Computerized Intervention for Reducing Intimate Partner Violence for Perinatal Women seeking Mental Health Treatment

项目摘要： 亲密伴侣受害是围产期妇女面临的一个重大社会和公共卫生问题。 IPV将妇女置于几种精神疾病的高风险之中，这将围产期从 一个已经充满挑战的过程变成了一个潜在的压倒性过程。IPV和未经治疗的精神疾病 围产期对妇女造成不利的身体和情绪后果的双重风险， 发育中的胎儿/婴儿。鉴于寻求心理健康治疗的妇女中IPV的高比率， 与其他医疗机构（如初级保健）相比，卫生诊所是重点病例的更有效场所。 发现和干预。此外，IPV的存在增加了脱离接触的可能性。 这可能进一步损害妇女及其胎儿/婴儿的健康和安全。尽管 IPV和精神健康疾病妇女的高风险概况，筛查和干预率低， 在心理健康环境中患有IPV的女性心理健康患者。本次R01奖的目标是填补 这一关键差距，建立在我们有希望的R21研究结果，以测试是否创新的干预， "在关系授权中的力量"（SURE），减少IPV的频率比注意力， 时间和信息匹配的控制条件的围产期妇女寻求心理卫生保健。我们提出了一个 两组，随机对照试验，其中186例围产期IPV妇女寻求产前护理 他们将被分配到（a）SURE，一个计算机交付的单次简短干预加一个 干预者主导的电话助推器，与动机性访谈一致，并通过文献了解 针对目标人群和目标风险因素的有效干预措施，或（B）计算机提供的 干预加一个干预者主导的电话助推器控制条件。计算机提供的随访 评估将在基线评估后6周、3个月、6个月和12个月进行。 具体目标1是检验假设，即SURE，与注意力、时间和信息相匹配 对照条件下，将在6周、3个月、6个月和12个月时降低IPV的频率。具体 目的2是检验与对照条件相比，SURE将导致更大的阳性反应的假设。 情感和幸福感，以及后续更大的情感支持。成本的经济评价 将进行干预，以指导今后的执行和传播。具体目标3是探索 SURE对授权和自我效能的中间结果的直接影响。该方案的结果 的研究预计将告知IPV重点干预措施的发展，这些干预措施具有成本效益， 向寻求心理健康服务的受害围产期妇女提供并广泛传播。我们还 预计这项研究可能对其他生育的IPV预防工作产生重大影响， 寻求心理健康治疗的受害妇女和一般受害妇女。 .

Project Summary: Intimate partner victimization (IPV) is a significant social and public health problem among perinatal women. IPV places a woman at high risk for several psychiatric disorders, which transforms the perinatal period from an already challenging process into a potentially overwhelming one. IPV and untreated mental illness during the perinatal period poses a dual risk of adverse physical and emotional outcomes for women and their developing fetus/infant. Given the high rates of IPV among women who seek mental health treatment, mental health clinics compared to other medical settings (e.g. primary care) are more effective sites for focused case finding and intervention. In addition, the presence of IPV increases the likelihood of disengagement from treatment, which could further compromise the health and safety of women and their fetus/infant. Despite the high-risk profile of women with IPV and mental health illness, there are low screening and intervention rates of female mental health patients with IPV within mental health settings. The objective of this R01 Award is to fill this critical gap by building upon our promising R21 findings to test whether the innovative intervention, “Strength for U in Relationship Empowerment” (SURE), reduces the frequency of IPV more than an attention, time, and information matched control condition in perinatal women seeking mental health care. We propose a two-group, randomized controlled trial in which 186 perinatal women with IPV women seeking prenatal care who will be assigned to either (a) SURE, a computer-delivered, single-session brief intervention plus one interventionist-led phone booster that is consistent with motivational interviewing and informed by the literature on effective interventions for our target population and targeted risk factors, or (b) a computer-delivered intervention plus one interventionist-led phone booster control condition. Computer-delivered follow-up assessments will occur at 6 weeks, 3 months, 6 months, and 12 months after the baseline assessment. Specific Aim 1 is to test the hypothesis that SURE, compared to an attention, time and information matched control condition, will reduce the frequency of IPV at 6 weeks, 3 months, 6 months, and 12 months. Specific Aim 2 is to test the hypothesis that SURE, compared to the control condition, will result in greater positive affect and well-being as well as greater emotional support at follow-up. An economic evaluation of the costs of the intervention will occur to guide future implementation and dissemination. Specific Aim 3 is to explore the direct effect of SURE on the intermediate outcomes of empowerment and self-efficacy. Results of this program of research are expected to inform the development of IPV focused interventions that are cost-effective, high- reaching, and widely disseminable for victimized perinatal women seeking mental health services. Further, we anticipate that this study could have significant implications for IPV prevention efforts for other childbearing victimized women seeking mental health treatment and victimized women, in general. .