Computer-Based Intervention for Victimized Perinatal Women with Mental Illness

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DESCRIPTION (provided by applicant): Intimate partner violence (IPV) is a significant social and public health problem among perinatal women. Research suggests that from 21 percent to 33 percent of perinatal women report IPV and there is an enormous amount of morbidity associated with IPV. Moreover, IPV places a woman at high risk for several psychiatric disorders, which transforms the perinatal period from an already challenging process into a potentially overwhelming one. Further, IPV and untreated mental illness during the perinatal period pose a dual risk of adverse physical and emotional outcomes for women and their developing fetus/infant. Experts in the field advocate for more IPV screening and intervention to take place among women who are at high-risk for IPV. Given the high rates of IPV among women who seek mental health treatment, mental health clinics compared to other medical settings (e.g. primary care) are more effective sites for focused case finding and intervention. Further, the presence of IPV increases the likelihood of disengagement from treatment, which could compromise the ability of women with IPV to effectively use important shelter and community resources necessary for establishing safety for themselves and their children. A timely intervention might reduce the risk of future IPV, improve treatment utilization, and reduce mental health symptoms. Despite the high-risk profile of women with IPV and mental health illness, there are low screening and intervention rates of female mental health patients with IPV within mental health settings. The objective of this R21 Award is to develop and assess an innovative, high- reach, easily implementable, low-cost computer-delivered intervention, the ROSE Program (Reach out for a Safe Environment) that will address known barriers in early identification and intervention with perinatal women with recent IPV who seek mental health treatment. The R21 proposes two distinct phases to assess the ROSE Program with perinatal women with recent IPV. During the Development Phase, the research team will develop the intervention to meet the needs of our target group, develop the software for the computer- delivered intervention incorporating information gained in focus groups, and conduct an open trial with 8 participants. During the Pilot Study Phase, we will conduct a two-group, randomized controlled study with a sample of 50 perinatal treatment-seeking women with recent IPV, which will provide the necessary groundwork to examine the efficacy of the ROSE Program in a future, large clinical trial. If the proposed intervention is found to be efficacious in our vulnerable taret population, we anticipate that it could have significant implications for a cost-effective, high-reaching and widely disenable intervention for other childbearing, victimized women seeking mental health treatment.