This article describes the Engage, Motivate, Protect, Organize, self-Worth, Educate, Respect (EMPOWER) Clinic for Survivors of Sex Trafficking and Sexual Violence located at Gouverneur Health in New York, New York, as a model for integrated gynecologic and psychiatric care of survivors of sexual and gender-based violence. Although patients with a history of sexual trauma often have critical health needs that persist long after the traumatic event, most existing services for survivors of sexual violence focus solely on the provision of acute care immediately after the violence has occurred. There are very few clinics in the United States dedicated to managing the significant long-term medical consequences and sequelae of sexual violence in a trauma-informed setting. We report on best practices for the provision of trauma-sensitive medical care to this patient population based on those employed at the EMPOWER Clinic. In particular, we outline some of the unique considerations for treating survivors relating to taking a patient history, conducting the physical and gynecologic examinations, ensuring confidentiality, and managing legal issues. Finally, we reflect on the challenges faced in sustaining the EMPOWER Clinic and the importance of the existence of a clinic dedicated to this specific population.

There is a growing awareness of the prevalence and negative health effects associated with traumatic events, including childhood abuse and adversity, intimate partner violence, adult sexual assault, and exposure to combat and community violence. Health care systems have attempted to address this link by becoming trauma informed through universal trauma precautions and screening protocols. We review several clinical and methodological concerns associated with universal trauma screening in adult health care settings including: deciding which traumas to assess in which populations, integrating retrospective recall with current functioning to facilitate referrals, and guarding against adverse patient reactions and insurance discrimination. We outline potential implications for program development and future research including: adapting and refining screening tools, integrating patient preferences and privacy concerns into screening protocols, assessing resource limitations, and integrating public health advocacy into screening programs.

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Objective: To describe behavioral and genetic beliefs about developing hypertension (HTN) by sociodemographic factors and self-reported HTN status, and among those with a history of HTN, evaluate associations between HTN-related causal beliefs and behavior change attempts. Method: Data from the 2014 Health Information National Trends Survey were evaluated. HTN causal beliefs questions included (a) “How much do you think health behaviors like diet, exercise, and smoking determine whether or not a person will develop high blood pressure/HTN?”; and (b) “How much do you think genetics, that is characteristics passed from one generation to the next, determine whether or not a person will develop high blood pressure/HTN?” Multivariate logistic regressions evaluated associations between HTN causal beliefs and behavior change attempts including diet, exercise, and weight management. Results: Approximately 1,602 out of 3,555 respondents with nonmissing data (33% weighted) reported ever having HTN. In logistic regression models, results show that the more strongly people believed in the impact of behavior on developing HTN, the higher their odds for behavior change attempts. Beliefs about genetic causes of HTN were not associated with behavior change attempts. Women had higher odds of attempts to increase fruit and vegetable intake, reduce soda intake, and lose weight compared to men. Blacks and Hispanics were significantly more likely than Whites to report attempts to lose weight. Conclusions: Beliefs about behavioral causes of HTN, but not genetic, were associated with behavior change attempts. Health messages that incorporate behavioral beliefs and sociodemographic factors may enhance future prohealth behavior changes.

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Anniversaries of traumatic events are associated with increased symptoms of posttraumatic stress disorder (PTSD), depression, and anxiety, especially in individuals with prior mental health symptoms. However, research has largely focussed on 1‐year anniversaries, and it is unclear whether symptom exacerbation persists for more distal, or milestone, anniversaries. Symptoms typically decrease over time after traumatic events, but major anniversaries may be associated with increases in mental health symptoms. During and 3 months after the 50th anniversary of the political protest violence at Kent State University on May 4, 1970, 115 individuals completed measures of PTSD, depression, anxiety, and anniversary‐related stress. Participants reported greater stress (t(97) = 4.04 p ≤ .001) during the 50th anniversary compared to 3 months later, but there were no differences in total PTSD (t(114) = .65, p = .52) or depression/anxiety symptoms (all p's > .05). Even in higher‐risk individuals (those who previously received mental health services), symptoms did not differ during versus after the anniversary. In general, long‐term anniversaries may contribute to transient increases in distress but do not induce major changes in mental health symptoms.

Rates of, and relationships between, posttraumatic stress disorder (PTSD), depression, anxiety, and posttraumatic growth (PTG) decades after a single-incident trauma remain unclear. During a two-month period surrounding the 50th anniversary of the political protest violence at Kent State University on May 4, 1970, 132 individuals completed measures of PTG, PTSD, depression, anxiety, and sleep difficulties. Participants were, on average, 19 years old (SD = 3.01) on May 4, 1970, and 44% were present at the protests. 17% met cutoff scores consistent with PTG, 6% for PTSD, 8% for anxiety, 11% for depression and 20% for sleep difficulties. PTG was significantly and positively correlated with PTSD ( r = .32, 95% CI: 0.17-0.44) and anxiety ( r = .23, 95% CI: 0.08-0.38) but not depression or sleep difficulties after controlling for additional trauma exposure since May 4, 1970. All relationships were best explained by linear rather than curvilinear relationships and were not moderated by proximity to the events of May 4, 1970. Results indicate that clinicians working with survivors of trauma decades later may be able to capitalize on the adaptive functions of PTG to foster positive treatment outcomes.

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