research paper on sexual harassment in the workplace

Sexual Harassment of Women: Climate, Culture, and Consequences in Academic Sciences, Engineering, and Medicine (2018)

Chapter: 7 findings, conclusions, and recommendations, 7 findings, conclusions, and recommendations.

Preventing and effectively addressing sexual harassment of women in colleges and universities is a significant challenge, but we are optimistic that academic institutions can meet that challenge—if they demonstrate the will to do so. This is because the research shows what will work to prevent sexual harassment and why it will work. A systemwide change to the culture and climate in our nation’s colleges and universities can stop the pattern of harassing behavior from impacting the next generation of women entering science, engineering, and medicine.

Changing the current culture and climate requires addressing all forms of sexual harassment, not just the most egregious cases; moving beyond legal compliance; supporting targets when they come forward; improving transparency and accountability; diffusing the power structure between faculty and trainees; and revising organizational systems and structures to value diversity, inclusion, and respect. Leaders at every level within academia will be needed to initiate these changes and to establish and maintain the culture and norms. However, to succeed in making these changes, all members of our nation’s college campuses—students, faculty, staff, and administrators—will need to assume responsibility for promoting a civil and respectful environment. It is everyone’s responsibility to stop sexual harassment.

In this spirit of optimism, we offer the following compilation of the report’s findings, conclusions, and recommendations.

FINDINGS AND CONCLUSIONS

Chapter 2: sexual harassment research.

• Sexual harassment is a form of discrimination that consists of three types of harassing behavior: (1) gender harassment (verbal and nonverbal behaviors that convey hostility, objectification, exclusion, or second-class status about members of one gender); (2) unwanted sexual attention (unwelcome verbal or physical sexual advances, which can include assault); and (3) sexual coercion (when favorable professional or educational treatment is conditioned on sexual activity). The distinctions between the types of harassment are important, particularly because many people do not realize that gender harassment is a form of sexual harassment.
• Sexually harassing behavior can be either direct (targeted at an individual) or ambient (a general level of sexual harassment in an environment) and is harmful in both cases. It is considered illegal when it creates a hostile environment (gender harassment or unwanted sexual attention that is “severe or pervasive” enough to alter the conditions of employment, interfere with one’s work performance, or impede one’s ability to get an education) or when it is quid pro quo sexual harassment (when favorable professional or educational treatment is conditioned on sexual activity).
• There are reliable scientific methods for determining the prevalence of sexual harassment. To measure the incidence of sexual harassment, surveys should follow the best practices that have emerged from the science of sexual harassment. This includes use of the Sexual Experiences Questionnaire, the most widely used and well-validated instrument available for measuring sexual harassment; assessment of specific behaviors without requiring the respondent to label the behaviors “sexual harassment”; focus on first-hand experience or observation of behavior (rather than rumor or hearsay); and focus on the recent past (1–2 years, to avoid problems of memory decay). Relying on the number of official reports of sexual harassment made to an organization is not an accurate method for determining the prevalence.
• Some surveys underreport the incidence of sexual harassment because they have not followed standard and valid practices for survey research and sexual harassment research.
• While properly conducted surveys are the best methods for estimating the prevalence of sexual harassment, other salient aspects of sexual harassment and its consequences can be examined using other research methods , such as behavioral laboratory experiments, interviews, case studies, ethnographies, and legal research. Such studies can provide information about the presence and nature of sexually harassing behavior in an organization, how it develops and continues (and influences the organizational climate), and how it attenuates or amplifies outcomes from sexual harassment.
• Women experience sexual harassment more often than men do.
• Gender harassment (e.g., behaviors that communicate that women do not belong or do not merit respect) is by far the most common type of sexual harassment. When an environment is pervaded by gender harassment, unwanted sexual attention and sexual coercion become more likely to occur—in part because unwanted sexual attention and sexual coercion are almost never experienced by women without simultaneously experiencing gender harassment.
• Men are more likely than women to commit sexual harassment.
• Coworkers and peers more often commit sexual harassment than do superiors.
• Sexually harassing behaviors are not typically isolated incidents; rather, they are a series or pattern of sometimes escalating incidents and behaviors.
• Women of color experience more harassment (sexual, racial/ethnic, or combination of the two) than white women, white men, and men of color do. Women of color often experience sexual harassment that includes racial harassment.
• Sexual- and gender-minority people experience more sexual harassment than heterosexual women do.
• The two characteristics of environments most associated with higher rates of sexual harassment are (a) male-dominated gender ratios and leadership and (b) an organizational climate that communicates tolerance of sexual harassment (e.g., leadership that fails to take complaints seriously, fails to sanction perpetrators, or fails to protect complainants from retaliation).
• Organizational climate is, by far, the greatest predictor of the occurrence of sexual harassment, and ameliorating it can prevent people from sexually harassing others. A person more likely to engage in harassing behaviors is significantly less likely to do so in an environment that does not support harassing behaviors and/or has strong, clear, transparent consequences for these behaviors.

Chapter 3: Sexual Harassment in Academic Science, Engineering, and Medicine

• Male-dominated environment , with men in positions of power and authority.
• Organizational tolerance for sexually harassing behavior (e.g., failing to take complaints seriously, failing to sanction perpetrators, or failing to protect complainants from retaliation).
• Hierarchical and dependent relationships between faculty and their trainees (e.g., students, postdoctoral fellows, residents).
• Isolating environments (e.g., labs, field sites, and hospitals) in which faculty and trainees spend considerable time.
• Greater than 50 percent of women faculty and staff and 20–50 percent of women students encounter or experience sexually harassing conduct in academia.
• Women students in academic medicine experience more frequent gender harassment perpetrated by faculty/staff than women students in science and engineering.
• Women students/trainees encounter or experience sexual harassment perpetrated by faculty/staff and also by other students/trainees.
• Women faculty encounter or experience sexual harassment perpetrated by other faculty/staff and also by students/trainees.
• Women students, trainees, and faculty in academic medical centers experience sexual harassment by patients and patients’ families in addition to the harassment they experience from colleagues and those in leadership positions.

Chapter 4: Outcomes of Sexual Harassment

• When women experience sexual harassment in the workplace, the professional outcomes include declines in job satisfaction; withdrawal from their organization (i.e., distancing themselves from the work either physically or mentally without actually quitting, having thoughts or

intentions of leaving their job, and actually leaving their job); declines in organizational commitment (i.e., feeling disillusioned or angry with the organization); increases in job stress; and declines in productivity or performance.

• When students experience sexual harassment, the educational outcomes include declines in motivation to attend class, greater truancy, dropping classes, paying less attention in class, receiving lower grades, changing advisors, changing majors, and transferring to another educational institution, or dropping out.
• Gender harassment has adverse effects. Gender harassment that is severe or occurs frequently over a period of time can result in the same level of negative professional and psychological outcomes as isolated instances of sexual coercion. Gender harassment, often considered a “lesser,” more inconsequential form of sexual harassment, cannot be dismissed when present in an organization.
• The greater the frequency, intensity, and duration of sexually harassing behaviors, the more women report symptoms of depression, stress, and anxiety, and generally negative effects on psychological well-being.
• The more women are sexually harassed in an environment, the more they think about leaving, and end up leaving as a result of the sexual harassment.
• The more power a perpetrator has over the target, the greater the impacts and negative consequences experienced by the target.
• For women of color, preliminary research shows that when the sexual harassment occurs simultaneously with other types of harassment (i.e., racial harassment), the experiences can have more severe consequences for them.
• Sexual harassment has adverse effects that affect not only the targets of harassment but also bystanders, coworkers, workgroups, and entire organizations.
• Women cope with sexual harassment in a variety of ways, most often by ignoring or appeasing the harasser and seeking social support.
• The least common response for women is to formally report the sexually harassing experience. For many, this is due to an accurate perception that they may experience retaliation or other negative outcomes associated with their personal and professional lives.
• The dependence on advisors and mentors for career advancement.
• The system of meritocracy that does not account for the declines in productivity and morale as a result of sexual harassment.
• The “macho” culture in some fields.
• The informal communication network , in which rumors and accusations are spread within and across specialized programs and fields.
• The cumulative effect of sexual harassment is significant damage to research integrity and a costly loss of talent in academic science, engineering, and medicine. Women faculty in science, engineering, and medicine who experience sexual harassment report three common professional outcomes: stepping down from leadership opportunities to avoid the perpetrator, leaving their institution, and leaving their field altogether.

Chapter 5: Existing Legal and Policy Mechanisms for Addressing Sexual Harassment

• An overly legalistic approach to the problem of sexual harassment is likely to misjudge the true nature and scope of the problem. Sexual harassment law and policy development has focused narrowly on the sexualized and coercive forms of sexual harassment, not on the gender harassment type that research has identified as much more prevalent and at times equally harmful.
• Much of the sexual harassment that women experience and that damages women and their careers in science, engineering, and medicine does not meet the legal criteria of illegal discrimination under current law.
• Private entities, such as companies and private universities, are legally allowed to keep their internal policies and procedures—and their research on those policies and procedures—confidential, thereby limiting the research that can be done on effective policies for preventing and handling sexual harassment.
• Various legal policies, and the interpretation of such policies, enable academic institutions to maintain secrecy and/or confidentiality regarding outcomes of sexual harassment investigations, arbitration, and settlement agreements. Colleagues may also hesitate to warn one another about sexual harassment concerns in the hiring or promotion context out of fear of legal repercussions (i.e., being sued for defamation and/or discrimination). This lack of transparency in the adjudication process within organizations can cover up sexual harassment perpetrated by repeat or serial harassers. This creates additional barriers to researchers

and others studying harassment claims and outcomes, and is also a barrier to determining the effectiveness of policies and procedures.

• Title IX, Title VII, and case law reflect the inaccurate assumption that a target of sexual harassment will promptly report the harassment without worrying about retaliation. Effectively addressing sexual harassment through the law, institutional policies or procedures, or cultural change requires taking into account that targets of sexual harassment are unlikely to report harassment and often face retaliation for reporting (despite this being illegal).
• Fears of legal liability may prevent institutions from being willing to effectively evaluate training for its measurable impact on reducing harassment. Educating employees via sexual harassment training is commonly implemented as a central component of demonstrating to courts that institutions have “exercised reasonable care to prevent and correct promptly any sexually harassing behavior.” However, research has not demonstrated that such training prevents sexual harassment. Thus, if institutions evaluated their training programs, they would likely find them to be ineffective, which, in turn, could raise fears within institutions of their risk for liability because they would then knowingly not be exercising reasonable care.
• Holding individuals and institutions responsible for sexual harassment and demonstrating that sexual harassment is a serious issue requires U.S. federal funding agencies to be aware when principal investigators, co-principal investigators, and grant personnel have violated sexual harassment policies. It is unclear whether and how federal agencies will take action beyond the requirements of Title IX and Title VII to ensure that federal grants, composed of taxpayers’ dollars, are not supporting research, academic institutions, or programs in which sexual harassment is ongoing and not being addressed. Federal science agencies usually indicate (e.g., in requests for proposals or other announcements) that they have a “no-tolerance” policy for sexual harassment. In general, federal agencies rely on the grantee institutions to investigate and follow through on Title IX violations. By not assessing and addressing the role of institutions and professional organizations in enabling individual sexual harassers, federal agencies may be perpetuating the problem of sexual harassment.
• To address the effect sexual harassment has on the integrity of research, parts of the federal government and several professional societies are beginning to focus more broadly on policies about research integrity and on codes of ethics rather than on the narrow definition of research misconduct. A powerful incentive for change may be missed if sexual harassment is not considered equally important as research misconduct, in terms of its effect on the integrity of research.

Chapter 6: Changing the Culture and Climate in Higher Education

• A systemwide change to the culture and climate in higher education is required to prevent and effectively address all three forms of sexual harassment. Despite significant attention in recent years, there is no evidence to suggest that current policies, procedures, and approaches have resulted in a significant reduction in sexual harassment. It is time to consider approaches that address the systems, cultures, and climates that enable sexual harassment to perpetuate.
• Strong and effective leaders at all levels in the organization are required to make the systemwide changes to climate and culture in higher education. The leadership of the organization—at every level—plays a significant role in establishing and maintaining an organization’s culture and norms. However, leaders in academic institutions rarely have leadership training to thoughtfully address culture and climate issues, and the leadership training that exists is often of poor quality.
• Evidence-based, effective intervention strategies are available for enhancing gender diversity in hiring practices.
• Focusing evaluation and reward structures on cooperation and collegiality rather than solely on individual-level teaching and research performance metrics could have a significant impact on improving the environment in academia.
• Evidence-based, effective intervention strategies are available for raising levels of interpersonal civility and respect in workgroups and teams.
• An organization that is committed to improving organizational climate must address issues of bias in academia. Training to reduce personal bias can cause larger-scale changes in departmental behaviors in an academic setting.
• Skills-based training that centers on bystander intervention promotes a culture of support, not one of silence. By calling out negative behaviors on the spot, all members of an academic community are helping to create a culture where abusive behavior is seen as an aberration, not as the norm.
• Reducing hierarchical power structures and diffusing power more broadly among faculty and trainees can reduce the risk of sexual ha

rassment. Departments and institutions could take the following approaches for diffusing power:

• Make use of egalitarian leadership styles that recognize that people at all levels of experience and expertise have important insights to offer.
• Adopt mentoring networks or committee-based advising that allows for a diversity of potential pathways for advice, funding, support, and informal reporting of harassment.
• Develop ways the research funding can be provided to the trainee rather than just the principal investigator.
• Take on the responsibility for preserving the potential work of the research team and trainees by redistributing the funding if a principal investigator cannot continue the work because he/she has created a climate that fosters sexual harassment and guaranteeing funding to trainees if the institution or a funder pulls funding from the principal investigator because of sexual harassment.
• Orienting students, trainees, faculty, and staff, at all levels, to the academic institution’s culture and its policies and procedures for handling sexual harassment can be an important piece of establishing a climate that demonstrates sexual harassment is not tolerated and targets will be supported.
• Institutions could build systems of response that empower targets by providing alternative and less formal means of accessing support services, recording information, and reporting incidents without fear of retaliation.
• Supporting student targets also includes helping them to manage their education and training over the long term.
• Confidentiality and nondisclosure agreements isolate sexual harassment targets by limiting their ability to speak with others about their experiences and can serve to shield perpetrators who have harassed people repeatedly.
• Key components of clear anti-harassment policies are that they are quickly and easily digested (i.e., using one-page flyers or infographics and not in legally dense language) and that they clearly state that people will be held accountable for violating the policy.
• A range of progressive/escalating disciplinary consequences (such as counseling, changes in work responsibilities, reductions in pay/benefits, and suspension or dismissal) that corresponds to the severity and frequency of the misconduct has the potential of correcting behavior before it escalates and without significantly disrupting an academic program.
• In an effort to change behavior and improve the climate, it may also be appropriate for institutions to undertake some rehabilitation-focused measures, even though these may not be sanctions per se.
• For the people in an institution to understand that the institution does not tolerate sexual harassment, it must show that it does investigate and then hold perpetrators accountable in a reasonable timeframe. Institutions can anonymize the basic information and provide regular reports that convey how many reports are being investigated and what the outcomes are from the investigation.
• An approach for improving transparency and demonstrating that the institution takes sexual harassment seriously is to encourage internal review of its policies, procedures, and interventions for addressing sexual harassment, and to have interactive dialogues with members of their campus community (especially expert researchers on these topics) around ways to improve the culture and climate and change behavior.
• Cater training to specific populations; in academia this would include students, postdoctoral fellows, staff, faculty, and those in leadership.
• Attend to the institutional motivation for training , which can impact the effectiveness of the training; for instance, compliance-based approaches have limited positive impact.
• Conduct training using live qualified trainers and offer trainees specific examples of inappropriate conduct. We note that a great deal of sexual harassment training today is offered via an online mini-course or the viewing of a short video.
• Describe standards of behavior clearly and accessibly (e.g., avoiding legal and technical terms).
• To the extent that the training literature provides broad guidelines for creating impactful training that can change climate and behavior, they include the following:
• Establish standards of behavior rather than solely seek to influence attitudes and beliefs. Clear communication of behavioral expectations, and teaching of behavioral skills, is essential.
• Conduct training in adherence to best standards , including appropriate pre-training needs assessment and evaluation of its effectiveness.
• Creating a climate that prevents sexual harassment requires measuring the climate in relation to sexual harassment, diversity, and respect, and assessing progress in reducing sexual harassment.
• Efforts to incentivize systemwide changes, such as Athena SWAN, 1 are crucial to motivating organizations and departments within organizations to make the necessary changes.
• Enacting new codes of conduct and new rules related specifically to conference attendance.
• Including sexual harassment in codes of ethics and investigating reports of sexual harassment. (This is a new responsibility for professional societies, and these organizations are considering how to take into consideration the law, home institutions, due process, and careful reporting when dealing with reports of sexual harassment.)
• Requiring members to acknowledge, in writing, the professional society’s rules and codes of conduct relating to sexual harassment during conference registration and during membership sign-up and renewal.
• Supporting and designing programs that prevent harassment and provide skills to intervene when someone is being harassed.
• Strengthening statements on sexual harassment, bullying, and discrimination in professional societies’ codes of conduct, with a few defining it as research misconduct.
• Factoring in harassment-related professional misconduct into scientific award decisions.
• Professional societies have the potential to be powerful drivers of change through their capacity to help educate, train, codify, and reinforce cultural expectations for their respective scientific, engineering, and medical communities. Some professional societies have taken action to prevent and respond to sexual harassment among their membership. Although each professional society has taken a slightly different approach to addressing sexual harassment, there are some shared approaches, including the following:

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1 Athena SWAN (Scientific Women’s Academic Network). See https://www.ecu.ac.uk/equalitycharters/athena-swan/ .

• There are many promising approaches to changing the culture and climate in academia; however, further research assessing the effects and values of the following approaches is needed to identify best practices:
• Policies, procedures, trainings, and interventions, specifically how they prevent and stop sexually harassing behavior, alter perception of organizational tolerance for sexually harassing behavior, and reduce the negative consequences from reporting the incidents. This includes informal and formal reporting mechanisms, bystander intervention training, academic leadership training, sexual harassment training, interventions to improve civility, mandatory reporting requirements, and approaches to supporting and improving communication with the target.
• Mechanisms for target-led resolution options and mechanisms by which the target has a role in deciding what happens to the perpetrator, including restorative justice practices.
• Mechanisms for protecting targets from retaliation.
• Rehabilitation-focused measures for disciplining perpetrators.
• Incentive systems for encouraging leaders in higher education to address the issues of sexual harassment on campus.

RECOMMENDATIONS

RECOMMENDATION 1: Create diverse, inclusive, and respectful environments.

• Academic institutions and their leaders should take explicit steps to achieve greater gender and racial equity in hiring and promotions, and thus improve the representation of women at every level.
• Academic institutions and their leaders should take steps to foster greater cooperation, respectful work behavior, and professionalism at the faculty, staff, and student/trainee levels, and should evaluate faculty and staff on these criteria in hiring and promotion.
• Academic institutions should combine anti-harassment efforts with civility-promotion programs.
• Academic institutions should cater their training to specific populations (in academia these should include students/trainees, staff, faculty, and those in leadership) and should follow best practices in designing training programs. Training should be viewed as the means of providing the skills needed by all members of the academic community, each of whom has a role to play in building a positive organizational climate focused on safety and respect, and not simply as a method of ensuring compliance with laws.
• Academic institutions should utilize training approaches that develop skills among participants to interrupt and intervene when inappropriate behavior occurs. These training programs should be evaluated to deter

mine whether they are effective and what aspects of the training are most important to changing culture.

• Anti–sexual harassment training programs should focus on changing behavior, not on changing beliefs. Programs should focus on clearly communicating behavioral expectations, specifying consequences for failing to meet these expectations, and identifying the mechanisms to be utilized when these expectations are not met. Training programs should not be based on the avoidance of legal liability.

RECOMMENDATION 2: Address the most common form of sexual harassment: gender harassment.

Leaders in academic institutions and research and training sites should pay increased attention to and enact policies that cover gender harassment as a means of addressing the most common form of sexual harassment and of preventing other types of sexually harassing behavior.

RECOMMENDATION 3: Move beyond legal compliance to address culture and climate.

Academic institutions, research and training sites, and federal agencies should move beyond interventions or policies that represent basic legal compliance and that rely solely on formal reports made by targets. Sexual harassment needs to be addressed as a significant culture and climate issue that requires institutional leaders to engage with and listen to students and other campus community members.

RECOMMENDATION 4: Improve transparency and accountability.

• Academic institutions need to develop—and readily share—clear, accessible, and consistent policies on sexual harassment and standards of behavior. They should include a range of clearly stated, appropriate, and escalating disciplinary consequences for perpetrators found to have violated sexual harassment policy and/or law. The disciplinary actions taken should correspond to the severity and frequency of the harassment. The disciplinary actions should not be something that is often considered a benefit for faculty, such as a reduction in teaching load or time away from campus service responsibilities. Decisions regarding disciplinary actions, if indicated or required, should be made in a fair and timely way following an investigative process that is fair to all sides. 2
• Academic institutions should be as transparent as possible about how they are handling reports of sexual harassment. This requires balancing issues of confidentiality with issues of transparency. Annual reports,

2 Further detail on processes and guidance for how to fairly and appropriately investigate and adjudicate these issues are not provided because they are complex issues that were beyond the scope of this study.

that provide information on (1) how many and what type of policy violations have been reported (both informally and formally), (2) how many reports are currently under investigation, and (3) how many have been adjudicated, along with general descriptions of any disciplinary actions taken, should be shared with the entire academic community: students, trainees, faculty, administrators, staff, alumni, and funders. At the very least, the results of the investigation and any disciplinary action should be shared with the target(s) and/or the person(s) who reported the behavior.

• Academic institutions should be accountable for the climate within their organization. In particular, they should utilize climate surveys to further investigate and address systemic sexual harassment, particularly when surveys indicate specific schools or facilities have high rates of harassment or chronically fail to reduce rates of sexual harassment.
• Academic institutions should consider sexual harassment equally important as research misconduct in terms of its effect on the integrity of research. They should increase collaboration among offices that oversee the integrity of research (i.e., those that cover ethics, research misconduct, diversity, and harassment issues); centralize resources, information, and expertise; provide more resources for handling complaints and working with targets; and implement sanctions on researchers found guilty of sexual harassment.

RECOMMENDATION 5: Diffuse the hierarchical and dependent relationship between trainees and faculty.

Academic institutions should consider power-diffusion mechanisms (i.e., mentoring networks or committee-based advising and departmental funding rather than funding only from a principal investigator) to reduce the risk of sexual harassment.

RECOMMENDATION 6: Provide support for the target.

Academic institutions should convey that reporting sexual harassment is an honorable and courageous action. Regardless of a target filing a formal report, academic institutions should provide means of accessing support services (social services, health care, legal, career/professional). They should provide alternative and less formal means of recording information about the experience and reporting the experience if the target is not comfortable filing a formal report. Academic institutions should develop approaches to prevent the target from experiencing or fearing retaliation in academic settings.

RECOMMENDATION 7: Strive for strong and diverse leadership.

• College and university presidents, provosts, deans, department chairs, and program directors must make the reduction and prevention of sexual

harassment an explicit goal of their tenure. They should publicly state that the reduction and prevention of sexual harassment will be among their highest priorities, and they should engage students, faculty, and staff (and, where appropriate, the local community) in their efforts.

• Academic institutions should support and facilitate leaders at every level (university, school/college, department, lab) in developing skills in leadership, conflict resolution, mediation, negotiation, and de-escalation, and should ensure a clear understanding of policies and procedures for handling sexual harassment issues. Additionally, these skills development programs should be customized to each level of leadership.
• Leadership training programs for those in academia should include training on how to recognize and handle sexual harassment issues, and how to take explicit steps to create a culture and climate to reduce and prevent sexual harassment—and not just protect the institution against liability.

RECOMMENDATION 8: Measure progress.

Academic institutions should work with researchers to evaluate and assess their efforts to create a more diverse, inclusive, and respectful environment, and to create effective policies, procedures, and training programs. They should not rely on formal reports by targets for an understanding of sexual harassment on their campus.

• When organizations study sexual harassment, they should follow the valid methodologies established by social science research on sexual harassment and should consult subject-matter experts. Surveys that attempt to ascertain the prevalence and types of harassment experienced by individuals should adopt the following practices: ensure confidentiality, use validated behavioral instruments such as the Sexual Experiences Questionnaire, and avoid specifically using the term “sexual harassment” in any survey or questionnaire.
• Academic institutions should also conduct more wide-ranging assessments using measures in addition to campus climate surveys, for example, ethnography, focus groups, and exit interviews. These methods are especially important in smaller organizational units where surveys, which require more participants to yield meaningful data, might not be useful.
• Organizations studying sexual harassment in their environments should take into consideration the particular experiences of people of color and sexual- and gender-minority people, and they should utilize methods that allow them to disaggregate their data by race, ethnicity, sexual orientation, and gender identity to reveal the different experiences across populations.
• The results of climate surveys should be shared publicly to encourage transparency and accountability and to demonstrate to the campus community that the institution takes the issue seriously. One option would be for academic institutions to collaborate in developing a central repository for reporting their climate data, which could also improve the ability for research to be conducted on the effectiveness of institutional approaches.
• Federal agencies and foundations should commit resources to develop a tool similar to ARC3, the Administrator-Researcher Campus Climate Collaborative, to understand and track the climate for faculty, staff, and postdoctoral fellows.

RECOMMENDATION 9: Incentivize change.

• Academic institutions should work to apply for awards from the emerging STEM Equity Achievement (SEA Change) program. 3 Federal agencies and private foundations should encourage and support academic institutions working to achieve SEA Change awards.
• Accreditation bodies should consider efforts to create diverse, inclusive, and respectful environments when evaluating institutions or departments.
• Federal agencies should incentivize efforts to reduce sexual harassment in academia by requiring evaluations of the research environment, funding research and evaluation of training for students and faculty (including bystander intervention), supporting the development and evaluation of leadership training for faculty, and funding research on effective policies and procedures.

RECOMMENDATION 10: Encourage involvement of professional societies and other organizations.

• Professional societies should accelerate their efforts to be viewed as organizations that are helping to create culture changes that reduce or prevent the occurrence of sexual harassment. They should provide support and guidance for members who have been targets of sexual harassment. They should use their influence to address sexual harassment in the scientific, medical, and engineering communities they represent and promote a professional culture of civility and respect. The efforts of the American Geophysical Union are especially exemplary and should be considered as a model for other professional societies to follow.
• Other organizations that facilitate the research and training of people in science, engineering, and medicine, such as collaborative field sites (i.e., national labs and observatories), should establish standards of behavior

3 See https://www.aaas.org/news/sea-change-program-aims-transform-diversity-efforts-stem .

and set policies, procedures, and practices similar to those recommended for academic institutions and following the examples of professional societies. They should hold people accountable for their behaviors while at their facility regardless of the person’s institutional affiliation (just as some professional societies are doing).

RECOMMENDATION 11: Initiate legislative action.

State legislatures and Congress should consider new and additional legislation with the following goals:

• Better protecting sexual harassment claimants from retaliation.
• Prohibiting confidentiality in settlement agreements that currently enable harassers to move to another institution and conceal past adjudications.
• Banning mandatory arbitration clauses for discrimination claims.
• Allowing lawsuits to be filed against alleged harassers directly (instead of or in addition to their academic employers).
• Requiring institutions receiving federal funds to publicly disclose results from campus climate surveys and/or the number of sexual harassment reports made to campuses.
• Requesting the National Science Foundation and the National Institutes of Health devote research funds to doing a follow-up analysis on the topic of sexual harassment in science, engineering, and medicine in 3 to 5 years to determine (1) whether research has shown that the prevalence of sexual harassment has decreased, (2) whether progress has been made on implementing these recommendations, and (3) where to focus future efforts.

RECOMMENDATION 12: Address the failures to meaningfully enforce Title VII’s prohibition on sex discrimination.

• Judges, academic institutions (including faculty, staff, and leaders in academia), and administrative agencies should rely on scientific evidence about the behavior of targets and perpetrators of sexual harassment when assessing both institutional compliance with the law and the merits of individual claims.
• Federal judges should take into account demonstrated effectiveness of anti-harassment policies and practices such as trainings, and not just their existence , for use of an affirmative defense against a sexual harassment claim under Title VII.

RECOMMENDATION 13: Increase federal agency action and collaboration.

Federal agencies should do the following:

• Increase support for research and evaluation of the effectiveness of policies, procedures, and training on sexual harassment.
• Attend to sexual harassment with at least the same level of attention and resources as devoted to research misconduct. They should increase collaboration among offices that oversee the integrity of research (i.e., those that cover ethics, research misconduct, diversity, and harassment issues); centralize resources, information, and expertise; provide more resources for handling complaints and working with targets; and implement sanctions on researchers found guilty of sexual harassment.
• Require institutions to report to federal agencies when individuals on grants have been found to have violated sexual harassment policies or have been put on administrative leave related to sexual harassment, as the National Science Foundation has proposed doing. Agencies should also hold accountable the perpetrator and the institution by using a range of disciplinary actions that limit the negative effects on other grant personnel who were either the target of the harassing behavior or innocent bystanders.
• Reward and incentivize colleges and universities for implementing policies, programs, and strategies that research shows are most likely to and are succeeding in reducing and preventing sexual harassment.

RECOMMENDATION 14: Conduct necessary research.

Funders should support the following research:

• The sexual harassment experiences of women in underrepresented and/or vulnerable groups, including women of color, disabled women, immigrant women, sexual- and gender-minority women, postdoctoral trainees, and others.
• Policies, procedures, trainings, and interventions, specifically their ability to prevent and stop sexually harassing behavior, to alter perception of organizational tolerance for sexually harassing behavior, and to reduce the negative consequences from reporting the incidents. This should include research on informal and formal reporting mechanisms, bystander intervention training, academic leadership training, sexual harassment and diversity training, interventions to improve civility, mandatory reporting requirements, and approaches to supporting and improving communication with the target.
• Approaches for mitigating the negative impacts and outcomes that targets experience.
• The prevalence and nature of sexual harassment within specific fields in

science, engineering, and medicine and that follows good practices for sexual harassment surveys.

• The prevalence and nature of sexual harassment perpetrated by students on faculty.
• The amount of sexual harassment that serial harassers are responsible for.
• The prevalence and effect of ambient harassment in the academic setting.
• The connections between consensual relationships and sexual harassment.
• Psychological characteristics that increase the risk of perpetrating different forms of sexually harassing behaviors.

RECOMMENDATION 15: Make the entire academic community responsible for reducing and preventing sexual harassment.

All members of our nation’s college campuses—students, trainees, faculty, staff, and administrators—as well as members of research and training sites should assume responsibility for promoting civil and respectful education, training, and work environments, and stepping up and confronting those whose behaviors and actions create sexually harassing environments.

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Over the last few decades, research, activity, and funding has been devoted to improving the recruitment, retention, and advancement of women in the fields of science, engineering, and medicine. In recent years the diversity of those participating in these fields, particularly the participation of women, has improved and there are significantly more women entering careers and studying science, engineering, and medicine than ever before. However, as women increasingly enter these fields they face biases and barriers and it is not surprising that sexual harassment is one of these barriers.

Over thirty years the incidence of sexual harassment in different industries has held steady, yet now more women are in the workforce and in academia, and in the fields of science, engineering, and medicine (as students and faculty) and so more women are experiencing sexual harassment as they work and learn. Over the last several years, revelations of the sexual harassment experienced by women in the workplace and in academic settings have raised urgent questions about the specific impact of this discriminatory behavior on women and the extent to which it is limiting their careers.

Sexual Harassment of Women explores the influence of sexual harassment in academia on the career advancement of women in the scientific, technical, and medical workforce. This report reviews the research on the extent to which women in the fields of science, engineering, and medicine are victimized by sexual harassment and examines the existing information on the extent to which sexual harassment in academia negatively impacts the recruitment, retention, and advancement of women pursuing scientific, engineering, technical, and medical careers. It also identifies and analyzes the policies, strategies and practices that have been the most successful in preventing and addressing sexual harassment in these settings.

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• Sexual Harassment at Work in the Era of #MeToo

Many see new difficulties for men in workplace interactions and little effect on women’s career opportunities

Table of contents.

• Acknowledgments
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Recent allegations against prominent men in entertainment, politics, the media and other industries have sparked increased attention to the issue of sexual harassment and assault, in turn raising questions about the treatment of the accused and the accusers and what lies ahead for men and women in the workplace .

A new Pew Research Center survey finds that, when it comes to sexual harassment in the workplace, more Americans think men getting away with it and female accusers not being believed are major problems than say the same about employers firing men before finding out all the facts or women making false accusations. And while these attitudes differ somewhat by gender, they vary most dramatically between Democrats and Republicans.

The nationally representative survey of 6,251 adults was conducted online Feb. 26-March 11, 2018, using Pew Research Center’s American Trends Panel . 1

Many Americans also believe the increased focus on sexual harassment and assault poses new challenges for men as they navigate their interactions with women at work. About half (51%) say the recent developments have made it harder for men to know how to interact with women in the workplace. Only 12% say this increased focus has made it easier for men, and 36% say it hasn’t made much difference.

At the same time, Americans see little upside for women’s workplace opportunities as a result of the increased focus on sexual harassment and assault. Just 28% say it will lead to more opportunities for women in the workplace in the long run, while a somewhat smaller share (20%) say it will lead to fewer opportunities and 51% say it won’t make much of a difference.

The survey also finds that 59% of women and 27% of men say they have personally received unwanted sexual advances or verbal or physical harassment of a sexual nature, whether in or outside of a work context. Among women who say they have been sexually harassed, more than half (55%) say it has happened both in and outside of work settings.

Large partisan gaps in concerns about men getting away with sexual harassment and women not being believed

When asked about sexual harassment and sexual assault in the workplace today, half of Americans think that men getting away with this type of behavior is a major problem. Similarly, 46% see women not being believed when they claim they have experienced sexual harassment or assault as a major problem.

Smaller shares see premature firings (34%) and false claims of sexual harassment or assault (31%) as major problems.

In general, women are more likely than men to be concerned about sexual harassment going unpunished and victims not being believed. Some 52% of women say that women not being believed is a major problem, compared with 39% of men. And while a 55% majority of women think that men getting away with sexual harassment is a major problem, 44% of men say the same. Men and women express similar levels of concern over employers firing men who have been accused of sexual harassment before knowing all the facts and about women making false claims of sexual harassment.

Concerns about sexual harassment in the workplace vary even more widely along partisan lines when it comes to men getting away with it and women not being believed. About six-in-ten Democrats and Democratic-leaning independents say that men getting away with sexual harassment (62%) and women not being believed when they claim they have experienced it (60%) are major problems. By contrast, just 33% of Republicans and Republican-leaning independents see men getting away with it as a major problem, and 28% say the same about women not being believed.

Because the gender gap exists within each party coalition, this leaves Democratic women as the most concerned and Republican men as the least on both of these questions. For example, 63% of Democratic women and 56% of Democratic men say that women not being believed is a major problem, compared with 34% of Republican women and 21% of Republican men.

Conversely, Republicans are somewhat more likely than Democrats to say that employers prematurely firing men accused of sexual harassment is a major problem (38% vs. 31%) and to say the same about women falsely claiming they have experienced sexual harassment (34% vs. 29%).

Democrats who describe their political views as liberal express particularly high levels of concern about men getting away with sexual harassment (71% vs. 55% of moderate or conservative Democrats say this is a major problem) and women not being believed (67% vs. 54%). In contrast, moderate or conservative Democrats are more likely than their liberal counterparts to express concern about men accused of sexual harassment being fired prematurely and women making false accusations. A similar pattern is evident among Democrats with at least a bachelor’s degree and those with less education. For example, 39% of Democrats with a high school diploma or less education see employers firing accused men prematurely as a major problem, compared with 32% of those with some college experience and 22% of those with at least a bachelor’s degree. Differences by ideology and educational level tend to be less pronounced among Republicans.

Older adults, Republicans more likely to say increased focus on sexual harassment has made it harder for men to know how to interact with women in the workplace

Many Americans see the increased focus on sexual harassment and assault as potentially creating challenges for men at work while not necessarily having a positive impact for women in terms of career opportunities. About half (51%) think the increased attention to the issue has made it harder for men to know how to interact with women in the workplace, while 12% say it’s made it easier for men and 36% say it hasn’t made much difference.

At least a plurality of men (55%) and women (47%) say the recent developments have made it harder for men to navigate workplace interactions. There is a large partisan gap on this question, however, with Republicans and Republican-leaning independents far more likely than Democrats and Democratic leaners to say the increased focus on sexual harassment and assault has made it harder for men to know how to interact with women in the workplace. Most Republicans (64%) say this is the case, compared with 42% of Democrats.

Republican men are particularly likely to express this view: 68% say workplace interactions with women are harder now, compared with a narrower majority of Republican women (59%). Democratic men and women are both far less likely to say the same (45% and 40%, respectively).

There is a significant age gap on this question as well. Among adults ages 65 and older, about two-thirds (66%) say the heightened attention has made navigating workplace interactions more difficult for men. By comparison, 52% of those ages 50 to 64, 47% of those 30 to 49 and 42% of those younger than 30 say the same.

Roughly half of all adults say the increased focus on sexual harassment will have little impact on women’s career opportunities

A relatively small share of Americans think the increased focus on sexual harassment and assault will lead to more opportunities for women in the workplace in the long run. Roughly three-in-ten (28%) expect this outcome, while 20% believe this will lead to fewer opportunities for women and 51% say it won’t make much difference. Men and women express similar views on this question.

Democrats and Democratic-leaning independents are far more likely than Republicans and Republican leaners to say women will have more opportunities in the workplace in the long run as a result of the increased focus on sexual harassment. About four-in-ten Democrats (39%) say this, compared with just 15% of Republicans. Liberal Democrats are especially likely to hold this view – about half (48%) think the increased attention to sexual harassment will lead to more opportunities for women, while about three-in-ten moderate or conservative Democrats (31%) say the same.

Among Democrats, views on this issue vary by educational attainment. About half of Democrats with a bachelor’s degree or more education (52%) think this increased focus will lead to more opportunities for women, compared with 37% of those with some college experience and 29% of those with a high school education or less.

About six-in-ten women say they have received unwanted sexual advances or experienced sexual harassment

Some 44% of Americans say they have received unwanted sexual advances or verbal or physical harassment of a sexual nature. About six-in-ten women (59%) say they have experienced this, while 27% of men say the same.

Among women, those with at least some college education are far more likely than those with less education to say they have experienced sexual harassment. Seven-in-ten women with a bachelor’s degree or more education and 65% of women with some college but no bachelor’s degree say they have been sexually harassed, compared with 46% of women with a high school education or less.

Reports of unwanted sexual advances or sexual harassment are also more common among white women: 63% in this group say this has happened to them, compared with half of black and Hispanic women. The shares of women saying they have been sexually harassed are largely similar across age groups.

While somewhat higher shares of Democratic than Republican women say they have received unwanted sexual advances or experienced sexual harassment, majorities of both groups say this has happened to them (63% vs. 56%).

Among women who say they have received unwanted sexual advances or experienced sexual harassment, more than half (55%) say this has happened to them both in and outside of a professional or work setting. Overall, 69% of women who say they have experienced sexual harassment say this happened in a professional or work setting; 85% say they have experienced this outside of work.

Among men who say they have been sexually harassed, roughly four-in-ten (42%) say they experienced it both in and out of work situations. Overall, about six-in-ten men who say they have been sexually harassed (61%) say it happened in a professional or work setting; 80% say they experienced this outside of a work situation.

Men and women who say they have experienced sexual harassment are more likely than their counterparts to say that men getting away with sexual harassment or assault is a major problem. Fully 61% of women and 51% of men who say they have experienced sexual harassment hold this view, compared with 46% of women and 41% of men who say they have not been sexually harassed.

On other concerns related to sexual harassment in the workplace, the views of men do not vary by whether they report experiencing sexual harassment or not. Among women, however, the experience of sexual harassment is linked to concerns about this issue. For example, 58% of women who say they have experienced sexual harassment say that women not being believed is a major problem when it comes to sexual harassment in the workplace, compared with 43% of women who do not report having been sexually harassed.

All references to party affiliation include those who lean toward that party: Republicans include those who identify as Republicans and independents who say they lean toward the Republican Party, and Democrats include those who identify as Democrats and independents who say they lean toward the Democratic Party.

References to college graduates or people with a college degree comprise those with a bachelor’s degree or more. “Some college” includes those with an associate degree and those who attended college but did not obtain a degree. “High school” refers to those who have a high school diploma or its equivalent, such as a General Education Development (GED) certificate.

References to whites and blacks include only those who are non-Hispanic and identify as only one race. Hispanics are of any race.

• For more details, see the Methodology section of the report. ↩

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Sexual Harassment in Workplace: A Literature Review

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Half of Women in New Hampshire Have Experienced Sexual Harassment at Work

• Kristin Smith
• Sharyn Potter
• Jane Stapleton

  download the brief

Key findings.

Over half of women and nearly one-quarter of men in New Hampshire have been victims of sexual harassment at their workplaces during their lifetimes.

Women are more likely to state they suffered work-related consequences (for example, financial loss, being fired or demoted) than men (33 percent and 25 percent, respectively), but similar shares reported quitting their jobs as a result of the harassment (21 percent and 17 percent, respectively).

Sexual harassment in the workplace is a serious problem affecting workers across the United States and in New Hampshire. Nationwide, approximately four in ten women and more than one in ten men have been victims of workplace sexual harassment in their lifetimes. 1 Research shows that such harassment has lasting economic, health, and family-related consequences for victims and their families: it increases victims’ job exits and financial stress, alters career paths, and has deleterious consequences for mental and physical health, including depression, anger, and self-doubt. 2

In New Hampshire, more than half of women (52 percent) and nearly one quarter of men (22 percent) have been victims of sexual harassment at work during their lifetimes (Table 1), 3 and women are more likely than men to have experienced any type of sexual harassment. Four in ten women reported being stared at, leered at, or ogled in a way that made them feel uncomfortable; one-third reported that coworkers had made offensive remarks about their appearance, body, or sexual activities; and about one-quarter (24 percent) reported that they were touched in an uncomfortable way or that someone exposed themselves physically while they were at work. About one-quarter of women reported that others displayed, used, or distributed sexist materials while at work; and over 10 percent reported that others threatened retaliation for not being sexually cooperative or implied faster promotion for being sexually cooperative. Just over 10 percent of men reported that coworkers made offensive remarks about their appearance, body, or sexual activities or that others displayed, used, or distributed sexist materials while at work; just under 10 percent of men reported experiencing other types of workplace sexual harassment.

Women More Likely to Suffer Work-Related Consequences Than Men

The detrimental consequences of workplace sexual harassment can be multifaceted and lasting, with negative effects on victims, their families, and workplaces. Victims of workplace sexual harassment suffer work-related consequences, including quitting their job, being fired or demoted, experiencing a voluntary or involuntary work transfer, taking leave, or having their work schedule modified. When asked to consider their most recent sexual harassment experience, women in the New Hampshire survey were more likely to state they suffered a work-related consequence than men (33 percent and 25 percent, respectively); however, the sample sizes are small and should be interpreted with caution. About one-fifth of women and men reported quitting their jobs in response to recent sexual harassment victimization (21 percent and 17 percent, respectively; Figure 1). Both women and men in New Hampshire reported financial stress due to sexual harassment (about 10 percent of each), according with existing research that shows a strong link between workplace sexual harassment and financial stress, largely due to job change, either voluntary or forced. 4

Sexual harassment negatively impacts victims’ physical and mental health, causing anxiety, depression, and diminished self-esteem, self-confidence, and psychological well-being. A higher proportion of women reported anxiety or depression than men as a result of the most recent sexual harassment victimization (27 percent and 19 percent, respectively); however, the sample sizes are small and should be interpreted with caution . Similar proportions of women and men reported feeling bad about themselves (about 10 percent each).

Sexual harassment is problematic for the workplace, as it reduces worker morale and job satisfaction, diminishes productivity, and increases absenteeism and worker withdrawal. It can be indicative of a toxic environment if employers fail to address harassers or protect victims. 5 Employers would do well to invest in prevention, such as bystander intervention training, and encourage victims’ use of supports to mitigate the negative effects of workplace sexual harassment. 6

The data used in this analysis were collected in the Granite State Poll (GSP) in April and July 2018. The GSP, a random-digit-dialing telephone survey administered by the University of New Hampshire Survey Center, provides a statewide representative sample of approximately 500 households and collects demographic, economic, and employment information. The authors developed a Sexual Harassment at Work Topical Module that was added to the GSP based on established definitions of sexual harassment at work in previous studies, including the National Study on Sexual Harassment and Assault Study, the Youth Development Study, and the SEQ: DoD Study. For a full definition of workplace sexual harassment, with examples, see the United Nations report . All analyses are weighted using household-level weights provided by the UNH Survey Center based on U.S. Census Bureau estimates of the New Hampshire population. 

1 . Holly Kearl, “The Facts Behind the #metoo Movement: A National Study on Sexual Harassment and Assault” (Reston, VA: Stop Street Harassment, 2018).

2. Heather McLaughlin, Christopher Uggen, and Amy Blackstone, “The Economic and Career Effects of Sexual Harassment on Working Women,” Gender & Society 31, no. 3 (2017): 333–58; Jason Houle et al., “The Impact of Sexual Harassment on Depressive Symptoms During the Early Occupational Career,” Society and Mental Health 1 (2011): 89–105.

3. Since 2007, University of New Hampshire Prevention Innovation Research Center researchers have engaged in research on sexual assault, relationship violence, stalking, harassment, and emotional abuse in New Hampshire. See D. Laflamme, G. Mattern, M. Moynihan, and S.J. Potter, “Sexual Assault in New Hampshire: A Report from the New Hampshire Coalition Against Domestic and Sexual Violence” (2011),  https://www.nhcadsv.org/uploads/1/0/7/5/107511883/sexualassaultinnh.pdf (authors listed alphabetically) ; D. Laflamme, G. Mattern, M. Moynihan, and S.J. Potter, ”Violence Against Men in New Hampshire” (2009),  https://www.nhcadsv.org/uploads/1/0/7/5/107511883/vam_report_final.pdf (authors listed alphabetically) ; V. Banyard, L. Bujno, D. Laflamme, G. Mattern, M. Moynihan, and S.J. Potter, “Violence Against Women in New Hampshire” (2007), https://www.nhcadsv.org/uploads/1/0/7/5/107511883/vaw_report_final.pdf  (authors listed alphabetically) .

4. McLaughlin et al., 2017.

5. Victoria L. Banyard, Sharyn J. Potter, and Heather Turner, “The Impact of Interpersonal Violence in Adulthood on Women’s Job Satisfaction and Productivity: The Mediating Roles of Mental and Physical Health,” Psychology of Violence 1 (2011): 16–28; Victoria L. Banyard and Sharyn J. Potter, “Victimization in the Lives of Employed Women: Disclosure in the Workplace,” Family and Intimate Partner Violence Quarterly 3 (2010): 1–20; Chelsea Willness, Piers Steel, and Kibeom Lee, “A Meta-Analysis of the Antecedents and Consequences of Workplace Sexual Harassment,” Personnel Psychology 60 (2007): 127–62.

6. Sharyn J. Potter and Jane G. Stapleton, “Sexual Harassment in the Workplace: The Importance of Cultural Change,” Business NH Magazine, January 2018, p. 52.

Acknowledgments

This research was funded by the Carsey School of Public Policy and the Prevention Innovations Research Center . The authors would like to thank Michael Ettlinger, Curt Grimm, Michele Dillon, Marybeth Mattingly, Laurel Lloyd, and Bianca Nicolosi at the Carsey School of Public Policy; Jennifer Scrafford, Caroline Leyva, Laurie Dawe, and Taylor Flagg at the Prevention Innovations Research Center; and Patrick Watson for his editorial assistance.

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Ever evolving technologies in the workplace create new mediums for sexual harassment, and employers and staff need support on how to prevent and respond to the potential harms. 

This project conducted by a team at Monash University led by Associate Professor Asher Flynn, with Professor Anastasia Powell from RMIT University, offers crucial insights to aid Australian employers and policymakers in understanding and combating workplace technology-facilitated sexual harassment (WTFSH) effectively.

The study featured:

• 20 in-depth interviews with industry stakeholders
• a national survey with over 3,300 Australian adults
• focus groups with young adults to identify current gaps in WTFSH response mechanisms.

The findings underscore the significance of the problem, with 1 in 7 Australian adults surveyed reporting they had engaged in WTFSH.

Results also reflect that gender is a key factor in perpetration. Men were more likely to report they had engaged in WTFSH than women, and male-dominated workplaces were associated with much higher rates of WTFSH than workplaces dominated by women.

Sexist and gender-discriminatory attitudes and the endorsement of sexual harassment myths were two of the strongest predictors of engagement in WTFSH. These results emphasise the critical importance of gender-competent leadership in the workplace.

Publication details

This work is part of the ANROWS research reports series . ANROWS research reports are in-depth reports on empirical research produced under ANROWS’s research program.

ASHER FLYNN Associate Professor, Criminology, School of Social Sciences, Monash University

ANASTASIA POWELL Professor, Criminology and Justice Studies, RMIT University

LISA WHEILDON Criminology, School of Social Sciences, Monash University

ISBN: 978-1-922645-82-1 (paperback)

ISBN: 978-1-922645-83-8 (PDF)

Suggested citation

Flynn, A., Powell, A., & Wheildon, L. (2024). Workplace technology-facilitated sexual harassment: Perpetration, responses and prevention (Research report, 03/2024). ANROWS.

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A systematic review of the literature: Gender-based violence in the construction and natural resources industry

• Joyce Lo 1 , 
• Sharan Jaswal 1 , 
• Matthew Yeung 1 , 
• Vijay Kumar Chattu 1,2,3 , 
• Ali Bani-Fatemi 1 , 
• Aaron Howe 1 , 
• Amin Yazdani 4 , 
• Basem Gohar 5,6 , 
• Douglas P. Gross 7 , 
• Behdin Nowrouzi-Kia 1,6 ,  , 
• 1. Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON M5G 1V7, Canada
• 2. Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai 600077, India
• 3. Department of Community Medicine, Faculty of Medicine, Datta Meghe Institute of Medical Sciences, Wardha 442107, India
• 4. Canadian Institute for Safety, Wellness & Performance, School of Business, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON N2G 4M4, Canada
• 5. Department of Population Medicine, University of Guelph, Guelph, ON N1G 2W1, Canada
• 6. Centre for Research in Occupational Safety & Health, Laurentian University, Sudbury, ON P3E 2C6, Canada
• 7. Department of Physical Therapy, University of Alberta, Edmonton, AB, T6G 2G4, Canada
• Received: 08 February 2024 Revised: 09 April 2024 Accepted: 12 April 2024 Published: 08 May 2024
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• Download PDF

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Gender-based violence (GBV) poses a significant concern in the construction and natural resources industries, where women, due to lower social status and integration, are at heightened risk. This systematic review aimed to identify the prevalence and experience of GBV in the construction and natural resources industries. A systematic search across databases including PubMed, OVID, Scopus, Web of Science, and CINAHL was conducted. The Risk of Bias Instrument for Cross-sectional Surveys of Attitudes and Practices by McMaster University and the Critical Appraisal of Qualitative Studies by the Center for Evidence Based Medicine at the University of Oxford were used to assess the studies included in the review. Six articles were included after full-text analysis. GBV was reported in the construction, mining, urban forestry, and arboriculture sectors. Workplace GBV was measured differently across the studies, and all studies examined more than one form of GBV. The main forms of GBV discussed in these studies were discrimination, sexual harassment, and sexism. The studies provided some insight for demographic factors that may or may not be associated with GBV, such as age, region of work, and number of years working in the industry. The review also suggests that workplace GBV has a negative impact on mental health and well-being outcomes, such as higher levels of stress and lower job satisfaction. The current research has not established the effectiveness of interventions, tools, or policies in these workplaces. Thus, additional research should include intervention studies that aim to minimize or prevent GBV in male-dominated workplaces. The current study can bring awareness and acknowledgement towards GBV in the workplace and highlight the importance of addressing it as this review outlines the negative consequences of GBV on mental health and well-being in these male-dominated industries.

• construction ,
• gender-based violence ,
• natural resources ,
• systematic review ,

Citation: Joyce Lo, Sharan Jaswal, Matthew Yeung, Vijay Kumar Chattu, Ali Bani-Fatemi, Aaron Howe, Amin Yazdani, Basem Gohar, Douglas P. Gross, Behdin Nowrouzi-Kia. A systematic review of the literature: Gender-based violence in the construction and natural resources industry[J]. AIMS Public Health, 2024, 11(2): 654-666. doi: 10.3934/publichealth.2024033

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Bullying and Sexual Harassment in the Legal Profession

Download report (ENG) Descargar informe (ESP)

The legal profession has a problem. In 2018, the IBA and Acritas conducted the largest-ever global survey on bullying and sexual harassment in the profession. Nearly 7,000 individuals from 135 countries responded, from across the spectrum of legal workplaces: law firms, in-house, barristers’ chambers, government and the judiciary. The results provide empirical confirmation that bullying and sexual harassment are rife in the legal profession. Approximately one in two female respondents and one in three male respondents had been bullied in connection with their employment. One in three female respondents had been sexually harassed in a workplace context, as had one in 14 male respondents.

In Us Too? Bullying and Sexual Harassment in the Legal Profession (May 2019), the IBA Legal Policy & Research Unit (LPRU) analysed this data to understand the nature, extent and impact of the problem and inform the development of solutions. The Us Too? report outlines 10 recommendations for achieving positive change, and highlights steps the IBA will take to lead by example. Read more

Following the publication of Us Too? , the IBA undertook an unprecedented global engagement campaign. During visits to 30 cities across six continents, the IBA held public events and met with hundreds of stakeholders. In May 2020, the IBA announced the next phase of work, seeking to maintain momentum and draw on the insight gathered during the campaign. This next phase included the development of an anti-harassment e-learning series with The College of Law Australia , a discussion paper on the use of technology to address harassment , a report on the regulatory dimensions of inappropriate behaviour (forthcoming) and collaboration with Osiris Labs to develop immersive anti-harassment training (ongoing).

The IBA remains committed to addressing bullying and sexual harassment in the legal profession. Read more .

Report summary

A report summary is avaliable to download in the languages below.

The IBA and The College of Law Australia are pleased to provide this e-learning training for use by the legal profession to ensure safe, supportive and respectful workplaces for everyone.

“ This important report is a clarion call for urgent action. I urge you to absorb its facts and findings and then make a difference .”

Julia Gillard AC, 27th Prime Minister of Australia

Further research

Beyond Us Too? Regulatory Responses to Bullying and Sexual Harassment in the Legal Profession

Beyond Us Too? Regulatory Responses to Bullying and Sexual Harassment in the Legal Profession explores how disciplinary and regulatory bodies are seeking to address inappropriate behaviour within legal workplaces. A follow-up to the International Bar Association's landmark 2019 report, Us Too? , this new report draws on a survey of approximately 70 disciplinary/regulatory bodies within the law around the world. It outlines the different strategies being pursued by regulators to curb bullying and sexual harassment within the law and provides guidance based on the insight of fellow disciplinary and regulatory bodies.

Innovation-led cultural change: can technology effectively address workplace harassment?

In the post #MeToo era, there has been a global awakening to the pervasive and endemic nature of sexual harassment, accompanied by a realisation of the prevalence of these negative behaviours in the workplace context. However, the limitations associated with traditional reporting methods and the fear of retaliation means many targets choose to remain silent. Trust Tech has been at the forefront of new efforts to facilitate reporting of such incidents. This new report from the IBA explores how the emerging field of Trust Tech empowers workplaces, representative bodies and regulators to provide flexible channels for targets to report incidents.

Click to see a map of events from the global campaign

The Legal Policy & Research Unit took part in a variety of global events and meetings to promote the report and wider work in combatting sexual harassment in the legal profession.

Media coverage See all  

Bullying and sexual harassment rife among lawyers, global survey finds The Guardian , 15 May 2019

Sexual harassment and bullying rife in legal profession Financial Times , 15 May 2019

Julia Gillard AC (27th Prime Minister of Australia) 23 September 2019, Seoul

Chief Justice Anne Ferguson (Supreme Court of Victoria) 13 August 2019, Melbourne

Emerita Professor Patricia Easteal (University of Canberra) 5 August 2019, Canberra

Justice Melissa Perry (Federal Court of Australia) 1 August 2019, Sydney

Dame Laura Cox QC 15 May 2019, London

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Sexual exploitation and harassment in the spotlight at IBA, British High Commission and CPS event in Tanzania

14 November 2019

United Nations Office on Drugs and Crime, High-Level Meeting of the Global Judicial Integrity Network

Doha, Qatar, 24-26 February 2020

The IBA met with the Bar Council of Ireland and several Irish law firms to discuss these matters.

Global organisations gather at The Hague to discuss solutions to bullying and sexual harassment

6 November 2019

In Hong Kong, the IBA partnered with The Women’s Foundation and Freshfields Bruckhaus Deringer to host a public event. The IBA also presented on these issues to numerous local and international firms, and hosted a roundtable discussion with Women in Law Hong Kong. Events in partnership with the Hong Kong Bar Association, Equal Opportunities Commission and Chinese University of Hong Kong were regrettably postponed.

Kuala Lumpur

In Kuala Lumpur, the IBA partnered with ZICO Law (Zaid Ibrahim & Co) to host a public event. The IBA also presented to the partnership of one of the largest firms in Malaysia. Cooperation with the Malaysia Bar is ongoing.

IBA President to launch report on bullying and sexual harassment in the legal profession, at NBA AGC

22 August 2019

IBA Senior Legal Advisor Kieran Pender spoke at the European Commission-supported Eurocadres conference ‘Time to End Stress: Professionals and Managers in the Front Line’. He also met with several local law firms to discuss the IBA report.

Mexico City

In Miami, the IBA co-hosted an event with the Dade County Bar Association, held at Greenberg Traurig.

Greenberg Traurig and Chambers Host Seventh Annual Diversity Summit

6 December 2019

IBA Senior Legal Advisor Kieran Pender presented on the report to the offices of several international law firms in Paris, and met with the general counsel of an influential French company.

Australian and New Zealand Bar Associations - Antipodean Advocacy: Trans-Tasman Perspectives

Queenstown, New Zealand, 23-24 August 2019

São Paulo: IBA President urges legal profession to call time on ‘endemic’ bullying and sexual harassment

1 November 2019

São Paulo: Presidente da IBA irá encorajar profissionais do direito a erradicar o “endêmico” bullying e o assédio sexual

Seminar - Bullying and Sexual Harassment in the Legal Profession

Sydney, Australia, 1 August 2019

In Singapore, the IBA partnered with the Singapore International Chamber of Commerce, the Association of Women for Action and Research and Freshfields Bruckhaus Deringer to host a public event. The IBA also partnered with the Law Society of Singapore to hold a roundtable lunch for managing partners, and separate events for the Law Society’s young lawyer and female lawyer committees. The IBA also presented on these issues to numerous local and international firms, and several in-house legal teams.

Washington DC

In Wellington, the IBA co-hosted an event with the New Zealand Law Society, held at Kensington Swan.

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Discrimination, Harassment, Abuse and Bullying in the Workplace: Contribution of Workplace Injustice to Occupational Health Disparities

Cassandra a. okechukwu.

1 Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, United States

Kerry Souza

2 Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Washington, District of Columbia, United States

Kelly D. Davis

3 Department of Human Development and Family Studies, Pennsylvania State University, University Park, Pennsylvania, United States

A. Butch de Castro

4 Department of Psychosocial and Community Health, University of Washington, Seattle, Washington, United States

This paper synthesizes research on the contribution of workplace injustices – discrimination, harassment, abuse and bullying – to occupational health disparities. A conceptual framework is presented to illustrate the pathways through which injustices at the interpersonal and institutional level lead to differential risk of vulnerable workers to adverse occupational health outcomes. Members of demographic minority groups are more likely to be victims of workplace injustice and suffer more adverse outcomes when exposed to workplace injustice compared to demographic majority groups. A growing body of research links workplace injustice to poor psychological and physical health, and a smaller body of evidence links workplace injustice to unhealthy behaviors. Although not as well studied, studies also show that workplace injustice can influence workers’ health through effects on workers’ family life and job-related outcomes. Lastly, this paper discusses methodological limitations in research linking injustices and occupational health disparities and makes recommendations to improve the state of research.

INTRODUCTION

The aim of this paper was to synthesize and evaluate research demonstrating how workplace injustice – discrimination, harassment, abuse and bullying –may contribute to occupational health disparities. Reflecting historical and current societal power imbalances, forces within and outside workplaces can result in the mistreatment of workers (individually or as a group) through unjust practices [ Jones 2000 , Turney 2003 , Hodson, et al. 2006 , Lopez, et al. 2009 ]. We theorize that mistreatment of workers in the workplace may exacerbate health disparities between groups of workers. We reviewed the peer-reviewed literature reporting direct and indirect associations of workplace injustices with health outcomes. The extant literature contains a diffuse body of work on workplace injustice from different disciplines; many of which are unrelated to health. Our synthesis is limited to papers that present evidence of the contribution of workplace injustice to occupational health disparities. Our review led us to propose a conceptual framework ( Figure 1 ) to illustrate the various relationships suggested by research studies. To complement conceptual models that illustrate relationships between other workplace factors and health, this model illustrates pathways between workplace injustices and health outcomes that are supported by the extant scientific literature. Our starting point for a conceptual framework for the contributions of work to health disparities is the Ecosocial approach advanced by Krieger [ Krieger 1994 , Krieger, et al. 2008 ].

A Model for understanding the contribution of workplace injustice to occupational health disparities

In summarizing this evidence, we acknowledge the vast literature on workplace/organizational justice that describes employees’ perceptions of equity between workers’ input and workplace procedures, interactions and outcomes [ Elovainio, et al. 2002 ]. Although this literature is relevant to the health of workers, our discussion does not extend to this topic.

Workplace Injustices: Definitions and Scope

Definitions and scope of workplace injustice(s) differ according to the discipline and body of literature reviewed. The United States Equal Employment Opportunity Commission (EEOC) protects workers from injustice based on age, disability, gender/sex, genetic information, national origin, pregnancy, race/color, or religion (2011). Though excluded from this EEOC definition, other federal agencies and some state and local laws also protect workers from workplace injustice based on sexual orientation and gender identity. For the purposes of this paper, we defined workplace injustice as workplace-related discrimination, harassment, abuse or bullying. We considered how these injustices, including bullying which is usually status-blind, might differentially impact workers who are socially disadvantaged. Perpetration of workplace injustice can occur at the institutional or interpersonal level.

Institutional or structural injustice

Jones’ (2000) characterization of institutional racism as structurally constructed differential access to societal opportunities, goods and services can be applied to the characterization of institutional workplace injustice. This injustice is “normative, sometimes legalized” and “structural, having been codified in our institutions of custom, practice, and law, so there need not be an identifiable perpetrator” (p. 1212). Institutional injustice can persist even after levels of individual injustice have lessened in a society [ Williams and Mohammed 2009 ].

Interpersonal injustice

At the individual/interpersonal level, workplace injustice can be intentional or unintentional and encompasses acts of commission and omission. Studies have documented a range of such unfair practices faced by vulnerable workers, from isolating or excluding socially/economically disadvantaged workers from workplace events and activities to subjecting them to overtly hostile actions and behaviors (e.g. being subjected to insults and jokes related to one's race/ethnicity). Studies suggest that African-American and other racial/ethnic minority workers are more likely to report being targets of derogatory comments and having their work duties and activities made difficult by others [ Alleyne 2004 ; Raver and Nishii 2010 ].

Types of Workplace Injustice

Workplace discrimination refers to actions of institutions and/or individuals within them, setting unfair terms and conditions that systematically impair the ability of members of a group to work [ Rospenda, et al. 2009 ]. Often, it is motivated by beliefs of inferiority of a disadvantaged outgroup compared to a dominant group [ Roberts, et al. 2004 ]. Racism, or discrimination based on race, justifies the mistreatment and dominance of members of a particular racial or ethnic group due to beliefs of their genetic and/or cultural inferiority; it also carries a history of societal power relationships between races [ Williams 1997 ]. Discrimination can also occur between disadvantaged groups themselves. For example, de Castro et al. (2006) found that some ethnic groups were favored over others among immigrant worker groups. This favoritism was initiated and perpetuated by both coworkers and employers/supervisors alike [ de Castro, et al. 2006 ]. Latino indigenous-speaking farm workers in Oregon reported differentially distributed hazardous work conditions, including lack of educational materials in languages they understood, between themselves and Spanish-speaking workers; they also reported that these conditions were often perpetrated by Spanish-speaking Latino former farmworkers who had risen through the ranks to become supervisors [ Farquhar, et al. 2008 ]. Similarly, in a study of 356 African-American workers, 43% of the 219 workers who reported workplace discrimination reported that the perpetrators included fellow African-Americans [ Din-Dzietham, et al. 2004 ].

Discrimination against workers with disabilities, younger and older workers, and gender persists, as well. Studies have shown that discrimination against workers with disabilities has both societal and historical influences and persists despite being prohibited by the Americans with Disabilities Act [ Scheid 2005 , Stuart 2006 , Snyder, et al. 2010 , Moore, et al. 2011 ]. Ageism, discrimination based on age, has been shown to have a curvilinear life course trajectory whereby it disproportionately impacts younger workers in their 20s and older workers above 50 [ Gee, et al. 2007 ].

Workplace harassment differs from discrimination because it involves negative actions toward a worker due to attributes, such as race/ethnicity, gender etc., that lead to a hostile workplace whereas discrimination involves unequal treatment or limiting of opportunities due to these attributes [ Rospenda et al, 2009 ]. Harassment must target workers’ protected EEOC status in order to meet the US legal definition [ Ehrenreich 1999 , Carbo 2008 ]. Sexual harassment is a type of workplace harassment that is typically characterized along gender/sex lines [ Pina et al, 2009 ]. Fitzgerald and colleagues (1999) delineated four types of sexual harassment—sexist behavior, sexual hostility, unwanted sexual attention, and sexual coercion. Sexist behaviors describe actions in which one's gender or sex is the primary target of discrimination [ Fitzgerald, et al. 1999 ]. This overlap in definition can make distinguishing between gender discrimination versus harassment difficult. The other three describe experiences that are more physical and sexual in nature.

Workplace bullying or abuse involves actions that offend or socially exclude a worker or group of workers, or actions that have a negative effect on the person or group's work tasks [ Grubb, et al. 2004 ]. These actions are often status-blind and occur repeatedly and regularly over a period of time [ Grubb, et al. 2004 ]. The actions taken and workers’ sensitivity to them can vary according to culture [ Cassitto, et al. 2003 ].

PATHWAYS: FROM INJUSTICE TO HEALTH DISPARITIES

Conceptual framework.

Using Ecosocial theory of disease distribution as a basis [ Krieger 1994 , Krieger, et al. 2008 ], we present a working model ( Figure 1 ) to illustrate potential pathways linking workplace injustice exposures and health disparities. In the following section, we define components of our model and discuss evidence from the literature to support the pathways between them. Our model is not a causal diagram; presence of arrows between components in the model does not imply that causal analyses have been conducted.

Labor stratification into Hazardous Positions

Our conceptual model ( Figure 1 ) shows labor stratification, in which minority and other disadvantaged workers are systematically hired into certain (usually lower power) positions [ Landsbergis, Grzywacz, & LaMontagne, 2012 ]. Labor stratification has been documented to occur upstream, before entry into the labor force, through unfair access to or denial of employment opportunities. Experimental studies have documented employers responding negatively to job applicants based on age, gender, race, and sexual orientation, thereby discriminating against or preferentially hiring applicants for certain types of jobs [ Crow, et al. 1998 , Hebl, et al. 2002 , Horvath and Ryan 2003 , Pager 2003 , Bertrand and Mullainathan 2004 , Pager, et al. 2009 ]. Other studies, based on self-report, have also found discrimination and bias in hiring and/or promotion based on sexual orientation and age of applicants [ Johnson and Neumark 1996 , Badgett, et al. 2007 ]. An analysis of court cases showed that, in some fields, women may encounter a “maternal wall,” whereby they are denied employment and/or promotion due to pregnancy or childbirth [ Williams and Westfall 2006 ].

The occupational health literature supports the observation that racial/ethnic minorities and immigrants are often over-represented in jobs with poorer working conditions [ Frumkin, et al. 1999 , Murray 2003 , Agudelo-Suarez, et al. 2009 , Berdahl 2008 ]. Among African-Americans, Haggerty and Johnson (1995) point out that labor stratification is part of broader societal level injustices, notably poor educational systems thereby predisposing African-American workers to limited, hazardous, poor-quality job opportunities in adulthood [ Haggerty and Johnson 1995 ].

Differential Assignment to Hazardous Duties

Even when workers are in the same occupational position, some workers are directly exposed to more occupational hazards through assignment of the most hazardous duties to socially and economically disadvantaged populations, thus increasing their risk for work-related injury or illness [ Murray 2003 , de Castro, et al. 2006 , Farquhar, et al. 2008 , Delp, et al. 2009 , Shannon, et al. 2009 ]. An early documented example is that of the Gauley Bridge/Hawk's Nest tunnel disaster in 1930 [ Cherniack 1986 ]. Although various explanations for disproportionate incidence of pneumoconiosis and associated death among African-American compared to White workers were posited, an examination of job placement of workers in the mine revealed race-based job assignment as the root cause. African-American workers were de facto assigned to the deepest, dustiest parts of the tunnel, while White workers were more likely to be assigned to work outside.

Available evidence suggests that, after controlling for differences in education and experience, African-American and Hispanic workers are consistently more likely to be employed in occupations where serious injuries and illnesses are more likely to occur [ Robinson 1984 , Robinson 1987 , Loomis and Richardson 1998 , Shannon, et al. 2009 ]. However, the social forces behind disproportionate exposures of minority worker groups to occupational hazards may be complex. An analysis of illnesses and injury rates over a 10-year period showed that disparities were dynamic and sometimes disappear when researchers control for job characteristics such as work schedule, union representation, health insurance and job hours [ Berdahl 2008 ].

A U.S. study of a unionized, multi-ethnic working class sample found that 85% of workers reported high exposure to at least one occupational hazard [ Quinn, et al. 2007 ]. A similar proportion of this same group of workers was exposed to one of three workplace injustices (bullying, sexual harassment, or racial discrimination) [ Krieger, et al. 2006 ]. Analyses of the same sample showed that exposure to occupational hazards was unevenly distributed based on race and gender: Being a minority in any way increased workers’ chances of being exposed to hazards [ Barbeau, et al. 2007 , Krieger, et al. 2005 , Krieger, et al. 2006 , Krieger, et al. 2008 , Krieger, et al. 2010 ].

Though empirical evidence is limited, some researchers have suggested that differential enforcement of occupational health and safety regulations or policies in industries and occupations where minority workers predominate may be another mechanism for disparities. One example is the OSHA exemption for farms with less than ten employees. Somervell and Conway (2011) showed that worker fatality rates in states that observe this exemption were higher than in states that do not. U.S. farm workers are largely immigrant, Latino workers [ Farquhar, et al. 2008 , Somervell and Conway 2011 ]. Other researchers have noted that a majority of the workers impacted by the suspension of both prevailing wage policies and enforcement of occupational safety and health regulations during the Hurricane Katrina and Rita cleanup process were Hispanic day laborers [ Delp et al, 2009 ; Pastor et al, 2006 ]. A more thorough analysis of the policies and decisions surrounding disaster cleanup events is needed to determine whether or not policies and decisions differentially impact minority workers.

The extent to which occupational factors contribute to overall health is inadequately described, but we hypothesize, based on our review of literature, that it is possible that differential exposure to occupational hazards among minority workers may be a significant contributor to the overall experience of health disparities. Several studies have explored the relative importance of work exposures to overall health, and the findings are intriguing. For example, a recent examination of government employees in an European city found that physical conditions at work explained most of the observed occupational class inequalities in health [ Kaikkonen, et al. 2009 ]. Likewise, a French study found a social gradient in exposure to physical, ergonomic and chemical hazards in addition to a gradient in experiences of workplace bullying, in which managers and professionals were less likely to be exposed to any hazard compared to associate professionals/technicians, clerks/service workers, and blue-collar workers [ Niedhammer, et al. 2008 ]. Similar studies with US samples could not be found. More research studies, in cohorts for which detailed occupation information is available, must be conducted to help explain observed differences in health outcomes.

PATHWAYS FROM EXPOSURE TO OUTCOME

Potential modifiers.

Some studies have identified factors that appear to modify observed effects of workplace injustices on health and other outcomes. In Figure 1 , these factors are represented as potential modifiers. Workplace injustice may further contribute to health disparities by having differential effects on disadvantaged populations compared to dominant groups. For example, racial/ethnic minorities have been reported to have increased risks of the post-traumatic stress disorder (PTSD)-related effects when exposed to workplace bullying [ Rodríguez-Muñoz, et al. 2010 ]. Similarly, in another study, even though experiences of workplace bullying were significantly associated with negative emotional reactions for all targets, African-Americans reported significantly higher emotional response to racial/ethnic bullying compared to other groups [ Fox and Stallworth 2005 ]. Also, generalized bullying has been associated with higher numbers of psychological symptoms and increases in drinking to intoxication for women compared to men [ Rospenda, et al. 2009 ]. In contrast, an Italian study found that men were more likely to develop depressive disorder with increasing severity of bullying [ Nolfe, et al. 2010 ].

A study by Krieger (1990) demonstrated how keeping quiet about experiences of discrimination may take a toll on health. African-American women who did not tell others about the unfair treatment they received were four times more likely to report high blood pressure than women who told others (a similar association was not significant for White women) [ Krieger 1990 ]. Likewise, one study found that while lack of equality was associated with poorer self-reported health for both men and women, women's health was influenced when inequality existed for men and/or women whereas men's was only affected when men were the victims of inequality [ Bildt 2005 ].

Stress-Mediated Pathway

In Figure 1 , the main pathway linking exposures to workplace injustice and health outcomes is via stress. Evidence for this pathway in the model is derived from the psychological literature supporting the “stressor-stress-strain” framework. According to work by Lazarus and Folkman (1984) , negative health effects result when an individual perceives situational demands as stressful and this stress experience exceeds their capacity to cope [ Lazarus and Folkman 1984 ]. Experiences of discrimination, harassment and bullying in the workplace can operate as stressors provoking a psychological and/or physiological stress response. There is strong empirical evidence that psychological stress can affect biological host resistance through the activation of neuroendocrinological and immunological responses [ Cohen, et al. 2007 ]. The activation of these responses can include disturbances in the circadian cortisol profile, which several studies have found among targets of workplace injustice [ Kudielka and Kern 2004 , Huebner and Davis 2005 , Hansen, et al. 2006 , Townsend, et al. 2011 ]. These types of disruptions in cortisol have been shown to lead to a multitude of chronic negative health conditions [ Cohen, et al. 2007 ]. More studies are needed to directly and clearly show the link from exposure to workplace injustice to physiological responses and, in turn, to negative health outcomes.

OUTCOMES: CONTRIBUTIONS OF INJUSTICE TO HEALTH DISPARITES

Health outcomes.

The broader literature on stress and health has established links between experiences of discrimination and harassment and adverse health outcomes. Workplace injustices have been directly associated with three types of outcomes: psychological and physical health, health behaviors, and job outcomes. There is a small but suggestive body of evidence suggesting a fourth outcome—family well-being. These outcomes can be seen on the right-hand side of our model ( Figure 1 ).

Several cross-sectional studies have found evidence of symptoms and diagnosis of PTSD among workers exposed to workplace bullying and sexual harassment [ Leymann and Gustafsson 1996 , Schneider, et al. 1997 , Mikkelsen and Einarsen 2002 , Matthiesen and Einarsen 2004 , Tehrani 2004 , Willness, et al. 2007 , Buchanan and Fitzgerald 2008 , Larsen and Fitzgerald 2010 , Rodríguez-Muñoz, et al. 2010 ]. In explaining how bullying may lead to PTSD, Einarsen and colleague (2003) posit that although the experience of workplace injustice is often not life-threatening, the experience threatens the inner world of the target by shattering basic cognitive schema about fairness and justice and negatively influences one's social and personal identity leading to PTSD.

A meta-analysis of the antecedents and consequences of sexual harassment found evidence for the association of sexual harassment with general poor mental health [ Willness, et al. 2007 ]. Although anxiety and depression were the most prevalent conditions, the strongest evidence of effect was found for PTSD [ Willness, et al. 2007 ]. These symptoms may be worsened for minorities through an interactive effect of sexual and racial/ethnic harassment [ Buchanan and Fitzgerald 2008 ].

Another mechanism through which minority workers might experience more severe outcomes is through attribution. A study, which included a meta-analysis, showed that social context (e.g. gender or racial composition of workplace) influenced workers’ attribution of their experiences of injustice; attribution in turn impacted the severity of outcomes with internal and personal attribution leading to worse health outcomes [ Hershcovis & Barling, 2010 ]. An association between workplace bullying and short- and long-term change in psychological distress and depression has been shown with both cross-sectional and longitudinal studies [ Kivimäki, et al. 2003 , Hogh, et al. 2005 , Nolfe, et al. 2010 ]. One longitudinal study suggested the possibility of a cyclical relationship in which developing depression increased the risk of workers becoming targets of bullying, which then increased depressive symptoms [ Kivimäki, et al. 2000 ]. However, worker inputs to injustice exposures are not represented on our conceptual model and are beyond the scope of this review.

Evidence from cross-sectional studies suggests that workers who experience racial/ethnic discrimination in the workplace suffer a range of negative psychological health outcomes, such as more days of poor mental health [ Roberts, et al. 2004 ], psychological distress [ Eaton 2003 , Krieger, et al. 2010 ], anxiety and depression [ Bhui et al, 2005 , Agudelo-Suarez, et al. 2009 , Hammond, et al. 2010 , Raver and Nishii 2010 ], negative emotions [ Fox and Stallworth 2005 ], and emotional trauma [ Alleyne 2004 ]. Although these studies utilized self–report of discrimination, experimental research has provided added evidence for the influence of work-related racial discrimination on mental health [ Salvatore and Shelton 2007 ]. Workplace ageism has been linked to psychological distress among older workers [ Yuan 2007 ]. This might particularly impact older women [ Encel and Studencki 1997 , Handy and Davy 2007 , Walker, et al. 2007 ]. A review of literature elucidated how ageism and sexism may operate concomitantly to negatively influence the health of older working women [ Payne and Doyal 2010 ].

Other studies suggest somatic health effects of workplace injustice. An experimental study found that working under an unfavorable supervisor (whose actions included bullying) led to clinically significant increases in workers’ blood pressure [ Wager, et al. 2003 ]. Cross-sectional studies provide other evidence of an association between workplace injustice and somatic health. Those who experience racial discrimination may be at increased risk for work-related injury or illness [ Murray 2003 , de Castro, et al. 2006 , Farquhar, et al. 2008 , Delp, et al. 2009 , Shannon, et al. 2009 ]. Racial/ethnic discrimination, sexual harassment and bullying have been negatively associated with self-rated health and unhealthy days [ Krieger 1999 , Nazroo 2003 , Gunnarsdottir, et al. 2006 , Fujishiro 2009 , de Castro, et al. 2010 ] while racial discrimination and workplace bullying were associated with bodily pain [ Burgess, et al. 2009 , Saastamoinen, et al. 2009 ]. Sexual harassment has also been linked to a host of physical health symptoms, including headaches, stomach aches and disrupted sleep [ Gutek and Koss 1993 , Goldenhar, et al. 1998 , Magley, et al. 1999 , Wasti, et al. 2000 , Willness, et al. 2007 ].

Non-targeted witnesses of workplace injustice may also be at risk for adverse health outcomes. Non-bullied witnesses to workplace bullying reported more anxiety [ Hansen, et al. 2006 ], and, workers who witnessed repeated bullying in their workplace were almost twice more likely to report acute pain than those who did not witness it [ Saastamoinen, et al. 2009 ]. A U.S. study found that bullying witnesses reported better outcomes (work quality and health) than bullying victims; however, witnesses’ outcomes were worse than those of non-witnesses [ Lutgen-Sandvik, et al. 2007 ]. Among a sample of female employees in a public utility and food processing plant, Glomb and colleagues found that observing sexual harassment was linked to lower psychological well-being, similar to individuals who experienced the harassment directly [ Glomb, et al. 1997 ]. Another study found that observing the mistreatment was linked to poor psychological well-being, even after controlling for one's own experiences [ Miner-Rubino and Cortina 2004 , Miner-Rubino and Cortina 2007 ]. Researchers have posited that the influence on bystander health is partly because bystanders develop a fear of becoming a target [ Hoel, et al. 2004 ]. Yet to be evaluated is whether bystander effects are worse when the witnesses are members of the same disadvantaged group as the target.

Health Behaviors

Experiencing workplace injustice may lead to unhealthy behaviors that likely operate as maladaptive coping mechanisms. Evidence from the stress and health literature suggests that stress influences health through changes in health behavior [ Steptoe, et al. 1998 , Droomers, et al. 1999 , Epel, et al. 2000 , Ng and Jeffery 2003 ]. Recent research suggests similar processes with workplace injustice. For example, workplace racial discrimination has been associated with smoking [ Okechukwu, et al. 2010 ], and heavy alcohol use has been linked to sexual harassment among women [ Gradus, et al. 2008 ] and to workplace bullying [ Rospenda, et al. 2009 ].

Job Outcomes

As illustrated in figure 1 , negative job outcome is a potential outcome of workplace injustices. Workplace racial discrimination and bullying have been linked to both self-reported and medically-certified sickness absence, although the strongest associations were between bullying and medically-certified sickness absence [ Kivimäki, et al. 2000 , Alleyne 2004 ]. A cross sectional study found that sexual harassment explained the greater risk for sickness absence among female metal workers in male-dominated worksites compared to those in female dominated worksites [ Hensing and Alexanderson 2004 ]. An important feature of bullying and discrimination includes restriction of information or services related to advancement [ Alexis and Vydelingum 2004 ]. With exposure to workplace injustice, targets may become socially isolated and/or ostracized [ Zapf, et al. 1996 , Lutgen-Sandvik, et al. 2007 ], and, might engage in higher levels of counterproductive work behaviors (e.g., tardiness) and reduced productivity, and/or withdraw from seeking promotions, thus lessening their credibility and value at work [ Spratlen-Price 1995 , Day and Schoenrade 1997 , Caver and Livers 2002 , Fox and Stallworth 2005 , Allan, et al. 2009 ].

Career advancement has also been shown to be hindered by workplace injustices leading directly to premature exit from the workforce, particularly among socially disadvantaged workers, or indirectly via sickness absence and other health consequences [ Alexis and Vydelingum 2004 , Giga, et al. 2008 ]. This premature exit may also result from behavioral hints encouraging them to quit their job, which disadvantaged workers may already be more likely to encounter in the workplace [ Giga, et al. 2008 ].

Income has been linked to both physical and mental health [ Pappas, et al. 1993 , Marmot 2002 ]. Thus, workplace injustice could influence health disparities by reducing wages available to socially and economically disadvantaged groups. White men in the U.S. still earn considerably more than equally qualified women and men of other races/ethnicities [ IWPR 2010 ]. Although the Equal Pay Act of 1963 prohibits employers from paying men and women who perform equal tasks at different pay rates, a gender wage gap persists [ IWPR 2010 , US Dept of Commerce 2011 ]. In some organizations, men are still promoted to management positions over their equal female counterparts [ Blau and DeVaro 2007 ]. Also, many women encounter a “glass ceiling,” unable to move up the corporate ladder despite their achievements [ Williams 2001 ]. A wage penalty between 9% and 18% per child has been noted among mothers [ Gangl and Ziefle 2009 ]. In contrast, men seem to benefit in career advancement from having families [ Friedman and Greenhaus 2000 ]. Studies have found that leaves of absence are associated with fewer promotions and smaller salary increases [ Poppleton, et al. 2008 ], and that women are more affected than men because of they usually have heavier caregiving burdens [ Kelly 2005 ]. The wage penalty based on sexual orientation, though, is more complicated. A review of nine studies found that gay and bisexual men earned 10% to 32% less than heterosexual men [ Badgett, et al. 2007 ]. However, the review also found no statistically significant difference in earnings by sexual orientation among male workers in California, demonstrating, in this case, that context at the state-level mattered. The results regarding wage differentials by sexual orientation among women is more equivocal with some studies finding that lesbians earned more while other studies found that they earned less than heterosexual women. [ Badgett 1995 , Black, et al. 2003 , Badgett, et al. 2007 ].

Family Well-Being

In Figure 1 , family well-being is the final component that may be linked to exposure to workplace injustice. From a family systems perspective, family members are linked, and, thus, what happens to one member can influence others through their interactions and communications [ Cox and Paley 1997 ]. As such, health outcomes of workplace injustice can extend beyond the worker via family interactions. One pathway, characterized as the “kick the dog” phenomenon by Hoobler and Brass (2010), occurs when an abused worker acts abusively towards family members. In one study, family members of workers who experienced bullying reported that the workers engaged in family undermining when they got home [ Hoobler, et al. 2010 ]. Furthermore, the stress and well-being of the victim of injustice may cross over and influence family members’ well-being [ Westman 2001 ]. For example, among Mexican-American families, Crouter and colleagues (2006) found that men's reports of workplace racism were associated with depressive symptoms for them and their wives. This effect was moderated by acculturation: the more workplace racism fathers in less acculturated families experienced, the more depressive symptoms family members reported. This association was not apparent in families with higher levels of acculturation [ Crouter, et al. 2006 ]. Thus, workplace injustice may affect family members directly, due to lack of resources from deserved pay and promotions for example, or indirectly due to the disadvantaged workers’ distress or health.

MEASUREMENT AND METHODOLOGICAL CONSIDERATIONS

Qualitative studies have provided rich perspectives from workers to explain how workplace injustice plays out in the labor market, within their jobs, and at worksites [ Agudelo-Suarez, et al. 2009 , de Castro, et al. 2006 , Baillien, et al. 2008 , Bowleg, et al. 2008 , Farquhar, et al. 2008 , Allan, et al. 2009 , Delp, et al. 2009 , van Heugten 2010 ]. Some studies have taken a grounded theory approach to allow for the emergence of themes explicitly or implicitly indicative of workplace injustice. Some of these qualitative studies did not necessarily have a predetermined aim of documenting the occurrence of a particular injustice, but rather initially set out to examine physical and/or psychosocial working conditions of a particular racial/ethnic minority group or groups. For example, de Castro and colleagues (2006) reviewed worker complaints received at a community-based workers’ rights center. The authors discovered that many complaints about working conditions and arrangements were tinged with experiences of discrimination based on workers’ race or ethnicity.

Other studies have quantified workplace injustices using either a self-labeling or operational method through surveys [ Bond, et al. 2007 ]. With self-labeling, study participants indicate whether they have been exposed to a pre-defined type of injustice. The operational method commonly involves study participants indicating whether or not they have experienced different events in a list of acts within a specified period. The number and frequency of experienced acts is then used to classify whether one has or has not experienced a particular workplace injustice. Studies using both methods have shown that prevalence is consistently lower in the self-labeling versus operational method [ Mikkelsen and Einarsen 2001 , Krieger, et al. 2005 , Lutgen-Sandvik, et al. 2007 , Chan, 2008 , Hogh, et al. 2011 ].

An important issue for both methods relates to timing, duration, and severity of the experience, which are often not measured [ Rospenda, et al. 2005 , Badgett, et al. 2007 , Bond, et al. 2007 , Saunders, et al. 2007 , Williams, et al. 2008 , Estrada, et al. 2011 ]. Some measures have a wide window for capturing the timing of the injustice. For example, the widely used measure of sexual harassment (SEQ) has a 24-month reference period (see [ Gutek, et al. 2004 ] for a critique). One-time assessments do not capture the ebb and flow of emotions and experiences related to workplace injustice occurring over time. Sampling and the timing of study participant recruitment poses a barrier to elucidating injustice-health linkages.

Other limitations of studies linking workplace injustices and health outcomes are inconsistencies in measuring different exposures and their outcomes. Currently, no authoritative definitions of the various types of workplace injustice exist. As a result, studies have measured discrimination, harassment, bullying and abuse using different definitions; with some strictly employing legal definitions whereas others use more inclusive definitions. Also, some assessments consist of a one-item measure (e.g., whether a person has been ever discriminated/harassed/abused against at work because of race, religion, sex, age, marital status, nationality, disability, or for any other reason). A key finding in the literature on stress and health is that such failure to develop measures for and comprehensively assess stressful experiences has the end result of understating the impact of stress on health [ Thoits 2010 ].

Additionally, the majority of studies on workplace injustice have been cross-sectional. Although cross-sectional studies provide information about the distribution of disease and can suggest associations between exposures and health outcomes, they do not provide evidence of causality. Furthermore, cross-sectional designs provide little information in terms of temporality, severity of the injustice event(s), or predictability for worker health and organizational outcomes. Cross-sectional studies are valuable for describing the experience of specific worker groups at one point in time, but longitudinal study designs are needed to better understand the unfolding relationship of workplace injustice and health.

An added issue for occupational-related studies is that most samples are drawn from white-collar settings where fewer minority workers work [ Harris, et al. 2011 ]. Few studies of workplace injustice have targeted workers in service settings and even fewer have been of blue-collar workers. Further, studies often fail to consider contextual and historical contributions to workplace injustices such as the historical and current ratio of men to women in the workplace and the race, age, sexual orientation, and gender of supervisors. For example, men might become targets of bullying and sexual harassment in occupations that are historically female. This has been found among nursing assistants where one study found that male nursing assistants reported prevalence of bullying that was twice the prevalence reported by female nursing assistants [ Eriksen and Einarsen 2004 ].

More studies utilizing multiple reporters, such as manager, coworkers, and family members, are also needed. Experiencing injustice in the workplace may “ripple” beyond the parties involved through the work context and into the family and other contexts. Including a diverse sample of reporter perspectives could provide evidence of the extent to which incidents of workplace injustice occur, and, offer insight into possible interventions. Depending on the nature of the workplace injustice, obtaining multiple reports from others at work is not always feasible.

Studies examining interactions of more than one type of workplace injustice are needed. How much do workplace injustices co-occur and what are the health implications of concomitant exposures? One methodological obstacle to such studies is that distinguishing between exposures, (e.g. bullying of racial minorities versus racial discrimination) can be difficult. Being a minority appears to increase the likelihood of being a target of injustice and both bullying and sexual harassment occur in racialized forms [ Alexis and Vydelingum 2004 , Woods, et al. 2009 , Fielden, et al. 2010 ]. A study examining discrimination exposure among job applicants found that African-American male homosexual job candidates were the most likely target of discrimination while White female heterosexual candidates were the least likely to experience discrimination [ Crow, et al. 1998 ]. Several studies addressing the additive influence of minority and immigration status on health are suggestive. A Danish study of the intersection of race/ethnicity and immigration status found that Western immigrants reported the same level of bullying as Danish workers while non-Western immigrants had 85% higher risk of experiencing workplace bullying than Danish workers [ Hogh, et al. 2011 ].

One study suggested only a minimal additive effect of ethnic harassment, gender harassment, and generalized workplace harassment on mental and physical health [ Raver and Nishii 2010 ]. The investigators theorized that workers adapt, thus further harassment does not yield significantly higher negative effects. This is a premise of the adaptation level theory, which posits that people subconsciously adjust to exposure to one form of workplace injustice by using coping strategies that buffer them from further harm [ Raver and Nishii 2010 ]. However, other studies use comparisons of exposure to injustice to exposure to trauma to conclude that exposure to multiple injustices is associated with much greater distress (thus potentially more health harming) than exposure to one injustice [ Yoder and Aniakudo 1995 , Bowleg, et al. 2003 , Krupnick, et al. 2004 , Buchanan and Fitzgerald 2008 ]. These discrepant findings could be due to the timing, severity, and/or type of injustices experienced. The magnitude of additive or multiplicative effect of exposure to multiple workplace injustice is a question that can be answered empirically through more studies, particularly if designed longitudinally and informed by a lifecourse perspective. Studies could also incorporate recruitment strategies that allow the recruitment of study participants who have been exposed to the multiple exposures under study.

These study design issues may, in part, reflect the difficulties researchers face in gathering data on workplace injustice. As noted by Badgett and colleagues (2007) , employers do not easily cooperate with research on workplace injustice compared to other types of workplace studies (e.g. worksite health promotion), and findings from such studies could have legal and financial implications and/or cause damage to employer's image.

CONCLUSIONS AND RECOMMENDATIONS

The extant literature describes the phenomena of discrimination, harassment, abuse and bullying in the workplace and the potential outcomes of these exposures. Although there are exceptions, these unjust experiences are most often described as affecting workers in non-dominant and/or disadvantaged worker groups. Our review pointed out that these same worker groups often hold more hazardous jobs and have been shown to experience poorer general health. We explored how various forms of workplace injustice have been shown to operate and contribute to disparate health among these workers. Additionally, we suggested a conceptual model informed by current evidence to illustrate pathways between workplace injustice experiences and health disparities. The model is offered as a starting point for researchers to build upon in exploring the potential mechanisms between these exposures and health disparities and under what conditions these disparities occur. The intent of this conceptual model is to contribute to the “unpacking” of the complex contributions of workplace injustices to health disparities.

Prospective studies and refinement of methods for characterizing and quantifying workplace injustices are needed to establish causative roles and to disentangle the contributions of various exposures. Future studies should employ representative samples and oversample disadvantaged worker groups. The literature on workplace ageism and its health effects are lacking; as the workforce ages and workers delay retirement, this is a timely area for study.

Though the body of literature directly linking workplace injustice and health is small, we believe that our conceptual model is a working model that incorporates the evidence to date. While more research should be done to characterize the relationship between workplace injustice and health, the current evidence supports the pathways in this model and points to a potentially important role for workplace injustice in the health status of working people and likely their families.

Evidence for the influence of workplace injustices on health outcomes

Conflict of Interest: The authors have no conflict of interest.

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• Open access
• Published: 13 May 2024

Sexual and reproductive health implementation research in humanitarian contexts: a scoping review

• Alexandra Norton 1 &
• Hannah Tappis 2  

Reproductive Health volume  21 , Article number:  64 ( 2024 ) Cite this article

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Meeting the health needs of crisis-affected populations is a growing challenge, with 339 million people globally in need of humanitarian assistance in 2023. Given one in four people living in humanitarian contexts are women and girls of reproductive age, sexual and reproductive health care is considered as essential health service and minimum standard for humanitarian response. Despite growing calls for increased investment in implementation research in humanitarian settings, guidance on appropriate methods and analytical frameworks is limited.

A scoping review was conducted to examine the extent to which implementation research frameworks have been used to evaluate sexual and reproductive health interventions in humanitarian settings. Peer-reviewed papers published from 2013 to 2022 were identified through relevant systematic reviews and a literature search of Pubmed, Embase, PsycInfo, CINAHL and Global Health databases. Papers that presented primary quantitative or qualitative data pertaining to a sexual and reproductive health intervention in a humanitarian setting were included.

Seven thousand thirty-six unique records were screened for inclusion, and 69 papers met inclusion criteria. Of these, six papers explicitly described the use of an implementation research framework, three citing use of the Consolidated Framework for Implementation Research. Three additional papers referenced other types of frameworks used in their evaluation. Factors cited across all included studies as helping the intervention in their presence or hindering in their absence were synthesized into the following Consolidated Framework for Implementation Research domains: Characteristics of Systems, Outer Setting, Inner Setting, Characteristics of Individuals, Intervention Characteristics, and Process.

This review found a wide range of methodologies and only six of 69 studies using an implementation research framework, highlighting an opportunity for standardization to better inform the evidence for and delivery of sexual and reproductive health interventions in humanitarian settings. Increased use of implementation research frameworks such as a modified Consolidated Framework for Implementation Research could work toward both expanding the evidence base and increasing standardization.

Plain English summary

Three hundred thirty-nine million people globally were in need of humanitarian assistance in 2023, and meeting the health needs of crisis-affected populations is a growing challenge. One in four people living in humanitarian contexts are women and girls of reproductive age, and provision of sexual and reproductive health care is considered to be essential within a humanitarian response. Implementation research can help to better understand how real-world contexts affect health improvement efforts. Despite growing calls for increased investment in implementation research in humanitarian settings, guidance on how best to do so is limited. This scoping review was conducted to examine the extent to which implementation research frameworks have been used to evaluate sexual and reproductive health interventions in humanitarian settings. Of 69 papers that met inclusion criteria for the review, six of them explicitly described the use of an implementation research framework. Three used the Consolidated Framework for Implementation Research, a theory-based framework that can guide implementation research. Three additional papers referenced other types of frameworks used in their evaluation. This review summarizes how factors relevant to different aspects of implementation within the included papers could have been organized using the Consolidated Framework for Implementation Research. The findings from this review highlight an opportunity for standardization to better inform the evidence for and delivery of sexual and reproductive health interventions in humanitarian settings. Increased use of implementation research frameworks such as a modified Consolidated Framework for Implementation Research could work toward both expanding the evidence base and increasing standardization.

Peer Review reports

Over the past few decades, the field of public health implementation research (IR) has grown as a means by which the real-world conditions affecting health improvement efforts can be better understood. Peters et al. put forward the following broad definition of IR for health: “IR is the scientific inquiry into questions concerning implementation – the act of carrying an intention into effect, which in health research can be policies, programmes, or individual practices (collectively called interventions)” [ 1 ].

As IR emphasizes real-world circumstances, the context within which a health intervention is delivered is a core consideration. However, much IR implemented to date has focused on higher-resource settings, with many proposed frameworks developed with particular utility for a higher-income setting [ 2 ]. In recognition of IR’s potential to increase evidence across a range of settings, there have been numerous reviews of the use of IR in lower-resource settings as well as calls for broader use [ 3 , 4 ]. There have also been more focused efforts to modify various approaches and frameworks to strengthen the relevance of IR to low- and middle-income country settings (LMICs), such as the work by Means et al. to adapt a specific IR framework for increased utility in LMICs [ 2 ].

Within LMIC settings, the centrality of context to a health intervention’s impact is of particular relevance in humanitarian settings, which present a set of distinct implementation challenges [ 5 ]. Humanitarian responses to crisis situations operate with limited resources, under potential security concerns, and often under pressure to relieve acute suffering and need [ 6 ]. Given these factors, successful implementation of a particular health intervention may require different qualities than those that optimize intervention impact under more stable circumstances [ 7 ]. Despite increasing recognition of the need for expanded evidence of health interventions in humanitarian settings, the evidence base remains limited [ 8 ]. Furthermore, despite its potential utility, there is not standardized guidance on IR in humanitarian settings, nor are there widely endorsed recommendations for the frameworks best suited to analyze implementation in these settings.

Sexual and reproductive health (SRH) is a core aspect of the health sector response in humanitarian settings [ 9 ]. Yet, progress in addressing SRH needs has lagged far behind other services because of challenges related to culture and ideology, financing constraints, lack of data and competing priorities [ 10 ]. The Minimum Initial Service Package (MISP) for SRH in Crisis Situations is the international standard for the minimum set of SRH services that should be implemented in all crisis situations [ 11 ]. However, as in other areas of health, there is need for expanded evidence for planning and implementation of SRH interventions in humanitarian settings. Recent systematic reviews of SRH in humanitarian settings have focused on the effectiveness of interventions and service delivery strategies, as well as factors affecting utilization, but have not detailed whether IR frameworks were used [ 12 , 13 , 14 , 15 ]. There have also been recent reviews examining IR frameworks used in various settings and research areas, but none have explicitly focused on humanitarian settings [ 2 , 16 ].

Given the need for an expanded evidence base for SRH interventions in humanitarian settings and the potential for IR to be used to expand the available evidence, a scoping review was undertaken. This scoping review sought to identify IR approaches that have been used in the last ten years to evaluate SRH interventions in humanitarian settings.

This review also sought to shed light on whether there is a need for a common framework to guide research design, analysis, and reporting for SRH interventions in humanitarian settings and if so, if there are any established frameworks already in use that would be fit-for-purpose or could be tailored to meet this need.

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews was utilized to guide the elements of this review [ 17 ]. The review protocol was retrospectively registered with the Open Science Framework ( https://osf.io/b5qtz ).

Search strategy

A two-fold search strategy was undertaken for this review, which covered the last 10 years (2013–2022). First, recent systematic reviews pertaining to research or evaluation of SRH interventions in humanitarian settings were identified through keyword searches on PubMed and Google Scholar. Four relevant systematic reviews were identified [ 12 , 13 , 14 , 15 ] Table 1 .

Second, a literature search mirroring these reviews was conducted to identify relevant papers published since the completion of searches for the most recent review (April 2017). Additional file 1 includes the search terms that were used in the literature search [see Additional file 1 ].

The literature search was conducted for papers published from April 2017 to December 2022 in the databases that were searched in one or more of the systematic reviews: PubMed, Embase, PsycInfo, CINAHL and Global Health. Searches were completed in January 2023 Table 2 .

Two reviewers screened each identified study for alignment with inclusion criteria. Studies in the four systematic reviews identified were considered potentially eligible if published during the last 10 years. These papers then underwent full-text review to confirm satisfaction of all inclusion criteria, as inclusion criteria were similar but not fully aligned across the four reviews.

Literature search results were exported into a citation manager (Covidence), duplicates were removed, and a step-wise screening process for inclusion was applied. First, all papers underwent title and abstract screening. The remaining papers after abstract screening then underwent full-text review to confirm satisfaction of all inclusion criteria. Title and abstract screening as well as full-text review was conducted independently by both authors; disagreements after full-text review were resolved by consensus.

Data extraction and synthesis

The following content areas were summarized in Microsoft Excel for each paper that met inclusion criteria: publication details including author, year, country, setting [rural, urban, camp, settlement], population [refugees, internally displaced persons, general crisis-affected], crisis type [armed conflict, natural disaster], crisis stage [acute, chronic], study design, research methods, SRH intervention, and intervention target population [specific beneficiaries of the intervention within the broader population]; the use of an IR framework; details regarding the IR framework, how it was used, and any rationale given for the framework used; factors cited as impacting SRH interventions, either positively or negatively; and other key findings deemed relevant to this review.

As the focus of this review was on the approach taken for SRH intervention research and evaluation, the quality of the studies themselves was not assessed.

Twenty papers underwent full-text review due to their inclusion in one or more of the four systematic reviews and meeting publication date inclusion criteria. The literature search identified 7,016 unique papers. After full-text screening, 69 met all inclusion criteria and were included in the review. Figure  1 illustrates the search strategy and screening process.

Flow chart of paper identification

Papers published in each of the 10 years of the review timeframe (2013–2022) were included. 29% of the papers originated from the first five years of the time frame considered for this review, with the remaining 71% papers coming from the second half. Characteristics of included publications, including geographic location, type of humanitarian crisis, and type of SRH intervention, are presented in Table  3 .

A wide range of study designs and methods were used across the papers, with both qualitative and quantitative studies well represented. Twenty-six papers were quantitative evaluations [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ], 17 were qualitative [ 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ], and 26 used mixed methods [ 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 ]. Within the quantitative evaluations, 15 were observational, while five were quasi-experimental, five were randomized controlled trials, and one was an economic evaluation. Study designs as classified by the authors of this review are summarized in Table  4 .

Six papers (9%) explicitly cited use of an IR framework. Three of these papers utilized the Consolidated Framework for Implementation Research (CFIR) [ 51 , 65 , 70 ]. The CFIR is a commonly used determinant framework that—in its originally proposed form in 2009—is comprised of five domains, each of which has constructs to further categorize factors that impact implementation. The CFIR domains were identified as core content areas influencing the effectiveness of implementation, and the constructs within each domain are intended to provide a range of options for researchers to select from to “guide diagnostic assessments of implementation context, evaluate implementation progress, and help explain findings.” [ 87 ] To allow for consistent terminology throughout this review, the original 2009 CFIR domains and constructs are used.

Guan et al. conducted a mixed methods study to assess the feasibility and effectiveness of a neonatal hepatitis B immunization program in a conflict-affected rural region of Myanmar. Guan et al. report mapping data onto the CFIR as a secondary analysis step. They describe that “CFIR was used as a comprehensive meta-theoretical framework to examine the implementation of the Hepatitis B Virus vaccination program,” and implementation themes from multiple study data sources (interviews, observations, examination of monitoring materials) were mapped onto CFIR constructs. They report their results in two phases – Pre-implementation training and community education, and Implementation – with both anchored in themes that they had mapped onto CFIR domains and constructs. All but six constructs were included in their analysis, with a majority summarized in a table and key themes explored further in the narrative text. They specify that most concerns were identified within the Outer Setting and Process domains, while elements identified within the Inner Setting domain provided strength to the intervention and helped mitigate against barriers [ 70 ].

Sarker et al. conducted a qualitative study to assess provision of maternal, newborn and child health services to Rohingya refugees residing in camps in Cox’s Bazar, Bangladesh. They cite using CFIR as a guide for thematic analysis, applying it after a process of inductive and deductive coding to index these codes into the CFIR domains. They utilized three of the five CFIR domains (Outer Setting, Inner Setting, and Process), stating that the remaining two domains (Intervention Characteristics and Characteristics of Individuals) were not relevant to their analysis. They then proposed two additional CFIR domains, Context and Security, for use in humanitarian contexts. In contrast to Guan et al., CFIR constructs are not used nor mentioned by Sarker et al., with content under each domain instead synthesized as challenges and potential solutions. Regarding the CFIR, Sarker et al. write, “The CFIR guided us for interpretative coding and creating the challenges and possible solutions into groups for further clarification of the issues related to program delivery in a humanitarian crisis setting.” [ 51 ]

Sami et al. conducted a mixed methods case study to assess the implementation of a package of neonatal interventions at health facilities within refugee and internally displaced persons camps in South Sudan. They reference use of the CFIR earlier in the study than Sarker et al., basing their guides for semi-structured focus group discussions on the CFIR framework. They similarly reference a general use of the CFIR framework as they conducted thematic analysis. Constructs are referenced once, but they do not specify whether their application of the CFIR framework included use of domains, constructs, or both. This may be in part because they then applied an additional framework, the World Health Organization (WHO) Health System Framework, to present their findings. They describe a nested approach to their use of these frameworks: “Exploring these [CFIR] constructs within the WHO Health Systems Framework can identify specific entry points to improve the implementation of newborn interventions at critical health system building blocks.” [ 65 ]

Three papers cite use of different IR frameworks. Bolan et al. utilized the Theoretical Domains Framework in their mixed methods feasibility study and pilot cluster randomized trial evaluating pilot use of the Safe Delivery App by maternal and newborn health workers providing basic emergency obstetric and newborn care in facilities in the conflict-affected Maniema province of the Democratic Republic of the Congo (DRC). They used the Theroetical Domains Framework in designing interview questions, and further used it as the coding framework for their analysis. Similar to the CFIR, the Theoretical Domains Framework is a determinant framework that consists of domains, each of which then includes constructs. Bolan et al. utilized the Theoretical Domains Framework at the construct level in interview question development and at the domain level in their analysis, mapping interview responses to eight of the 14 domains [ 83 ]. Berg et al. report using an “exploratory design guided by the principles of an evaluation framework” developed by the Medical Research Council to analyze the implementation process, mechanisms of impact, and outcomes of a three-pillar training intervention to improve maternal and neonatal healthcare in the conflict-affected South Kivu province of the DRC [ 67 , 88 ]. Select components of this evaluation framework were used to guide deductive analysis of focus group discussions and in-depth interviews [ 67 ]. In their study of health workers’ knowledge and attitudes toward newborn health interventions in South Sudan, before and after training and supply provision, Sami et al. report use of the Conceptual Framework of the Role of Attitudes in Evidence-Based Practice Implementation in their analysis process. The framework was used to group codes following initial inductive coding analysis of in-depth interviews [ 72 ].

Three other papers cite use of specific frameworks in their intervention evaluation [ 19 , 44 , 76 ]. As a characteristic of IR is the use of an explicit framework to guide the research, the use of the frameworks in these three papers meets the intention of IR and serves the purpose that an IR framework would have in strengthening the analytical rigor. Castle et al. cite use of their program’s theory of change as a framework for a mixed methods evaluation of the provision of family planning services and more specifically uptake of long-acting reversible contraception use in the DRC. They describe use of the theory of change to “enhance effectiveness of [long-acting reversible contraception] access and uptake.” [ 76 ] Thommesen et al. cite use of the AAAQ (Availability, Accessibility, Acceptability and Quality) framework in their qualitative study assessing midwifery services provided to pregnant women in Afghanistan. This framework is focused on the “underlying elements needed for attainment of optimum standard of health care,” but the authors used it in this paper to evaluate facilitators and barriers to women accessing midwifery services [ 44 ]. Jarrett et al. cite use of the Centers for Disease Control and Prevention’s (CDC) Guidelines for Evaluating Public Health Surveillance Systems to explore the characteristics of a population mobility, mortality and birth surveillance system in South Kivu, DRC. Use of these CDC guidelines is cited as one of four study objectives, and commentary is included in the Results section pertaining to each criteria within these guidelines, although more detail regarding use of these guidelines or the authors’ experience with their use in the study is not provided [ 19 ].

Overall, 22 of the 69 papers either explicitly or implicitly identified IR as relevant to their work. Nineteen papers include a focus on feasibility (seven of which did not otherwise identify the importance of exploring questions concerning implementation), touching on a common outcome of interest in implementation research [ 89 ].

While a majority of papers did not explicitly or implicitly use an IR framework to evaluate their SRH intervention of focus, most identified factors that facilitated implementation when they were present or served as a barrier when absent. Sixty cite factors that served as facilitators and 49 cite factors that served as barriers, with just three not citing either. Fifty-nine distinct factors were identified across the papers.

Three of the six studies that explicitly used an IR framework used the CFIR, and the CFIR is the only IR framework that was used by multiple studies. As previously mentioned, Means et al. put forth an adaptation of the CFIR to increase its relevance in LMIC settings, proposing a sixth domain (Characteristics of Systems) and 11 additional constructs [ 2 ]. Using the expanded domains and constructs as proposed by Means et al., the 59 factors cited by papers in this review were thematically grouped into the six domains: Characteristics of Systems, Outer Setting, Inner Setting, Characteristics of Individuals, Intervention Characteristics, and Process. Within each domain, alignment with CFIR constructs was assessed for, and alignment was found with 29 constructs: eight of Means et al.’s 11 constructs, and 21 of the 39 standard CFIR constructs. Three factors did not align with any construct (all fitting within the Outer Setting domain), and 14 aligned with a construct label but not the associated definition. Table 5 synthesizes the mapping of factors affecting SRH intervention implementation to CFIR domains and constructs, with the construct appearing in italics if it is considered to align with that factor by label but not by definition.

Table 6 lists the CFIR constructs that were not found to have alignment with any factor cited by the papers in this review.

This scoping review sought to assess how IR frameworks have been used to bolster the evidence base for SRH interventions in humanitarian settings, and it revealed that IR frameworks, or an explicit IR approach, are rarely used. All four of the systematic reviews identified with a focus on SRH in humanitarian settings articulate the need for more research examining the effectiveness of SRH interventions in humanitarian settings, with two specifically citing a need for implementation research/science [ 12 , 13 ]. The distribution of papers across the timeframe included in this review does suggest that more research on SRH interventions for crisis-affected populations is taking place, as a majority of relevant papers were published in the second half of the review period. The papers included a wide range of methodologies, which reflect the differing research questions and contexts being evaluated. However, it also invites the question of whether there should be more standardization of outcomes measured or frameworks used to guide analysis and to facilitate increased comparison, synthesis and application across settings.

Three of the six papers that used an IR framework utilized the CFIR. Guan et al. used the CFIR at both a domain and construct level, Sarker et al. used the CFIR at the domain level, and Sami et al. did not specify which CFIR elements were used in informing the focus group discussion guide [ 51 , 65 , 70 ]. It is challenging to draw strong conclusions about the applicability of CFIR in humanitarian settings based on the minimal use of CFIR and IR frameworks within the papers reviewed, although Guan et al. provides a helpful model for how analysis can be structured around CFIR domains and constructs. It is worth considering that the minimal use of IR frameworks, and more specifically CFIR constructs, could be in part because that level of prescriptive categorization does not allow for enough fluidity in humanitarian settings. It also raises questions about the appropriate degree of standardization to pursue for research done in these settings.

The mapping of factors affecting SRH intervention implementation provides an example of how a modified CFIR framework could be used for IR in humanitarian contexts. This mapping exercise found factors that mapped to all five of the original CFIR domains as well as the sixth domain proposed by Means et al. All factors fit well within the definition for the selected domain, indicating an appropriate degree of fit between these existing domains and the factors identified as impacting SRH interventions in humanitarian settings. On a construct level, however, the findings were more variable, with one-quarter of factors not fully aligning with any construct. Furthermore, over 40% of the CFIR constructs (including the additional constructs from Means et al.) were not found to align with any factors cited by the papers in this review, also demonstrating some disconnect between the parameters posed by the CFIR constructs and the factors cited as relevant in a humanitarian context.

It is worth noting that while the CFIR as proposed in 2009 was used in this assessment, as well as in the included papers which used the CFIR, an update was published in 2022. Following a review of CFIR use since its publication, the authors provide updates to construct names and definitions to “make the framework more applicable across a range of innovations and settings.” New constructs and subconstructs were also added, for a total of 48 constructs and 19 subconstructs across the five domains [ 90 ]. A CFIR Outcomes Addendum was also published in 2022, based on recommendations for the CFIR to add outcomes and intended to be used as a complement to the CFIR determinants framework [ 91 ]. These expansions to the CFIR framework may improve applicability of the CFIR in humanitarian settings. Several constructs added to the Outer Setting domain could be of particular utility – critical incidents, local attitudes, and local conditions, each of which could help account for unique challenges faced in contexts of crisis. Sub-constructs added within the Inner Setting domain that seek to clarify structural characteristics and available resources would also be of high utility based on mapping of the factors identified in this review to the original CFIR constructs. As outcomes were not formally included in the CFIR until the 2022 addendum, a separate assessment of implementation outcomes was not undertaken in this review. However, analysis of the factors cited by papers in this review as affecting implementation was derived from the full text of the papers and thus captures content relevant to implementation determinants that is contained within the outcomes.

Given the demonstrated need for additional flexibility within an IR framework for humanitarian contexts, while not a focus of this review, it is worth considering whether a different framework could provide a better fit than the CFIR. Other frameworks have differing points of emphasis that would create different opportunities for flexibility but that do not seem to resolve the challenges experienced in applying the CFIR to a humanitarian context. As one example, the EPIS (Exploration, Preparation, Implementation, Sustainment) Framework considers the impact of inner and outer context on each of four implementation phases; while the constructs within this framework are broader than the CFIR, an emphasis on the intervention characteristics is missing, a domain where stronger alignment within the CFIR is also needed [ 92 ]. Alternatively, the PRISM (Practical, Robust Implementation and Sustainability Model) framework is a determinant and evaluation framework that adds consideration of context factors to the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) outcomes framework. It has a stronger emphasis on intervention aspects, with sub-domains to account for both organization and patient perspectives within the intervention. While PRISM does include aspects of context, external environment considerations are less robust and intentionally less comprehensive in scope, which would not provide the degree of alignment possible between the Characteristics of Systems and Outer Setting CFIR domains for the considerations unique to humanitarian environments [ 93 ].

Reflecting on their experience with the CFIR, Sarker et al. indicate that it can be a “great asset” in both evaluating current work and developing future interventions. They also encourage future research of humanitarian health interventions to utilize the CFIR [ 51 ]. The other papers that used the CFIR do not specifically reflect on their experience utilizing it, referring more generally to having felt that it was a useful tool [ 65 , 70 ]. On their use of an evaluation framework, Berg et al. reflected that it lent useful structure and helped to identify aspects affecting implementation that otherwise would have gone un-noticed [ 67 ]. The remaining studies that utilized an IR framework did not specifically comment on their experience with its use [ 72 , 83 ]. While a formal IR framework was not engaged by other studies, a number cite a desire for IR to contribute further detail to their findings [ 21 , 37 ].

In their recommendations for strengthening the evidence base for humanitarian health interventions, Ager et al. speak to the need for “methodologic innovation” to develop methodologies with particular applicability in humanitarian settings [ 7 ]. As IR is not yet routinized for SRH interventions, this could be opportune timing for the use of a standardized IR framework to gauge its utility. Using an IR framework to assess factors influencing implementation of the MISP in initial stages of a humanitarian response, and interventions to support more comprehensive SRH service delivery in protracted crises, could lend further rigor and standardization to SRH evaluations, as well as inform strategies to improve MISP implementation over time. Based on categorizing factors identified by these papers as relevant for intervention evaluation, there does seem to be utility to a modified CFIR approach. Given the paucity of formal IR framework use within SRH literature, it would be worth conducting similar scoping exercises to assess for explicit use of IR frameworks within the evidence base for other health service delivery areas in humanitarian settings. In the interim, the recommended approach from this review for future IR on humanitarian health interventions would be a modified CFIR approach with domain-level standardization and flexibility for constructs that may standardize over time with more use. This would enable use of a common analytical framework and vocabulary at the domain level for stakeholders to describe interventions and the factors influencing the effectiveness of implementation, with constructs available to use and customize as most appropriate for specific contexts and interventions.

This review had a number of limitations. As this was a scoping review and a two-part search strategy was used, the papers summarized here may not be comprehensive of those written pertaining to SRH interventions over the past 10 years. Papers from 2013 to 2017 that would have met this scoping review’s inclusion criteria may have been omitted due to being excluded from the systematic reviews. The review was limited to papers available in English. Furthermore, this review did not assess the quality of the papers included or seek to assess the methodology used beyond examination of the use of an IR framework. It does, however, serve as a first step in assessing the extent to which calls for implementation research have been addressed, and identify entry points for strengthening the science and practice of SRH research in humanitarian settings.

With one in 23 people worldwide in need of humanitarian assistance, and financing required for response plans at an all-time high, the need for evidence to guide resource allocation and programming for SRH in humanitarian settings is as important as ever [ 94 ]. Recent research agenda setting initiatives and strategies to advance health in humanitarian settings call for increased investment in implementation research—with priorities ranging from research on effective strategies for expanding access to a full range of contraceptive options to integrating mental health and psychosocial support into SRH programming to capturing accurate and actionable data on maternal and perinatal mortality in a wide range of acute and protracted emergency contexts [ 95 , 96 ]. To truly advance guidance in these areas, implementation research will need to be conducted across diverse humanitarian settings, with clear and consistent documentation of both intervention characteristics and outcomes, as well as contextual and programmatic factors affecting implementation.

Conclusions

Implementation research has potential to increase impact of health interventions particularly in crisis-affected settings where flexibility, adaptability and context-responsive approaches are highlighted as cornerstones of effective programming. There remains significant opportunity for standardization of research in the humanitarian space, with one such opportunity occurring through increased utilization of IR frameworks such as a modified CFIR approach. Investing in more robust sexual and reproductive health research in humanitarian contexts can enrich insights available to guide programming and increase transferability of learning across settings.

Availability of data and materials

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

Availability, Accessibility, Acceptability and Quality

Centers for Disease Control and Prevention

Consolidated Framework for Implementation Research

Democratic Republic of the Congo

Exploration, Preparation, Implementation, Sustainment

• Implementation research

Low and middle income country

Minimum Initial Service Package

Practical, Robust Implementation and Sustainability Model

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

Reach, Effectiveness, Adoption, Implementation, Maintenance

• Sexual and reproductive health

World Health Organization

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Unicorns Podcast: Guiding corporates through landmark workplace sexual harassment law reforms

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The Unicorns Podcast connects you to some of the best and brightest founders, CEOs, executives, business owners, innovators, entrepreneurs and inspiring leaders who make things happen and inspire others.

Host Justin Kelly, former broadcast journalist and PR veteran, chats with leaders from across Australia and internationally on business strategy; what it takes to build a successful company; how to overcome challenges, and advice for those on a similar journey.

In this episode, Justin interviews Prabha Nandagopal, the founder of Elevate Consulting Partners.

Everyone has the right to feel safe and respected at work. Figures show that a staggering 1 in 3 people have been sexually harassed in their workplace. Since the “positive duty” legislation took effect in December 2023, many businesses have sought guidance on complying with these sweeping changes.

With the Australian Human Rights Commission now actively monitoring and enforcing adherence to the new laws, organisations nationwide are looking for assistance to ensure they meet their legal obligations and foster safe, respectful workplaces. Prabha Nandagopal was the senior legal advisor on the Respect@Work report, a key architect of the new positive duty compliance framework and founder of Elevate Consulting Partners.

Prabha and the Elevate Consulting team bring vast experience in combating sex-based discrimination and harassment, as well as respect at work and pay equality.

Prabha established the compliance and enforcement team at the Australian Human Rights Commission, giving her a unique understanding of effective measures businesses and organisations can take to meet their obligations.

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‘not so hospitable’: majority of adelaide hospitality workers in research paper report sexual harassment.

Extent of sexual abuse revealed in Adelaide hospital industry revealed in research paper

Trigger warning: This article contains descriptions of sexual assault

Jeanie Walker remembers, as young chef, being awarded apprentice of the year — and then her feeling of excitement crashing when a colleague remarked: “Who did you suck off to get that award.”

Walker, who has now worked in the hospitality industry for four decades, said sexual abuse is so prevalent she was groped almost daily and sexual harassment was just part of the workplace banter.

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“Nearly every conversation involved sex or commenting on the fact I’ve got big breasts or that I was female — unbelievable things, really, when I think back,” Walker said.

She said people would come into venues drunk, put their arms around female staff, kiss them on the neck and call them “their little sweet pea”.

The prevalance of sexual harassment and abuse in the Adelaide hospitality industry has been outlined in a research paper which found 57 per cent of respondents had been sexually harassed and 41 per cent sexually assaulted.

The investigation detailed the experiences of workers who reported sexual comments, groping, forced kissing, oral sex and rape.

Walker, now the owner of a vegan restaurant, said she began working in hospitality as 15-year-old with not much understanding of sexual abuse.

She alleged she was raped twice when working in hospitality.

Remembering what she endured in silence then now makes her emotional.

She said she had to bury a lot of the memories to “fit in” and excel in her industry.

“We were constantly targeted and harassed on a daily basis, it was just part of the routine,” she said.

“To get by as a female chef in the industry back then, you had to be twice as tough and you had to just wear it and continue on. There were no mechanisms for complaining.”

Extent of sexual abuse revealed

Some of the testimonies shared in the paper, Not So Hospitable, include instances of physical abuse where a male colleague thrust his groin into a staff member who was kneeling over, and others who coerced staff members into kissing.

One woman said a male patron put his fingers between her legs and said: “That’s a prime cut you’ve got there, chef.”

Another alleged she was assaulted by her boss.

“He told me I’d still be getting paid and roughly grabbed my hair and brought me down to my knees. I screamed and he smacked my face. He told me I was stupid for screaming in a club and that his office was soundproof,” the woman said in her testimony.

Stories of harassment were also included, such as a female worker who said: “My boss would address me as a ‘slut’ and ‘whore’ in the office in front of my other male colleagues.”

Another said she worked in a venue that had a dedicated day known as sexual assault Sundays, when “the more senior staff were allowed to make sexual jokes and harass the younger staff”.

Jamie Alexandra Bucirde worked with The University of Melbourne researchers on the report, initiated from a grassroots movement inviting women to share their experiences of sexual violence in the industry.

Bucirde said she was motivated when she saw hundreds of Adelaide women share stories of abuse but was told they could not be considered case studies for policy change because they were not part of a formal body of work.

Having worked in hospitality for 10 years before becoming a sexologist, Bucirde said she was not surprised by the testimonies but was shocked by the prevalence of abuse — and the number of respondents (33 per cent) who were underage.

The report draws on the stories of 359 male and female hospitality workers who submitted testimonies between August 2022 and December 2022.

Of 320 respondents who shared information on the perpetrator’s role, 23 per cent said their managers were part of the abuse, 22 per cent said it involved patrons and 19 per cent said it was their boss.

Bucirde said it was “unsurprising” the report found 48 per cent of people said their managers did nothing when they reported abuse, and 29 per cent felt they could not report abuse.

“We found that 8 per cent of these people who tried to report had their shifts cut or they were fired,” she said.

“If these venues have these perpetrators in positions of power (who) don’t help with reporting because it’s self-regulated, off course things are going to get brushed under the rug.”

Most of the incidents of abuse happened in bars (39 per cent) and cafes (38 per cent).

About 12 per cent of testimonies came from people who worked in bottle shops, wineries and fast food outlets.

A smaller portion of respondents worked in festivals (8 per cent) and hotels (5 per cent).

Bucirde hopes the study will lead to sexual violence being included in existing Responsible Service of Alcohol training for the hospitality industry in South Australia.

“It sets a new baseline of access to information and education,” she said.

The South Australian government said it was considering a range of measures to tackle the behaviour of sexual harassment and abuse perpetrators, including in the hospitality industry.

“Every person and every industry and organisation has a role to play in tackling sexual assault and all violence toward women and the disrespectful attitudes toward women and gender inequality that underpins it,” a spokesperson said.

- With Kimberely Pratt.

If you or someone you know is impacted by sexual assault, domestic or family violence, call 1800RESPECT on 1800 737 732 or visit 1800RESPECT . org.au . In an emergency, call 000.

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