Implementation and Scale-Up of a Caregiver Intervention for Mothers who have Survived Intimate Partner Violence: the Mediational Intervention for Sensitizing Caregivers

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PROJECT SUMMARY Exposure to intimate partner violence (IPV) constitutes a traumatic stress environment and incurs profound impacts on both mothers’ caregiving and children’s’ mental health outcomes. Children who are exposed to IPV are more likely to develop a variety of psychopathology. Sensitive and responsive caregiving has been identified as an important protective factor that may buffer the negative impact of IPV exposure. The Mediational Intervention for Sensitizing Caregivers (MISC) has demonstrated positive treatment effects on child mental health problems and is currently being adapted and evaluated in the sponsor’s RCT (R01HD102436; PI: Sharp) for African American IPV-exposed mothers in a community partner organization’s rehousing program. While MISC holds promise for this population, no data has yet been collected to evaluate whether MISC is amenable to scale-up for delivery in community organization settings. This translational research gap is significant because of the high prevalence of IPV exposure in African American families (1 in 4 African American children in the U.S. are exposed to IPV) and the paucity of available data on factors related to the adoption of IPV-parenting interventions. Consistent with the NIMH’s strategic objectives 3 (prevention of mental illness) and 4 (public health impact), the proposed research will evaluate the evidence-based MISC parenting intervention for implementation using mixed methodology and the Consolidated Framework for Implementation Research (CFIR) for scale-up in two IPV-community organization settings. This project will identify key barriers and facilitators to the implementation of MISC that will be incorporated in a future scale-up and evaluation project in an additional research proposal. Using CFIR constructs in a parallel convergent design , the following mixed method aims will be completed. For Aim 1, we will identify MISC Characteristics for scale-up suitability using qualitative interviews (N=10) with MISC-Implementation experts (caseworkers and administrative leaders who are implementing MISC in their IPV organization in the sponsor’s RCT). Interviews will focus on the perception of MISC and how it may fit into their existing workload. For Aim 2, we will assess outer setting characteristics for MISC scale-up suitability via quantitative survey of stakeholders (N=50) in the IPV field. Surveys will focus on policies and incentives that drive IPV initiatives. For Aim 3, we will assess inner setting characteristics at two community partner agencies via focus groups with IPV caseworkers (N=20) to explore factors related to workload and culture. Each aim will identify salient barriers and facilitators to implementation related to each CFIR construct and comprehensive recommendations will be created based on these findings for future scale-up. The proposed project will be the first to evaluate the capacity and feasibility of adoption of an evidence-based caregiver intervention in an IPV-community organization setting and will extend the literature to consider multi-level factors in implementing community-based interventions.