Recovering from Intimate Partner Violence Through Strengths and Empowerment (RISE): Tailoring and Evaluating a Patient-Centered Counseling Intervention for Women Veterans

通过优势和赋权从亲密伴侣暴力中恢复（RISE）：为女性退伍军人定制和评估以患者为中心的咨询干预措施

• 批准号: 9291950
• 负责人: Katherine M Iverson
• 金额: --
• 依托单位: VA BOSTON HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-10-01 至 2020-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9291950
• 关键词: Address; Boston; Brain Injuries; Caring; Cessation of life; Clinical; Collaborations; Communities; Complement; Coping Skills; Counseling; Detection; Development; Disclosure; Education; Effectiveness; Ensure; Female; Focus Groups; Generic Drugs; Health; Health Services; Healthcare; Healthcare Systems; High Prevalence; Human Resources; Hybrids; Individual; Injury; Institutes; Intervention; Interview; Length; Manuals; Mental Depression; Mental Health; Mental Health Services; Methods; Modeling; Outcome; Patient-Centered Care; Patients; Phase; Post-Traumatic Stress Disorders; Preventive care; Preventive service; Primary Health Care; Protocols documentation; Provider; Psychologist; Quality of life; Randomized Clinical Trials; Research; Research Personnel; Resources; Safety; Self Care; Self Efficacy; Services; Site; Social Work; Social support; Structure; Suicide; Symptoms; Testing; Time; Veterans; Visit; Woman; Women' s Health; Women' s Health Services; base; behavior change; behavioral health; chronic pain; clinical practice; coping; design; effective intervention; empowerment; evidence base; experience; flexibility; formative assessment; health administration; health service use; high risk; improved; innovation; intimate partner violence; motivational enhancement therapy; patient oriented; physical conditioning; practice-based research network; preference; premature; primary care setting; programs; psychosocial; rapid technique; response; routine care; routine practice; screening; trial comparing; user-friendly

Background Intimate partner violence (IPV) is a major health concern for women Veterans. IPV is associated with numerous physical and mental health conditions. VHA is implementing IPV screening programs to identify female patients who experience past-year IPV. Despite strong evidence that screening increases detection of IPV, less is established about how to intervene following IPV disclosure in health care settings, in order to improve health outcomes. Existing healthcare- based interventions result in minimal effects on health and well-being, likely because they are too brief and generic. In response, the PI has developed Recovering from IPV through Strengths and Empowerment (RISE), based on the IPV-related health care needs and preferences of women Veterans. RISE is designed to be delivered in primary care and is an individualized, variable-length, modular-based intervention that addresses 1) safety planning; 2) education on the health effects of IPV; 3) increasing coping skills and self-care; 4) enhancing social support; 5) making difficult decisions; and 6) connecting with resources. Objectives The objective of this proposal is to refine and formally evaluate RISE for women Veterans who experience IPV. The aims are to: 1) tailor and refine RISE to accommodate differences in service structures and personnel in different primary care settings; 2) conduct a formative evaluation of RISE with women Veterans to inform the development of a user-friendly, tailored implementation protocol and intervention manual; and 3) examine the effects of RISE on women Veterans’ individual psychosocial outcomes. Methods We will conduct the proposed research at two Women’s Health Practice-Based Research Network sites (Boston, MA and West Haven, CT). For Aim 1, we will tailor and refine RISE through input from a Stakeholder Advisory Board, focus groups with Women Veterans (n=24- 32), and interviews with providers (n=24). To achieve Aim 2, we will conduct a formative open trial of RISE (n=up to 20 women Veterans). Qualitative and quantitative findings from patients and providers will inform the development of a user-friendly, tailored implementation protocol and intervention manual. For Aim 3, we will conduct a Hybrid 1 randomized clinical trial (n=60) to examine the effects of RISE on women Veterans’ psychosocial outcomes (e.g., empowerment, self-efficacy, health, and service use). Anticipated Impacts on Veteran’s Health Care VHA’s Blueprint for Excellence identifies patient-centeredness and “advancing innovations in women Veterans’ health care” as key strategic transformational strategies. This project will help achieve these aims by evaluating a patient-centered IPV intervention that is tailored to women Veterans’ needs, preferences, and circumstances. It is imperative to complement current VHA IPV screening efforts with an effective intervention. RISE fills an essential unmet need in our healthcare system, ensuring that women Veterans who experience IPV receive care that leads to improved health and psychosocial outcomes.

背景 亲密伴侣暴力 (IPV) 是女性退伍军人的一个主要健康问题。 VHA 正在实施 IPV 筛查。 尽管有强有力的证据，但仍有一些计划来识别过去一年经历过 IPV 的女性患者。 筛查增加了 IPV 的检测，但关于如何干预以下方面的规定较少 医疗保健机构中的 IPV 披露，以改善现有的医疗保健结果。 基于基础的干预措施对健康和福祉的影响极小，可能是因为它们 过于简短和笼统 作为回应，PI 开发了“从 IPV 中恢复”： 优势与赋权 (RISE)，基于 IPV 相关的医疗保健需求和 RISE 旨在提供初级保健服务，并且是一种针对女性退伍军人的偏好。 个性化、可变长度、基于模块化的干预，解决 1) 安全规划； 关于 IPV 对健康影响的教育； 3) 提高应对技能和自我护理； 社会支持；5）做出艰难的决定；6）与资源联系。 目标 该提案的目的是完善并正式评估女性退伍军人的 RISE， 体验 IPV 的目标是：1) 定制和完善 RISE 以适应差异。 2）进行形成性 与女性退伍军人一起对 RISE 进行评估，以告知开发一个用户友好的、量身定制的 实施方案和干预手册；3) 检查 RISE 对妇女的影响 退伍军人的个人心理社会结果。 方法 我们将在两个基于妇女健康实践的研究中进行拟议的研究 对于目标 1，我们将定制和完善 RISE 网络站点（马萨诸塞州波士顿和康涅狄格州西黑文）。 通过利益相关者咨询委员会、女性退伍军人焦点小组（n=24- 32），以及与提供商的访谈（n=24） 为了实现目标 2，我们将进行正式的公开。 RISE 试验（n = 最多 20 名女性退伍军人）的定性和定量结果。 提供商将告知用户友好的、量身定制的实施协议的开发 对于目标 3，我们将进行混合 1 随机临床试验 (n=60)。 研究 RISE 对女性退伍军人心理社会结果的影响（例如， 赋权、自我效能、健康和服务使用）。 对退伍军人医疗保健的预期影响 VHA 的卓越蓝图明确了以患者为中心和“推进创新 女性退伍军人医疗保健”作为关键的战略转型战略，该项目将有所帮助。 通过评估专为女性量身定制的以患者为中心的 IPV 干预措施来实现这些目标 退伍军人的需求、偏好和情况必须补充当前的 VHA。 通过有效干预的 IPV 筛查工作填补了我们未满足的基本需求。 医疗保健系统，确保经历 IPV 的女性退伍军人获得领先的护理 改善健康和心理社会结果。