Bair-Merritt Megan H, Jennings Jacky M, Chen Rusan, Burrell Lori, McFarlane Elizabeth, Fuddy Loretta, Duggan Anne K
Division of General Pediatrics and Adolescent Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Arch Pediatr Adolesc Med. 2010 Jan;164(1):16-23. doi: 10.1001/archpediatrics.2009.237.
To estimate whether home visitation beginning after childbirth was associated with changes in average rates of mothers' intimate partner violence (IPV) victimization and perpetration as well as rates of specific IPV types (physical assault, verbal abuse, sexual assault, and injury) during the 3 years of program implementation and during 3 years of long-term follow-up.
Randomized controlled trial.
Oahu, Hawaii.
Six hundred forty-three families with an infant at high risk for child maltreatment born between November 1994 and December 1995. Intervention Home visitors provided direct services and linked families to community resources. Home visits were to initially occur weekly and to continue for at least 3 years.
Women's self-reports of past-year IPV victimization and perpetration using the Conflict Tactics Scale. Blinded research staff conducted maternal interviews following the child's birth and annually when children were aged 1 to 3 years and then 7 to 9 years.
During program implementation, intervention mothers as compared with control mothers reported lower rates of IPV victimization (incidence rate ratio [IRR], 0.86; 95% confidence interval [CI], 0.73-1.01) and significantly lower rates of perpetration (IRR, 0.83; 95% CI, 0.72-0.96). Considering specific IPV types, intervention women reported significantly lower rates of physical assault victimization (IRR, 0.85; 95% CI, 0.71-1.00) and perpetration (IRR, 0.82; 95% CI, 0.70-0.96). During long-term follow-up, rates of overall IPV victimization and perpetration decreased, with nonsignificant between-group differences. Verbal abuse victimization rates (IRR, 1.14, 95% CI, 0.97-1.34) may have increased among intervention mothers.
Early-childhood home visitation may be a promising strategy for reducing IPV.
评估产后开始的家访是否与项目实施的3年期间以及长期随访的3年期间母亲亲密伴侣暴力（IPV）受害率和施暴率的平均变化以及特定IPV类型（身体攻击、言语虐待、性侵犯和伤害）的发生率有关。
随机对照试验。
夏威夷瓦胡岛。
1994年11月至1995年12月间出生的643个有婴儿受虐待高风险的家庭。干预家访人员提供直接服务并将家庭与社区资源联系起来。家访最初每周进行一次，并持续至少3年。
使用冲突策略量表，女性对过去一年IPV受害情况和施暴情况的自我报告。研究人员在孩子出生后以及孩子1至3岁、7至9岁时每年进行一次产妇访谈，访谈人员对研究情况不知情。
在项目实施期间，与对照母亲相比，干预组母亲报告的IPV受害率较低（发病率比[IRR]，0.86；95%置信区间[CI]，0.73 - 1.01），施暴率显著较低（IRR，0.83；95% CI，0.72 - 0.96）。考虑特定的IPV类型，干预组女性报告的身体攻击受害率（IRR，0.85；95% CI，0.71 - 1.00）和施暴率（IRR，0.82；95% CI，0.70 - 0.96）显著较低。在长期随访期间，总体IPV受害率和施暴率下降，组间差异无统计学意义。干预组母亲的言语虐待受害率（IRR，1.14，95% CI，0.97 - 1.34）可能有所增加。
幼儿家访可能是减少IPV的一种有前景的策略。
