A nurse-delivered, clinic-based intervention to address intimate partner violence among low-income women in Mexico City: findings from a cluster randomized controlled trial.
A nurse-delivered, clinic-based intervention to address intimate partner violence among low-income women in Mexico City: findings from a cluster randomized controlled trial.
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DOI：
10.1186/s12916-017-0880-y
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发表时间：
2017-07-12
期刊：
影响因子：
9.3
通讯作者：
Olavarrieta CD
中科院分区：
文献类型：
--
作者：
Gupta J;Falb KL;Ponta O;Xuan Z;Campos PA;Gomez AA;Valades J;Cariño G;Olavarrieta CD
低收入和中等收入国家缺乏对卫生部门针对亲密伴侣暴力 (IPV) 的干预措施的严格评估。我们的目的是评估加强护士提供的干预是否会减少 IPV 并提高安全规划行为、社区资源的使用、生殖胁迫和心理生活质量的水平。我们将墨西哥城的 42 家公共卫生诊所随机分为治疗组和对照组。在治疗诊所中，女性在基线 (T1) 时接受护士提供的课程（IPV 筛查、支持转诊、健康/安全风险评估），并在 3 个月后 (T2) 接受加强咨询课程。在对照诊所，妇女接受护士的筛查和转诊卡。调查在 T1、T2 和 T3（距基线 15 个月）进行。我们的主要成果是去年的身体和性 IPV。通过三水平随机截距模型进行意向治疗分析，以按时间评估治疗状态的相互作用项。 2013 年 4 月至 10 月期间，950 名近期有 IPV 经验的女性（480 名在对照诊所，470 名在治疗诊所）参加了该研究。虽然在 T3（2014 年 7 月至 12 月）时，参加治疗（OR，0.40；95% CI，0.28–0.55；P < 0.01）和对照（OR，0.51；95% CI，0.36–0.72；P < 0.01）诊所的女性均观察到 IPV 降低，但没有观察到显着的治疗效果（OR，0.78；95% CI，0.49–1.24；P = 0.30）。在 T2（2013 年 7 月至 12 月）时，与对照诊所的女性相比，治疗诊所的女性在心理生活质量（β，1.45；95% CI，0.14–2.75；P = 0.03）和安全计划行为（β，0.41；95% CI，0.02–0.79；P = 0.03）方面有显着改善。 P = 0.04）。虽然治疗诊所和对照诊所的女性 IPV 水平均有所下降，但加强的护士干预并没有在降低 IPV 方面更有效。加强护理干预可能会在解决安全计划和心理生活质量方面提供短期改善。护士可以在帮助有 IPV 经验的女性方面发挥支持作用。临床试验.gov (NCT01661504)。注册日期：2012 年 8 月 2 日 本文的在线版本 (doi:10.1186/s12916-017-0880-y) 包含补充材料，可供授权用户使用。
Rigorous evaluations of health sector interventions addressing intimate partner violence (IPV) in low- and middle-income countries are lacking. We aimed to assess whether an enhanced nurse-delivered intervention would reduce IPV and improve levels of safety planning behaviors, use of community resources, reproductive coercion, and mental quality of life. We randomized 42 public health clinics in Mexico City to treatment or control arms. In treatment clinics, women received the nurse-delivered session (IPV screening, supportive referrals, health/safety risk assessments) at baseline (T1), and a booster counselling session after 3 months (T2). In control clinics, women received screening and a referral card from nurses. Surveys were conducted at T1, T2, and T3 (15 months from baseline). Our main outcome was past-year physical and sexual IPV. Intent-to-treat analyses were conducted via three-level random intercepts models to evaluate the interaction term for treatment status by time. Between April and October 2013, 950 women (480 in control clinics, 470 in treatment clinics) with recent IPV experiences enrolled in the study. While reductions in IPV were observed for both women enrolled in treatment (OR, 0.40; 95% CI, 0.28–0.55; P < 0.01) and control (OR, 0.51; 95% CI, 0.36–0.72; P < 0.01) clinics at T3 (July to December 2014), no significant treatment effects were observed (OR, 0.78; 95% CI, 0.49–1.24; P = 0.30). At T2 (July to December 2013), women in treatment clinics reported significant improvements, compared to women in control clinics, in mental quality of life (β, 1.45; 95% CI, 0.14–2.75; P = 0.03) and safety planning behaviors (β, 0.41; 95% CI, 0.02–0.79; P = 0.04). While reductions in IPV levels were seen among women in both treatment and control clinics, the enhanced nurse intervention was no more effective in reducing IPV. The enhanced nursing intervention may offer short-term improvements in addressing safety planning and mental quality of life. Nurses can play a supportive role in assisting women with IPV experiences. Clinicaltrials.gov (NCT01661504). Registration Date: August 2, 2012 The online version of this article (doi:10.1186/s12916-017-0880-y) contains supplementary material, which is available to authorized users.
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影响因子：
7.7
作者：
Díaz-Olavarrieta, C;Paz, F;Campbell, J
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