PROJECT 2: Penn State University's Translational Center for Child Maltreatment Studies (TCCMS)

项目2：摘要 性虐待/性侵犯（SA）的幸存者需要及时，熟练，创伤知情的医疗保健，以解决伤害， 感染/怀孕的风险，法医证据收集，以帮助司法结果，并提供心理 对治疗至关重要的支持。SA创伤可能对个人健康产生破坏性影响， 社会的成本。青少年由于其发育阶段，特别容易受到性骚扰的伤害。 因此，至关重要的是，青少年谁的经验SA有机会获得专门的同情， 创伤知情的健康和法医护理，以减轻创伤，促进愈合和正义。由于 由于全国缺乏法医保健专家，个人获得高质量SA的机会存在很大差异， 在乎性侵犯法医检查远程医疗（SAFE-T）计划旨在通过以下方式减少差异： 为农村和服务不足的医院提供专家性侵犯护士检查员（teleSANE）护理， 远程保健技术。TeleSANE在SA检查期间为当地护士和患者提供24/7支持， 确保为患者提供最佳实践、适当的证据收集和支持性体验。的 性侵犯法医检查远程保健青少年评估是一个多地点（农村和 城市）研究，旨在评估SAFE-T模型对青少年护理质量、医疗保健和 宣传服务利用、健康和福祉以及起诉决策。使用pre-post 实施设计，我们将前瞻性地收集数据，从176名青少年谁接受SA照顾，从我们的8 建立合作医院，并将SAFE-T（n=117）与SAFE-T之前的常规治疗（UC; n=59）进行比较 实施.更多的跨学科社区数据将为这项评价提供关键信息。的 本评价的目的是：1）通过评估SAFE-T与UC在法医SA护理质量方面的差异， 通过独立专家对检查证据的审查， 2）检查短期和长期健康和福祉结果的群体差异，如 创伤后应激障碍、学校/工作参与、医疗保健和宣传服务利用、风险承担和应对; 3） 检查前和后SAFE-T组在起诉决策和案件进展方面的差异， 就关键要素（即幸存者参与寻求司法结果， （四）影响决策的因素;（五）经济成本-- 使用高质量的跨学科数据对SAFE-T模型实施进行效益分析（CBA）， 研究成果的货币化（例如，健康与心理健康利用，计画成本效益，保留率 幸存者参与学校/工作）以及司法程序的效率/效力。这 代表了远程医疗的最全面的评估，以改善SA的访问和护理质量， 青少年。研究结果将阐明法医SA远程医疗咨询对护理质量的影响， 健康和福祉，以及解决创伤，以支持健康地过渡到成年。

PROJECT 2: ABSTRACT Survivors of sexual abuse/assault (SA) require timely, skilled, trauma-informed health care to address injuries, risk of infection/pregnancy, forensic evidence collection to aid justice outcomes, and to provide psychological support essential to healing. SA trauma can have devastating impacts on individual health and poses great costs to society. Adolescents are particularly vulnerable to SA victimization due to their developmental stage. Therefore, it is essential that adolescents who experience SA have access to specialized compassionate, trauma-informed health and forensic care to mitigate trauma and that promotes healing and justice. Due to a national shortage of forensic health care specialists, great disparities exist in individuals’ access to quality SA care. The Sexual Assault Forensic Examination Telehealth (SAFE-T) program aims to decrease disparities by providing expert sexual assault nurse examiner (teleSANE) care to rural and underserved hospitals through telehealth technology. TeleSANEs provide 24/7 support to local nurses and patients during SA exams, ensuring best practices, proper evidence collection, and a supportive experience exists for the patient. The Sexual Assault Forensic Examination Telehealth (SAFE-T) Adolescent Evaluation is a multi-site (rural and urban) study designed to evaluate the impact of the SAFE-T model on adolescent care quality, healthcare and advocacy service utilization, health and well-being, and prosecutorial decision-making. Using a pre-post implementation design, we will prospectively gather data from 176 adolescents who receive SA care from our 8 established partner hospitals and compare SAFE-T (n=117) to usual care (UC; n=59) prior to SAFE-T implementation. Additional interdisciplinary community data will provide key information for this evaluation. The aims of this evaluation will: 1) Test SAFE-T vs. UC differences in forensic SA care quality by assessing survivor experience of care and through independent expert review of examination evidence and documentation; 2) Examine group differences in short and long-term health and well-being outcomes such as PTSD, school/work engagement, health care and advocacy service utilization, risk-taking, and coping; 3) Examine pre- and post-SAFE-T group differences in prosecutorial decision-making and case progression by interviewing district attorneys about key elements (i.e. survivor participation in seeking justice outcomes, quality and availability of forensic evidence) that influence decision-making; and 4) Conduct an economic cost- benefit analysis (CBA) of the SAFE-T model implementation using high quality, interdisciplinary data, monetization of study outcomes (e.g., health and mental healthcare utilization, program cost-benefit, retention of SANEs, survivor engagement in school/work), and efficiency/effectiveness of justice processes. This represents the most comprehensive evaluation of telehealth to improve SA access and quality of care for adolescents. The findings will elucidate the influence of forensic SA telehealth consultation on care quality, health and well-being, and resolution of trauma to support a healthy transition to adulthood.