5 - (IOP 4) A Programmatic, Survivor-centered, and Trauma-informed Approach to Assessing Barriers and Facilitators in Sexual Assault Services

Sexual violence is a public health issue that disproportionately affects sexual and gender expansive individuals, people of color—particularly Indigenous and multiracial individuals—and those experiencing financial hardship (Basile et al., 2022; James et al., 2019). Although post-assault services exist, many survivors face barriers to accessing medical, mental health, advocacy, and legal support.

While research has examined barriers to help-seeking after sexual violence (e.g., Zinzow et al., 2021), no study to our knowledge has reviewed how measures assess these barriers. Assessing these measures is crucial for improving system and service design, particularly in understanding how structural- and organizational-level barriers shape service experiences for marginalized survivors. In our first study, we critically reviewed 10 measures assessing barriers and facilitators to service access after sexual violence, applying a socioecological framework to evaluate how these factors are assessed across individual, provider, community, and structural levels. Barriers at the community level were largely absent, and only three measures examined facilitators. Four measures included cultural or identity-specific factors and only three incorporated feedback from survivors. Many measures focused on a single service type, such as mental health care, while few measures were accessible, developed for diverse literacy levels, or translated beyond English.

To address these gaps, we developed the Barriers and Facilitators to Sexual Assault Services Scale (BF-SAS) using a trauma-informed, socioecological framework. We then conducted cognitive interviews with sexual assault survivors (n = 27) to refine survey items, ensuring they assessed lived experiences and culturally specific factors. Survivors identified provider dismissiveness, racial and gender-based discrimination, and fears of retaliation from perpetrators or authorities as major barriers. Many noted that services were fragmented and expressed a need for a single, coordinated system to meet multiple needs. Community stigma and fear of judgment from family, religious leaders, and peers discouraged help-seeking. Structural barriers, including limited trauma-informed care and lack of service visibility, further hindered access. Facilitators included trauma-informed, identity-affirming providers, confidential and culturally specific resources, and access to peer-led advocacy networks.

Findings highlight the need for trauma-informed, culturally responsive, and survivor-driven approaches to improve access to services. This presentation will discuss how survivor-informed insights can help researchers, clinicians, and service providers develop more affirming, accessible, and equitable systems of care. The Barriers and Facilitators to Sexual Assault Services Scale (BF-SAS) provides a practical tool for identifying and addressing barriers and facilitators across the socioecological model and can inform policy and practice efforts to improve service equity for underserved survivors.