Developing Comprehensive Screening and Treatment for Intimate Partner Violence Perpetration

对亲密伴侣暴力行为进行全面筛查和治疗

• 批准号: 10535427
• 负责人: Galina Alexandra Portnoy
• 金额: --
• 依托单位: VA CONNECTICUT HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-10-01 至 2025-09-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10535427
• 关键词: Address; Area; Assessment tool; Behavior Therapy; Caring; Child; Clinical; Communities; Comprehensive Health Care; Conflict (Psychology); Connecticut; Consensus; Data; Detection; Family; Feedback; Focus Groups; Funding; Goals; Guidelines; Health; Health Services; Health Services Needs; Healthcare; Healthcare Systems; Home; Homogeneously Staining Region; Hybrids; Individual; Intervention; Knowledge; Manuals; Measurement; Medical center; Mentorship; Methodology; Modeling; Outcome; Patients; Pilot Projects; Policies; Population; Positioning Attribute; Predictive Value; Prevention; Procedures; Process; Property; Protocols documentation; Provider; Psychologist; Psychometrics; Public Health; Receiver Operating Characteristics; Recommendation; Reference Standards; Reporting; Research; Research Methodology; Research Personnel; Risk; Safety; Sampling; Screening procedure; Services; Specificity; Testing; Training; Validation; Veterans; Veterans Health Administration; Woman; Women' s Health; Women' s Health Services; Work; acceptability and feasibility; brief screening; career; clinical practice; design; effective intervention; effectiveness/implementation trial; evidence base; experience; implementation science; improved; infancy; innovation; instrument; intervention refinement; intimate partner violence; male; men; post-traumatic stress; prevent; primary outcome; programs; psychological violence; psychosocial; relationship violence; research study; response; routine screening; satisfaction; screening; secondary outcome; sexual violence; substance use; therapy development; tool; trial design; violence perpetration; violence victimization

Background: Intimate partner violence (IPV) is a major public health concern with significant negative consequences for those who experience it and wide-ranging impact on children, families, and the healthcare system. However, IPV is an especially prevalent health issue for Veterans, who are at increased risk of both experiencing and perpetrating IPV. More than one out of three women Veterans experience IPV and up to 60% of Veteran men report IPV perpetration. Although VHA currently recommends routine screening of IPV experiences among women Veterans, no guidelines or instruments currently exist for IPV perpetration screening. Moreover, effective intervention development for IPV perpetration is in its infancy with no evidence- based individual treatment available for IPV perpetration. In order to improve Veterans' health and reduce rates of IPV, effective and acceptable screening and treatment for IPV perpetration must exist. Significance/Impact: IPV perpetration detection, followed by behavioral intervention, are urgently needed for IPV cessation and improved health of Veterans with these common presenting problems. Yet there has been little progress to develop tools and procedures for IPV perpetration, and no guidelines on best practices for IPV perpetration screening or treatment exist. The findings of the proposed research will improve the health and functioning of Veterans and their families, enhance much needed healthcare response for this population, and inform VHA national efforts for IPV response among Veterans. Innovation: This project is innovative in its focus on IPV perpetration. With the majority of IPV research focusing on IPV victimization, there is currently a significant gap in knowledge related to IPV perpetration, including limited tools and procedures with which to address perpetration of IPV among Veterans. Enhancing services for those who experience IPV is essential, but insufficient. In order to reduce and prevent IPV, a comprehensive healthcare response necessitates implementing validated screening to detect IPV perpetration among Veterans and developing intervention protocols to address IPV perpetration. Completion of the CDA research aims will provide VHA with the data and tools necessary to inform IPV efforts, practices, and policy. Aims: The primary objective of this research is to decrease IPV among Veterans. To do so, we must have effective and acceptable tools and protocols. Aim 1: Evaluate the psychometric properties and cut-scores of a previously developed IPV screening tool. Aim 2: Identify an effective IPV perpetration intervention process and essential treatment components and develop an intervention manual. Aim 3: Conduct a pilot study of the IPV perpetration manualized intervention in a sample of Veterans. Methodology: For Aim 1, we will calculate the sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratios of the screening instrument in comparison to the reference standard in a sample of [male] Veterans (n=113). To achieve Aim 2, we will a) engage in a consensus process with IPV experts to select intervention components from four pre-existing treatment models; b) solicit Veterans’ feedback through focus group discussions (n=4 focus groups); and c) refine the intervention, develop intervention manual, and present manual to stakeholders. For Aim 3, we will use a pre-post design to assess feasibility, safety, acceptability, and satisfaction (primary outcomes) and patient- and partner-reported changes on indicators of psychosocial health (secondary outcomes) among Veterans (n=20). Next Steps/Implementation: Research proposed in this CDA will provide the necessary groundwork for developing and implementing screening and intervention for IPV perpetration among Veterans, a critical need in VA care. Completion of these aims will inform an IIR proposal, to further evaluate and implement VHA's IPV perpetration response. Specifically, I will use findings from the CDA to refine the manualized IPV perpetration intervention, which I will then test in a larger Hybrid Type 1 effectiveness-implementation trial.

背景：亲密伴侣暴力（IPV）是一个主要的公共卫生问题， 对那些经历过它的人的后果以及对儿童，家庭和医疗保健的广泛影响 系统然而，IPV是退伍军人特别普遍的健康问题，他们的风险增加 经历并实施IPV。超过三分之一的女性退伍军人经历IPV，高达60% 的退伍军人报告IPV犯罪。尽管VHA目前建议对IPV进行常规筛查， 根据妇女退伍军人的经验，目前没有关于IPV犯罪的准则或文书。 筛选此外，针对IPV犯罪的有效干预措施尚处于起步阶段，没有证据表明- 基于IPV犯罪的个人治疗。为了改善退伍军人的健康状况， 为了预防IPV，必须对IPV的实施进行有效和可接受的筛查和治疗。 意义/影响：IPV犯罪检测，其次是行为干预，迫切需要 IPV停止和改善退伍军人的健康与这些常见的问题。然而， 在为实施IPV开发工具和程序方面进展甚微，没有关于IPV最佳做法的指导方针 存在犯罪筛查或治疗。拟议研究的结果将改善健康状况， 退伍军人及其家人的职能，加强该人群急需的医疗保健响应，以及 为退伍军人中IPV响应的VHA国家努力提供信息。 创新：该项目在关注IPV犯罪方面具有创新性。大多数IPV研究 关注IPV受害，目前在与IPV犯罪相关的知识方面存在重大差距， 包括有限的工具和程序，以解决退伍军人中的IPV犯罪。增强 为经历IPV的人提供服务是必要的，但还不够。为了减少和预防IPV， 全面的医疗保健响应需要实施有效的筛查，以检测IPV的实施 在退伍军人和制定干预协议，以解决IPV犯罪。完成CDA 研究目标将为VHA提供必要的数据和工具，以告知IPV的努力，实践和政策。 目的：本研究的主要目的是降低退伍军人的IPV。为此，我们必须 有效和可接受的工具和协议。目的1：评估一个人的心理测量学特性和切分。 以前开发的IPV筛选工具。目标2：确定有效的IPV犯罪干预程序， 基本治疗内容，并制定干预手册。目标3：对投资促进机构进行试点研究 对退伍军人样本进行手动干预。 方法：对于目标1，我们将计算灵敏度、特异性、阳性和阴性预测值， 筛选仪器与参比标准品相比的阳性和阴性似然比， [男性]退伍军人样本（n=113）。为了实现目标2，我们将a）与IPV开展共识进程 专家从四种现有的治疗模式中选择干预成分; B）征求退伍军人的意见， 通过焦点小组讨论（n=4个焦点小组）提供反馈;以及c）完善干预措施， 干预手册，并向利益攸关方提供手册。对于目标3，我们将使用前后设计来评估 可行性、安全性、可接受性和满意度（主要结局）以及患者和合作伙伴报告的变更 退伍军人（n=20）的心理社会健康指标（次要结果）。 后续步骤/实施：本CDA中提出的研究将为以下方面提供必要的基础： 制定和实施对退伍军人中IPV犯罪的筛查和干预，这是一项迫切需要 在VA护理。这些目标的完成将通知IIR提案，以进一步评估和实施VHA的IPV 犯罪反应。具体来说，我将使用CDA的调查结果来完善手动IPV犯罪 干预，然后我将在一个更大的混合1型有效性实施试验中进行测试。