CSUB Public Policy Analysis Work in Progress Powerpoint Presentation Hi, i have a powerpoint presentation that I already did and present so its my fina

CSUB Public Policy Analysis Work in Progress Powerpoint Presentation Hi,

i have a powerpoint presentation that I already did and present so its my final project, I need you to go deep in the case and add couple of policy recommendation for the case. This presentation is called WORK IN PROGRESS so I still need to submit a final paper at the end of the semester. So I need to go little forward in the PPT presentation. AS I MENTIONED I NEED COUPLE OF POLICY RECOMMENDATION. AND PLEASE ADD THE SPEECH OF EACH SLIDE ON THE NOTES AT THE BOTTOM.

PLEASE CHECK THE ARTICLE AND MY PPT PRESENTATION, YOU CAN CHANGE ON THE PPT ALSO.

The presentation should include the following topics:

• problem/issue/questions analyzed and/or the hypothesis

• models and/or concepts included in the study

• data, methods, variables — dependent and independent

• key findings* and limitations

• implications – management and/or policy *As part of the presentation:

• Present, summarize and discuss at least one table/exhibit from the paper.

• Present at least one key finding of the paper and its policy and/or management implications.

POLICY RECOMMENDATION RESEARCH ARTICLE
Gaps in Sexual Assault Health Care Among Homeless
Young Adults
Diane M. Santa Maria, DrPH, RN,1 Khara Breeden, DNP, RN,2 Stacy A. Drake, PhD, MPH, RN,1
Sarah C. Narendorf, PhD,3 Anamika Barman-Adhikari, PhD,4 Robin Petering, PhD,5
Hsun-Ta Hsu, PhD,6 Jama Shelton, PhD,7 Kristin Ferguson-Colvin, PhD,8 Kimberly Bender, PhD4
Introduction: Young adults experiencing homelessness are at increased risk for sexual assault.
Receiving a post?sexual assault examination has important implications for HIV and unintended
pregnancy prevention; yet, utilization is not well understood. In a population at elevated risk for
HIV, unintended pregnancy, and sexual violence, identifying barriers and facilitators to post?
sexual assault examination is imperative.
Methods: As part of a large, multisite study to assess youth experiencing homelessness across
7 cities in the U.S, a cross-sectional survey was conducted between June 2016 and July 2017. Data
were analyzed in 2019 to determine the prevalence and correlates of sexual violence and examine
the correlates of post?sexual assault examination utilization.
Results: Respondents (n=1,405), aged 18?26 years, were mainly youth of color (38% black, 17%
Latinx) and identi?ed as cisgender male (59%) and lesbian, gay, bisexual, or queer (29%). HIV risks
were high: 23% of participants had engaged in trade sex, 32% had experienced sexual assault as a
minor, and 39% had experienced sexual exploitation. Young adults reported high rates of sexual
assault (22%) and forced sex (24%). Yet, only 29% of participants who were forced to have sex
received a post?sexual assault examination. Latinx young adults were more likely than other races/
ethnicities to receive post-assault care. Participants frequently said they did not get a post?sexual
assault exam because they did not want to involve the legal system and did not think it was
important.
Conclusions: Interventions are needed to increase use of preventive care after experiencing sexual
assault among young adults experiencing homelessness.
Am J Prev Med 2020;58(2):191?198. © 2019 American Journal of Preventive Medicine. Published by Elsevier
Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
INTRODUCTION
A
pproximately 19% of cisgender women and 2%
of cisgender men reported a lifetime history of
rape.1 Although these rates are alarming, young
adults experiencing homelessness are at even higher
risk than their housed peers, with a prevalence rate of
lifetime sexual assault as high as 35%.2 Sexual violence
contributes to high risk for HIV, sexually transmitted
infections (STIs), and unintended pregnancy.
In the general population, demographic factors such
as race, sexual orientation, and gender identity are
associated with an increased risk for sexual assault. Black
cisgender women are more likely to experience assault
From the 1Cizik School of Nursing, University of Texas Health Science
Center at Houston, Houston, Texas; 2Texas County Forensic Nurse Examiners, Houston, Texas; 3Graduate College of Social Work, University of
Houston, Houston, Texas; 4Graduate School of Social Work, University of
Denver, Denver, Colorado; 5Suzanne Dworak-Peck School of Social
Work, University of Southern California, Los Angeles, California; 6School
of Social Work, University of Missouri, Columbia, Missouri; 7Silberman
School of Social Work at Hunter College, New York, New York; and
8
School of Social Work, Arizona State University, Phoenix, Arizona
Address correspondence to: Diane Santa Maria, DrPH, RN, Cizik
School of Nursing, University of Texas Health Science Center at Houston,
6901 Bertner Avenue, Suite 591, Houston TX 77030.
E-mail: diane.m.santamaria@uth.tmc.edu.
0749-3797/$36.00
https://doi.org/10.1016/j.amepre.2019.09.023
© 2019 American Journal of Preventive Medicine. Published by Elsevier Inc.
Am J Prev Med 2020;58(2):191?198
This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
191
192
Santa Maria et al / Am J Prev Med 2020;58(2):191?198
before age 25 years compared with white cisgender
women, and black undergraduate students have higher
odds of sexual assault than white, Latinx, and Asian
students.3,4 Lesbian, gay, bisexual, queer (LGBQ), and
transgender youth report experiencing more sexual violence than heterosexual and cisgender youth,4 and transgender individuals experience sexual violence twice as
often as cisgender LGBQ individuals.5 Among those
experiencing homelessness, rates of sexual assault are
also higher in women than men and were highest among
transgender people.6?8 Other risk factors that have been
found to increase the risk of sexual assault include substance use, exposure to violence, child abuse, sexual
behaviors, peer relationships, health status, and homelessness experience, as well as early onset and longer
length of homelessness and trading sex.2,7,9?13
Major public health concerns of sexual violence are
exposure to HIV and STIs and unintended pregnancy.14?17
The Centers for Disease Control and Prevention treatment
guidelines for post?sexual assault care are aimed at targeting these risks.18 Use of HIV nonoccupational postexposure prophylaxis for sexual assault patients is recommended in the guidelines based on exposure timing and
characteristics.19 However, little is known about post?sexual assault healthcare utilization among youth experiencing
homelessness.
Care for acute sexual assault, including HIV/STIs and
unintended pregnancy prevention, often depends on a
youth to disclose sexual violence and seek care within the
brief post-assault window related to prevention medication
ef?cacy. Tragically, few people seek post?sexual assault
care at all, let alone in time for HIV and pregnancy prevention?based interventions. In a nationally representative
sample, only 21% of sexual assault patients sought medical
attention, with those who experienced physical assault
being more likely to disclose the sexual assault and seek
services.14,20 Other correlates of seeking post-assault medical care are race (identifying as black), experiencing genital
injuries, concern about STIs or pregnancy, and reporting
the incident to the police.14 Perceived shame, guilt, having
a relationship with the perpetrator, and having negative
past experiences with the healthcare system have been
associated with not seeking care.14,21?23 In addition,
healthcare-seeking behaviors are often lower among young
adults experiencing homelessness and adolescent boys and
young men.24,25
Experiencing sexual assault has signi?cant acute and
chronic physical and mental health implications,
highlighting the important role of prevention, screening,
and treatment interventions.26 Yet, the literature has 2
important limitations addressed in this study. First,
most studies among youth experiencing homelessness
are derived from single-city samples, which potentially
reduces the generalizability of the ?ndings. Second, little
has been published on the knowledge, incidence, and
correlates of post?sexual assault examination among
this population. Therefore, this study was conducted to
assess the prevalence and correlates of sexual assault and
utilization of post?sexual assault examination in a large
sample of youth experiencing homelessness from 7 cities
across the U.S. to inform prevention and healthcare
service delivery.
METHODS
Interdisciplinary researchers examined youth experiencing homelessness (aged 18?26 years) in Los Angeles, San Jose, Phoenix,
St. Louis, Denver, Houston, and New York City between June
2016 and July 2017. Using a cross-sectional study design and a
standardized study protocol, data were collected through a selfadministered survey completed on a tablet. IRBs at the authors’
academic institutions approved the study procedures.
Study Sample
Using purposive sampling, each site recruited approximately 200
unique young adults from service agencies including drop-in centers, shelters, and transitional housing to capture the variation in
experiences and demographics of young people accessing different
types of homeless services. Participation was limited to Englishspeaking youth owing to previous research indicating few non?
English speaking young adults are accessing homeless services.27
Youth at the service agencies during the data collection period
were approached and screened for eligibility. Participants had to
be aged 18?26 years and homeless or unstably housed.
A research assistant reviewed informed consent, and participants indicated whether they agreed to participate by clicking a
box on the tablet. After securing consent, a person identi?cation
code was generated for each participant. Next, the young person
completed the Rapid Estimate of Adult Literacy in Medicine short
form screener.28 Youth were asked to complete the self-administered survey independently on the tablet if they scored higher
than 3, though study staff were available to assist participants.
The survey took about 50 minutes to complete. Participants
received a $10 (in Phoenix) or $20 gift card (all other locations)
for a local store.
Measures
The survey assessed demographics and homelessness factors using
previously validated measures. Age was dichotomized as 18?21
and 22?26 years to align with federal and state legislation and
funding guidelines using 21 years as the maximum age for young
adults to remain in foster care and receive services funded by the
Runaway Homeless Youth Act.29,30 Youth self-identi?ed as cisgender men, cisgender women, transgender, or gender expansive.
Race/ethnicity was de?ned as white, black, Latinx, other, and
mixed race. Youth identi?ed as lesbian, gay, bisexual, queer, or
heterosexual. For homelessness, youth indicated where they slept
the night before (coded as couch sur?ng if they were staying with
a friend, relative, or acquaintance; sheltered if they stayed in a
shelter or transitional housing; and outside if they stayed in a
www.ajpmonline.org
Santa Maria et al / Am J Prev Med 2020;58(2):191?198
place not meant for human habitation). To assess for childhood
onset homelessness, age at ?rst homelessness was dichotomized as
before age 18 years or after age 18 years. Length of current homelessness was dichotomized as >2 years or
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