An Adaptive Intervention to Improve Health, Safety and Empowerment Outcomes Among Immigrant Women with Intimate Partner Violence Experiences

亲密伴侣暴力(IPV)对移民妇女的影响不成比例。然而，移民妇女 仍然是一个研究不足、服务不足的人群，需要经过严格的文化评估以证据为基础 针对他们的健康和安全需求的有效干预措施。这项研究使用了顺序、多次 分配，随机试验(智能设计)，严格评估适应文化知识的 干预措施是针对有知识产权经验的移民妇女的需要而制定的。对于第一阶段随机化， 研究将使用正在进行的weWomen随机对照试验(RCT)(1R01HD081179- 01A1)，其中被虐待的移民妇女被随机分配到WWmyPlan在线干预或 常规护理控制手臂和安全、心理健康和赋权的结果分别在3、6和12岁时进行评估 几个月的随访期。在这项研究中，没有报告安全性有显著改善的女性(即 在赋权方面，从基线到12个月(即，无应答者)，妇女区域合作伙伴关系将重新 利用增强的干预组件(即，文本消息)随机化到第二阶段随机化 和电话)。有关结果(安全性和赋权)的数据将在6个月和12个月后重新进行评估 随机化。在第一阶段(形成阶段)，使用并行混合方法设计，我们将在- 就WWmyPlan在线干预的效用深入采访当前的weWomen参与者 构成(定性)并分析安全和赋权干预反应的调节因素 正在进行的weWomen随机对照试验(定量)中12个月的随访结果。此外，根据来自 移民妇女和来自不同群体的IPV幸存者的IPV专家，我们将 在文化上量身定做并预先测试增强组件的内容(短信和电话) (定性)。在阶段2(增强干预评估)阶段，通过重新随机选择参与者，我们将 评估增强WWmyPlan的两种策略的相对有效性(仅限文本或以下各项的组合 短信和电话)关于WWmyPlan非响应者的安全和赋权结果 干预。此外，这项研究还将比较无反应者组和有反应者组 WWmplan干预，以确定增强策略是否将无响应者带到了 关于安全和赋权的响应人员。在第三阶段(传播和实施)，研究报告将 确定采用、实施和维护原始和 通过为移民妇女服务的方案加强干预，并制定战略以减少障碍和 在强项的基础上发展壮大。为此，这项研究将从服务于移民和组织的提供者那里收集数据 仅接受WWmyPlan的IPV领导人以及移民幸存者和那些获得WWmyPlan 增强的组件。这种干预将产生一种基于证据的文化知情干预 IPV的移民幸存者，供服务于移民妇女的从业者使用。

Intimate partner violence (IPV) disproportionately affects immigrant women. However, immigrant women remain an understudied and underserved population in need for evidence-based rigorously evaluated culturally competent interventions that address their health and safety needs. This study uses a sequential, multiple assignment, randomized trial (SMART design) to rigorously evaluate an adaptive culturally informed intervention tailored to needs of immigrant women with IPV experiences. For the first stage randomization, the study will use data collected by the ongoing weWomen randomized controlled trial (RCT) (1R01HD081179- 01A1) in which abused immigrant women are being randomized to the WWmyPlan online intervention or the usual care control arm and safety, mental health and empowerment outcomes are assessed at 3, 6 and 12 months following up. In this study, women who do not report significant improvement in safety (i.e., reduction in IPV) and in empowerment from baseline to 12 months (i.e., non-responders) in the weWomen RCT will be re- randomized to a second stage randomization with augmented intervention components (i.e., text messages and phone calls). Data on outcomes (safety and empowerment) will be assessed at 6 and 12 months of re- randomization. In Phase 1 (formative phase), using a concurrent mixed methods design, we will conduct in- depth interviews with current weWomen participants on the utility of WWmyPlan online intervention components (qualitative) and analyze moderators of intervention response in the safety and empowerment outcomes at 12 months follow-up in the ongoing weWomen RCT (quantitative). Further, based on input from experts on IPV among immigrant women and from diverse groups of immigrant survivors of IPV, we will culturally tailor and pre-test the content of the augmented components (text messaging and phone calls) (qualitative). In Phase 2 (Enhanced intervention evaluation) phase, by re-randomizing participants, we will assess the relative effectiveness of two strategies for augmenting WWmyPlan (text only or a combination of text and phone) on safety and empowerment outcomes among the non-responders of the WWmyPlan intervention. In addition, the study will compare the non-responder group of women to the responder group of WWmplan intervention to determine if the strategies of augmentation brought the non-responders to the level of responders on safety and empowerment. In Phase 3 (Dissemination and Implementation), the study will identify facilitators and barriers to the adoption, implementation and maintenance of use of the original and augmented intervention by programs serving immigrant women and design strategies to decrease barriers and build on strengths. For this, the study will collect data from providers serving immigrants and organizational leaders as well as immigrant survivors of IPV who received WWmyPlan only and those who received the augmented components. The intervention will result in an evidence-based culturally informed intervention for immigrant survivors of IPV for use by practitioners serving immigrant women.