narrative summaries to elucidate themes. Validity checks included double review of the first eight chapters of the novel to establish consistency in our analysis approach, iterative discussions in-person and electronically to arbitrate discrepancies, and review of our analysis with other abuse and sexual practice experts. To characterize IPV, we used the U.S. Centers for Disease Control and Prevention's definitions of emotional abuse (intimidation/threats; isolation; stalking; and humiliation) and sexual violence (forced sex acts/contact against a person's will, including using alcohol/drugs or intimidation/pressure). To characterize harm, we used Smith's conceptualizations of perceived threat, managing, altered identity, yearning, entrapment, and disempowerment experienced by abused women. Results: Emotional abuse is present in nearly every interaction, including: stalking (Christian deliberately follows Anastasia and appears in unusual places, uses a phone and computer to track Anastasia's whereabouts, and delivers expensive gifts); intimidation (Christian uses intimidating verbal and nonverbal behaviors, such as routinely commanding Anastasia to eat and threatening to punish her); and isolation (Christian limits Anastasia's social contact). Sexual violence is pervasive-including using alcohol to compromise Anastasia's consent, as well as intimidation (Christian initiates sexual encounters when genuinely angry, dismisses Anastasia's requests for boundaries, and threatens her). Anastasia experiences reactions typical of abused women, including: constant perceived threat ('my stomach churns from his threats'); altered identity (describes herself as a 'pale, haunted ghost'); and stressful managing (engages in behaviors to 'keep the peace,' such as withholding information about her social whereabouts to avoid Christian's anger). Anastasia becomes disempowered and entrapped in the relationship as her behaviors become mechanized in response to Christian's abuse. Conclusions: Our analysis identified patterns in Fifty Shades that reflect pervasive intimate partner violence-one of the biggest problems of our time. Further, our analysis adds to a growing body of literature noting dangerous violence standards being perpetuated in popular culture. [ABSTRACT FROM AUTHOR]

Background: We conducted a qualitative study to examine acute, situational factors and chronic stressors that triggered severe intimate partner violence (IPV) in women. Methods: Our sample consisted of 17 heterosexual couples, where the male was in detention for IPV and made telephone calls to his female victim. We used up to 4 hours of telephone conversational data for each couple to examine the couple's understanding of (1) acute triggers for the violent event and (2) chronic stressors that created the underlying context for violence. Grounded theory guided our robust, iterative data analysis involving audiotape review, narrative summation, and thematic organization. Results: Consistently across couples, violence was acutely triggered by accusations of infidelity, typically within the context of alcohol or drug use. Victims sustained significant injury, including severe head trauma (some resulting in hospitalization/surgery), bite wounds, strangulation complications, and lost pregnancy. Chronic relationship stressors evident across couples included ongoing anxiety about infidelity, preoccupation with heterosexual gender roles and religious expectations, drug and alcohol use, and mental health concerns (depression, anxiety, and suicide ideation/attempts). Conclusions: Disseminated models feature jealousy as a strategy used by perpetrators to control IPV victims and as a red flag for homicidal behavior. Our findings significantly extend this notion by indicating that infidelity concerns, a specific form of jealousy, were the immediate trigger for both the acute violent episode and resulting injuries to victims and were persistently raised by both perpetrators and victims as an ongoing relationship stressor. [ABSTRACT FROM AUTHOR]

The article discusses research on predictors of drop-in center attendance among substance-abusing homeless adolescents in the U.S. According to the authors of the study, homeless youths are a vulnerable and disenfranchised group that experience social exclusion and inadequate access to health care services and who are at risk of sexual assault. An overview of predictors of drop-in center attendance, such as unavailability of parents, and statistics on the various predictors is presented.