Intervention for Poor Pregnant Women with Partner Abuse

描述（由申请人提供）：伴侣虐待（PA）每年影响大约324,000名孕妇。经历PA的孕妇产后不良后果的风险很高，包括杀人、医疗保健的高利用率以及身体和心理上的困难。PA的心理健康结果，即创伤后应激障碍（PTSD）和抑郁症，将产后时期从一个已经具有挑战性的过程转变为一个潜在的压倒性的过程，这可能威胁到母亲、婴儿和她的其他孩子的健康。此外，这些情感上的困难可能会损害女性获得必要支持和资源的能力，从而增加自己和孩子的安全。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地测试过。一个更被忽视的领域是为经济上处于不利地位的妇女制定这种干预措施。低收入妇女尤其容易患前列腺癌以及与前列腺癌相关的心理健康后遗症。此外，低收入妇女面临器质性障碍，限制了她们获得心理健康治疗的机会，尽管存在精神障碍，但很少有人得到心理健康治疗。

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.