Factors Associated With Follow-Up Attendance Among Rape Victims Seen in Acute Medical Care
Open accessAbstract
OBJECTIVE: Rape is associated with posttraumatic stress disorder (PTSD) and related comorbidities. Most victims do not obtain treatment for these conditions. Acute care medical settings are well positioned to link patients to services; however, difficulty engaging victims and low attendance at provided follow-up appointments is well documented. Identifying factors associated with follow-up can inform engagement and linkage strategies. METHOD: Administrative, patient self-report, and provider observational data from Harborview Medical Center were combined for the analysis. Using logistic regression, we examined factors associated with follow-up health service utilization after seeking services for rape in the emergency department. RESULTS: Of the 521 diverse female (n = 476) and male (n = 45) rape victims, 28% attended the recommended medical/counseling follow-up appointment. In the final (adjusted) logistic regression model, having a developmental or other disability (OR = 0.40, 95% CI = 0.21-0.77), having a current mental illness (OR = 0.25, 95% CI = 0.13-0.49), and being assaulted in public (OR = 0.50, 95% CI = 0.28-0.87) were uniquely associated with reduced odds of attending the follow-up. Having a prior mental health condition (OR = 3.02, 95% CI = 1.86-4.91), a completed Sexual Assault Nurse Examiner's (SANE) examination (OR = 2.97, 95% CI = 1.84-4.81), and social support available to help cope with the assault (OR = 3.54, 95% CI = 1.76-7.11) were associated with an increased odds of attending the follow-up. CONCLUSIONS: Findings point to relevant characteristics ascertained at the acute care medical visit for rape that may be used to identify victims less likely to obtain posttraumatic medical and mental health services. Efforts to improve service linkage for these patients is warranted and may require alternative service delivery models that engage rape survivors and support posttraumatic recovery.
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Of those individuals who receive a sexual assault exam, only 28-36% follow up with recommended care or resources.
“Of those individuals who receive a SA exam, only 28–36% follow up with recommended care or resources (Ackerman et al., 2006; Darnell et al., 2015; Gilmore et al., 2018; Holmes et al., 1998).”
From “Having One Person Tell Me I Didn’t Do the Wrong Thing”: The Impact of Support on the Post-Sexual Assault Exam Experience (2024) · cites this paper as Darnell et al., 2015
The Results report that 28% of 521 patients attended a recommended follow-up appointment, supporting the lower end of the cited range. But this rate covers the study cohort, not specifically patients who completed a sexual assault exam; the Discussion treats exam completion as a separate predictor of attendance. The Limitations also say the study did not track use of other resources after the emergency visit. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThere is limited knowledge about individuals' post-sexual-assault-exam support pathways or experiences and their ability or desire to further access support.
“However, there is limited knowledge about individuals’ post-SA exam support pathways or experiences and their ability or desire to further access support (Ackerman et al., 2006; Darnell et al., 2015).”
From “Having One Person Tell Me I Didn’t Do the Wrong Thing”: The Impact of Support on the Post-Sexual Assault Exam Experience (2024) · cites this paper as Darnell et al., 2015
The Introduction describes limited prior research on factors predicting post-rape follow-up attendance, and the Discussion reports a gap between patients’ interest in counseling and their subsequent attendance. These passages support uncertainty about further access to care, but the paper does not establish a broader lack of knowledge about individuals’ support pathways or experiences after the exam. The indexed passages provide section labels but no page numbers. (LLM, conf=0.82)
Experimental — accuracy not yet measuredOther studies have found that follow-up care with medical or mental health services after a SA exam is often low.
“Other studies have found that follow-up care with medical or mental health services after a SA exam is often low (Ackerman et al., 2006; Darnell et al., 2015).”
From “Having One Person Tell Me I Didn’t Do the Wrong Thing”: The Impact of Support on the Post-Sexual Assault Exam Experience (2024) · cites this paper as Darnell et al., 2015
Social support and having a SANE perform the sexual assault exam are associated with receiving follow-up medical care or counseling.
“The limited evidence that exists has found that social support and having a SANE perform the SA exam are associated with receiving follow-up medical care or counseling (Darnell et al., 2015)”
From “Having One Person Tell Me I Didn’t Do the Wrong Thing”: The Impact of Support on the Post-Sexual Assault Exam Experience (2024) · cites this paper as Darnell et al., 2015
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Wright, E. N., Miyamoto, S., & Anderson, J. (2024) · Violence Against Women · doi:10.1177/10778012231156153 · Cited by 5 · see citing works
“…that exists has found that social support and having a SANE perform the SA exam are associated with receiving follow-up medical care or counseling (Darnell et al., 2015) while having a mental illness, being assaulted by a partner, or drug use prior to SA is associated with a lower likelihood of…”
BackgroundInfluential
- Authors
- Darnell, D., Peterson, R., Berliner, L., Stewart, T., Russo, J., Whiteside, L., & Zatzick, D.
- Affiliations
- University of Washington (US)
- Corresponding author
- Darnell, Doyanne
- Venue
- Psychiatry
- Publisher
- Informa UK Limited
- Published
- 2015-01-02
- Volume
- 78
- Issue
- 1
- Pages
- 89-101
- ISSN
- 0033-2747 (ISSN-L)
- 1943-281X
- PMC
- PMC4777603
- OpenAlex
- W2259225243
- Cited by
- 36
- References
- 5
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 4 · 2023: 7 · 2022: 2 · 2021: 3 · 2020: 4 · 2019: 3 · 2018: 3 · 2017: 1 · 2016: 2
- FWCI
- 4.67
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K24MH086814, T32MH082709)
- Topics
- Social Sciences › Gender Studies › Sexual Assault and Victimization Studies
- Social Sciences › Health › Intimate Partner and Family Violence
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- rape, sexual assault, post-traumatic stress disorder, follow-up appointment attendance, emergency department care, social support, mental illness, developmental disabilities, service utilization
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Counseling, Female, Follow-Up Studies, Humans, Male, Mental Health Services, Middle Aged, Rape, Stress Disorders, Post-Traumatic, Crime Victims, Young Adult
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