Linda F. C. Bullock’s research while affiliated with University of Missouri and other places

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Publications (7)


An Empowerment-Based Intervention for Chinese Immigrant Women Experiencing Intimate Partner Violence: Feasibility and Acceptability
  • Article

August 2024

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25 Reads

Journal of the American Psychiatric Nurses Association

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Linda F C Bullock

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Background Intimate partner violence (IPV) is a significant public health concern, particularly in vulnerable populations such as Chinese immigrant women. Aim This study aimed to assess the feasibility and acceptability of an empowerment-based intervention integrated with relaxation and self-compassion techniques for Chinese immigrant women experiencing IPV. Methods The present study was a part of a pilot randomized controlled trial (RCT). A total of 50 Chinese immigrant women who had experienced IPV in the past year were recruited online and randomized to either the intervention or the control group. The intervention group engaged in seven weekly sessions delivered with a phone call and a mobile application. Quantitative and qualitative data were collected through surveys and interviews to evaluate intervention adherence, participants’ perceptions, and areas for improvement. Results 64% of the participants completed each weekly session, demonstrating favorable intervention adherence. The intervention was perceived to be helpful by most participants, with reported decreases in stress, anxiety, fatigue, pain, and family conflicts, and with reported improvements in emotion regulation and self-compassion. However, technical issues with the mobile platform and lack of personalization were identified as limitations. Conclusion This study demonstrates the feasibility and acceptability of the intervention for Chinese immigrant women experiencing IPV and warrants a full-scale RCT to determine its efficacy. It will be essential to personalize the intervention and reduce any barriers to participation.


Descriptive statistics for facilitators and barriers to PrEP prescribing
Cross-tabulation of percentage of African American patients versus pre-exposure prophylaxis (PrEP) stage of change
Barriers and Facilitators That Influence HIV Pre- exposure Prophylaxis (PrEP)-Prescribing Behaviors Among Primary Care Providers in the Southern United States
  • Article
  • Full-text available

August 2024

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27 Reads

Cureus

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Mathie Enriquez

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[...]

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The Southern United States (US) bears the highest burden of HIV prevalence in the country, disproportionately affecting African American communities. Despite the proven efficacy of pre-exposure prophylaxis (PrEP) in reducing HIV transmission, its uptake remains suboptimal in this region. This study aimed to identify factors influencing PrEP-prescribing behaviors among primary care providers (PCPs) in the Southern US through the application of the transtheoretical model of behavior change. A cross-sectional survey was conducted among PCPs in 10 Southern states to assess their PrEP-prescribing practices, barriers, and facilitators. The results indicate that non-White PCPs and those practicing in urban and suburban settings are more likely to prescribe PrEP. Key barriers include lack of training, perceived stigma, and systemic issues such as health insurance coverage and time constraints. Significant facilitators are access to prescribing resources, streamlined insurance procedures, and patient motivation. Targeted educational programs and policy changes to address these barriers can enhance PrEP uptake, thereby reducing HIV transmission in high-risk populations. The findings underscore the need for tailored interventions to support PCPs in integrating PrEP into routine care, ultimately contributing to better public health outcomes in the Southern US.

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Participant Flow Diagram.
Changes in self-judgment over time in the SHE and control groups.
SHE = Self-Compassion, Health, and Empowerment; T1 = Baseline; T2 = Immediately after the intervention; T3 = 8 Weeks after the intervention.
Baseline Sample Characteristics.
Group Differences across Time on Outcome Measures.
Self-Compassion, Health, and Empowerment: A Pilot Randomized Controlled Trial for Chinese Immigrant Women Experiencing Intimate Partner Violence

October 2023

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63 Reads

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4 Citations

Chinese immigrant survivors of men’s violence experience both significant mental health impacts from abuse and barriers to formal services. Therefore, we examined the preliminary efficacy of an innovative mobile-based empowerment-based intervention (self-compassion, health, and empowerment; SHE) that specifically focuses on abused Chinese immigrant women in the US. This pilot study used a two-arm randomized controlled design with repeated measures. A convenience sample (N = 50) of Chinese immigrant women who experienced past year intimate partner violence (IPV) were recruited online and randomly assigned to the intervention or control group (25 per group). We assessed IPV exposure, safety behaviors, depressive symptoms, anxiety symptoms, post-traumatic stress disorder (PTSD) symptoms, and self-compassion at baseline, post-intervention, and 8-week follow-up. Of 95 eligible participants, 50 (52.6%) agreed to participate and completed baseline data collection; intervention completion rate was 64%. We found a significant group and time interaction for self-judgment (a self-compassion component), with a significant reduction seen in the intervention group compared to the control group. Despite no other significant group differences observed over time, the intervention group showed consistent trends toward improvements in most outcome measures, including specific types of IPV (i.e., negotiation, psychological aggression, and sexual coercion), depressive and PTSD symptoms, self-compassion, and certain components of self-compassion (i.e., isolation and over-identification) when compared to the control group. Our findings suggest that the SHE intervention shows promise in improving the mental health well-being of Chinese immigrant survivors. However, a fully powered randomized controlled trial is warranted to determine its efficacy. Our intervention has the potential to be translated in the Chinese immigrant populations with the necessary organizational support.


PRISMA flow diagram summarizing screening process.
The breastfeeding experience and support model for low-income women.
Note. “WIC sends mixed messages” is depicted as both positive and negative.
PubMed Search Strategy.
Qualitative Metasynthesis Inclusion and Exclusion Attributes and Rationales.
Sample Attributes From Articles Included in Qualitative Metasynthesis.
The Work of Breastfeeding Among Women of Low Socioeconomic Status: A Qualitative Metasynthesis

March 2023

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33 Reads

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1 Citation

Global Qualitative Nursing Research

A theory-generating qualitative metasynthesis was used to explore the questions: (a) How do mothers of low socioeconomic status in the United States express their attitudes and beliefs on breastfeeding? (b) How do mothers of low socioeconomic status in the United States describe the types of support received related to breastfeeding? Databases were searched from January 2000 to June 2022. Eleven qualitative studies were evaluated, and six themes were identified. A model was developed illustrating how the themes impact a mother’s decision to breastfeed. Positive factors included shared narratives, knowledge of breastfeeding physiology, and social network. However, more negative influences were heard such as opinions passed on from family and friends, lack of teaching and anticipatory guidance, limited support and follow up, and the perception of conflicting messages from health care professionals. This model identifies constructs that can be used as starting points for interventions, policy development and/or health promotion education.


"Get Stuck and Can't Walk Out": Exploring the Needs for Support Among Chinese Immigrant Women Experiencing Intimate Partner Violence in the U.S

January 2023

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49 Reads

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2 Citations

Violence and Victims

Chinese immigrant survivors of intimate partner violence (IPV) in the United States have been overlooked and underserved. The purpose of this study was to explore their perceptions of resources for assistance as well as their priority needs. We conducted phone interviews with 20 Chinese immigrant women who had experienced IPV in the past year. The women expressed their needs for emotional support, culturally specific services, a variety of online resources to meet different demands, being empowered, raising the Chinese community’s awareness about IPV, and batterer intervention programs. These women’s testimonies shows that greater effort should be directed toward addressing those needs in order to reduce IPV and its impacts on health in this vulnerable group of women.


“It Never Goes Away”: Chinese Immigrant Women’s Experiences of Intimate Partner Violence

November 2021

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79 Reads

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8 Citations

Objective: Very little research has been conducted on intimate partner violence (IPV) against Chinese immigrant women living in the United States, including qualitative explorations of the lived experiences of IPV among Chinese immigrant survivors. This study presents Chinese immigrant women’s experiences of IPV and its mental health consequences, with a focus on the roles of traditional culture, immigration, and acculturation in survivors’ experiences. Method: Phone interviews were conducted with 20 Chinese immigrant women living in the United States who had experienced IPV during the past year. Participants’ mean age was 29 years; they were recruited via social network sites. Results: Almost all participants reported emotional abuse, three reported physical violence, and one reported sexual violence. They experienced “cold violence” frequently, and they described how IPV tortured them mentally. The women shared their thoughts on how their experiences of IPV were shaped by traditional Chinese patriarchal family structure, immigration, financial and legal dependence on their abuser, adjustment to life in the United States, and social isolation. Conclusions: There is a need for further research on the prevalence, causes, and consequences of “cold violence” and the development and validation of measures for this type of abuse. It is important to consider culture, immigration, and acculturation in services for Chinese immigrant women who experience IPV. Culturally appropriate, accessible services are needed to meet these women’s needs.

Citations (3)


... After screening titles and abstracts, 493 full-text papers were considered for inclusion, of which 103 studies with 19,230 participants met the eligibility criteria and were included. [111][112][113][114][115][116][117][118][119][120][121][122][123][124][125][126][127][128][129][130] A total of 96 studies contributed to meta-analyses for at least one outcome (Fig. 1). References to the studies awaiting assessment as well as the excluded studies and the reasons for exclusion are reported in the Supplementary S2. ...

Reference:

Comparative efficacy and acceptability of psychosocial interventions for PTSD, depression, and anxiety in asylum seekers, refugees, and other migrant populations: a systematic review and network meta-analysis of randomised controlled studies
Self-Compassion, Health, and Empowerment: A Pilot Randomized Controlled Trial for Chinese Immigrant Women Experiencing Intimate Partner Violence

... Studying violence during pregnancy presents numerous challenges, including obtaining reliable data and discerning its specific impacts. Additionally, the influence of environmental factors, such as socioeconomic status (3, 7) and culture (8,9) (e.g., perceptions of intimate partner violence within relationship dynamics) remains unclear. Considering the complexity of a phenomenon such as intimate partner violence, it is likely that the impacts of violence vary across different populations (10,11). ...

"Get Stuck and Can't Walk Out": Exploring the Needs for Support Among Chinese Immigrant Women Experiencing Intimate Partner Violence in the U.S
  • Citing Article
  • January 2023

Violence and Victims

... Follow-up qualitative phone interviews with 20 victim-survivors found that the Chinese migrant women faced significant sociocultural (shame, stigma and losing face) and immigration-specific barriers in seeking help (Li et al, 2022a). Furthermore, traditional Chinese cultural beliefs and values (patriarchal family structure, virtues of morally good women and family harmony) significantly impacted the occurrence of DV and decisions about staying in abusive relationships (Li et al, 2022b). Other scholarship on DV with a focus on Asian and South Asian diaspora in Australia, Canada and the US has found that certain cultural norms and gender-role beliefs, such as pressure to maintain the family unit, stigma, shame and 'losing face', can impact women's tolerance of DV, while racism and stereotyping severely limits access to services (Midlarsky et al, 2006;Chang, 2022). ...

“It Never Goes Away”: Chinese Immigrant Women’s Experiences of Intimate Partner Violence