Intervention for Poor Pregnant Women with Partner Abuse

描述(由申请人提供)：虐待伴侣(PA)每年影响大约324,000名孕妇。经历过PA的孕妇有很高的产后不良结局风险，包括杀人、医疗服务利用率高以及身体和心理困难。PA的心理健康后果，即创伤后应激障碍(PTSD)和抑郁，将产后从一个已经具有挑战性的过程转变为一个潜在的压倒性过程，这可能会威胁到母亲、婴儿和其他孩子的福祉。此外，这些情绪上的困难可能会损害妇女获得必要的支持和资源以增加自己和孩子的安全的能力。不幸的是，几乎没有旨在减少PA对围产期妇女心理健康影响的干预措施被开发或系统测试。更被忽视的一个领域是为经济上处于不利地位的妇女制定这种干预措施。低收入妇女特别容易患PA以及与PA有关的心理健康后遗症。此外，低收入妇女面临工具障碍，限制了她们获得心理健康治疗的机会，尽管存在精神障碍，但很少有人获得心理健康治疗。 总体而言，这项治疗开发赠款的目的是：(I)为患有PA的孕妇制定干预措施；(Ii)进行一项随机对照研究，以评估拟议干预与加强照常护理条件下的初步疗效，样本为100名在过去一年内报告PA的接受公共援助的孕妇。主要结果将是产后抑郁症或创伤后应激障碍的存在，以及在获得旨在建立安全性的资源方面的有效性程度。建议的干预措施，即ROSE计划，是一种面向个人的干预措施，旨在针对那些可能导致产后与PA相关的心理健康困难(即，创伤后应激障碍和抑郁)的因素(即，不良的社会支持、角色转换和生活压力源)。这项先导性研究将为评估这一新干预措施的有效性的更大规模的临床试验奠定基础。

DESCRIPTION (provided by applicant): Partner abuse (PA) affects approximately 324,000 pregnant women annually. Pregnant women who experience PA are at high risk for adverse postpartum outcomes that include homicide, high utilization of medical care as well as physical and psychological difficulties. The mental health outcomes of PA, that is posttraumatic stress disorder (PTSD) and depression, transform the postpartum period from an already challenging process into a potentially overwhelming one, which may threaten the well-being of the mother, infant, and her other children. Furthermore, these emotional difficulties may compromise a woman's ability to access the necessary support and resources to increase safety for herself and her children. Unfortunately, virtually no interventions that aim to decrease the impact of PA on the mental health of perinatal women have been developed or systematically tested. An area of even greater neglect is the development of such an intervention for financially disadvantaged women. Low-income women are especially vulnerable to PA and to the mental health sequelae related to PA. Further, low-income women face instrumental barriers that limit their access to mental health treatment and few are offered mental health treatment, despite the presence of a psychiatric disorder. Overall, the aims of this treatment development grant are to: (i) develop an intervention for pregnant women with PA and (ii) conduct a randomized controlled study to evaluate the initial efficacy of the proposed intervention compared to an enhanced care-as-usual condition in a sample of 100 pregnant women on public assistance who report PA within the last year. The primary outcomes will be the presence of postpartum depression or PTSD as well as degree of effectiveness in accessing resources designed to establish safety. The proposed intervention, the ROSE Program, "Reach Out for a Safe Environment," is an interpersonally oriented intervention that targets those factors (i.e., poor social support, role transitions, and life stressors) that may contribute to postpartum mental health difficulties associated with PA (i.e., PTSD and depression). This pilot study will lay the groundwork for a larger clinical trial evaluating the efficacy of this new intervention.