Developing Comprehensive Screening and Treatment for Intimate Partner Violence Perpetration

对亲密伴侣暴力行为进行全面筛查和治疗

• 批准号: 10535427
• 负责人: Galina Alexandra Portnoy
• 金额: --
• 依托单位: VA CONNECTICUT HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-10-01 至 2025-09-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10535427
• 关键词: Address; Area; Assessment tool; Behavior Therapy; Caring; Child; Clinical; Communities; Comprehensive Health Care; Conflict (Psychology); Connecticut; Consensus; Data; Detection; Family; Feedback; Focus Groups; Funding; Goals; Guidelines; Health; Health Services; Health Services Needs; Healthcare; Healthcare Systems; Home; Homogeneously Staining Region; Hybrids; Individual; Intervention; Knowledge; Manuals; Measurement; Medical center; Mentorship; Methodology; Modeling; Outcome; Patients; Pilot Projects; Policies; Population; Positioning Attribute; Predictive Value; Prevention; Procedures; Process; Property; Protocols documentation; Provider; Psychologist; Psychometrics; Public Health; Receiver Operating Characteristics; Recommendation; Reference Standards; Reporting; Research; Research Methodology; Research Personnel; Risk; Safety; Sampling; Screening procedure; Services; Specificity; Testing; Training; Validation; Veterans; Veterans Health Administration; Woman; Women' s Health; Women' s Health Services; Work; acceptability and feasibility; brief screening; career; clinical practice; design; effective intervention; effectiveness/implementation trial; evidence base; experience; implementation science; improved; infancy; innovation; instrument; intervention refinement; intimate partner violence; male; men; post-traumatic stress; prevent; primary outcome; programs; psychological violence; psychosocial; relationship violence; research study; response; routine screening; satisfaction; screening; secondary outcome; sexual violence; substance use; therapy development; tool; trial design; violence perpetration; violence victimization

Background: Intimate partner violence (IPV) is a major public health concern with significant negative consequences for those who experience it and wide-ranging impact on children, families, and the healthcare system. However, IPV is an especially prevalent health issue for Veterans, who are at increased risk of both experiencing and perpetrating IPV. More than one out of three women Veterans experience IPV and up to 60% of Veteran men report IPV perpetration. Although VHA currently recommends routine screening of IPV experiences among women Veterans, no guidelines or instruments currently exist for IPV perpetration screening. Moreover, effective intervention development for IPV perpetration is in its infancy with no evidence- based individual treatment available for IPV perpetration. In order to improve Veterans' health and reduce rates of IPV, effective and acceptable screening and treatment for IPV perpetration must exist. Significance/Impact: IPV perpetration detection, followed by behavioral intervention, are urgently needed for IPV cessation and improved health of Veterans with these common presenting problems. Yet there has been little progress to develop tools and procedures for IPV perpetration, and no guidelines on best practices for IPV perpetration screening or treatment exist. The findings of the proposed research will improve the health and functioning of Veterans and their families, enhance much needed healthcare response for this population, and inform VHA national efforts for IPV response among Veterans. Innovation: This project is innovative in its focus on IPV perpetration. With the majority of IPV research focusing on IPV victimization, there is currently a significant gap in knowledge related to IPV perpetration, including limited tools and procedures with which to address perpetration of IPV among Veterans. Enhancing services for those who experience IPV is essential, but insufficient. In order to reduce and prevent IPV, a comprehensive healthcare response necessitates implementing validated screening to detect IPV perpetration among Veterans and developing intervention protocols to address IPV perpetration. Completion of the CDA research aims will provide VHA with the data and tools necessary to inform IPV efforts, practices, and policy. Aims: The primary objective of this research is to decrease IPV among Veterans. To do so, we must have effective and acceptable tools and protocols. Aim 1: Evaluate the psychometric properties and cut-scores of a previously developed IPV screening tool. Aim 2: Identify an effective IPV perpetration intervention process and essential treatment components and develop an intervention manual. Aim 3: Conduct a pilot study of the IPV perpetration manualized intervention in a sample of Veterans. Methodology: For Aim 1, we will calculate the sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratios of the screening instrument in comparison to the reference standard in a sample of [male] Veterans (n=113). To achieve Aim 2, we will a) engage in a consensus process with IPV experts to select intervention components from four pre-existing treatment models; b) solicit Veterans’ feedback through focus group discussions (n=4 focus groups); and c) refine the intervention, develop intervention manual, and present manual to stakeholders. For Aim 3, we will use a pre-post design to assess feasibility, safety, acceptability, and satisfaction (primary outcomes) and patient- and partner-reported changes on indicators of psychosocial health (secondary outcomes) among Veterans (n=20). Next Steps/Implementation: Research proposed in this CDA will provide the necessary groundwork for developing and implementing screening and intervention for IPV perpetration among Veterans, a critical need in VA care. Completion of these aims will inform an IIR proposal, to further evaluate and implement VHA's IPV perpetration response. Specifically, I will use findings from the CDA to refine the manualized IPV perpetration intervention, which I will then test in a larger Hybrid Type 1 effectiveness-implementation trial.

背景：亲密伴侣暴力（IPV）是一个主要的公共卫生问题，显着负面 对那些经历过它的人以及对儿童，家庭和医疗保健的大范围影响的后果 系统。但是，对于退伍军人而言，IPV是一个特别普遍的健康问题，他们的风险增加了 经历和进行IPV。三分之一的退伍军人体验IPV，最多60％ 资深男子报告IPV犯罪。尽管VHA目前建议进行IPV的常规筛选 女性退伍军人之间的经验，目前不存在IPV犯罪的指南或工具 筛选。此外，IPV实施的有效干预开发仍处于起步阶段，没有证据 - 基于个人治疗可用于IPV进行。为了改善退伍军人的健康并降低利率 IPV的有效且可接受的IPV持续性筛查和治疗必须存在。 显着性/影响：迫切需要IPV犯罪检测，然后进行行为干预。 IPV停止并改善了退伍军人的健康状况。但是有 开发IPV实施工具和程序的进展很少，没有关于IPV最佳实践的准则 存在造成筛查或治疗。拟议研究的发现将改善健康状况 退伍军人及其家人的运作，增强对该人群的急需医疗保健反应，并 告知VHA国家在退伍军人之间进行IPV响应的努力。 创新：该项目的重点是IPV犯罪。大多数IPV研究 为了关注IPV胜利，目前与IPV犯罪有关的知识存在很大差距， 包括有限的工具和程序来解决退伍军人之间IPV的持续性。增强 为体验IPV的人提供服务是必不可少的，但不足。为了减少和防止IPV， 全面的医疗保健响应必要实施经过验证的筛查以检测IPV实施 在退伍军人和制定干预方案中以解决IPV实施方案。 CDA的完成 研究目的将为VHA提供为IPV工作，实践和政策提供必要的数据和工具。 目的：这项研究的主要目的是减少退伍军人的IPV。为此，我们必须有 有效且可接受的工具和协议。目标1：评估A 先前开发的IPV筛选工具。目标2：确定有效的IPV犯罪干预过程，并 必不可少的治疗组件并制定干预手册。 AIM 3：进行IPV的试点研究 在退伍军人样本中进行犯罪手动干预。 方法论：对于目标1，我们将计算灵敏度，特异性，正面和负预测价值，以及 与A中的参考标准相比 [男性]退伍军人样本（n = 113）。为了实现目标2，我们将a）与IPV进行共识过程 专家从四个现有治疗模型中选择干预组件； b）征求退伍军人 通过焦点小组讨论的反馈（n = 4个焦点小组）； c）完善干预措施，发展 干预手册，并向利益相关者提供手册。对于AIM 3，我们将使用前设计进行评估 可行性，安全性，可接受性和满意度（主要结果）以及患者和伴侣报告的变化 关于退伍军人中的社会心理健康指标（次要结果）（n = 20）。 下一步/实施：CDA中提出的研究将为 在退伍军人中开发和实施IPV持续性的筛查和干预，这是一个迫切的需求 在VA护理中。这些目标的完成将为IIR提案提供信息，以进一步评估和实施VHA的IPV 犯罪响应。具体来说，我将使用CDA的发现来完善手动IPV犯罪 干预措施，然后我将在较大的1型混合型有效性试验中进行测试。