The Interconnections Project: Development and Evaluation of a Community-Based Depression Program for African American Violence Survivors

ABSTRACT

BACKGROUND

Multi-faceted depression care programs based within the healthcare system have been found to be effective, but may not fully address the needs of African American Intimate Partner Violence (IPV) survivors, many of whom are not seeking depression care in healthcare settings.

OBJECTIVES

To develop and evaluate a multifaceted, community-based depression care program (the Interconnections Project) for African American women with a history of IPV.

METHODS

We used a community-based participatory research (CBPR) approach to develop, implement, and evaluate the intervention. Participants were African American women who had current depressive symptoms and a lifetime history of IPV. They participated in a 6-month intervention where a peer advocate provided education, skills training, and case management services, and used Motivational Interviewing to support self-management behaviors. We conducted pre-intervention and post-intervention assessments using quantitative and qualitative data.

RESULTS

Fifty-nine women participated, with 92 % attending any sessions and 51 % attending at least 6 h of intervention activities. Intervention changes made to better accommodate participants’ unpredictable schedules improved participation rates. Participants noted high levels of satisfaction with the program. There were significant improvements in depression severity (PHQ-9 13.9 to 7.9, p < 0.001), self-efficacy, self-management behaviors, and self-esteem (all p < 0.001), but no increase in use of antidepressants. Common themes related to why the program was helpful included that the program was by and for African American women, that it fostered trust, and that it taught self-management strategies with practical, lasting value.

CONCLUSION

Culturally specific, community-based interventions led by peer advocates may be a promising way to help African American IPV survivors effectively address depression.

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Acknowledgements

We would like to thank the former and current Bradley Angle House and Lifeworks NW employees who contributed to the project, including Olivia McClelland, MSW, Fowzia Abdulla, and Sara Brownell, MSW; and research assistants Anandam Hilde, MD, MPH, Jannie Whitlock, and Shalanda Carr. We would also like to thank our collaborators Dr. Bentson McFarland and Ms. Corliss McKeever for their guidance and expertise.

This study was funded by the National Institutes of Mental Health (K23MH073008 and 1R21MH082139; PI Nicolaidis) and the Kaiser Permanente Community Fund – Northwest Health Foundation (grant #10571; PI Nicolaidis).

Portions of this manuscript were presented at the Family Violence Prevention Fund’s National Conference on Health and Domestic Violence in New Orleans, LA, in October, 2009, and the Community Campus Partnerships for Health Annual Conference in Portland, OR in May, 2010.

Conflicts of Interest

The authors declare that they do not have a conflict of interest.

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Correspondence to Christina Nicolaidis MD, MPH.

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APPENDIX B

APPENDIX B

Table 3 Intervention Outcomes by Hours of Participation in Intervention

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Nicolaidis, C., Wahab, S., Trimble, J. et al. The Interconnections Project: Development and Evaluation of a Community-Based Depression Program for African American Violence Survivors. J GEN INTERN MED 28, 530–538 (2013). https://doi.org/10.1007/s11606-012-2270-7

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KEY WORDS

  • community-based participatory research
  • depression
  • intimate partner violence
  • African Americans
  • community interventions