First published on October 20, 2014 in observance of the COPH’s 30^th anniversary celebration.

October is Domestic Violence Awareness Month.

Like many entities directed at the greater public good, the USF College of Public Health’s Harrell Center was the product of a private philanthropist’s gift. James Harrell and his family wanted to do something to help eliminate family violence, and they acted on that desire. The result was a 1997 endowment that set the stage for what has become an international force.

“The intent of the Harrell family was to provide a center that would focus on family violence,” affirmed Dr. Martha Coulter, the center’s founding director, “but they were particularly interested in looking at the prevention of family violence, as well as research that would be directly applicable to prevention and intervention.

“So the mission of the Harrell Center, really, is to be an intermediary between research and practice, to do research that is focused on family violence intervention and prevention across the lifespan.

“The grant was an endowment, so the funding is very limited, because it’s just the interest on the endowment. Now, most of the income is from other grants and contracts,” Coulter said, “but what the Harrell endowment did was provide the base for doing that kind of research.”

Brick sponsored by the Harrell Center in remembrance of James Harrell after his death in 2007.

One of three faculty members at the center full-time, Coulter, whose doctorate is in maternal and child health, teaches three courses: Family and Community Violence, Child Maltreatment, and Child Health, in addition to coordinating the maternal and child health academic concentration at COPH.

“In the very beginning, there was only the grant and the establishment of the center conceptually,” she said. “Over the years, we’ve developed.”

That development recently necessitated alignment into three divisions.

“The specific divisions – the redesigning of the organizational chart – has really been something that I’ve done this year,” Coulter said. “Before that, over the years, we’ve just developed these different projects and all worked together, but it looked like now we were at a place where we really needed to have a little bit more separate organization and to develop some strategic goals and objectives in each of those content areas.”

The result is a children’s services division directed by Dr. Lianne Estefan, an intimate partner violence division directed by Coulter, and an elder mistreatment division directed by Dr. Carla Vandeweerd. Dr. Karen Liller recently joined the center as a regular collaborator focusing her attention on the overlap between child maltreatment and unintentional injury, Coulter said, and “usually about 10” graduate students round out her staff. A community advisory board is among the center’s numerous external extensions.

“The children’s section has been very involved in looking at issues regarding the prevention of violence in the community,” Coulter explained, “and the center has developed a virtual research institute with one of the community agencies, Champions for Children, which is a multi-program unit, so that we can do research that is truly collaborative. We’ve worked very consistently with them over the years.”

Graphic that Harrell Center graduate assistant Natasha Hojati created for the Center’s Facebook page.

Coulter said that much of what her intimate partner violence section does involves the courts, so much so that she has become a regular consultant for the courts and has undertaken the task of evaluating the effectiveness of their intervention programs for batterers. Developing and continually improving guidelines for batterer intervention and responses to the needs of victims have been major off-shoot projects.

Among the section’s more significant research findings is that female batterers are falling through the cracks. While the county’s intervention for male batterers has been “very effective,” Coulter said, it has largely failed to successfully intervene with female batterers, who comprise about 15 percent of all convicted batterers in Hillsborough County.

“The clinical providers of these programs,” she said, “have been saying for a long time that they didn’t think the state-mandated curriculum for men was really the right curriculum to use for women.”

Among many leaders and dignitaries who have visited the Harrell Center over the years was then-Attorney General Janet Reno, who attended an elder abuse conference sponsored by the Center in 2001. The attorney general is pictured above with students Seraphine Pitt (left) and Carol Williams, and below with Dr. Coulter.

The elder mistreatment division concentrates on elders with dementia and the kinds of violence against them, which is, Coulter said, “fairly common, unfortunately, from both spousal caretakers and children taking care of elderly parents. The dynamics of this are very different from other sorts of domestic violence and really have a lot to do with people not understanding how to help people who have dementia.”

Coulter said she considers a new project in the division to be particularly tantalizing and potentially groundbreaking.

Called the Senior Surfers Project, Coulter said it looks at the rapidly expanding but little-known phenomenon of women over 50 seeking relationships online and getting responses from people who wind up physically, emotionally or financially harming them.

All previous research on Internet connections leading to violent encounters has been on adolescents, she said, so Senior Surfers is another project aiming to keep potentially overlooked victims out of the cracks – in this case, the cracks that open at the nexus of society and technology.

Dr. Coulter chats with Judge Dennis Alvarez (left) and James Harrell at a 1997 function.

With so much involvement in the local community, including working closely with the Spring and, until its recent demise thanks to funding shortfalls, the Family Justice Center, the Harrell Center’s global impact might be surprising to some, but global involvement has proven beneficial on numerous fronts.

Dr. Pnina S. Klein, a clinical and developmental psychologist and professor of education at Bar-Ilan University in Israel, recently led a Mediational Intervention for Sensitizing Caregivers workshop on campus to promote cognitive functioning and attachment by improving parent-caregiver interactions with infants and young children.

Attendees included community professionals, physicians and COPH students, faculty and staff.  Dr. Robert Nelson, a joint professor in COPH and the Morsani College of Medicine, sponsored attendance by a visiting group of physicians and clinicians from Ecuador.

“It’s been used all over the world,” Coulter said of MISC. “The outcomes internationally of this program have shown that it’s very effective in strengthening attachment and reducing child maltreatment, so we brought Dr. Klein here from Israel this year to do a training for community people and staff here, as well as faculty and students.”

Dr. Martha Coulter, Harrell Center founding director (right in both photos), in Ecuador in 2007.

Elsewhere on the international front, Coulter is working with the medical school in Panama to begin collecting information and developing guidelines for Panamanian health providers to improve their responses to intimate partner violence. She’s also working in Quito, Ecuador, to develop a program that will provide fundamental intervention services for indigenous populations.

Children in a remote Himalayan village in India read books sent to them by the Harrell Center.

Coulter went to India in 2012 with a group that collected data on maternal/child health and family violence among the 26 indigenous tribes in the Himalayas as a response to one tribal leader’s interest in addressing those issues. Progress has been slow, she said, because the tribes are not formally centralized in any way, and the terrain is difficult and isolating. The center recently collected books to send to children there. A librarian navigates dirt paths on a bicycle to deliver them.

Not surprisingly, Coulter’s five-year vision for the Harrell Center is about more expansion, mostly ideological, and lots of it.

“I would like to expand our depth in looking at female offenders and the way the courts respond to them,” she said.

“We’ve applied for some grants to look with a lot more depth at issues related to fathers. This is an area that has been somewhat neglected and needs a lot of attention. What are the ways that we can help fathers from the very beginning develop the kinds of skills that will be more nurturing and less likely to produce problems?

“As far as the center itself,” she said, “I think the area that we really need to expand the most is our capacity for doing community training and education and technical assistance.”

“I’d also like to see us focus on more primary intervention in a public health direction.   A lot of what we’ve done has been secondary response intervention, but I would like to see us working with primary situations – families, parent-child relationships.”

Coulter said an example of the center’s involvement in this area is its participation in the Hillsborough County Violence Prevention Collaborative, a plan for reducing violence throughout the county.

Community events also make Coulter’s expansion list. Recent ones have included fundraisers with artists and bands, and even a biker run.

“I would like to see us expand these community events, because they have been very helpful. The center doesn’t have much funding,” she said, “and the funding that we get is almost always research funding, so if we want to do things that are outside the research arena, we have to raise the money ourselves.”

Story by David Brothers, College of Public Health. Photos courtesy of Dr. Martha Coulter, Eric Younghans, Dr. Robert Nelson, USF Health and the Harrell Center.

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October is Domestic Violence Awareness Month

The USF College of Public Health Harrell Center for the Study of Family Violence is working in collaboration with the Spring of Tampa Bay and the Hillsborough County Domestic Violence Task Force to learn more about the experiences of Black and Afro-Latina women survivors of domestic violence in Hillsborough County, Fla.

The project, called the “Listening Sessions Project,” aims to understand how Black and Afro-Latina women perceive and experience various aspects of the justice system after experiencing domestic violence, according to Dr. Abraham Salinas Miranda, USF COPH assistant professor and director of the Harrell Center.

“Is the domestic violence services experience the same for Black women or Afro-Latinas compared to White women or is it different? By services, we mean criminal justice services and other victim assistance services. We need to investigate any differential treatment or responses with the aim of improving racial equity,” Salinas Miranda said.

The project is conducted in two parts, according to Kacy Amory, project coordinator and USF PhD criminology student who is also serving as a graduate research assistant in the Harrell Center.

The first part consists of an initial survey with questions about their experiences which leads into structured virtual interviews gauging their experiences and recommendations.

Eligible participants must identify as a Black or Afro-Latina woman who has experienced domestic violence in the last 24 months and is a resident of Hillsborough County with access to e-mail and internet.

All participant information will remain confidential, but will come with big impact, according to Amory.

“By sharing their experiences, they’re able to have a direct impact. They are giving their experiences in a way in which they can be directed into recommendations for changes in the system that can also be beneficial for future women who are going through the same circumstances that they did,” Amory said.

“We know that the domestic violence is part of a spectrum of interpersonal violence. When you find domestic violence, you find child maltreatment and other forms of violence. But, underlying the violence are the social determinants of health,” Salinas Miranda said. “There are studies that suggest that providers perceive African-American women in a different way. For instance, they may be less likely to be addressed with a trauma-informed lens and that is systemic racism and discrimination.”

Salinas Miranda also says that “in our county, we are very fortunate that service providers have identified advancing racial equity in domestic violence services as a key goal for our system of care.”

The Spring of Tampa Bay, a certified domestic violence center for Hillsborough County providing services such as a hotline, emergency housing, case management, prevention programs, and legal advocacy is helping to inform women of the option to take part in this project.

According to Florida Department of Law Enforcement, there were 7,083 domestic violence offenses in Hillsborough County in 2020.  

Jen Shtab, coordinated community response trainer for the Spring of Tampa Bay, says the Listening Sessions Project will help get a better understanding of what is happening more locally.

Shtab said she hopes this project exemplifies a commitment toward making changes at the systems level so that all entities can be more responsive to survivors of domestic violence in Hillsborough County.

“The hope is that recommendations will come out of it and that we can begin implementing those recommendations to make changes so that we have a more equitable criminal justice response and more accessible services for women of color who are survivors of domestic violence,” she said.  

To learn more about the Listening Sessions Project, visit the Harrell Center website.

Related media:

Lifeline | The Spring of Tampa Bay [Video]

Lifeline | Victim Assistance and Victim Compensation [Video]

LifeLine | Understanding Injunction for Protection [Video]

Story by Anna Mayor, USF College of Public Health

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The American Public Health Association (APHA) held its annual meeting and expo virtually this year from Oct. 24-28, and USF College of Public Health (COPH) students and faculty took part in the many offerings. 

According to the APHA website, “The APHA Annual Meeting and Expo is the largest and most influential yearly gathering of public health professionals, bringing the public health community together to experience robust scientific programming, networking, social events, poster sessions and more.” 

The theme of this year’s meeting was “Creating the Healthiest Nation: Preventing Violence” and featured a mix of live and on-demand sessions.

Throughout the course of the APHA meeting there were Zoom meet and greets, a film festival, live exhibitor presentations, pre-recorded poster presentations, a social media scavenger hunt, a virtual dance class and the opportunity to win prizes and more. Webinars focused on urgent topics like climate change, COVID-19, advancing racial equity and the Flint, Mich., water crisis. As it does every year, the COPH had a booth where attendees could learn more about the college’s many public health programs and degrees.

Thousands of new abstracts are presented each year, making the APHA Annual Meeting the most influential gathering in public health, and dozens of COPHers presented their research. 

Dr. Abraham Salinas-Miranda, a COPH assistant professor and director of the college’s Harrell Center for the Study of Family Violence, was a frequent presenter and moderator at this year’s meeting. 

“I have been an active member of the Family Violence Prevention Caucus at the APHA since 2015,” said Salinas. “As part of my involvement, I volunteer to provide support as a moderator, since family violence is my area of research. I get to learn a lot every year of the types of research and hot topics in family violence. It’s very interesting.”

One of the presentations/panels Salinas was involved in was Initiating a community-centered approach in addressing domestic violence: The Hillsborough County domestic violence coordinated community response project. 

“Established partnerships are the key ingredient for a successful coordinated community response (CCR) and tailoring the CCR Model (which is an international safety audit analysis model) to the community needs, with flexibility and a strengths-based focus, resulted in increased engagement and prompt decision-making,” said Salinas.

Other faculty and students from around the college displayed and discussed their research. 

Assistant Professor Dr. Miguel Reina Ortiz received an APHA Excellence in Abstract Submission on an International Topic Award for research on HIV testing among pregnant women that he conducted with the COPH’s Dr. Ricardo Izurieta and others.

“Economic incentives were effective in motivating pregnant women living in a high HIV urban setting in Ecuador to get tested for HIV, even after controlling for the fact that some pregnant women had been previously tested for HIV,” said Reina. “This is encouraging as it may help us understand ways to devise strategies to increase HIV testing among pregnant women, which, when coupled with timely treatment, can reduce the risk of mother-to-child HIV transmission,” said Reina. You can read more about the research here.

A sampling of other research presented by COPH faculty and students included:

• Trends in COVID-19 cases and deaths by gender among Florida residents of reproductive age
• Health and well-being outcomes of males raised in mother-absent homes: A scoping review
• The benefits of fatherhood involvement in Florida maternal, infant and early childhood home visiting programs

COPH students and faculty also took part in poster presentations. 

Three COPH students, Jan Dahrendorff, Kristi Miley and Emma Tumarkin, presented posters at the Annual Delta Omega Student Poster Session. 

According to its website, the Delta Omega Honorary Society promotes graduate study in public health and recognizes outstanding achievement in the field. Each year, 19 students who attend schools with active Delta Omega chapters are selected to present their research. 

“This is the second year in a row that all three COPH student nominees for the National Delta Omega Poster competition were selected as finalists,” said Ellen Kent, coordinator of USF Health Service Corps and Sunshine ERC.

You can read more about the college’s Delta Omega presenters and their research here.

One of the highlights of the APHA meeting was a review course of the Certified in Public Health (CPH) exam. The session was led by the COPH’s Dr. Jaime Corvin and included presentations by COPH Dean Dr. Donna Petersen and Drs. Karen Liller and Anna Torrens Armstrong. Getting a CPH distinguishes one as a public health professional with knowledge of key public health sciences.

For a snapshot of everything the APHA Annual Meeting and Expo had to offer, click here.

Story by Donna Campisano, USF College of Public Health

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While 32.5 percent of women in Haiti have experienced a form of intimate partner violence (IPV), the determinants are not well understood.

But, researchers from the USF College of Public Health’s Harrell Center for the Study of Family Violence have delved more into the “who.”

Dr. Abraham Salinas-Miranda, director of the Harrell Center, and James Occean, an undergraduate USF chemistry student and Harrell Center research intern, examined the “Prevalence and Factors Associated With Intimate Partner Violence Among Women in Haiti: Understand Household, Individual, Partner, and Relationship Characteristics.” Their work has been published in the Journal of Interpersonal Violence.

“Intimate partner violence is a significant public health problem in developing countries, specifically in my native country, Haiti,” said Occean, who is also a research assistant in Dr. Monica Uddin’s lab at the USF Genomics Program.

Using results from the 2016-2017 Haiti Demographic and Health Survey, they examined the prevalence of IPV and its subtypes (emotional, physical, and sexual abuse) among married or cohabitating women between the ages of 15 to 49 years by their husbands or partners.

“The Haiti Demographic Health Survey is a nationally representative dataset, which is supported by USAID and uses the gold standard methodology of population-based surveys; and this was the latest data available for Haiti,” Salinas-Miranda said.

They found that of the 32.5 percent of women who experienced IPV, 24.7 percent was emotional, 16.8 percent was physical and 10.5 percent was sexual violence.

They also found the odds of reporting IPV were influenced by a range of other factors.

“Women who reported being afraid of their husband also reported experiencing IPV, and we saw that women who reported controlling behaviors—such as their husband not letting them see friends—also experienced IPV,” Occean said.

Having children in the home, exhibiting attitudinal acceptance of “wife-beating,” previously witnessing their own father beating their mother, and having a partner who drank alcohol were all shown to increase the likelihood of a woman experiencing IPV.

“We also saw that women who witnessed parental IPV were also more likely to report IPV victimization and this shows that, not only does it affect the women, but if affects future generations,” Occean said.

Salinas-Miranda, who mentored Occean during his first publication, said that these findings point to the need for a cultural change.

“These findings indicate a need to really work at changing the culture of male-dominance or patterns of toxic masculinity that may be there,” Salinas-Miranda said. “The fact that a sizable portion of women accept wife-beating is very concerning.”

Salinas-Miranda said while this is an initial study, future studies could examine how those factors differ in varying provinces in Haiti and how it compares to other countries.

“It’s reassuring to see a young male trying to do research in this area because it’s a problem that affects us all. Yes, it’s gender-based violence, but it affects us all and we should all care about this. Men play a key role in breaking the cycle of violence,” he said. “While we assisted James initially, he eventually took off on his own, and we are extremely proud of him.”

 Story by Anna Mayor, USF College of Public Health

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October is Domestic Violence Awareness Month

USF College of Public Health alumna Aditi Desai is using a special set of skills and her public health passion to reach vulnerable populations – through yoga.

Desai recently returned from Nairobi, Kenya, where she completed her 200 hour yoga teacher training with the Africa Yoga Project. Now that she’s returned stateside, she’s begun her volunteer work with the Purple Dot Yoga Project.

Aditi Desai practicing her poses beachside. (Photo courtesy of Aditi Desai)

“I became attracted to Purple Dot Yoga because of its mission to help empower women,” Desai said. “I love the fact that I can use something I love [yoga] to help others. Yoga is such a powerful tool in life and being able to spread it makes my soul shine!”

The Purple Dot Yoga Project works with survivors of domestic violence and abuse.

Desai also works as a health education specialist with a medication assisted treatment program at Tri-City Health Centers in Fremont, Calif. In both of her positions, being able to effectively communicate is crucial.

“It is tremendously important that I not only listen, but really hear and try to empathize with the community that I’m serving,” she said. “I’m working with an extremely vulnerable population so listening to them and adjusting my teaching practices to better serve them and allow them time to heal is the most important thing I can do as a teacher.”

Desai credits the COPH for helping her to build the skills to be able to truly listen to the communities she’s trying to serve.

“USF COPH was the best thing that happened to me and my career,” Desai said.

Alumna Aditi Desai. (Photo courtesy of Aditi Desai).

The Orlando, Fla. native earned her bachelor’s degree in psychology, with minors in biology, chemistry, and photography, from Mercer University in 2009.

She graduated from the COPH with an MPH in global health practice and a graduate certificate in epidemiology in 2013.  Desai intended on a different academic path and often refers to her introduction to public health as “accidental.”

“I was planning on attending medical school and when I didn’t get in I thought instead of wasting time and retaking the MCATs, I would go ahead and get a master’s level degree while studying,” Desai said. “Little did I know, I would fall in love with the master’s degree coursework!”

Aditi practicing yoga on the patio with her four-legged-friend before her classes. (Photo courtesy of Aditi Desai)

Although she’s come so far—between Nairobi, multiple professional positions, working with the U.S. Peace Corps in Uganda—Desai has no intention of stopping anytime soon. The first thing on her list: the Purple Dot Yoga Project.

“I hope to expand the project to northern California,” she said. “I plan to continue acting as a volunteer yoga teacher.”

Desai also hopes to tackle a new vulnerable population using her yogi practices.

“I am going to expand my yoga practices into teaching those in addiction recovery,” she said. “Using yoga to empower vulnerable populations is my ultimate goal and whatever I can do to achieve that, I will.”

Along with her work she’s doing with Purple Dot Yoga, Desai will also begin teaching yoga with The Art of Yoga, an organization that teaches yoga to young girls in juvenile detention centers.

“This is a great opportunity to expand my yoga reach as yoga is being used to not only empower these young girls, but also to help them change their futures,” Desai said. “Similar to the work of Purple Dot Yoga, yoga is being used as a tool to help and change lives for the better.”

***

Fast Five for COPH Alumni:

What did you dream of becoming when you were young?

An astronaut! I still love space, the solar system and the stars.

Where would we find you on the weekends?

Probably in the park doing yoga or binging on Netflix.

What is the last book you read?

“The Alienist” by Caleb Carr.

What superpower would you like to have?

Flight!

What’s your all-time favorite movie?

Bollywood: Dilwale Dulhania Le Jayenge (Hollywood: I Love You, Man!).

Story by Shelby Bourgeois, USF College of Public Health

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Punta Gorda, the southernmost town in Belize, is often described by residents as “the forgotten city,” according to Dr. Ismael Hoare, assistant professor in Global Health at the USF College of Public Health.

Hoare and Dr. Martha Coulter, professor in Community and Family Health, have just completed the final phase of their research examining public health concerns among indigenous groups in Belize, including the Maya, both Q’eqchi and Mopan communities, and the Garifuna and Kriol populations.

The research is part of a larger project with other COPH researchers who conducted similar work with indigenous populations in Ecuador and Panama.

Punta Gorda, Belize. (Photo source: Google Maps)

Hoare and Coulter worked together to establish a community advisory board, planning key informant interviews with community stakeholders in the community.

They then conducted focus groups with the community to discuss their concerns on topics including nutrition, drug and alcohol abuse, domestic violence, HIV, lack of health services, entry into the health system, and other emergent findings.

Hoare spoke with men and Coulter spoke with women.

“The key informant interviews basically provided the basis for the focus group,” Hoare said. “The focus group is to substantiate and add to key informant groups. We found that they are corroborating what we had found in the key informant interviews.”

The focus groups took place June 27 to July 21 in an area of Belize that Hoare said needs research data to vouch for more financial support in health care.

Dr. Ismael Hoare in Punta Gorda, Belize. (Photo courtesy of Dr. Martha Coulter).

“I think we’re uncovering quite a few things,” Hoare said. “Because of the lack of research attention in that community, a number of issues are artificially absent. For example, the presence of HIV/AIDS, diabetes, hypertension and chronic pulmonary disease, according to official records [for that region], are practically non-existent.”

Hoare said that he’s met with the chief executive officer of the Ministry of Health in the region and provided him with updates as research was conducted, someone who he said, was happy to be receiving this support as their offices have been short-staffed and unable to conduct research on this region.

More than 40 percent of Punta Gorda’s residents, according to Hoare, are living in poverty and the area experiences frequent limitations on human resources for health services.

“Communities are concerned for the health of their population and are willing to assist once they are aware of the intent of the research,” he said. “The issue here is for us to be able to establish a linkage with community groups and work along with them to complete research projects so they can see benefits for their population.”

According to Coulter, the public health care system located in Punta Gorda offers public health care for individuals living in town, with the assistance of a private volunteer health agency. But, for people in the villages and rural areas, health care means traveling a large distance.

An event on World AIDS Day in Belize with a focus on both AIDS and violence. (Photo courtesy of Martha Coulter)

“Some of these villages require walking long distances and then taking a bus to get into town,” Coulter said. “It’s quite a hardship to get the kind of care they need. Community health workers do go out to the villages, but it’s not frequently and they are not able to offer clinical health care. The volunteer health agency also has a mobile unit which is able to visit some villages, but there are still significant gaps in service.  In addition, the health center in Punta Gorda has limited resources to provide specialty care.”

Coulter said the mayor and other leaders in the community are concerned about not having sufficient resources to respond to public health issues in the community, with more attention being given to larger population areas in Belize.

“They are hoping that as a result of our data collection, they can argue for additional resources,” she said.

The next step will involve coding and analyzing data from the focus groups and pulling all the information together to provide to the community advisory board, according to Coulter.

For Hoare and Coulter, this research is the first step to creating public health change in Belize’s southernmost town.

“I hope that we can positively impact the services they are provided,” Hoare said.

Story by Anna Mayor, USF College of Public Health

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Dr. Martha Coulter and COPH alumna Melissa Mercado-Crespo published “Co-occurrence of intimate partner violence and child maltreatment: Service providers perceptions.”  The research appears in the February issue of the Journal of Family Violence.

Martha Coulter, DrPH, MSW

Coulter is a professor in the USF College of Public Health’s Department of Community and Family Health.  She also directs The Harrell Center, an intermediary between research and practice that seeks to end family violence by understanding it.  Mercado-Crespo is one of 3,000 Epidemic Intelligence Service officers with the Centers for Disease Control and Prevention in Atlanta.

Melissa Mercado-Crespo, PhD

* * *

Coulter, M., Mercado-Crespo, M. (2015) Co-occurrence of intimate partner violence and child maltreatment: Service providers perceptions. Journal of Family Violence.  DOI 10.1007/s10896-014-9667-5.

The research is posted online.

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