Measures Assessing Barriers and Facilitators to Post-Sexual Violence Services: A Critical Review.

Abstract

Sexual violence (SV) is a significant public health problem associated with poor health, social, and economic outcomes. Although services exist to support survivors of SV, many do not access these services. This critical review examines measures used to assess barriers and facilitators to post-SV services and whether these measures address the full breadth of concerns among SV survivors, particularly those who hold marginalized identities. Eligible studies had to be original and peer-reviewed, include a measure of barriers or facilitators to service-seeking, and focus on SV survivors. We reviewed 10 measures that assessed barriers and/or facilitators to mental health, medical, advocacy, and legal services among SV survivors. These measures were designed for and/or applied to survivors of intimate partner violence, human trafficking, military sexual trauma, child sexual abuse, and adult sexual assault. Populations sampled included college students, military personnel, gender and sexual minority youth, women living with HIV, and crime victims seeking legal services. Using a social-ecological model approach, we assessed barriers at the individual, interpersonal/community/provider, and structural/organizational levels. Barriers at the community level were largely absent, and only three measures addressed facilitators. Five measures provided some psychometric data with survivors, and only three incorporated survivor feedback in their development. Four measures included some cultural and/or identity-specific factors. Future research should prioritize the development of trauma- and violence-informed measures that incorporate survivor feedback and address diverse cultural and identity contexts to improve service access and utilization.