Intervening during the Prenatal Period with Women Exposed to Intimate Partner Violence to Improve Maternal Functioning and Infant Adjustment

点击翻译按钮获取中文摘要

PROJECT SUMMARY Intimate partner violence (IPV) occurs at alarmingly high rates, with the highest risk of IPV exposure during pregnancy. IPV during this critical juncture is associated with postpartum depression, posttraumatic stress, disruption to the mother-infant relationship, and poor infant outcomes. There is also emerging evidence suggesting that the COVID-19 pandemic is exacerbating the prevalence of IPV. Paired with other, on-going pandemic-related stressors, women with a history of IPV, especially those in the perinatal period, may be particularly vulnerable to the negative ramifications of COVID-19. A critical need therefore exists for longitudinal research investigating the effects of the pandemic on IPV-exposed women and their young children. Given that the conditions of the pandemic fluctuate significantly across persons and time, intensive longitudinal methods that are able to capture dynamic change are likely to provide valuable insights into risk and resilience in these families. This urgent competitive revision seeks to address these pressing questions, leveraging the existing strengths of an ongoing NICHD-funded study of a theoretically-driven intervention program with pregnant, IPV-exposed women, the Pregnant Moms’ Empowerment Program (PMEP; MPIs Miller-Graff & Howell, R01HD098092). The specific aims of the parent proposal are to (1) evaluate the efficacy of the PMEP for women’s mental health, resilience and IPV victimization across the perinatal period, (2) evaluate the efficacy of the PMEP in promoting infant development and (3) test process models for treatment change for women and infants in the context of a two-site. The parent project includes assessments at 4 time points (2 prenatal, 3 months postpartum, 1 year postpartum). Currently (n=67) women of a targeted N=230 have enrolled in the parent project, and the project has fully adapted to telehealth delivery and assessments, allowing us to maintain excellent participant retention throughout the pandemic. The project proposed for the competitive revision will add monthly assessments of pandemic-related stressors and the collection of a 30-day daily diary on stress, mood, and mother-child relational quality immediately following the final assessment wave (i.e., 1 year postpartum), to address three unique and timely aims: (1) evaluating the indirect effects of intervention on pandemic-related stressors, (2) examining the moderating effect of social and instrumental supports, and (3) analyzing dynamic associations in daily maternal mood, perceived stress, and mother-child relational quality. Analyses will be conducted using multilevel and structural equation modeling. This project is innovative – not just in the context of the pandemic – but also in the field of IPV research more generally for its multi-time scale, multi-method design. Further, the specific aims address pressing questions relative to the social and behavioral impacts of COVID-19 on children and families, providing valuable information for the public health response that is informed by the needs of individuals most significantly affected by the pandemic.