Evaluating a health care provider delivered intervention to reduce intimate partner violence and mitigate associated health risks: study protocol for a randomized controlled trial in Mexico City

Kathryn L Falb, Claudia Diaz-Olavarrieta, Paola A Campos, Jimena Valades, Roosebelinda Cardenas, Giselle Carino, Jhumka Gupta, Kathryn L Falb, Claudia Diaz-Olavarrieta, Paola A Campos, Jimena Valades, Roosebelinda Cardenas, Giselle Carino, Jhumka Gupta

Abstract

Background: Intimate partner violence (IPV) victimization is a prevalent issue among women residing in Mexico City. Comprehensive and integrated health care provider (HCP) delivered programs in clinic-settings are needed, yet few have been evaluated in Latin America, including Mexico. In addition, there has been minimal attention to interventions among lower income women presenting at settings outside of antenatal care clinics. The current randomized controlled trial seeks to increase midlevel HCPs' capacity, specifically nurses, who are often the first point of contact in this setting, to identify women presenting at health clinics with experiences of IPV and to assist these women with health risk mitigation. Specific outcomes include changes in past-year IPV (physical and/or sexual), reproductive coercion, safety planning, use of community resources, and quality of life.

Methods/design: Forty-two public health clinics in Mexico City were randomized to treatment or control clinics. Nurses meeting eligibility criteria in treatment groups received an intensive training on screening for IPV, providing supportive referrals, and assessing for health and safety risks. Nurses meeting eligibility criteria at control clinics received the standard of care which included a one-day training focused on sensitizing staff to IPV as a health issue and referral cards to give to women. Women were screened for eligibility (currently experiencing abuse in a heterosexual relationship, 18-44 years of age, non-pregnant or in first trimester) by research assistants in private areas of waiting rooms in health clinics. Consenting women completed a baseline survey and received the study protocol for that clinic. In treatment clinics, women received the nurse delivered session at baseline and received a follow-up counseling session after three months. Surveys are conducted at baseline, three months, and fifteen months from baseline.

Discussion: This study will provide important insight into whether a nurse-delivered program can assist women currently experiencing abuse in a Latin American context. Findings can be used to inform IPV programs and policies in Mexico City's public health clinics.

Trial registration: NCT01661504.

Figures

Figure 1
Figure 1
Abuse assessment screening.

References

    1. World Health Organization, London School of Hygiene and Tropical Medicine, South African Medical Research Council . Global and regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: World Health Organization; 2013.
    1. Campbell JC. The health consequences of intimate partner violence. Lancet. 2002;359:1331–1336. doi: 10.1016/S0140-6736(02)08336-8.
    1. Decker MR, Miller E, Kapur N, Gupta J, Raj A, Silverman JG. Intimate partner violence and sexually transmitted disease symptoms in a national sample of married Bangladeshi women. Int J Gynaecol Obstet. 2008;100(1):18–23. doi: 10.1016/j.ijgo.2007.06.045.
    1. Ellsberg M, Jansen HAFM, Heise L, Watts CH, Garcia-Moreno C, WHO Multi-County Study on Women’s Health and Domestic Violence against Women Study Team Intimate partner violence and women’s physical and mental health in the WHO multi-country study on women’s health and domestic violence: an observational study. Lancet. 2008;371(9619):1165–1172. doi: 10.1016/S0140-6736(08)60522-X.
    1. Sarkar NN. The impact of intimate partner violence on women’s reproductive health and pregnancy outcome. J Obstet Gynaecol. 2008;28(3):266–271. doi: 10.1080/01443610802042415.
    1. Silverman JG, Gupta J, Decker MR, Kapur N, Raj A. Intimate partner violence and unwanted pregnancy, miscarriage, induced abortion, and stillbirth among a national sample of Bangladeshi women. BJOG. 2007;114:1246–1252. doi: 10.1111/j.1471-0528.2007.01481.x.
    1. Miller E, Decker MR, McCauley HL, Tancredi DJ, Levensen RR, Waldman J, Schoenwald P, Silverman JG. Pregnancy coercion, intimate partner violence and unintended pregnancy. Contraception. 2010;81(4):316–322. doi: 10.1016/j.contraception.2009.12.004.
    1. Olaiz G, Rojas R, Valdez R, Palma O. Prevalencia de diferentes tipos de violencia en usuarias del sector salud en Mexico. Salud Publica Mex. 2006;48(S2):S232–S238. doi: 10.1590/S0036-36342006000800003.
    1. Romero-Gutierrez G, Cruz-Arvizu VH, Regalado-Cedillo CA, Ponce-Ponce de Leon AL. Prevalence of violence against pregnant women and associated maternal and neonatal complications in Leon, Mexico. Midwifery. 2011;27(5):750–753. doi: 10.1016/j.midw.2010.06.015.
    1. Castro R, Peek-Asa C, Ruiz A. Violence against women in Mexico: a study of abuse before and during pregnancy. Am J Public Health. 2003;93(7):1110–1116. doi: 10.2105/AJPH.93.7.1110.
    1. Bott S, Guedes A, Goodwin M, Mendoza JA. Violence against women in Latin America and the Caribbean: a comparative analysis of population-based data from 12 countries. Washington, D.C: Pan American Health Organization; 2013.
    1. World Health Organization . Responding to intimate partner violence and sexual violence against women: WHO clinical and policy guidelines. Geneva: WHO; 2013.
    1. Taft A, O’Doherty L, Hegarty K, Ramsay J, Davidson L, Feder G. Screening women for intimate partner violence in healthcare settings. Cochrane Database Syst Rev. 2013;30(4):CD007007.
    1. O’Doherty L, Taft A, Hegarty K, Ramsay J, Davidson L, Feder G. BMJ. 2014. Screening women for intimate partner violence in healthcare settings: abridged Cochrane systematic review and meta-analysis.
    1. MacMillan HL, Wathen CN, Jamieson E, Boyle MH, Shannon HS, Ford-Gilboe M, Worster A, Lent B, Coben JH, Campbell JC, McNutt LA, McMaster Violence Against Women Research Group Screening for intimate partner violence in health care settings: a randomized trial. JAMA. 2009;302(5):493–501. doi: 10.1001/jama.2009.1089.
    1. Hegarty K, O’Doherty L, Taft A, Chondros P, Brown S, Valpied J, Astbury J, Taket A, Gold L, Feder G, Gunn J. Screening and counselling in the primary care setting for women who have experienced intimate partner violence (WEAVE): a cluster randomised controlled trial. Lancet. 2013;283(988):249–258. doi: 10.1016/S0140-6736(13)60052-5.
    1. Jewkes R. Intimate partner violence: the end of routine screening. Lancet. 2013;382(9888):190–191. doi: 10.1016/S0140-6736(13)60584-X.
    1. Waalen J, Goodwin MM, Spitz AM, Petersen R, Saltzman LE. Screening for intimate partner violence by health care providers. Barriers and interventions. Am J Prev Med. 2000;19(4):230–237. doi: 10.1016/S0749-3797(00)00229-4.
    1. Kottenstette JB, Stulberg D. Time to routinely screen for intimate partner violence? J Fam Pract. 2012;62(2):90–92.
    1. Tiwari A, Leung WC, Leung TW, Humphreys J, Parker B, Ho PC. A randomised controlled trial of empowerment training for Chinese abused pregnancy women in Hong Kong. BJOG. 2005;112(9):1249–1256. doi: 10.1111/j.1471-0528.2005.00709.x.
    1. Kiely M, El-Mohandes AAE, El-Khorazaty MN, Gantz MG. An integrated intervention to reduce intimate partner violence in pregnancy: a randomized trial. Obstet Gynecol. 2010;115(2 Pt 1):273–283. doi: 10.1097/AOG.0b013e3181cbd482.
    1. Miller E, Jordan B, Levenson R, Silverman JG. Reproductive coercion: connecting the dots between partner violence and unintended pregnancy. Contraception. 2010;81(6):457–459. doi: 10.1016/j.contraception.2010.02.023.
    1. Miller E, Decker MR, McCauley HL, Tancredi DJ, Levenson RR, Waldman J, Schoenwald P, Silverman JG. A family planning clinic partner violence intervention to reduce risk associated with reproductive coercion. Contraception. 2011;83(3):274–280. doi: 10.1016/j.contraception.2010.07.013.
    1. Cripe SM, Sanchez SE, Sanchez E, Quintanilla BA, Alarcon CH, Gelaye B, Williams MA. Intimate partner violence during pregnancy: a pilot intervention program in Lima, Peru. J Interpers Violence. 2010;25(11):2054–2076. doi: 10.1177/0886260509354517.
    1. Decker MR, Frattaroli S, McCaw B, Coker AL, Miller E, Sharps P, Lane WG, Mandal M, Hirsch K, Strobino DM, Bennett WL, Campbell J, Gielen A. Transforming the healthcare response to intimate partner violence and taking best practices to scale. J Womens Health. 2012;21(12):1222–1229. doi: 10.1089/jwh.2012.4058.
    1. Secretaria de Salud . Norma Oficial Mexicana. Violencia familiar, sexual y contra las mujeres. Criterios para la prevencion y atencion. NOM-046-SSA2-2005. 2009.
    1. Garcia-Moreno C, Goldberg R. Quality/Calidad/Qualite. New York: Population Council; 2006. Living up to their name: Profamilia take on gender-based violence.
    1. Watts C, Mayhew S. Reproductive health services and intimate partner violence: shaping a pragmatic response in Sub-Saharan Africa. Int Fam Plan Perspect. 2004;30(4):207–213. doi: 10.1363/3020704.
    1. Colombini M, Mayhew S, Watts C. Health-sector responses to intimate partner violence in low- and middle-income settings: a review of current models, challenges, and opportunities. Bull World Health Organ. 2008;86(8):635–642. doi: 10.2471/BLT.07.045906.
    1. World Health Organization . Expert meeting on health sector responses to violence against women, 17-19 March 2009. Geneva: WHO; 2010.
    1. Instituto Nactional de las Mujeres . Ley general de acceso de las mujeres a una vida libre de violencia. Mexico City: INMUJERES; 2007.
    1. World Health Organization . WHO multi-country study on women’s health and domestic violence against women: summary report of initial results on prevalence, health outcomes, and women’s responses. Geneva: WHO; 2005.
    1. McFarlane JM, Groff JY, O’Brien JA, Watson K. Secondary prevention of intimate partner violence: a randomized controlled trial. Nurs Res. 2006;55(1):52–61. doi: 10.1097/00006199-200601000-00007.
    1. Ware JE, Kosinski M, Keller SD. A 12-item short form health survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220–233. doi: 10.1097/00005650-199603000-00003.
    1. Agenda estadistica 2008. []
    1. Knaul FM, Gonzalez-Pier E, Gomez-Dantes O, Garcia-Junco D, Arreola-Ornelas H, Barraza-Llorens M, Sandoval R, Caballero F, Hernandez-Avila M, Juan M, Kershenobich D, Nigenda G, Ruelas E, Sepulveda J, Tapia R, Soberon G, Chertorivski S, Frenk J. The quest for universal health coverage: achieving social protection for all in Mexico. Lancet. 2012;380(9849):1259–1279. doi: 10.1016/S0140-6736(12)61068-X.
    1. Agenda Esadistica. []
    1. Bott S, Guedes A, Claramunt MC, Guezmes A. Improving the health sector response to gender based violence: a resource manual for health care professionals in developing countries. New York, NY: IPPF/WHR; 2010.
    1. Diaz Olavarrieta C, Campbell J, Garcia de la Cadena C. Domestic violence against chronic neurological patients. Arch Neurol. 1999;56:681–685. doi: 10.1001/archneur.56.6.681.
    1. Diaz Olavarrieta C, Ellerston C, Paz F, Ponce de Leon S, Alarcon D. Prevalence and correlates of battering among outpatients at a Mexican tertiary care institution. Soc Sci Med. 2002;55(9):1589–1602. doi: 10.1016/S0277-9536(01)00293-3.
    1. Tourangeau R, Smith TW. Asking sensitive questions: the impact of data collection mode, question format, and question context. Public Opin Q. 1996;60(2):275–304. doi: 10.1086/297751.
    1. Nelson HD, Bougatsos C, Blazina I. Screening women for intimate partner violence: a systematic review to update the U.S. Preventative Services Task Force recommendation. Ann Intern Med. 2012;156(11):796–808.
    1. Krishnan S, Subbiah K, Chandra P, Srinivasan K: Minimizing risks and monitoring safety of an antenatal care intervention to mitigate domestic violence among young Indian women: the Dil Mil trial.BMC Public Health 2012.,12(943): doi:10.1186/1471–2458–12–943
    1. World Health Organization . Putting women first: ethical and safety recommendations for research on domestic violence against women. Geneva: WHO; 2001.
    1. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101. doi: 10.1191/1478088706qp063oa.
    1. Jan S, Ferrari G, Watts CH, Hargreaves JR, Kim JC, Phetla G, Morison LA, Porter JD, Barnett T, Pronyk PM. Economic evaluation of a combined microfinance and gender training intervention for the prevention of intimate partner violence in rural South Africa. Health Policy Plan. 2011;26(5):366–372. doi: 10.1093/heapol/czq071.
    1. World Health Organization . Understanding and addressing violence against women. Geneva: World Health Organization; 2012.
    1. Heise L. What works to prevent partner violence? An evidence overview. London: London School of Hygiene and Tropical Medicine; 2011.
    1. Abramsky T, Devries K, Kiss L, Francisco L, Nakuti J, Musuya T, Kyegombe N, Starmann E, Kaye D, Michau L, Watts C. A community mobilisation intervention to prevent violence against women and reduce HIV/AIDS risk in Kampala, Uganda (the SASA! study): study protocol for a cluster randomised controlled trial. Trials. 2012;13(96):1–22.
    1. Landenburger KM. The dynamics of leaving and recovering from an abusive relationship. J Obstet Gynaecol Neonatal Nurs. 1998;27(6):700–706. doi: 10.1111/j.1552-6909.1998.tb02641.x.
    1. Klevens J, Kee R, Trick W, Garcia D, Angulo FR, Jones R, Sadowski LS. Effect of screening for partner violence on women’s quality of life: a randomized controlled trial. JAMA. 2012;308(7):681–689. doi: 10.1001/jama.2012.6434.
Pre-publication history
    1. The pre-publication history for this paper can be accessed here:

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren