Intervention for Poor Pregnant Women with Partner Abuse

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DESCRIPTION (provided by applicant): Partner abuse (PA) affects approximately 324,000 pregnant women annually. Pregnant women who experience PA are at high risk for adverse postpartum outcomes that include homicide, high utilization of medical care as well as physical and psychological difficulties. The mental health outcomes of PA, that is posttraumatic stress disorder (PTSD) and depression, transform the postpartum period from an already challenging process into a potentially overwhelming one, which may threaten the well-being of the mother, infant, and her other children. Furthermore, these emotional difficulties may compromise a woman's ability to access the necessary support and resources to increase safety for herself and her children. Unfortunately, virtually no interventions that aim to decrease the impact of PA on the mental health of perinatal women have been developed or systematically tested. An area of even greater neglect is the development of such an intervention for financially disadvantaged women. Low-income women are especially vulnerable to PA and to the mental health sequelae related to PA. Further, low-income women face instrumental barriers that limit their access to mental health treatment and few are offered mental health treatment, despite the presence of a psychiatric disorder. Overall, the aims of this treatment development grant are to: (i) develop an intervention for pregnant women with PA and (ii) conduct a randomized controlled study to evaluate the initial efficacy of the proposed intervention compared to an enhanced care-as-usual condition in a sample of 100 pregnant women on public assistance who report PA within the last year. The primary outcomes will be the presence of postpartum depression or PTSD as well as degree of effectiveness in accessing resources designed to establish safety. The proposed intervention, the ROSE Program, "Reach Out for a Safe Environment," is an interpersonally oriented intervention that targets those factors (i.e., poor social support, role transitions, and life stressors) that may contribute to postpartum mental health difficulties associated with PA (i.e., PTSD and depression). This pilot study will lay the groundwork for a larger clinical trial evaluating the efficacy of this new intervention.