Sandra L Martin

University of North Carolina at Chapel Hill, North Carolina, United States

Are you Sandra L Martin?

Claim your profile

Publications (82)228.59 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Many domestic violence and sexual assault survivors seeking help from domestic violence/sexual assault (DV/SA) programs have multiple health/social needs that may interfere with their ability to recover from violence experiences. Thus, DV/SA service providers should be well-trained in how to identify each survivor’s unique needs and resources so that an individualized plan of services/referrals can be delivered. Offering needed services in this wide range of topics will not only address survivors’ multiple concerns, but also will help survivors enhance their ability to recover from and prevent further violence. Unfortunately, there is a dearth of empirical information to inform training curricula for DV/SA service providers. To address this knowledge gap, this research examines NC DV/SA agencies’ current training practices and needs. We surveyed all NC DV/SA program directors (n=103) to assess staff training practices and needs (74% responded). Most directors reported that providers received at least some training in five areas: violence/safety (96%), emotional health (96%), disability (86%), physical health (79%), and substance use (77%). However, they also reported that many staff were not skillful in identifying and responding to multiple survivors’ needs, with 23% reporting that more than half of their program staff required additional training in violence/safety, 27% in physical health, 27% in emotional health, 33% in disability, and 42% in substance use. This statewide study is among the first to identify training practices/needs of DV/SA programs, with findings suggesting that there is a need for standardized, comprehensive, skill-based training curricula that address the many needs of survivors.
    142nd APHA Annual Meeting and Exposition 2014; 11/2014
  • [Show abstract] [Hide abstract]
    ABSTRACT: Intimate partner violence (IPV) is a significant public health problem in South Africa. However, limited research exists on IPV during pregnancy and the postpartum period in South Africa. The purpose of this study is to describe the prevalence, rates and correlates of IPV among South African women during pregnancy and the first 9 months postpartum. Data are from a longitudinal study with women recruited during pregnancy between 2008 and 2010 at a public clinic in Durban. We used a modified version of the World Health Organization's IPV scale to estimate prevalence and rates of IPV during pregnancy, at 4 months postpartum and 9 months postpartum and we used logistic regression to assess the correlates of IPV during this time. More than 20 % of all women experienced at least one act of physical, psychological or sexual IPV during pregnancy. Nearly one-quarter of all women experienced at least one act of physical, psychological or sexual IPV during the first 9 months postpartum. Psychological IPV was the most prevalent type of IPV during pregnancy and the first 4 months postpartum. Age and previous violence within the relationship were associated with IPV during pregnancy and IPV during the postpartum period. The high levels of IPV during pregnancy and the postpartum period highlight the need to develop screening and intervention strategies specifically for this time. Further, women should be screened not only for physical violence but also psychological violence given that psychological violence may result in distinct negative consequences.
    Maternal and child health journal. 06/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Population sexual mixing patterns can be quantified using Newman's assortativity coefficient (r). Suggested methods for estimating the SE for r may lead to inappropriate statistical conclusions in situations where intracluster correlation is ignored and/or when cluster size is predictive of the response. We describe a computer-intensive, but highly accessible, within-cluster resampling approach for providing a valid large-sample estimated SE for r and an associated 95% CI. We introduce needed statistical notation and describe the within-cluster resampling approach. Sexual network data and a simulation study were employed to compare within-cluster resampling with standard methods when cluster size is informative. For the analysis of network data when cluster size is informative, the simulation study demonstrates that within-cluster resampling produces valid statistical inferences about Newman's assortativity coefficient, a popular statistic used to quantify the strength of mixing patterns. In contrast, commonly used methods are biased with attendant extremely poor CI coverage. Within-cluster resampling is recommended when cluster size is informative and/or when there is within-cluster response correlation. Within-cluster resampling is recommended for providing valid statistical inferences when applying Newman's assortativity coefficient r to network data.
    Sexually transmitted infections 01/2014; · 2.18 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background and Purpose: Intimate partner violence (IPV) and sexual assault (SA) survivors are negatively affected by the aftermath of violence both physically and mentally (Campbell, 2002) and also experience financial and social impairments subsequent to victimization (Briere & Jordan, 2004). To address such needs, many survivors seek help from local IPV/SA agencies, which offer an array of services: individual counseling, legal and medical advocacy; safety planning; support groups, and shelter to provide a safe living environment (Riger et al., 2002). IPV/SA service providers have the challenging task of assessing survivors’ needs and tailoring service plans to meet those needs. With a range of available services, IPV/SA service providers need considerable expertise to design individualized service plans to best meet survivors’ needs. Accordingly, IPV/SA service providers require training to develop such expertise. Unfortunately, there is a lack of consensus regarding the content and extent of training required for effective IPV/SA service provision (Macy et al., 2009). Moreover, there is a dearth of research to inform standardized training curricula for IPV/SA service providers. To help build the knowledge base in these areas, we investigated IPV/SA agencies’ current training and technical practices, as well as their training needs. Methods: Our research team surveyed all IPV/SA agencies in North Carolina by developing a database of all IPV/SA agencies and their directors from the Websites of the three statewide IPV/SA organizations. We then confirmed the accuracy of the information by contacting each agency to obtain a final sample of 103 agency directors. With guidance from an expert panel of IPV/SA statewide leaders, we developed a survey to collect information regarding typical IPV/SA staff training practices and training needs. The web-based survey was administered over 13 weeks. Of those invited, 74% started the survey and 65% completed most or all of the survey. We then conducted descriptive analyses to assess training levels and ongoing training needs among all participating agencies. Results: The majority of respondents reported that personnel received initial trainings in five key areas of survivor concerns: violence/safety (95.5%), emotional health (95.5%), disability (86.4%), physical health (78.8%), and substance use (77.3%). However, respondents reported that more than half of their staff required additional training in violence/safety (22.7%), physical health (26.9%), emotional health (27.3%), disability (33.3%), and substance use (42.4%). Notably, there were no statistically significant differences (p=0.05) in training needs when comparing agencies that provided orientation trainings in each area with those that did not. Implications: This study is among one of the first to examine the training practices and needs of IPV/SA agencies. Respondents reported continuing educational needs in five key areas of survivor concerns regardless of whether agencies provided orientation trainings. Such findings suggest that there are critical training needs across IPV/SA advocates and agencies. Based on this research’s findings, we offer recommendations for standardized training curricula for IPV/SA service providers that address the complex needs of IPV/SA survivors.
    The Society for Social Work and Research 2014 Annual Conference; 01/2014
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Population-level mixing patterns can be quantified using Newman's assortativity coefficient r. Suggested methods for estimating the standard error for r may lead to inappropriate statistical conclusions in situations where intra-cluster correlation is ignored and/or when cluster size is predictive of the response. Methods: We describe a computer-intensive within-cluster resampling approach for providing a valid large-sample estimated standard error for r and an associated 95% confidence interval. Network data and a simulation model were employed to compare within-cluster resampling to standard methods when cluster size is informative. Results: For the analysis of network data, when cluster size is informative, simulations studies demonstrate that within-cluster resampling produces valid statistical inferences about Newman's assortativity coefficient, a popular statistic used to quantify the strength of mixing patterns. In contrast, commonly used methods are biased with attendant extremely poor confidence interval coverage. Within-cluster resampling is recommended when cluster size is informative and/or when there is within-cluster response correlation. Conclusions: Within-cluster resampling is recommended for providing valid statistical inferences when applying Newman's assortativity coefficient r to network data.
    141st APHA Annual Meeting and Exposition 2013; 11/2013
  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: Community-based Domestic Violence/Sexual Assault (DV/SA) programs exist nationwide, with 100 in North Carolina (NC). NC DV/SA programs serve over 75,000 persons annually, with many DV/SA survivors receiving longer-term services (shelter, individual/group counseling). Although DV/SA survivors have many needs (health, etc.), there are no standardized assessment instruments/procedures used by all DV/SA programs to: identify needs of survivors entering longer-term services (so appropriate wrap-around services/referrals may be put into place); and re-assess survivors at service-end to determine how well needs were met (service effectiveness). The goal of this 4-year collaboration with NC DV/SA survivors and programs was to develop/pilot-test standardized assessment instruments/procedures to address this service gap. Methods: To identify topics for the instruments, focus groups were conducted with NC DV/SA survivors and all NC DV/SA programs were surveyed (77% responded). Using these findings, instruments were drafted to assess survivors' goals, violence/legal experiences, safety, physical/emotional health, substance use, coping, and social support. Staff at 4 NC DV/SA programs piloted the instruments with survivors to assess feasibility/usefulness. Survivors' instrument responses also were analyzed. Results: The instruments: were acceptable to survivors; took 15-minutes to administer; were feasible to use; and identified important issues that staff could help survivors address. Analysis of survivors' instrument responses at service-entry showed that most survivors experienced high levels of violence, had high levels of physical/emotional health/substance abuse symptoms, and had low levels of coping and social support. All these improved significantly after DV/SA services. Conclusion: Standardized assessment procedures can be very useful to DV/SA programs and survivors.
    141st APHA Annual Meeting and Exposition 2013; 11/2013
  • [Show abstract] [Hide abstract]
    ABSTRACT: The objective of this study is to examine the association between physical and sexual violence exposure and somatic symptoms among female adolescents. We studied a nationally representative sample of 8,531 females, aged 11-21 years, who participated in the 1994-1995 Wave I of the National Longitudinal Study of Adolescent Health (Add Health). Female adolescents were asked how often they had experienced 16 specific somatic symptoms during the past 12 months. Two summary categorical measures were constructed based on tertiles of the distributions for the entire female sample: (a) total number of different types of symptoms experienced, and (b) number of frequent (once a week or more often) different symptoms experienced. Groups were mutually exclusive. We examined associations between adolescents' violence exposure and somatic symptoms using multinomial logistic regression analyses. About 5 % of adolescent females reported both sexual and non-sexual violence, 3 % reported sexual violence only, 36 % reported non-sexual violence only, and 57 % reported no violence. Adolescents who experienced both sexual and non-sexual violence were the most likely to report many different symptoms and to experience very frequent or chronic symptoms. Likelihood of high symptomatology was next highest among adolescents who experienced sexual violence only, followed by females who experienced non-sexual violence only. Findings support an exposure-response association between violence exposure and somatic symptoms, suggesting that symptoms can be markers of victimization. Treating symptoms alone, without addressing the potential violence experienced, may not adequately improve adolescents' somatic complaints and well-being.
    Maternal and Child Health Journal 01/2013; · 2.24 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Women who experience intimate partner violence (IPV) during pregnancy also tend to experience depressive symptoms. Unfortunately, little is known about how victimized women's levels of depressive symptoms change longitudinally before pregnancy, during pregnancy, and after infant delivery. In addition, few studies have used a comparison group of women to determine if levels of depressive symptoms among victimized women differ from depressive symptom levels in women who have not experienced IPV. To help address these knowledge gaps, we examined longitudinal trends in levels of depressive symptoms among a sample of 76 women who did (n = 33) and did not (n = 43) experience physical IPV during pregnancy. Using multilevel analysis, we estimated the relationship of physical IPV victimization and women's depressive symptom levels across six time periods: (a) the year before pregnancy, (b) first and second trimesters, (c) third trimester, (d) the first month postpartum, (e) Months 2 to 6 postpartum, and (f) Months 7 to 12 postpartum. Women who experienced physical IPV victimization during pregnancy had significantly higher levels of depressive symptoms during each time period (p < .05). No significant difference between the two groups was found in the rate of change in levels of depressive symptoms over time. These findings point to the importance of screening for IPV within health care settings and suggest that women physically abused during pregnancy need safety interventions that are coordinated with interventions targeting symptoms of depression.
    Journal of Interpersonal Violence 01/2013; · 1.64 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The objective of this study is to examine the association between physical and sexual violence exposure and somatic symptoms among female adolescents. We studied a nationally representative sample of 8,531 females, aged 11–21 years, who participated in the 1994–1995 Wave I of the National Longitudinal Study of Adolescent Health (Add Health). Female adolescents were asked how often they had experienced 16 specific somatic symptoms during the past 12 months. Two summary categorical measures were constructed based on tertiles of the distributions for the entire female sample: (a) total number of different types of symp-toms experienced, and (b) number of frequent (once a week or more often) different symptoms experienced. Groups were mutually exclusive. We examined associations between adolescents' violence exposure and somatic symptoms using multinomial logistic regression analyses. About 5 % of adolescent females reported both sexual and non-sexual violence, 3 % reported sexual violence only, 36 % reported non-sexual violence only, and 57 % reported no violence. Adolescents who experienced both sexual and non-sexual violence were the most likely to report many different symptoms and to experience very frequent or chronic symptoms. Likelihood of high symptomatology was next highest among adolescents who experienced sexual violence only, followed by females who experienced non-sexual violence only. Findings support an exposure– response association between violence exposure and somatic symptoms, suggesting that symptoms can be markers of victimization. Treating symptoms alone, without addressing the potential violence experienced, may not adequately improve adolescents' somatic complaints and well-being.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction:South Africa has high rates of intimate partner violence (IPV) directed against women. However, we know little about the scope of IPV during pregnancy and the postpartum period despite significant negative consequences. The purpose of this study is to describe the prevalence and severity of IPV that South African women experience before pregnancy, during pregnancy, three and nine months postpartum. Methods:Data come from a longitudinal study with 745 women recruited between May 2008 and June 2010 at a public clinic in Durban. We used a modified version of the World Health Organization's intimate partner violence scale to estimate prevalence and the proportion of women who experienced severe violence. Results:The prevalence of IPV decreased from 39% before pregnancy to 23% during pregnancy. Approximately 25% of women experienced IPV postpartum. The proportion of women who experienced severe violence also dropped from 13% to 3% during pregnancy; however, nearly 10% of women experienced severe violence postpartum. Conclusion:While the proportion of women who experienced IPV decreased during pregnancy, a quarter of all women still experienced some type of IPV during pregnancy, which is higher than most pregnancy-specific prevalence estimates in sub-Saharan Africa. Further, the high proportion of women who experience severe violence postpartum suggests that some women who experience severe IPV may only find a short period of respite from violence. Therefore, IPV prevention interventions are needed in both the prenatal and postnatal period to reduce the public health burden of IPV and particularly severe IPV during this time.
    140st APHA Annual Meeting and Exposition 2012; 10/2012
  • [Show abstract] [Hide abstract]
    ABSTRACT: Presenting continuous outcomes in Summary of Findings tables presents particular challenges to interpretation. When each study uses the same outcome measure, and the units of that measure are intuitively interpretable (e.g., duration of hospitalization, duration of symptoms), presenting differences in means is usually desirable. When the natural units of the outcome measure are not easily interpretable, choosing a threshold to create a binary outcome and presenting relative and absolute effects become a more attractive alternative. When studies use different measures of the same construct, calculating summary measures requires converting to the same units of measurement for each study. The longest standing and most widely used approach is to divide the difference in means in each study by its standard deviation and present pooled results in standard deviation units (standardized mean difference). Disadvantages of this approach include vulnerability to varying degrees of heterogeneity in the underlying populations and difficulties in interpretation. Alternatives include presenting results in the units of the most popular or interpretable measure, converting to dichotomous measures and presenting relative and absolute effects, presenting the ratio of the means of intervention and control groups, and presenting the results in minimally important difference units. We outline the merits and limitations of each alternative and provide guidance for meta-analysts and guideline developers.
    Journal of clinical epidemiology 10/2012; · 5.48 Impact Factor
  • CHANCE 09/2012; 14(1):30-35.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study is to estimate rates of suicide and homicide death among pregnant, postpartum and non-pregnant/non-postpartum women ages 14-44, and to determine comparative rates of violent death for pregnant and/or postpartum women compared to non-pregnant/non-postpartum women. North Carolina surveillance and vital statistics data from 2004 to 2006 were used to examine whether pregnant or postpartum women have higher (or lower) rates of suicide and homicide compared to other reproductive-aged women. The suicide rate for pregnant women was 27% of the rate for non-pregnant/non-postpartum women (rate ratio= 0.27, 95% CI = 0.11-0.66), and the suicide rate for postpartum women was 54% of the rate for non-pregnant/non-postpartum women (rate ratio = 0.54, 95% CI = 0.31-0.95). Homicide rates also were lower for pregnant and postpartum women, with the homicide rate for pregnant women being 73% of the rate for non-pregnant/non-postpartum women (rate ratio = 0.73, 95% CI = 0.39-1.37), and the homicide rate for postpartum women being half the rate for non-pregnant/non-postpartum women (rate ratio = 0.50, 95% CI = 0.26-0.98). Although pregnant and postpartum women are at risk for homicide and suicide death, the highest risk group is non-pregnant/non-postpartum women. Violence prevention efforts should target all women of reproductive age, and pay particular attention to non-pregnant/non-postpartum women, who may have less access to health care services than pregnant and postpartum women.
    Maternal and Child Health Journal 07/2011; 15(5):660-9. · 2.24 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Concerns have been expressed about the validity of self-reported data on sexual assault, as victims might be reluctant to disclose what happened to them. In this study, using an anonymous, web-based survey, a sample of 5,446 undergraduate women were asked about their experiences with physically forced sexual assault using both direct and indirect questioning methods. The prevalence of physically forced sexual assault obtained via indirect questioning was slightly higher than, though not substantially or statistically different from, the estimate obtained via direct questioning. The results suggest that either direct questioning yields reasonably valid estimates of the prevalence of sexual assault or that the item count technique does not produce estimates that are any more valid.
    Violence Against Women 02/2011; 17(2):219-35. · 1.33 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We investigated agency directors' perspectives about how service goals should be prioritized for domestic violence and sexual assault service subtypes, including crisis, legal advocacy, medical advocacy, counseling, support group, and shelter services. A sample of 97 (94% response rate) North Carolina domestic violence and/or sexual assault agency directors completed a survey asking participants to rank the importance of service goals. Overall, participants considered emotional support provision to be a critical service goal priority across all service types. Social support and self-care service strategies were deemed less important. However, prioritization of other service goals varied depending on the service type. Statistically significant differences on service goal prioritization based on key agency characteristics were also examined, and agency characteristics were found to relate to differences in service goal prioritization.
    Journal of Interpersonal Violence 01/2011; 26(16):3361-82. · 1.64 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We sought to examine relationships between women's sexual orientations and their sexual assault experiences before and during university. Self-reported responses on a web-based survey of 5,439 female undergraduates who participated in the Campus Sexual Assault study were analyzed to compare three groups: bisexuals, lesbians, and heterosexuals. Groups were compared in terms of the prevalence of sexual assault before and during university, and the extent to which sexual assault before university predicted sexual assault during university. The prevalence of sexual assault before and during university was higher among bisexuals and lesbians compared with heterosexuals (25.4% of bisexuals, 22.4% of lesbians, and 10.7% of heterosexuals were sexually assaulted before university; 24.0% of bisexuals, 17.9% of lesbians, and 13.3% of heterosexuals were sexually assaulted during university). Sexual assault before university was highly predictive of sexual assault during university, especially among non-heterosexuals. Compared with heterosexuals not sexually assaulted before university (the referent group), previously assaulted non-heterosexuals (bisexuals/lesbians) had eight times the odds of sexual assault during university (adjusted odds ratio [AOR] = 8.75), whereas previously assaulted heterosexuals had four times the odds of sexual assault during university (AOR, 4.40). However, there was no difference in the odds of sexual assault during university between non-heterosexuals not sexually assaulted before university and heterosexuals not sexually assaulted before university. Bisexual and lesbian women are more likely than heterosexual women to be sexually assaulted before and during university. Sexual assault before university is linked to sexual assault during university for all women, with this association being especially pronounced among non-heterosexuals.
    Women s Health Issues 01/2011; 21(3):199-205. · 1.61 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This article examines literature reviews of research articles and dissertations focused on the effectiveness of college- or university-based sexual violence prevention programs. Literature reviews were eligible for inclusion in this article if they examined empirical published peer-reviewed research articles or dissertation research that reported original data; focused on examining the effectiveness of programs that were developed to reduce sexual violence that occurred in college or university settings; offered recommendations for developing and implementing effective college- or university-based sexual assault prevention programs; and reviewed studies that occurred in the United States. Eight review articles met the inclusion criteria. The results suggest that the effectiveness of college- or university-based sexual violence prevention programs varies depending on the type of audience, facilitator, format, and program content. Recommendations from existing reviews of empirical research concerning these program characteristics should be considered by college or university administrators when designing and implementing their own programs on campus.
    Trauma Violence & Abuse 12/2010; 12(2):67-86. · 3.27 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Family violence prevention includes primary as well as secondary prevention strategies, such as those offered by Domestic Violence (DV) and Sexual Assault (SA) Agencies. These community-based agencies serve many of the most disadvantaged violence survivors. However, little empirical information exists concerning providers' perspectives regarding DV/SA Agency best practices, and even less documents actual DV/SA Agency practices. Therefore, this research surveyed directors of North Carolina (NC) DV/SA agencies regarding their perceptions of ideal best practices for three core services: crisis services, legal advocacy, and medical advocacy. 92% (n=97) of all NC DV/SA Agencies participated. Next, information was gathered from providers at four NC DV/SA Agencies to document actual practices during these three core services, allowing determination of how well actual practices matched ideal best practices. Results showed strong consensus among Agency directors regarding best practices that should occur during delivery of these three core services. For example, the four top ranked practices that should occur during crisis services included provision of: emotional support (endorsed by 94% of directors), safety planning (endorsed by 93%), information concerning violence/trauma (endorsed by 84%), and referrals to other community services (endorsed by 82%). Examination of actual practices at four DV/SA Agencies found that these best practices were not always delivered during crisis services. Among 270 clients receiving crisis services, 73% received emotional support, 46% received safety planning, 27% received information on violence/trauma, and 55% received referrals to community services. Similar patterns relating ideal and actual practices were found when legal and medical advocacy were examined.
    138st APHA Annual Meeting and Exposition 2010; 11/2010
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Earlier studies have shown an inverse association between the presence of nausea and vomiting in pregnancy (NVP) and spontaneous abortion (SAB), but no study to date has examined the effects of symptom duration on the risk of SAB. We examined NVP symptom severity and duration in relation to the occurrence of SAB. Data were collected from 2407 pregnant women in three US cities between 2000 and 2004 through interviews, ultrasound assessments and medical records abstractions. Discrete-time continuation ratio logistic survival models were used to examine the association between NVP and pregnancy loss. Lack of NVP symptoms was associated with increased risk for SAB [adjusted odds ratio (OR) = 3.2, 95% confidence interval (CI): (2.4, 4.3)], compared with having any symptoms. Reduced risks for SAB were found across most maternal age groups for those with NVP for at least half of their pregnancy, but the effects were much stronger in the oldest maternal age group [OR = 0.2, 95% CI: (0.1, 0.8)]. The absence of NVP symptoms is associated with an increased risk of early pregnancy loss. As symptom duration decreases, the likelihood of early loss increases, especially among women in the oldest maternal age group.
    Human Reproduction 11/2010; 25(11):2907-12. · 4.67 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Data on 7,424 soldier spouse abuse offenders were analyzed to determine the prevalence of substance use during abusive incidents, and to examine differences between substance-using and non-substance-using offenders. Results showed that 25% of all offenders used substances during abusive incidents, with males and non-Hispanic Whites being more likely to hav e used substances. Substance-using offenders were more likely to perpetrate physical spouse abuse and more severe spouse abuse. These findings underscore the importance of educating military personnel (including commanders) about links between substance use and domestic violence, and of coordinating preventive and therapeutic substance abuse and violence-related interventions.
    Violence Against Women 11/2010; 16(11):1295-310. · 1.33 Impact Factor

Publication Stats

967 Citations
228.59 Total Impact Points

Institutions

  • 1995–2014
    • University of North Carolina at Chapel Hill
      • Department of Maternal and Child Health
      North Carolina, United States
  • 2009
    • RTI International
      Durham, North Carolina, United States
  • 2005
    • Johns Hopkins Bloomberg School of Public Health
      • Department of Epidemiology
      Baltimore, MD, United States
  • 2004
    • Johns Hopkins University
      • School of Nursing
      Baltimore, Maryland, United States
    • Duke University
      Durham, North Carolina, United States
    • University of North Carolina at Charlotte
      Charlotte, North Carolina, United States
  • 2002
    • Columbia University
      • Department of Sociomedical Sciences
      New York City, NY, United States