Recovering from Intimate Partner Violence Through Strengths and Empowerment (RISE): Tailoring and Evaluating a Patient-Centered Counseling Intervention for Women Veterans

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Background Intimate partner violence (IPV) is a major health concern for women Veterans. IPV is associated with numerous physical and mental health conditions. VHA is implementing IPV screening programs to identify female patients who experience past-year IPV. Despite strong evidence that screening increases detection of IPV, less is established about how to intervene following IPV disclosure in health care settings, in order to improve health outcomes. Existing healthcare- based interventions result in minimal effects on health and well-being, likely because they are too brief and generic. In response, the PI has developed Recovering from IPV through Strengths and Empowerment (RISE), based on the IPV-related health care needs and preferences of women Veterans. RISE is designed to be delivered in primary care and is an individualized, variable-length, modular-based intervention that addresses 1) safety planning; 2) education on the health effects of IPV; 3) increasing coping skills and self-care; 4) enhancing social support; 5) making difficult decisions; and 6) connecting with resources. Objectives The objective of this proposal is to refine and formally evaluate RISE for women Veterans who experience IPV. The aims are to: 1) tailor and refine RISE to accommodate differences in service structures and personnel in different primary care settings; 2) conduct a formative evaluation of RISE with women Veterans to inform the development of a user-friendly, tailored implementation protocol and intervention manual; and 3) examine the effects of RISE on women Veterans’ individual psychosocial outcomes. Methods We will conduct the proposed research at two Women’s Health Practice-Based Research Network sites (Boston, MA and West Haven, CT). For Aim 1, we will tailor and refine RISE through input from a Stakeholder Advisory Board, focus groups with Women Veterans (n=24- 32), and interviews with providers (n=24). To achieve Aim 2, we will conduct a formative open trial of RISE (n=up to 20 women Veterans). Qualitative and quantitative findings from patients and providers will inform the development of a user-friendly, tailored implementation protocol and intervention manual. For Aim 3, we will conduct a Hybrid 1 randomized clinical trial (n=60) to examine the effects of RISE on women Veterans’ psychosocial outcomes (e.g., empowerment, self-efficacy, health, and service use). Anticipated Impacts on Veteran’s Health Care VHA’s Blueprint for Excellence identifies patient-centeredness and “advancing innovations in women Veterans’ health care” as key strategic transformational strategies. This project will help achieve these aims by evaluating a patient-centered IPV intervention that is tailored to women Veterans’ needs, preferences, and circumstances. It is imperative to complement current VHA IPV screening efforts with an effective intervention. RISE fills an essential unmet need in our healthcare system, ensuring that women Veterans who experience IPV receive care that leads to improved health and psychosocial outcomes.