TREATMENT OUTCOMES FOR ABUSED WOMEN IN PUBLIC CLINICS

受虐待妇女在公共诊所的治疗结果

• 批准号: 6528252
• 负责人: JANET Y GROFF
• 金额: $ 51.34万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-30 至 2004-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6528252
• 关键词: African American; Hispanic Americans; behavior modification; behavioral /social science research tag; caucasian American; child behavior; clinical research; clinical trials; domestic violence; family structure /dynamics; female; functional ability; group therapy; health care service utilization; health services research tag; human subject; human therapy evaluation; longitudinal human study; managed care; nursing intervention; outcomes research; patient care management; quality of life; self care; social behavior; social support network; spouse abuse; women's health

This 4-year randomized controlled trial will design, implement, and test the efficacy of nurse case management and group education for African- American, Hispanic, and White abused women attending inner city primary care clinics. These clinics are part of a county-wide system that maintains a computerized information system of inpatient and outpatient encounters. The theoretically-based intervention will build on empirically tested components designed to: increase safety planning behaviors; increase self-efficacy for safety behaviors; decrease frequency and severity of abuse; improve physical emotional and social well-being; decrease unscheduled medical care utilization; and increase work productivity. An additional objective is to evaluate the impact of the interventions on the health and functional status and medical utilization of abused women's children. Consecutive sampling of women 18-44 years of age presenting for medical care will be screened for domestic violence until a sample of 400 abused women is obtained. Participants will be randomized to one of 4 treatment cells in a factorial design: referral card, referral card + group education, referral card + case management, referral card + group education + case management. Nurse case management will include education on safety planning, crisis management, supportive care, anticipatory guidance, and referrals. Group education will consist of sessions conducted by local legal, social, and educational agencies for abused women. The factorial study design will allow testing the main effects of group education and nurse case management and the interaction of group education and case management on safety behaviors, health outcomes in the women and their children, and medical care utilization. Measures will be collected at baseline and every 6 months for 3 years after randomization. An economic evaluation of the program will be conducted using cost benefit analyses of the four alternative treatments from both societal and health care system perspectives.

这项为期 4 年的随机对照试验将设计、实施和测试护士病例管理和团体教育对在市中心初级保健诊所就诊的非裔美国人、西班牙裔和白人受虐待妇女的有效性。这些诊所是全县系统的一部分，该系统维护住院和门诊就诊的计算机化信息系统。基于理论的干预措施将建立在经过实证检验的组成部分之上，旨在： 增加安全规划行为；提高安全行为的自我效能；减少虐待的频率和严重程度；改善身体情绪和社交福祉；减少计划外医疗服务的使用；并提高工作效率。另一个目标是评估干预措施对受虐待妇女儿童的健康和功能状态以及医疗利用的影响。将对就医的 18 至 44 岁女性进行连续抽样，进行家庭暴力筛查，直至获得 400 名受虐待女性的样本。参与者将被随机分配到析因设计中的 4 个治疗单元之一：转介卡、转介卡 + 团体教育、转介卡 + 病例管理、转介卡 + 团体教育 + 病例管理。护士案例管理将包括安全规划、危机管理、支持性护理、预期指导和转介方面的教育。团体教育将包括由当地法律、社会和教育机构为受虐待妇女举办的课程。析因研究设计将允许测试团体教育和护士案例管理的主要影响以及团体教育和案例管理对安全行为、妇女及其子女的健康结果以及医疗保健利用的相互作用。将在基线时收集测量结果，并在随机分组后的 3 年内每 6 个月收集一次测量结果。将从社会和医疗保健系统的角度对四种替代疗法进行成本效益分析，对该计划进行经济评估。