Community Health Center Intervention for Intimate Partner Violence<br>

社区卫生中心对亲密伴侣暴力的干预<br>

• 批准号: 7825190
• 负责人: KARIN V RHODES
• 金额: $ 50万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-24 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7825190
• 关键词: Address; Advocacy; Advocate; Affect; Alcohol abuse; Alcohols; Area; Awareness; Battered Women; Behavior; Behavioral; Categories; Climate; Clinical Trials; Communities; Community Health; Community Health Centers; Consent; Counseling; Data; Detection; Early identification; Early treatment; Economics; Education; Effectiveness; Effectiveness of Interventions; Emotional; Enrollment; Ethnic group; Evaluation; Experimental Designs; Family; Family Violence; Family health status; Female; Financial Support; Funding; Future; Goals; Grant; HIV/STD; Health; Health Promotion; Health Surveys; Healthcare; High Prevalence; Home visitation; House Call; Household; Income; Individual; Injury; Institutes; Intervention; Life; Link; Low income; Methods; Minority; Occupations; Organizational Culture; Outcome; Patients; Pharmaceutical Preparations; Philadelphia; Population; Preparation; Prevalence; Prevention; Problem behavior; Procedures; Process; Provider; Public Health; Randomized Clinical Trials; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Recruitment Activity; Research; Research Infrastructure; Research Personnel; Research Training; Resources; Risk; Screening procedure; Secondary Prevention; Self Disclosure; Sex Orientation; Social Class; Social Marketing; Social Work; Social Workers; Social support; Socioeconomic Status; Stimulus; System; Testing; Textiles; Time; Tobacco; Training; Violence; Woman; Work; advocacy organizations; base; cost; design; emotional disclosure; experience; falls; follow up assessment; graduate student; health care service utilization; health disparity; improved; innovation; intergenerational; intervention program; intimate partner violence; male; men; motivational intervention; partner violence; peer; perpetrators; physical conditioning; population based; prevent; primary outcome; programs; psychologic; racial and ethnic; response; skills; social; success; transmission process; treatment as usual

DESCRIPTION (provided by applicant): This application addresses broad Challenge area (09): Health Disparities and the Specific Challenge Topic, 09-MD-103*: Initiating Innovative Interventions to Prevent Family Violence. The adverse emotional and physical health burden of intimate partner violence (IPV) falls disproportionately on low income women, contributing to intergenerational transmission of violence and to the health disparities seen in urban minority populations. High prevalence rates among patients seen in health care settings provide abundant opportunity for IPV risk identification, early intervention and prevention. However, after two decades of calls for routine screening, there is still no evidence that IPV screening improves outcomes for abused women. In large part this is because practical effective routine screening methods have not been implemented and providers have been reluctant to initiate the discussion given the lack of adequate system-wide responses to IPV identification. Our proposal builds on strong preliminary work that finds allowing patients to self- disclose IPV risk as part of a social health survey significantly increases identification of IPV. However, IPV identification alone will not reduce family violence. Our multi-disciplinary research team includes the Philadelphia Department of Public Health (PDPH), community-based advocacy organization, Institute for Safe Families, Health Federation of Philadelphia with its innovative home visiting advocacy program, and Brown Partners, a local social marketing firm specializing the design of culturally-appropriate health promotion messages. Together, we propose a large scale demonstration project using a quasi-experimental design to evaluate the impact of a multi- level intervention on IPV detection and social work counseling. The four intervention components are (1) an effective social health screening procedure 2) provider training and social marketing to increase IPV awareness and elevate clinician confidence in their ability to address and refer IPV; (3) IPV- focused motivational counseling for male and female patients by specially trained social workers; and (4) community-based family advocates providing social support and help linking abused women to resources. In addition to the demonstration trial, a pilot treatment study will recruit 60 abused women to assess intervention acceptability, feasibility and procedures for collecting data needed for a large randomized controlled trial. The goal of the future RCT will be to test the effectiveness of the multi-level intervention for improving outcomes for abused women. Consistent with the goals of reducing disparities and economic stimulus, this project builds community-based research infrastructure. It will be conducted in four Philadelphia Health Department community health centers serving 50,000 low income primarily minority patients, and will create 6 new FTE jobs.

描述（由申请人提供）：本申请涉及广泛的挑战领域 (09)：健康差异和具体挑战主题，09-MD-103*：启动创新干预措施以预防家庭暴力。亲密伴侣暴力 (IPV) 造成的不良情感和身体健康负担过多地落在低收入妇女身上，导致暴力的代际传播和城市少数民族人口的健康差距。医疗机构中患者的高患病率为 IPV 风险识别、早期干预和预防提供了充足的机会。然而，在呼吁进行常规筛查二十年后，仍然没有证据表明 IPV 筛查可以改善受虐待妇女的结局。这在很大程度上是因为实际有效的常规筛查方法尚未实施，而且由于缺乏对 IPV 识别的足够的全系统响应，提供商不愿发起讨论。我们的建议建立在强有力的初步工作的基础上，该工作发现，作为社会健康调查的一部分，允许患者自我披露 IPV 风险可显着提高 IPV 的识别率。然而，仅靠 IPV 识别并不能减少家庭暴力。我们的多学科研究团队包括费城公共卫生部 (PDPH)、社区倡导组织、安全家庭研究所、费城健康联合会及其创新的家访倡导计划，以及 Brown Partners（一家专门设计适合文化的健康促进信息的当地社会营销公司）。我们共同提出了一个大规模示范项目，使用准实验设计来评估多层次干预对 IPV 检测和社会工作咨询的影响。四个干预组成部分是 (1) 有效的社会健康筛查程序 2) 提供者培训和社会营销，以提高 IPV 意识并提高临床医生对其处理和转诊 IPV 能力的信心； (3) 由经过专门培训的社会工作者为男性和女性患者提供以 IPV 为重点的动机咨询； (4) 以社区为基础的家庭倡导者提供社会支持并帮助受虐待的妇女获得资源。除了示范试验外，一项试点治疗研究还将招募 60 名受虐待妇女来评估干预措施的可接受性、可行性以及收集大型随机对照试验所需数据的程序。未来随机对照试验的目标将是测试多层次干预措施对改善受虐待妇女结局的有效性。与减少差距和经济刺激的目标相一致，该项目建立了基于社区的研究基础设施。该项目将在费城卫生局的四个社区健康中心开展，为 50,000 名低收入（主要是少数族裔）患者提供服务，并将创造 6 个新的全职工作岗位。