Scaling up Trauma and Violence-Informed Outreach With Women Affected by Violence

Using a participatory action research design, this study examines the process and impact of implementing an evidence-informed, strengths-based, trauma- and violence-informed outreach program with women at greatest risk of health and social inequities to mitigate the effects of multiple forms of violence in their lives. Through collaboration among community service leaders and staff, women with lived or living experience of gender-based violence, and researchers, this project aims to improve the capacity of organizations to build and sustain effective and trusting relationships with women in order to foster health, well-being, safety, and increased ability to independently navigate their support needs.

Study Overview

• Status: Completed
• Conditions: Gender-based Violence; Outreach Intervention
• Intervention / Treatment: Behavioral: STRENGTH Outreach Intervention

Detailed Description

Using collaborative research activities, an advanced model of the STRENGTH intervention developed in earlier community-based studies is being tested. That evidence showed that women have unique strengths and abilities in navigating their safety, health and well-being, and that a strengths-based approach is critical to communicate respect and build trusting relationships. Trust facilitates women's engagement and retention in health and social care and enhances their capacities to independently navigate these systems. Appropriate, safe, and responsive outreach can effectively improve safety, reduce overdose deaths, and enhance engagement with health and social care.

The study involves a case-based mixed method design to test an empirically driven model for outreach with women affected by violence, through a series of longitudinal studies with diverse sub-groups of women in differing social and geographical contexts. The two-year intervention study is embedded in a larger 7-year national project aimed at building capacity of outreach programs to prevent and mitigate the effects of gender-based violence and advance the theory and practice of community-based, participatory action research.

Intervention-specific Research Questions:

1. How effective is this outreach program in:

   • building trusting relationships with women?
   • supporting women to achieve their self-identified priorities and goals (short-term, medium-term, and long-term goals) in ways that foster safety, autonomy and rights to self-determination?
2. What factors enable or confound the success of the outreach intervention?

Project Objectives

To generate new knowledge about program delivery to effectively engage with women to:

• Build trusting relationships between women and short-term, medium-term and long-term supports
• Enhance women's capacity for autonomy, ability and confidence in achieving short-, medium-, and long-term goals
• To generate new knowledge about how to enhance delivery of health and social care services that are non-harmful and non-traumatizing

This research will provide important knowledge about how to more effectively design, implement and evaluate programs and practices that can increase social and health supports and mitigate the effects of gender-based and structural violence. It tests how an empirically driven model of outreach combined with enhanced service integration supports women to identify their priority needs and can bridge the gap in service needs and access with women affected by violence and inequities.

• Study Type: Interventional
• Enrollment (Actual): 39
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • British Columbia
    • Vancouver, British Columbia, Canada, V6T2B5
      • University of British Columbia

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Self-identify as a woman, therefore the study is trans-inclusive
• Have some degree of English proficiency in understanding and communication
• Live and/or spend significant time for work and/or health and social services in the service area of one of the participating community organizations
• Age 18 or over

Exclusion Criteria:

• Individuals not meeting the inclusion criteria listed above will be excluded from participation.
• In addition, women already enrolled in another program with wrap-around supports and who are able to independently navigate health and social care will not be eligible to participate in the outreach program intervention.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: STRENGTH Outreach Intervention; Participants enrolled in STRENGTH intervention elements	Behavioral: STRENGTH Outreach Intervention; The STRENGTH outreach intervention is a community-led, strengths-based, and trauma- and violence-informed program to support self-identifying women who experience interpersonal and structural gender-based violence. The outreach intervention aims to support individuals to achieve self-identified priorities.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in trust from baseline to 3 months	Change in trust achieved by the program with participants, measured using participants' self-rated trust in program rated from 1 to 5, with higher scores indicating higher trust and comparing baseline to 3 months post-baseline	Baseline (6 weeks post-enrollment) & 3 months
Change in trust from baseline to 6 months	Change in trust achieved by the program with participants, measured using participants' self-rated trust in program rated from 1 to 5, with higher scores indicating higher trust and comparing baseline to 6 months post-baseline	Baseline (6 weeks post-enrollment) & 6 months
Change in trust from baseline to 9 months	Change in trust achieved by the program with participants, measured using participants' self-rated trust in program rated from 1 to 5, with higher scores indicating higher trust and comparing baseline to 9 months post-baseline	Baseline (6 weeks post-enrollment) & 9 months
Change in trust from baseline to 12 months	Change in trust achieved by the program with participants, measured using participants' self-rated trust in program rated from 1 to 5, with higher scores indicating higher trust and comparing baseline to 12 months post-baseline	Baseline (6 weeks post-enrollment) & 12 months
Safety in Care Encounters at Baseline	Self-reported safety in clinical care encounters over the past three months using rating of 1 to 5 with higher scores being higher safety	Baseline (6 weeks post-enrollment)
Safety in Care Encounters at 3 months	Self-reported safety in clinical care encounters over the past three months using rating of 1 to 5 with higher scores being higher safety	3 months post-baseline
Safety in Care Encounters at 6 months	Self-reported safety in clinical care encounters over the past three months using rating of 1 to 5 with higher scores being higher safety	6 months post-baseline
Safety in Care Encounters at 9 months	Self-reported safety in clinical care encounters over the past three months using rating of 1 to 5 with higher scores being higher safety	9 months post-baseline
Safety in Care Encounters at 12 months	Self-reported safety in clinical care encounters over the past three months using rating of 1 to 5 with higher scores being higher safety	12 months post-baseline
Safety in Home Setting at Baseline	Self-reported safety in current home setting for the previous three months using a rating of 1 to 5 with higher scores being higher safety	Baseline (6-weeks post-enrollment)
Safety in Home Setting at 3 months	Self-reported safety in current home setting for the previous three months using a rating of 1 to 5 with higher scores being higher safety	3 months post-baseline
Safety in Home Setting at 6 months	Self-reported safety in current home setting for the previous three months using a rating of 1 to 5 with higher scores being higher safety	6 months post-baseline
Safety in Home Setting at 9 months	Self-reported safety in current home setting for the previous three months using a rating of 1 to 5 with higher scores being higher safety	9 months post-baseline
Safety in Home Setting at 12 months	Self-reported safety in current home setting for the previous three months using a rating of 1 to 5 with higher scores being higher safety	12 months post-baseline
Safety in Community Setting at Baseline	Self-reported safety in community for the previous three months using a rating of 1 to 5 with higher scores being higher safety	Baseline (6-weeks post-enrollment)
Safety in Community Setting at 3 months	Self-reported safety in community for the previous three months using a rating of 1 to 5 with higher scores being higher safety	3 months post-baseline
Safety in Community Setting at 6 months	Self-reported safety in community for the previous three months using a rating of 1 to 5 with higher scores being higher safety	6 months post-baseline
Safety in Community Setting at 9 months	Self-reported safety in community for the previous three months using a rating of 1 to 5 with higher scores being higher safety	9 months post-baseline
Safety in Community Setting at 12 months	Self-reported safety in community for the previous three months using a rating of 1 to 5 with higher scores being higher safety	12 months post-baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Priorities achieved at 3 months	Were participants' self-identified priorities achieved after 3 months of intervention (yes/no)	3 months
Priorities achieved at 6 months	Were participants' self-identified priorities achieved after 6 months of intervention (yes/no)	6 months
Priorities achieved at 9 months	Were participants' self-identified priorities achieved after 9 months of intervention (yes/no)	9 months
Priorities achieved at 12 months	Were participants' self-identified priorities achieved after 12 months of intervention (yes/no)	12 months
Priorities achieved at 18 months	Were participants' self-identified priorities achieved after 18 months of intervention (yes/no)	18 months
Priorities achieved at 21 months	Were participants' self-identified priorities achieved after 21 months of intervention (yes/no)	21 months
Priorities achieved at 24 months	Were participants' self-identified priorities achieved after 24 months of intervention (yes/no)	24 months
Priorities achieved at 15 months	Were participants' self-identified priorities achieved after 15 months of intervention (yes/no)	15 months

Collaborators and Investigators

• Sponsor: University of British Columbia
• Collaborators: Social Sciences and Humanities Research Council of Canada; Michael Smith Foundation for Health Research; Inner-City Women's Initiatives Society
• Investigators: Principal Investigator: Vicky Bungay, PhD, Professor

Study record dates

Study Major Dates

• Study Start (Actual): October 5, 2022
• Primary Completion (Actual): August 30, 2023
• Study Completion (Actual): August 30, 2023

Study Registration Dates

• First Submitted: September 22, 2022
• First Submitted That Met QC Criteria: October 3, 2022
• First Posted (Actual): October 4, 2022

Study Record Updates

• Last Update Posted (Actual): November 18, 2023
• Last Update Submitted That Met QC Criteria: November 16, 2023
• Last Verified: November 1, 2023

More Information

Terms related to this study

• Keywords: Gender-based Violence; Trauma-informed; Outreach Intervention
• Additional Relevant MeSH Terms: Wounds and Injuries
• Other Study ID Numbers: H22-01197

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No