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The Association Between Social Support and Stages of Change in Survivors of Intimate Partner Violence. - Journal of interpersonal violence
For survivors of intimate partner violence (IPV), it is often difficult to take steps to establish safety and obtain a violence free life. Researchers have applied stage of change theory to aid in understanding the experience of survivors, as well as, the factors that can help women who desire to make changes in or break free from a violent relationship. Social support is one factor that can be helpful to IPV survivors who are attempting to make changes in their relationship. The purpose of the current study was to examine the differences in social support experienced by women who are at varying points in the process of change. Shelter residents (N = 191) participated in this cross-sectional non-experimental study. Analyses demonstrated five distinct clusters or profiles of change among study participants and were labeled by the authors as follows: preparticipation, decision making, engagement, ambivalent, and action. All forms of social support (i.e., structural, functional, and satisfaction) were generally higher for individuals more engaged in the process of change. More specifically, differences were noted between the action and decision-making clusters and the engagement and decision-making clusters. These findings suggest that it is vital that clinicians working with survivors of IPV not only assess but also tailor interventions to meet survivors where they are in the process of change. Further, interventions that foster survivors' abilities to develop reliable and satisfying social support networks will be beneficial for survivors of IPV.Â© The Author(s) 2015.
Rapid HIV testing and counseling for residents in domestic violence shelters. - Women & health
Over one million Americans live with the human immunodeficiency virus (HIV), and roughly 20 percent of those living with HIV are unaware of their status. One way to decrease this epidemic is community-based rapid testing with high-risk populations. One high-risk population that has received limited attention is victims of intimate partner violence who seek shelter. In an effort to gain foundational information to implement rapid HIV testing and counseling services in domestic violence shelters, the current study conducted a series of focus groups with eighteen residents and ten staff of local shelters from October 15 to December 12, 2012. Participants provided valuable insight into how HIV rapid testing and counseling might be best implemented given the resources and constraints of shelter life. Despite identifying some potential barriers, most believed that the promise of quick results, the convenience and support afforded by the shelter venue, and the timing of the intervention at a point when women are making life changes would render the intervention acceptable to residents. Further insights are discussed in the article.
Preventing Obesity in the Military Community (POMC): the development of a clinical trials research network. - International journal of environmental research and public health
Obesity impacts the U.S. military by affecting the health and readiness of active duty service members and their families. Preventing Obesity in Military Communities (POMC) is a comprehensive research program within Patient Centered Medical Homes (PCMHs) in three Military Training Facilities. This paper describes three pilot randomized controlled trials that target critical high risk periods for unhealthy weight gain from birth to young adulthood: (1) pregnancy and early infancy (POMC-Mother-Baby), (2) adolescence (POMC-Adolescent), and (3) the first tour of duty after boot camp (POMC-Early Career). Each study employs a two-group randomized treatment or prevention program with follow up. POMC offers a unique opportunity to bring together research and clinical expertise in obesity prevention to develop state-of-the-art programs within PCMHs in Military Training Facilities. This research builds on existing infrastructure that is expected to have immediate clinical benefits to DoD and far-reaching potential for ongoing collaborative work. POMC may offer an economical approach for widespread obesity prevention, from conception to young adulthood, in the U.S. military as well as in civilian communities.
Is John Henryism a resilience factor in women experiencing intimate partner violence? - Anxiety, stress, and coping
Research suggests that posttraumatic stress disorder (PTSD) and depression are two common mental health problems in intimate partner violence (IPV) survivors. Research has found that while Black women consistently report higher rates of victimization than White women, they also report less severe PTSD and depressive symptoms, suggesting that Black IPV survivors might be more resilient to PTSD and depression than are White survivors.We implemented a correlational study with 81 Black and 100 White female survivors of IPV to determine if John Henryism (JH; i.e., a predisposed active coping mechanism) contributes to the resilience observed in Black IPV survivors.Participants completed the John Henryism Active Coping Scale, Center for Epidemiological Studies Depression Scale, Davidson Trauma Scale, and the Abusive Behavior Inventory.Results demonstrated that White woman endorsed more severe depressive symptoms as compared to Black women. Severity of PTSD symptoms and JH was not significantly different between races. JH did not moderate the relationship between race and depression; however, for PTSD, JH was found to be protective of PTSD in White women, while demonstrating little impact on Black women.The implications of these findings are discussed in terms of the minority stress model.
Patients and nursing staff views of using the education needs assessment tool in rheumatology clinics: a qualitative study. - Journal of clinical nursing
To evaluate the usability of the educational needs assessment tool in clinical practice, from a practitioner and patient perspective and to establish whether patients perceive that they are getting an equally good or equally inadequate education service for their needs.The educational needs assessment tool was developed to enable patients with Rheumatoid Arthritis to assess their education needs prior to a consultation with a health professional. The educational needs assessment tool has been translated into nine languages and measurement properties have been established, however, its usability in clinical practice has not been studied.A qualitative study embedded into a multicentre RCT in which patients had been randomised into either educational needs assessment tool-focused education (Experimental Group) or usual care (control group).Both groups were seen by a clinical nurse specialist. Sixteen patients and four clinical nurse specialists were recruited from the Rheumatology Outpatient Departments of three Acute Hospitals within the U K. Data were collected by interviews with patients and clinical nurse specialist. Analysis followed the Framework approach.Patients and clinical nurse specialist found completion of the educational needs assessment tool straightforward, comprehensive and easy to use. Completing the educational needs assessment tool helped patients to focus on what they needed to know from the clinical nurse specialist. Patients in both the control group and the experimental group felt supported and reassured by their clinical nurse specialist and perceived that they received a good and adequate education provision.This study provides useful insights into the ability of the educational needs assessment tool to assess the educational needs of patients with rheumatoid arthritis in routine clinical practice.The educational needs assessment tool would be useful as a structured guide for nurses when assessing and meeting individual patient educational needs. This has the potential to improve patient-centred care, involve patients more actively in their care and enhance the long-term effects of patient education provision.Â© 2014 John Wiley & Sons Ltd.
PTSD, comorbid depression, and the cortisol waking response in victims of intimate partner violence: preliminary evidence. - Anxiety, stress, and coping
Posttraumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD) are two highly comorbid and debilitating disorders experienced by more than half of intimate partner violence victims (IPV). Hypothalamic-pituitary-adrenal (HPA) abnormalities are common in both disorders, though the direction of abnormalities often differs. The present study examined the relationship between comorbid PTSD and MDD, and the (salivary) cortisol waking response in 104 recently abused IPV victims. Waking cortisol levels, area under the waking curve with respect to ground (AUCg), and AUC with respect to increase (AUCi) were examined to determine the relation of HPA dynamics to comorbidity for basal versus more dynamic measures. Prior to accounting for comorbidity, women with PTSD or MDD showed significantly greater AUCi than women without the respective disorder. Accounting for comorbidity, PTSD only did not differ from other groups, while MDD only and PTSD + MDD showed greater AUCi than women with neither disorder. Results were nonsignificant for waking cortisol levels or AUCg. Results suggest that MDD drives elevated waking cortisol response, but not basal cortisol activity in recently abused IPV victims. Results demonstrate the importance of examining comorbid diagnoses and HPA activity from a dynamic perspective. Therapeutic implications are discussed.
Correlates of Readiness to Change in Victims of Intimate Partner Violence. - Journal of aggression, maltreatment & trauma
Intimate partner violence (IPV) is a social problem associated with significant morbidity; however, victims don't always utilize treatment and resources. One's readiness to change may be one variable impacting their pursuit of treatment and other resources. The current study investigated correlates of readiness to change, and readiness to change's impact on treatment utilization. Data was collected from 223 women residing in battered women's shelters. Correlational analyses find that generally victims with more psychopathology and distress, as well as more social support, were more ready to change. PTSD symptoms, overall distress, and social support were the strongest predictors of readiness to change. Finally, victims higher in readiness to change were more likely to seek mental health treatment and other IPV-related services.
Factors influencing the relationship between sexual trauma and risky sexual behavior in college students. - Journal of interpersonal violence
While the relationship between sexual trauma and risky sexual behavior (RSB) has received much attention, only a handful of studies have investigated the factors that protect victims of sexual trauma from developing this maladaptive pattern of behavior. The current study investigated the protective role of social support, quality and quantity, in developing RSB, through the mechanism of problematic substance use. Two hundred and seventy-five female college students completed a series of self-reports assessing sexual trauma, problematic substance use, social support quality and quantity, and RSB. The results indicated a positive relationship between sexual trauma severity and RSB. Further, this relationship was mediated by participants' problematic substance use. Social support quality acted as a buffer against the relationship described above where quantity exacerbated this relationship. Implications will be discussed.
The role of PTSD and length of shelter stay in battered women's severity of re-abuse after leaving shelter. - Journal of aggression, maltreatment & trauma
Intimate Partner Violence (IPV) is associated with significant morbidity, including high rates of re-abuse even after women have taken steps to achieve safety. This study evaluated the roles of posttraumatic stress disorder (PTSD) symptom severity and length of shelter stay in the severity of re-abuse in 103 IPV victims over a six month period after leaving a battered women's shelter. Results suggest that the length of shelter stay is inversely related to re-abuse severity after leaving shelter. Additionally, more severe PTSD symptoms upon shelter exit were associated with greater re-abuse severity after leaving shelter. Furthermore, additional study findings support prior research suggesting that the emotional numbing symptoms of PTSD are a significant risk factor for re-abuse among IPV victims after leaving shelter.
Encouraging legal help seeking for victims of intimate partner violence: the therapeutic effects of the civil protection order. - Journal of traumatic stress
Civil protective orders (CPOs) are the most widely used justice system remedy for intimate partner violence (IPV), and were implemented to ensure safety and increase victim participation in the justice system. Limited data exists regarding the effectiveness of CPOs; however, theories of therapeutic jurisprudence argue that legal interventions in and of themselves can improve mental health outcomes. To test this hypothesis, we examined the effectiveness of having a CPO issued against one's abuser at improving the psychological sequelae of exposure to trauma. We used a longitudinal sample of female residents of battered women's shelters who had experienced IPV (N = 106; 55% African American). One-way analyses of variance using gain scores indicated that PTSD symptoms (effect size Î·(p)(2) = .16) and incidents of sexual revictimization (effect size Î·(p)(2) = .09) decreased from baseline to 6-months postshelter for women who had a CPO against their most recent abuser compared to women without a CPO. These results support theories of therapeutic jurisprudence, suggesting that having a CPO can improve mental health outcomes. Limitations and clinical implications of our findings are discussed, including arguing for a coordinated service system that incorporates both legal and psychological assistance to improve the mental health of victims of IPV.Copyright Â© 2012 International Society for Traumatic Stress Studies.
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