Group Interventions for Abused, Suicidal Black Women

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DESCRIPTION (provided by applicant): African American women's responses to intimate partner violence (IPV) and suicidality are influenced by cultural norms. This application compares a gender sensitive, culturally competent psychoeducational intervention (PEI) guided by the Theory of Triadic Influence (TTI) risk-protective model versus enhanced treatment as usual (ETAU) for reducing suicidal behavior, IPV, and associated risk factors and bolstering protective factors. The hybrid efficacy-effectiveness design uses a nonshelter sample, random assignment, and an intervention manual. Assessments informed by the TTI risk-protective framework focus on suicide and IPV-related outcome variables, risk and protective factors (intrapersonal, social/situation, culture/environment), and moderators of intervention response. The TTI-informed 10 session empowerment group (PEI) builds on our research and relevant intervention programs and the control condition is mental health treatment as usual plus an adherence enhancement protocol to facilitate treatment engagement (ETAU). Women are followed over time. The study is a prospective, RCT, using a 2X4 mixed-model design; the between-subjects variable is intervention condition (experimental (PEI), control (ETAU)) and the within-subjects variable is time (pre- intervention, post-intervention, 6 month follow-up, 1 year follow-up). The RCT follows the CONSORT recommendations. The sample consists of two groups of low-income, African American women in abusive relationships with a recent suicide attempt who seek services at Grady Health System: (a) women randomly assigned to PEI (experimental condition) (n = 95) and (b) women randomly assigned to ETAU (control condition) (n = 95). It is hypothesized that at post-intervention and follow-up, compared to women in the ETAU, women in the PEI will: (1) evidence more improvements in suicidal behavior and associated correlates (efficacy outcomes); (2) report greater reductions in IPV and greater improvements in associated correlates (efficacy outcomes); (3) evidence fewer risk factors (effectiveness outcomes); (4) evidence more protective factors (effectiveness outcomes); and (5) intrapersonal, social/situation, and cultural/environment variables will interact with intervention effects (moderators). Hierarchical linear modeling and structural equation modeling will be used to examine these predictions. Findings will guide our understanding of using interdisciplinary teams to target preventive interventions for IPV and suicide attempts in low-income, African American women, aid in disseminating the intervention, and inform State and national advocacy and policy efforts.