Computerized Intervention for Reducing Intimate Partner Violence for Perinatal Women seeking Mental Health Treatment

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Project Summary: Intimate partner victimization (IPV) is a significant social and public health problem among perinatal women. 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. IPV and untreated mental illness during the perinatal period poses a dual risk of adverse physical and emotional outcomes for women and their developing fetus/infant. 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. In addition, the presence of IPV increases the likelihood of disengagement from treatment, which could further compromise the health and safety of women and their fetus/infant. 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 R01 Award is to fill this critical gap by building upon our promising R21 findings to test whether the innovative intervention, “Strength for U in Relationship Empowerment” (SURE), reduces the frequency of IPV more than an attention, time, and information matched control condition in perinatal women seeking mental health care. We propose a two-group, randomized controlled trial in which 186 perinatal women with IPV women seeking prenatal care who will be assigned to either (a) SURE, a computer-delivered, single-session brief intervention plus one interventionist-led phone booster that is consistent with motivational interviewing and informed by the literature on effective interventions for our target population and targeted risk factors, or (b) a computer-delivered intervention plus one interventionist-led phone booster control condition. Computer-delivered follow-up assessments will occur at 6 weeks, 3 months, 6 months, and 12 months after the baseline assessment. Specific Aim 1 is to test the hypothesis that SURE, compared to an attention, time and information matched control condition, will reduce the frequency of IPV at 6 weeks, 3 months, 6 months, and 12 months. Specific Aim 2 is to test the hypothesis that SURE, compared to the control condition, will result in greater positive affect and well-being as well as greater emotional support at follow-up. An economic evaluation of the costs of the intervention will occur to guide future implementation and dissemination. Specific Aim 3 is to explore the direct effect of SURE on the intermediate outcomes of empowerment and self-efficacy. Results of this program of research are expected to inform the development of IPV focused interventions that are cost-effective, high- reaching, and widely disseminable for victimized perinatal women seeking mental health services. Further, we anticipate that this study could have significant implications for IPV prevention efforts for other childbearing victimized women seeking mental health treatment and victimized women, in general. .