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。本应用比较了性别敏感、文化上有能力的心理教育干预（PEI）在三合一影响理论（TTI）风险保护模型的指导下，与常规强化治疗（ETAU）在减少自杀行为、IPV及相关风险因素和增强保护因素方面的效果。混合功效设计采用非庇护所样本、随机分配和干预手册。由TTI风险保护框架提供的评估侧重于自杀和ipvv相关的结果变量、风险和保护因素（个人、社会/情境、文化/环境）以及干预反应的调节因素。tti告知10期授权小组（PEI）建立在我们的研究和相关干预计划的基础上，控制条件是常规的心理健康治疗加上依从性增强协议，以促进治疗参与（ETAU）。研究人员对女性进行了长期跟踪。本研究为前瞻性、随机对照试验，采用2X4混合模型设计；受试者间变量为干预条件（实验组（PEI）、对照组（ETAU）），受试者内变量为时间（干预前、干预后、随访6个月、随访1年）。该随机对照试验遵循CONSORT的建议。样本由两组在Grady Health System寻求服务的受虐待关系且近期有自杀企图的低收入非裔美国妇女组成：(a)随机分配到PEI（实验条件）的妇女（n = 95）和(b)随机分配到ETAU（对照条件）的妇女（n = 95）。假设在干预后和随访中，与ETAU的妇女相比，PEI的妇女将：(1)在自杀行为和相关因素（疗效结果）方面有更多的改善；(2)报告IPV的更大减少和相关指标的更大改善（疗效结果）；(3)证据较少的危险因素（有效性结果）；(4)证据较多的保护性因素（有效性结果）；(5)个人、社会/情境和文化/环境变量会与干预效果相互作用（调节因子）。层次线性模型和结构方程模型将被用来检验这些预测。研究结果将指导我们理解如何使用跨学科团队针对低收入非裔美国妇女的IPV和自杀企图进行针对性的预防干预，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.