MOthers' AdvocateS In the Community for Mothers with Experience of intimate partner violence

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In the United States, as many as 5 million women report experience of intimate partner violence (IPV; referring to sexual or physical violence by current or former partners) annually. Depression and posttraumatic stress disorder (PTSD) are the two most common mental health consequences of IPV. Developing depressive and PTSD symptoms after experiencing IPV also increases future risks of IPV. Motherhood and pregnancy increase the risk for prolonged exposure to physical, psychological and sexual IPV. With as many as 4% to 8% of pregnant women reporting IPV during pregnancy, IPV can start or worsen during the perinatal period. Pregnant women and mothers with children under 5 who experienced IPV exhibit poor physical health, mental health and obstetric outcomes; leading to increased utilization of health services; even after the IPV ends. There is only one intervention (Mother ADvocateS In the Community; MOSAIC) that effectively reduces IPV among Pregnant women and mothers with children under 5 with experience of IPV; it forms the basis of this proposal. The MOSAIC intervention uses non-professional mentor support provided by mothers in the community to reduce IPV. It combines elements of social support, advocacy and mentoring. MOSAIC has been found to be effective for reducing IPV in a previous large randomized trial. However, no existing intervention addresses both IPV and the depressive and PTSD symptoms that often follow IPV, are associated with suffering and morbidity, and potentiate future IPV risk among pregnant women and mothers with children under 5 or any group of women. Thus, there is a need for an integrated intervention that addresses depressive and PTSD symptoms while reducing subsequent IPV. The proposed project aims to create a MOSAIC Plus intervention by expanding the original MOSAIC intervention to include elements of interpersonal psychotherapy (IPT) to enhance mental health outcomes. The project will develop a mentoring intervention and explore its feasibility, acceptability, and potential engagement of target mechanisms for reducing depressive and PTSD symptoms and reducing subsequent risk of IPV among pregnant women and mothers with children under 5 who report IPV and elevated symptoms of maternal depression and PTSD. The control condition for the pilot randomized trial will be Enhanced Treatment As Usual (ETAU). Potential target mechanisms include increased social support and effectiveness obtaining resources. Interventions to improve mental health challenges experienced by pregnant women and mothers with children under 5 who report IPV are of great public health significance. Reducing symptoms of maternal depression and PTSD in women with the experience of IPV has significant public health benefits for mothers and their children.