Intervening during the Prenatal Period with Women Exposed to Intimate Partner Violence to Improve Maternal Functioning and Infant Adjustment

对遭受亲密伴侣暴力的妇女进行产前干预，以改善母亲功能和婴儿适应

• 批准号: 10221755
• 负责人: Kathryn H Howell
• 金额: $ 51.53万
• 依托单位: UNIVERSITY OF NOTRE DAME
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-26 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10221755
• 关键词: 1 year old; Address; Aftercare; Basic Science; Breastfed infant; Caring; Centers for Disease Control and Prevention (U.S.); Child; Child Rearing; Clinical; Clinical Trials Design; Cognitive; Collaborations; Communities; Control Groups; Corrosives; Data; Data Collection; Development; Discipline of obstetrics; Effectiveness; Elements; Empirical Research; Equation; Evaluation; Evidence based intervention; Exhibits; Exposure to; Family; Focus Groups; Future; Goals; Health; Hour; Infant; Infant Development; Interruption; Intervention; Intervention Studies; Interview; Knowledge; Language; Language Development; Lead; Mediating; Mediation; Mental Depression; Mental Health; Methods; Modeling; Mothers; Outcome; Participant; Personal Satisfaction; Pilot Projects; Plant Roots; Population; Post-Traumatic Stress Disorders; Postpartum Depression; Postpartum Period; Pregnancy; Pregnant Women; Prevalence; Process; Psychopathology; Public Health; Quality of life; Randomized Clinical Trials; Recording of previous events; Research; Resources; Sample Size; Site; Social Change; Social support; Stress; Structure; Survivors; Testing; Time; Translational Research; Victimization; Violence; Vulnerable Populations; Woman; Women' s Health; Work; active control; base; behavioral health; brief intervention; cognitive development; design; effective intervention; efficacy evaluation; empowerment; evidence base; high risk; improved; infant outcome; innovation; intergenerational; intervention program; intimate partner violence; perinatal intervention; perinatal period; physical conditioning; post-traumatic stress; pregnant; prenatal; programs; psychologic; recruit; resilience; response; social; stress resilience; theories; treatment effect; unborn child; violence exposure; violence perpetration; violence victimization

PROJECT SUMMARY Intimate partner violence (IPV) occurs at alarmingly high rates, with the highest risk of IPV exposure during pregnancy. IPV during this critical juncture is associated with postpartum depression, posttraumatic stress, disruption to the mother-infant relationship, and poor infant outcomes. Despite these deleterious effects to both the mother and infant, there is a lack of evidence-based interventions that have demonstrated effectiveness for this population. A critical need exists for a theoretically-driven intervention, rooted in translational research, that can demonstrate effectiveness in addressing the specific, developmental needs of IPV-exposed pregnant women and their children. In response to this need, the research team has created the Pregnant Moms’ Empowerment Program (PMEP). Using a multi-site, randomized clinical trial design, the specific objectives of the current study are to evaluate the efficacy of the PMEP program in addressing (1) maternal mental health, resilience, re-victimization, and parenting sensitivity and (2) early infant development, including cognitive, language, and socioemotional functioning. We also seek to evaluate mechanisms of treatment change – social support and empowerment. Participants will include 230 IPV-exposed pregnant women, half of whom will receive the PMEP and half of whom will be in a contact equivalent active control condition. Women in both conditions will participate in group-based treatment during 1, 2-hour session each week, for 5 weeks. Assessments will be administered at pre-treatment, post-treatment, 3 months postpartum (i.e., infants 3 months old), and 12 months postpartum (i.e., infants 1 year old). Assessments will include semi-structured interviews and observational data collection. We expect that providing the PMEP intervention during pregnancy will have positive effects for both mothers and infants across the perinatal period, addressing the negative intergenerational effects of IPV. Our central hypothesis is that the PMEP, developed based on previous empirical research, focus groups of community stakeholders, and pilot intervention data, will reduce re- victimization and improve maternal mental health, resilience, and parenting sensitivity. Analyses will be conducted using multilevel and structural equation modeling; pilot data support the adequacy of the proposed sample size to detect treatment effects for each study aim. This project is both innovative in its use of a multi- site, multi-method design and significant in that it addresses the needs of a vulnerable population that has few available treatment resources. It has the potential to improve both behavioral and mental health outcomes among not only pregnant women, but also their young children, which will reduce the public health burden of poor mental health during the prenatal period and improve the health and well-being of new mothers, their children, and their families. The proposed study will address a critical gap in both research and clinical work by creating an effective and sustainable intervention that can be readily implemented in community care settings.

项目摘要 亲密的伴侣暴力（IPV）以令人震惊的高率发生，在IPV暴露风险最高的情况下 怀孕期间的IPV。 母亲关系的破坏和婴儿的不良结果。 母亲和婴儿，缺乏基于证据的干预措施，这些干预措施证明了有效的有效性 这个人口的重要需求是理论上驱动的干预措施，植根于转化研究 可以证明在满足IPV暴露孕妇的特定发展需求方面有效 妇女和孩子们。 授权计划（PMEP）。 当前的研究是评估PMEP计划在解决（1）孕产妇心理健康方面的功效， 韧性，重新维数和育儿敏感性，以及（2）早期婴儿发育，包括认知， 语言和社会情感功能。 支持和授权。 接收PMEP，一半将处于触点等效的主动控制条件。 条件将在每周1，2小时的课程中参加基于小组的治疗，持续5周。 评估将在治疗前，治疗后，产后3个月进行（即婴儿3 几个月）和产后12个月（即婴儿1岁）。 访谈和观察数据收集。 将对整个围产期的麻烦和婴儿产生积极的影响，以解决负面 IPV的代际效应是PMEP 实证研究，社区利益相关者的焦点和试点干预数据将减少重新 受害并改善了孕产妇的心理健康，韧性和育儿敏感性 使用多级和结构方程模型进行了支持； 样本量检测每个研究的治疗方法。 网站，多方法设计和重要的意义，可以满足弱势人群的需求 可用的治疗资源。 不仅在孕妇，而且还会减轻公共卫生负担 在产前期间精神健康，改善新妈妈的健康和福祉 儿童及其家人。 在社区护理环境中，可以很容易地实施创建和有效和可持续的间隔INT。