Working to Break Barriers

The National Institute of Justice – the research branch of the DOJ – has tapped psychology professor Courtney Ahrens to help identify barriers that deter some minority women from reporting intimate partner violence.

Ahrens and Dr. Mindy Mechanic at California State University, Fullerton obtained a $925,000 grant from the NIJ to research the influence of culture on intimate partner violence.

“Do women from different cultures experience different forms of domestic violence? Do women from different cultures define domestic violence differently? How do victims choose to respond to that violence in their relationships, and who are they choosing to reach out to for help? That’s what we’re interested in looking at,” says Ahrens.

The hope is that the findings will help agencies and law enforcement to know what needs to be in place in order to encourage and empower women to report domestic violence.

The project focuses on four specific ethnic groups: Mexican American, Korean American, Vietnamese American and European American. Ahrens and Mechanic aim to conduct 75 interviews with women from each ethnic group – 300 total – to get a large enough sample group with which to make assessments.

In order to execute this project and maintain safety for these women, they have partnered with the Orange County Coalition of Community Health Providers to identify four health clinics that serve a high proportion of women from each ethnic group. Clinic staff who’ve established relationships with women are trained to inform them about the research project and assure them of confidentiality. Interviews are then set up as appointments at the clinic to not trigger any alarms if a patient is still with the abuser.

Students are involved heavily in the research project from conducting interviews to analyzing the results, Ahrens says. The interviews are conducted in English or in the native language of the participant. Ahrens recruits and trains students in her research lab on intimate partner violence – what it is, how common it is, what services are available and what barriers exist. She also spends a lot of time training in how to conduct interviews, review transcripts, translate interviews and code narratives. There are about 20 students of all grade levels working on this project.

The interview phase of the project is currently underway using questions that have been pilot-tested to make sure the wording of each question is culturally appropriate, such as language that is too informal or could be considered rude. Ahrens anticipates another year’s worth of data collection and a year’s worth of qualitative analysis. They have an extensive dissemination plan to make the results widely available to national organizations like the national chiefs of police, clinics and domestic violence groups.

The project is already being used as an informal pilot study for part of a Blue Shield grant that is trying to create a countywide response to women’s health issues. Ahrens’ research will be used to figure out how to create a universal screening process at hospitals and clinics throughout Orange County.

“So much of my own motivation for research is research in the name of public good,” she says. To be able to do something as practical as this and conduct research that is actually going to be implemented is pretty exciting.”

Improving Lives from Beginning to End

When Joy Goebel was a young nurse aide, one incident left a giant impression that shaped the work she does today.

“I remember caring for a child who was about 8- or 9-years-old and dying of cystic fibrosis. He was very sick and he asked me, ‘Am I dying?’” Goebel recounts this story with her eyes closed as if replaying the moment in her mind. It was hospital policy, she says, that staff were not allowed to talk to children about dying for fear of upsetting them.

“I was 19 or 20 years old and I was just flabbergasted. I remember being very, very sad that I couldn’t really talk to him about what he was facing.” Three days later the child died, and it was then that Goebel thought: “There’s got to be another way.”

Fast forward through years of experience working in acute care and home care settings and Goebel is now doing research on palliative care – care for people and their families who are facing and dealing with late life issues. Along with extensive first-hand knowledge of providing care, Goebel has an impressive macro-level grasp of the field, including how big organizations interact, what research has been done and where there are gaps, where money comes from, and what direction the field is going in.

Her current research involves a systematic review of palliative care interventions that is currently under review at the Journal of Palliative Medicine.

Palliative care involves a team of professionals who can help people deal with physical, emotional, psychological and spiritual issues they may be experiencing. Teams often include physicians, nurses, social workers and chaplains. Funded by a $15,000 grant from the Hospice and Palliative Nurses Association, Goebel surveyed palliative care providers to find out how they perceived the teams they worked on and how they thought it affected the quality of care patients and their families received.

“Intuitively, palliative care providers know what makes a good team, but we have to start looking at what interventions we can develop to improve the quality of care,” Goebel says.

The survey results can be supporting evidence for how resources should be allocated in the field, as well as other policies and systems that need to be in place to improve the field.

In addition to doing research and teaching nursing, Goebel has been funded by university President Jane Conoley as faculty director and campus liaison for the newly established CSU Institute for Palliative Care. The institute aims to look at how to improve entry workforce for the field of palliative care using resources from all the CSU schools. Goebel is tasked with identifying resources within all the departments on campus and system-wide to contribute to educating and improving the workforce.

“We all want to just pass away quickly, but the reality is the vast majority of us are going to have a long period of frailty,” Goebel says. “That whole period of frailty is one really big area of palliative care we’re working on to improve quality of life.”