Group Interventions for Abused, Suicidal Black Women

描述（由申请人提供）：非裔美国妇女对亲密伴侣暴力（IPV）和自杀的反应受到文化规范的影响。本申请比较了在三元影响理论（TTI）风险保护模型指导下的性别敏感、文化能力强的心理教育干预（PEI）与常规强化治疗（ETAU），以减少自杀行为、IPV和相关风险因素并增强保护因素。混合功效-效果设计使用非庇护所样本、随机分配和干预手册。由TTI风险保护框架提供信息的评估侧重于自杀和IPV相关的结果变量、风险和保护因素（自我、社会/情境、文化/环境）以及干预反应的调节因素。TTI知情的10次会议授权小组（PEI）建立在我们的研究和相关干预计划的基础上，控制条件是照常进行心理健康治疗，再加上一个促进治疗参与的依从性增强协议（ETAU）。妇女被跟踪一段时间。本研究是一项前瞻性RCT，采用2X 4混合模型设计;受试者间变量为干预条件（实验（PEI）、对照（ETAU）），受试者内变量为时间（干预前、干预后、6个月随访、1年随访）。RCT遵循CONSORT的建议。样本包括两组低收入，非洲裔美国妇女在虐待关系与最近自杀企图谁寻求服务格雷迪卫生系统：（a）妇女随机分配到PEI（实验条件）（n = 95）和（B）妇女随机分配到ETAU（控制条件）（n = 95）。假设在干预后和随访时，与ETAU中的女性相比，PEI中的女性将：（1）证明自杀行为和相关相关因素的改善更多（疗效结局）;（2）报告IPV降低幅度更大，相关相关指标改善幅度更大（疗效结局）;（3）证据较少的风险因素（有效性结局）;（4）证据更多的保护因素（效果结果）;（5）内在的，社会/情况，文化/环境变量将与干预效果（主持人）。层次线性模型和结构方程模型将被用来检查这些预测。调查结果将指导我们理解如何使用跨学科团队来针对低收入非洲裔美国妇女的IPV和自杀企图进行预防干预，帮助传播干预措施，并为州和国家的宣传和政策努力提供信息。

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.