Understanding and Measuring Help-Seeking Barriers among Intimate Partner Violence Survivors: Mixed-Methods Validation Study of the Icelandic Barriers to Help-Seeking for Trauma (BHS-TR) Scale

Karen Birna Thorvaldsdottir, Sigridur Halldorsdottir and Denise M. Saint Arnault
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Karen Birna Thorvaldsdottir: School of Health Sciences, University of Akureyri, 600 Akureyri, Iceland
Sigridur Halldorsdottir: School of Health Sciences, University of Akureyri, 600 Akureyri, Iceland
Denise M. Saint Arnault: Department of Health Behavior and Biological Sciences, University of Michigan, Ann Arbor, MI 48109, USA

IJERPH, 2021, vol. 19, issue 1, 1-21

Abstract: Intimate partner violence (IPV) against women is a global human rights violation of vast proportions and a severe public health problem. Despite high rates of adverse outcomes related to IPV, help-seeking and service utilization among survivors is low. This exploratory sequential mixed-methods study using a combined etic–emic approach describes the validation of the Icelandic Barriers to Help-Seeking for Trauma (BHS-TR) scale. The qualitative phase involved developing new items based on the experiences of 17 Icelandic IPV survivors, identifying barriers including beliefs that help-seeking is a sign of weakness, and the desire to safeguard oneself from re-traumatization. The quantitative phase examined the psychometrics of the BHS-TR in a sample of 137 IPV survivors in Iceland. Results supported an eight-factor structure (Financial Concerns; Unavailable/Not Helpful; External Constraints; Inconvenience; Weakness/Vulnerability; Problem Management Beliefs; Frozen/Confused; and Shame), which when grouped comprised two indices of Structural and Internal Barriers. The scale’s internal consistency was high (α = 0.87), and the results provided evidence of convergent, discriminant, and known-group validity. This study adds to the growing literature supporting the advantages of applying mixed methods for instrument development and validation, and its results highlight the significance of giving rise to the voices of survivors. The BHS-TR is the first trauma-specific and survivor-centered measure of help-seeking barriers available in Iceland. It can be used to provide valuable information that may guide the development of evidence-based interventions to break down barriers and help survivors find ways to trauma recovery.

Keywords: interpersonal trauma; intimate partner violence; help-seeking; barriers; mental health; trauma recovery; survivor-centered; cross-cultural adaptation; validation; mixed-methods research (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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