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

亲密伴侣暴力对移民妇女的影响尤其严重。然而，移民妇女 仍然是一个研究不足和服务不足的人口，需要基于证据的严格的文化评估， 采取适当的干预措施，满足他们的健康和安全需求。这项研究使用了一个连续的，多个 分配，随机试验（SMART设计），以严格评估适应性文化知情 针对有过移民援助经验的移民妇女的需要采取干预措施。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）（1 R 01 HD 081179- 01 A1），其中受虐待的移民妇女被随机分配到WWmyPlan在线干预或 在3、6和12岁时评估常规护理对照组和安全性、心理健康和赋权结果 几个月后。在这项研究中，没有报告安全性显著改善的女性（即，减少 IPV）和从基线到12个月的赋权（即，无应答者）将被重新分配。 随机化到具有增加的干预成分的第二阶段随机化（即，短信 电话）。将在再治疗6个月和12个月时评估结局数据（安全性和赋权）。 随机化在第一阶段（形成阶段），使用并行混合方法设计，我们将进行- 对当前weWomen参与者进行深入访谈，了解WWmyPlan在线干预的效用 成分（定性），并分析在安全和赋权干预反应的主持人 正在进行的weWomen RCT（定量）中12个月随访的结果。此外，根据来自 专家对IPV之间的移民妇女和来自不同群体的移民幸存者的IPV，我们将 文化定制和预先测试增强组件的内容（短信和电话） （定性）。在第2阶段（增强干预评估），通过重新随机化受试者，我们将 评估增强WWmyPlan的两种策略的相对有效性（纯文本或 短信和电话），在WWmyPlan的无应答者中了解安全和赋权结果 干预此外，该研究将比较无反应组的妇女和有反应组的妇女。 WWmplan干预，以确定增强策略是否使无应答者达到 关于安全和授权的反应。在第三阶段（传播和实施），研究将 确定采用、实施和维持使用原始和 通过为移民妇女服务的方案加强干预，并制定减少障碍的战略， 建立优势。为此，该研究将从为移民提供服务的供应商和组织收集数据。 领导人以及IPV的移民幸存者谁收到WWmyPlan只和那些谁收到 增强组件干预措施将产生一种基于证据的文化知情干预措施， 为移民妇女提供服务的从业人员可使用IPV的移民幸存者。

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.