title: Original research: Giving sexual assault survivors time to decide: an exploration of the use and effects of the nonreport option.
abstract: BACKGROUND
  Forensic nurses, sexual assault nurse examiners (SANEs), and victim advocates have long recognized the trauma of sexual assault crimes and the significance of survivors' decisions around reporting these crimes to law enforcement agencies. Until recently, survivors who didn't report the crime were not entitled to a free medical forensic examination. In a significant policy shift, the Violence Against Women and Department of Justice Reauthorization Act of 2005 provided an additional decision option with regard to the medical examination for survivors of sexual assault. This provision, referred to here as the nonreport option, was established to offer survivors a full range of reporting options and to ensure exemplary health care, with evidence collection as an important secondary goal.
  
  
  OBJECTIVE
  This study sought to examine the implementation of the nonreport option in Texas; explore its impact on SANEs, survivors, and the criminal justice system; and identify strengths and challenges of the nonreport process.
  
  
  METHODS
  A mixed-method approach was used that included qualitative interviews with 79 professionals who regularly respond to sexual assault crimes, a Web-based survey questionnaire of such professionals that yielded 131 completed surveys, and a review of existing data.
  
  
  RESULTS
  The step-by-step process involved in a nonreport case was described, and findings in three descriptive areas emerged: confidentiality processes, storage and shipment of evidence, and the use of the nonreport option. Beneficial effects of the nonreport option were identified in five areas: the role of SANEs, the impact on survivors, collaborative relationships, collateral crimes, and anonymous reporting strategies. Seven areas of remaining dilemmas were also identified.
  
  
  CONCLUSIONS
  Findings indicate that the nonreport option has had a considerable positive impact on SANEs, survivors of sexual assault, and the criminal justice system. But challenges remain if this option is to be fully utilized in the future; further research is warranted. The authors also present recommendations to improve health care delivery.
authors: Laurie Cook Heffron is a doctoral candidate at the University of Texas at Austin School of Social Work, where Noël Bridget Busch-Armendariz is a professor. Shetal S. Vohra is a research fellow at the Institute for Urban Policy Research and Analysis at the University of Texas at Austin College of Liberal Arts. Regina Jones Johnson is an associate professor at the University of Texas at Austin School of Nursing. Victoria Camp is an independent consultant in the field of sexual assault; at the time of research and writing, she was deputy director of the Texas Association Against Sexual Assault in Austin. This study was supported by the Office of the Governor of Texas, which administers the STOP Violence Against Women Formula Grant Program (subgrants 2293801 and 2287301). The opinions, findings, conclusions, and recommendations expressed in this article are those of the authors and do not necessarily reflect the views of the state of Texas or the U.S. Department of Justice's Office on Violence Against Women. Contact author: Laurie Cook Heffron, lcookheffron@austin.utexas.edu. The authors and planners have disclosed no potential conflicts of interest, financial or otherwise.
authors: Laurie Cook
authors: LC
authors: Heffron
authors: Noël Bridget
authors: NB
authors: Busch-Armendariz
authors: Shetal S
authors: SS
authors: Vohra
authors: Regina Jones
authors: RJ
authors: Johnson
authors: Victoria
authors: V
authors: Camp
mesh_terms: D000328:Adult; D003219:Confidentiality; D019548:Crime Victims / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D053604:Forensic Nursing / Q000331:legislation & jurisprudence*; D058869:Gynecological Examination / Q000706:statistics & numerical data*; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D010817:Physician-Patient Relations; D012742:Sex Offenses / Q000523:psychology / Q000706:statistics & numerical data*; D013781:Texas; D013997:Time Factors; D014481:United States