Preventing Suicidal Behavior in Abused Black Women

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DESCRIPTION (adapted from applicant's abstract): Given the investigator's prior research on the link between intimate partner violence (IPV) and suicide attempts in low income, African American women, secondary preventive interventions are needed for abused women with suicidal ideation to reduce the likelihood of their attempting suicide and decrease associated morbidity. The specific aims are to: (1) evaluate the efficacy of a group empowerment psychoeducational intervention (PEI) versus enhanced treatment as usual (ETAU) at post-intervention and follow-up in reducing suicidal behavior and its correlates; (2) compare the efficacy of PEI versus ETAU at post-intervention and follow-up in reducing IPV; (3) compare the effectiveness of PEI versus ETAU at post-intervention and follow-up in reducing individual, family-social, and community-level risk factors; (4) compare the effectiveness of PEI versus ETAU at post-intervention and follow-up in enhancing individual, family-social, and community-level protective factors; and (5) determine those individual, family-social, and community-level background variables that moderate the group assignment - outcomes link. It is hypothesized that at post-intervention and follow-up, compared to women in the ETAU, women in the PEI will evidence more improvements in suicidal behavior, greater reductions in IPV and risk factors, and more protective factors. It is predicted that background variables will interact with intervention effects. This hybrid efficacy-effectiveness trial uses a mixed model design: between-subjects variable is intervention condition (PEI, ETAU) and within-subjects variable is time (pre-intervention, post-intervention, 6-months and 1-year follow-ups). The sample consists of 2 groups (95 each) of low income, African American women currently in an abusive relationship with suicidal ideation. The ETAU includes a compliance enhancement intervention, treatment as usual in the community, and suicidal and IPV behavior monitoring. The PEI includes the ETAU plus a 10-session culturally-competent and gender-sensitive empowerment group intervention. The data for the first four specific aims will be analyzed using repeated measures multivariate analyses of variance, and the fifth specific aim will be analyzed with multiple linear and logistic regressions. Intent-to-treat analyses also will be conducted. This randomized controlled trial for a preventive intervention is innovative in its focus on suicidal ideation in abused women; its inclusion of low income, African American women; and its use of culturally-competent assessments and interventions.