A randomized controlled trial of a computer-based brief intervention for victimized perinatal women seeking mental health treatment
Intimate partner victimization (IPV) during the perinatal period is associated with adverse outcomes for the woman, her developing fetus, and any children in her care. Maternal mental health concerns, including depression and anxiety, are prevalent during the perinatal period particularly among women experiencing IPV. Screening and interventions for IPV targeting women seeking mental health treatment are lacking. In the current study, we examine the feasibility, acceptability, and the preliminary efficacy of a brief, motivational computer-based intervention, SURE (Strength for U in Relationship Empowerment), for perinatal women with IPV seeking mental health treatment. The study design was a two-group, randomized controlled trial with 53 currently pregnant or within 6-months postpartum women seeking mental health treatment at a large urban hospital-based behavioral health clinic for perinatal women. Findings support the acceptability and feasibility of the SURE across a number of domains including content, delivery, and retention. All participants (100%) found the information and resources in SURE to be helpful. Our preliminary results found the degree of IPV decreased significantly from baseline to the 4-month follow-up for the SURE condition (paired t-test, p < 0.001), while the control group was essentially unchanged. Moreover, there was a significant reduction in emotional abuse for SURE participants (p = 0.023) relative to participants in the control condition. There were also reductions in physical abuse although non-significant (p = 0.060). Future work will test SURE in a larger, more diverse sample. ClinicalTrials.gov Identifier: NCT02370394
KeywordsPerinatal Intimate partner victimization Computer intervention
This research was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) R21 HD077358 (PI: Zlotnick; Co-Is: Tzilos Wernette). The authors gratefully acknowledge the women who participated in this study, as well as the research staff at Women and Infant Hospital (Ms. Sarah Hill and Ms. Michelle Scully) for their assistance with data collection and computer programming.
This research was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) HD077358.
Compliance with ethical standards
Conflicts of interest
No competing financial interests exist for authors Golfo Tzilos Wernette and Christina Raker. Caron Zlotnick’s husband is a consultant for Soberlink.
- Bacchus LJ, Bullock L, Sharps P, Burnett C, Schminkey DL, Maria Buller A, Campbell J (2016) Infusing technology into perinatal home visitation in the United States for women experiencing intimate partner violence: exploring the interpretive flexibility of an mHealth intervention. J Med Internet Res 18(11):e302. https://doi.org/10.2196/jmir.6251 CrossRefPubMedPubMedCentralGoogle Scholar
- Certain HE, Mueller M, Jagodzinski T, Fleming MF (2007) Intimate partner violence in postpartum women. Abstracts/Contraception 76:168Google Scholar
- Hegarty K, Valpied J (2013) Composite abuse scale manual: version December 2013 [assessment instrument]Google Scholar
- Hill S, Schonbrun YC, Zlotnick C (2015) Perinatal women’s interest in a brief computer-based intervention for intimate partner violence. Paper presented at the annual meeting of the New England Psychological Association, Fitchburg, MA, October, 2015Google Scholar
- Iverson KM, Gradus JL, Resick PA, Suvak MK, Smith KF, Monson CM (2011) Cognitive-behavioral therapy for PTSD and depression symptoms reduces risk for future intimate partner violence among interpersonal trauma survivors. J Consult Clinical Psychol 79:193–202. https://doi.org/10.1037/a0022512 CrossRefGoogle Scholar
- Kuijpers K, van der Knaap L, Willem Winkel F (2012) Risk of revictimization of intimate partner violence: The role of attachment, anger and violent behavior of the victim. J Fam Violence 27(1):33–44Google Scholar
- Machisa MT, Christofides N, Jewkes R (2017) Mental ill health in structural pathways to women's experiences of intimate partner violence. PLoS One 12. https://doi.org/10.6084/m9.figshare.4733020
- Organization WHO (2013) Responding to intimate partner violence and sexual violence against women: WHO clinical and policy guidelines. http://www.who.int/reproductivehealth/publications/violence/9789241548595/en/.Google Scholar
- Tzilos Wernette GK, Plegue M, Kahler C, Sen A, Zlotnick C (2018) A pilot randomized controlled trial of a computer-delivered brief intervention for substance use and risky sex during pregnancy. J Womens Health 27(1):83–92 Google Scholar
- Warshaw C, Sullivan CM (2013) A systematic review of trauma-focused interventions for domestic violence survivors. U. S. Dept. of Health & Human ServicesGoogle Scholar
- Weir BW, O’Brien K, Bard RS, Casciato CJ, Maher JE, Dent CW, Dougherty JA, Stark MJ (2009) Reducing HIV and partner violence risk among women with criminal justice system involvement: a randomized controlled trial of two motivational interviewing-based interventions. AIDS Behav 13:509–522. https://doi.org/10.1007/s10461-008.9422-0 CrossRefPubMedGoogle Scholar