CDC Recognizes Nurse Leader for Groundbreaking Research on Domestic Violence

RWJF Nurse Faculty Scholar program director honored for work to protect battered women from injury and death.

    • December 6, 2012

When Jacquelyn Campbell began working as a school nurse in the 1970s, she spent her days on the routine tasks of health care in an inner city high school: taking temperatures, counseling troubled youth, and trying to figure out if nauseated girls were pregnant. Although she worked with a few adolescents who were abused by their parents, preventing violence was out of her league, she thought.

Campbell, RN, PhD, FAAN, knows better now, thanks in large part to her groundbreaking research showing that nurses can work alongside partners in health care, law enforcement and social work to protect women from the ravages of domestic violence.

For her work, Campbell is being hailed as one of the 20 most influential researchers in injury prevention over the last 20 years by the Centers for Disease Control and Prevention (CDC). She is the only nurse to receive the prestigious distinction.

Campbell began her work in the field as a master’s student in nursing nearly four decades ago. At the time, she was tasked with working with a group of young African American women she had known during her days as a school nurse. These women faced challenges ranging from poverty and homelessness to teen pregnancy and violence. Campbell’s mission? To prevent the worst health problems they might face and, at the same time, identify a research project for her master’s thesis that would help these women survive and thrive.

Campbell decided to take a look at the national mortality statistics and was shocked to discover that the leading cause of death among young African American women was homicide. But these women weren’t dying from random violence in the streets or gang activity. When she looked closely at the local homicide records, she found they were being killed by the people who supposedly loved them most: their husbands, their boyfriends, and their ex-boyfriends. She had uncovered an epidemic of death by domestic violence.

More startling still was her discovery that many of the women who were killed had called the police or sought care at local emergency departments. Doctors and nurses, she came to realize, had treated many of these women before sending them back to face danger in their homes and communities. “It was clear to me then that we needed to do something about the problem in the health care system,” Campbell says.

Friend Stabbed to Death

Campbell’s conviction took on even greater urgency after a friend—a former student in the high school where she had worked—was stabbed to death by her boyfriend. Campbell had known them both well. But she had never suspected abuse—even though “the signs were there.” She had noticed bruises on her friend’s face but couldn’t imagine she was being beaten by her boyfriend. “It just never occurred to me that he was hitting her,” Campbell says.

That attitude reflected conventional wisdom at the time.

The grassroots movement to end domestic violence was just picking up steam, and few health providers knew how to recognize the problem and respond to it. Safe houses, also known as shelters, were just beginning to open their doors, rape crisis lines were just starting to take calls, and advocacy groups were in their infancy. It was years before domestic violence was officially declared a public health problem in the United States and decades before Congress enacted major legislation to address it.

“At the time, we had thought about child abuse as being a nursing issue,” Campbell recalls. “But we hadn’t really thought about the other forms of family violence, whether it was intimate partner violence, elder abuse, or community violence. For the most part, it was very much covered up. It was hardly considered to be against the law.”

After her discovery, Campbell saw the problem in a new light—as central, and not peripheral, to health care, and to nursing in particular. If nurses and other providers had a better understanding of the dangers facing abused women, they might be able to take steps to protect them from murderous partners, she surmised.

She was right. In 1980, while an assistant professor at Wayne State University School of Nursing, Campbell devised the Danger Assessment, a tool to determine a battered woman’s risk of being killed by her partner. From her original research, other homicide studies, and interviews with abused women, she found that certain behaviors and conditions were especially strong indicators of homicide. If a man had choked his partner or used a weapon against her, for example, he was more likely to end up killing her than other abusive men. Campbell also found that few abused women sought protection in shelter organizations and that those who did were much less likely to experience violent re-assault from intimate partners.

In the years since, Campbell has worked with law enforcement and the Maryland Network Against Domestic Violence, a state domestic violence advocacy organization, to turn the Danger Assessment into the Lethality Assessment Project—a field tool for use by first responders. The tool is now widely used in Maryland, and the results are encouraging. In Maryland, the number of women who are killed each year by partners or ex-partners has dropped 40 percent—a more precipitous decline than has been found in other states, according to a report in the New Republic that cites data from the U.S. Department of Justice.

The Danger Assessment is just one of Campbell’s many accomplishments over a long and luminous career. She has also conducted groundbreaking research on the health effects of violence and health care interventions; the neurological effects of traumatic brain injuries on women who are victims of partner violence; and the interplay of violence and the transmission of HIV/AIDS.

In addition to research, Campbell has also played a foundational role in building the subspecialty of research on domestic violence. Three decades ago, she helped create a network of nurse advocates, researchers, and educators in the field. The organization—the Nursing Network on Violence Against Women International—now has global reach. It is holding its 19th annual conference in 2013, and hundreds of nurses and nurse scientists are expected to attend.

Campbell has also played an influential role in the field as an educator and mentor to dozens of students and faculty in nursing and public health.

In 2008, she became the national program director of the Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars program, which aims to develop the next generation of leaders in academic nursing through career development awards for outstanding junior nursing faculty. In this position, she has dedicated considerable time and effort to supporting junior nurse faculty and diversifying the ranks of nurse scientists.

Some of the program’s scholars are conducting research in the area of Campbell’s specialty. Angela Amar, PhD, RN, FAAN, for example, is studying access to support services for young women on college campuses who are victims of violence; Kathryn Laughon, PhD, RN, FAAN, is studying the impact of intimate partner violence and sexual assault on young women; Tina Bloom is testing an online decision aide for abused women in rural settings; and Rosa Gonzales-Guarda, PhD, RN, MPH, is studying the intersection of substance abuse, intimate partner violence and risky sexual behaviors among Hispanic adolescents.

Mentoring nursing students and faculty is a labor of love that Campbell hopes to continue for years to come. “Mentoring students has multiplied the effects of my research tremendously,” she says. “It’s been so gratifying to see these students go on to do groundbreaking and totally original work of their own, and to know that I helped set them on that course.”

Read more about the CDC Injury Center’s 20th Anniversary 20 for 20 Project, through which the center is paying tribute to Campbell and other leaders and visionaries who have had a transformative effect on the field of violence and injury prevention.

Read about all of the RWJF scholars honored by the CDC for their pioneering work in injury prevention research here.

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