Nursing ETDs

Publication Date

Fall 12-17-2018


Military sexual trauma (MST) is a significant problem in U.S. military service branches, service academies, and National Guard units, with both immediate and longer term traumatic effects on survivors who are disproportionately female. MST includes sexual harassment or assault during military service and the ensuing consequences for physical health and psychosocial well-being of service members and veterans. The Department of Defense is committed to reducing the incidence of sexual assault and harassment among service members, encouraging victims to report, and mitigating the impact of MST. However, the estimated prevalence of sexual assault among active duty service members remains unacceptably high, and only one-third of incidents are reported. Lawmakers have proposed numerous reforms related to MST, but few such efforts have been enacted into law. National interest groups have been active in advocating changes to statutes and policies related to MST, but relatively little is known about the strategies they use, factors vii associated with success, and how they collaborate to promote change. The focus of this qualitative case study was the strategies of national interest groups engaged in advocacy for survivors and in efforts to prevent MST or ameliorate its consequences. Telephone interviews were conducted with representatives of interest groups or lobbyists (n = 4), and congressional staff (n = 2) involved with MST issues. Eight strategies were identified from the interviews and grouped under themes of direct advocacy (cultivating relationships, putting a face on the problem, giving voice to survivors), mobilizing support (heightening public awareness, bringing pressure to bear), and engagement in the policy process (providing factual information, connecting the dots, involvement in MST legislation). Factors contributing to accomplishing policy goals included facilitating access to services or benefits, expertise, organizational reputation, and issue framing. Factors posing challenges included resistance to change, competing issues, size of agency or department, and costs. Changes in administration, party control, and seniority could either facilitate or impede policy change. Better understanding of strategies of interest groups and how they interact with each other and with congressional staff may increase the likelihood of achieving policy and legislative goals related to MST.

Degree Name


Level of Degree


Department Name

College of Nursing

First Committee Member (Chair)

Mark B. Parshall

Second Committee Member

Jonathan Eldredge

Third Committee Member

Stephen Hernandez

Fourth Committee Member

Emily Haozous



Document Type


Included in

Nursing Commons