Taft Angela J, Small Rhonda, Hegarty Kelsey L, Lumley Judith, Watson Lyndsey F, Gold Lisa
Mother and Child Health Research, La Trobe University, Melbourne, VIC, Australia.
BMC Public Health. 2009 May 27;9:159. doi: 10.1186/1471-2458-9-159.
Intimate partner violence (IPV) is prevalent globally, experienced by a significant minority of women in the early childbearing years and is harmful to the mental and physical health of women and children. There are very few studies with rigorous designs which have tested the effectiveness of IPV interventions to improve the health and wellbeing of abused women. Evidence for the separate benefit to victims of social support, advocacy and non-professional mentoring suggested that a combined model may reduce the levels of violence, the associated mental health damage and may increase a woman's health, safety and connection with her children. This paper describes the development, design and implementation of a trial of mentor mother support set in primary care, including baseline characteristics of participating women.
METHODS/DESIGN: MOSAIC (MOtherS' Advocates In the Community) was a cluster randomised trial embedded in general practice and maternal and child health (MCH) nursing services in disadvantaged suburbs of Melbourne, Australia. Women who were pregnant or with infants, identified as abused or symptomatic of abuse, were referred by IPV-trained GPs and MCH nurses from 24 general practices and eight nurse teams from January 2006 to December 2007. Women in the intervention arm received up to 12 months support from trained and supported non-professional mentor mothers. Vietnamese health professionals also referred Vietnamese women to bilingual mentors in a sub-study. Baseline and follow-up surveys at 12 months measured IPV (CAS), depression (EPDS), general health (SF-36), social support (MOS-SF) and attachment to children (PSI-SF). Significant development and piloting occurred prior to trial commencement. Implementation interviews with MCH nurses, GPs and mentors assisted further refinement of the intervention. In-depth interviews with participants and mentors, and follow-up surveys of MCH nurses and GPs at trial conclusion will shed further light on MOSAIC's impact.
Despite significant challenges, MOSAIC will make an important contribution to the need for evidence of effective partner violence interventions, the role of non-professional mentors in partner violence support services and the need for more evaluation of effective health professional training and support in caring for abused women and children among their populations.
ACTRN12607000010493.
亲密伴侣暴力(IPV)在全球普遍存在,在育龄早期有相当一部分女性遭受过这种暴力,它对女性和儿童的身心健康都有害。很少有设计严谨的研究来测试IPV干预措施对改善受虐妇女健康和幸福状况的有效性。有证据表明,社会支持、宣传和非专业指导对受害者有单独的益处,这表明综合模式可能会降低暴力程度、减少相关的心理健康损害,并可能改善女性的健康、安全状况以及增强其与子女的联系。本文描述了在初级保健中开展的一项指导母亲支持试验的开发、设计和实施情况,包括参与女性的基线特征。
方法/设计:MOSAIC(社区母亲倡导者)是一项整群随机试验,嵌入澳大利亚墨尔本贫困郊区的全科医疗和母婴健康(MCH)护理服务中。2006年1月至2007年12月期间,来自24家全科诊所和8个护士团队的经过IPV培训的全科医生和MCH护士,将怀孕或有婴儿且被认定为受虐或有受虐症状的女性转介过来。干预组的女性接受经过培训和支持的非专业指导母亲长达12个月的支持。在一项子研究中,越南卫生专业人员也将越南女性转介给双语指导者。12个月时的基线调查和随访调查测量了IPV(冲突策略量表)、抑郁(爱丁堡产后抑郁量表)、总体健康状况(健康调查简表SF-36)、社会支持(社会支持量表MOS-SF)以及与子女的依恋关系(父母与子女依恋量表PSI-SF)。在试验开始前进行了大量的开发和试点工作。对MCH护士、全科医生和指导者进行的实施访谈有助于进一步完善干预措施。在试验结束时对参与者和指导者进行深入访谈,以及对MCH护士和全科医生进行随访调查,将进一步揭示MOSAIC的影响。
尽管面临重大挑战,但MOSAIC将为有效伴侣暴力干预措施的证据需求、非专业指导者在伴侣暴力支持服务中的作用,以及对有效卫生专业培训和支持在照顾其人群中受虐妇女和儿童方面进行更多评估的需求做出重要贡献。
ACTRN12607000010493。