Preventing Suicidal Behavior in Abused Black Women

描述（改编自申请人摘要）：鉴于研究者之前对低收入、非裔美国妇女亲密伴侣暴力（IPV）与自杀企图之间关系的研究，需要对有自杀意念的受虐妇女进行二级预防干预，以降低其企图自杀的可能性并降低相关发病率。具体目的是：(1)评估团体授权心理教育干预（PEI）与常规强化治疗（ETAU）在干预后和随访中减少自杀行为及其相关因素的效果；(2)比较PEI与ETAU在干预后和随访中降低IPV的疗效；(3)比较PEI与ETAU在干预后和随访中降低个人、家庭、社会和社区层面风险因素的有效性；(4)比较PEI与ETAU在干预后和随访中增强个人、家庭、社会和社区层面保护因素的有效性；(5)确定那些调节群体分配-结果联系的个人、家庭、社会和社区背景变量。假设在干预后和随访中，与ETAU的妇女相比，PEI的妇女在自杀行为方面有更多的改善，IPV和危险因素的减少更大，保护因素更多。预测背景变量将与干预效果相互作用。本混合疗效试验采用混合模型设计：受试者间变量为干预条件（PEI、ETAU），受试者内变量为时间（干预前、干预后、6个月和1年随访）。样本由两组（每组95人）组成，均为低收入的非裔美国女性，目前处于有自杀念头的虐待关系中。ETAU包括依从性增强干预、社区常规治疗以及自杀和IPV行为监测。PEI包括ETAU和一个10次会议的文化能力和性别敏感的赋权小组干预。前四个具体目标的数据将使用重复测量多变量方差分析进行分析，第五个具体目标将使用多元线性和逻辑回归进行分析。意向治疗分析也将进行。这项预防性干预的随机对照试验在关注受虐妇女的自杀意念方面具有创新性；包括低收入的非裔美国妇女；以及它对文化能力评估和干预的使用。

DESCRIPTION (adapted from applicant's abstract): Given the investigator's prior research on the link between intimate partner violence (IPV) and suicide attempts in low income, African American women, secondary preventive interventions are needed for abused women with suicidal ideation to reduce the likelihood of their attempting suicide and decrease associated morbidity. The specific aims are to: (1) evaluate the efficacy of a group empowerment psychoeducational intervention (PEI) versus enhanced treatment as usual (ETAU) at post-intervention and follow-up in reducing suicidal behavior and its correlates; (2) compare the efficacy of PEI versus ETAU at post-intervention and follow-up in reducing IPV; (3) compare the effectiveness of PEI versus ETAU at post-intervention and follow-up in reducing individual, family-social, and community-level risk factors; (4) compare the effectiveness of PEI versus ETAU at post-intervention and follow-up in enhancing individual, family-social, and community-level protective factors; and (5) determine those individual, family-social, and community-level background variables that moderate the group assignment - outcomes link. It is hypothesized that at post-intervention and follow-up, compared to women in the ETAU, women in the PEI will evidence more improvements in suicidal behavior, greater reductions in IPV and risk factors, and more protective factors. It is predicted that background variables will interact with intervention effects. This hybrid efficacy-effectiveness trial uses a mixed model design: between-subjects variable is intervention condition (PEI, ETAU) and within-subjects variable is time (pre-intervention, post-intervention, 6-months and 1-year follow-ups). The sample consists of 2 groups (95 each) of low income, African American women currently in an abusive relationship with suicidal ideation. The ETAU includes a compliance enhancement intervention, treatment as usual in the community, and suicidal and IPV behavior monitoring. The PEI includes the ETAU plus a 10-session culturally-competent and gender-sensitive empowerment group intervention. The data for the first four specific aims will be analyzed using repeated measures multivariate analyses of variance, and the fifth specific aim will be analyzed with multiple linear and logistic regressions. Intent-to-treat analyses also will be conducted. This randomized controlled trial for a preventive intervention is innovative in its focus on suicidal ideation in abused women; its inclusion of low income, African American women; and its use of culturally-competent assessments and interventions.