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: 10461917
• 负责人: Kathryn H Howell
• 金额: $ 47.69万
• 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/10461917
• 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; psychological violence; recruit; resilience; response; sexual violence; 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。在这个关键时刻，IPV与产后抑郁，创伤后压力有关， 母亲关系的破坏和婴儿的不良结果。尽管对两者都有这些有害影响 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性 这个人口。对理论驱动的干预措施的关键需求源于翻译研究， 可以证明在满足IPV暴露孕妇的特定发展需求方面有效 妇女及其子女。为了应对这种需求，研究团队创造了怀孕的妈妈 授权计划（PMEP）。使用多站点的随机临床试验设计， 当前的研究是评估PMEP计划在解决（1）物质心理健康方面的效率， 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。我们还寻求评估治疗变化的机制 - 社会 支持和授权。参与者将包括230名IPV暴露的孕妇，其中一半将 接收PMEP，其中一半将处于接触等效的主动控制条件。两者中的女人 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 几个月大）和产后12个月（即1岁的婴儿）。评估将包括半结构 访谈和观察数据收集。我们希望在怀孕期间提供PMEP干预 对整个围产期的母亲和婴儿都会产生积极影响，以解决负面 IPV的代际效应。我们的中心假设是，根据以前的PMEP开发 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 胜利并改善孕产妇的心理健康，韧性和育儿敏感性。分析将是 使用多级和结构方程建模进行；飞行员数据支持提议的适当 样本量以检测每个研究目标的治疗效果。该项目的使用是创新的 网站，多方法设计以及重要的是，它解决了脆弱人群的需求 可用的治疗资源。它有可能改善行为和心理健康成果 在不仅孕妇，而且还会减少其年幼的孩子 在产前期间心理健康不良，改善了新妈妈的健康和福祉 孩子及其家人。拟议的研究将解决研究和临床工作的关键差距 创建有效且可持续的干预措施，可以在社区护理环境中容易实施。