National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, London, SE5 8BB, UK.
Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
BMC Public Health. 2021 May 25;21(1):980. doi: 10.1186/s12889-021-11012-3.
Substance use is a risk factor for intimate partner abuse (IPA) perpetration. Delivering perpetrator interventions concurrently with substance use treatment shows promise.
The feasibility of conducting an efficacy and cost-effectiveness trial of the ADVANCE 16-week intervention to reduce IPA by men in substance use treatment was explored. A multicentre, parallel group individually randomised controlled feasibility trial and formative evaluation was conducted. Over three temporal cycles, 104 men who had perpetrated IPA towards a female (ex) partner in the past year were randomly allocated to receive the ADVANCE intervention + substance use treatment as usual (TAU) (n = 54) or TAU only (n = 50) and assessed 16-weeks post-randomisation. Participants' (ex) partners were offered support and 27 provided outcome data. Thirty-one staff and 12 men who attended the intervention participated in focus groups or interviews that were analysed using the framework approach. Pre-specified criteria assessed the feasibility of progression to a definitive trial: 1) ≥ 60% of eligible male participants recruited; 2) intervention acceptable to staff and male participants; 3) ≥ 70% of participants followed-up and 4) levels of substance use and 5) IPA perpetrated by men in the intervention arm did not increase from average baseline level at 16-weeks post-randomisation.
70.7% (104/147) of eligible men were recruited. The formative evaluation confirmed the intervention's acceptability. Therapeutic alliance and session satisfaction were rated highly. The overall median rate of intervention session attendance (of 14 compulsory sessions) was 28.6% (range 14.3-64.3% by the third cycle). 49.0% (51/104) of men and 63.0% (17/27) of their (ex) partners were followed-up 16-weeks post-randomisation. This increased to 100% of men and women by cycle three. At follow-up, neither substance use nor IPA perpetration had worsened for men in the intervention arm.
It was feasible to deliver the ADVANCE intervention in substance use treatment services, although it proved difficult to collect data from female (ex)partners. While some progression criteria were met, others were not, although improvements were demonstrated by the third cycle. Lessons learned will be implemented into the study design for a definitive trial of the ADVANCE intervention.
ISRCTN79435190 prospectively registered 22nd May 2018.
物质使用是亲密伴侣虐待（IPA）发生的一个风险因素。同时提供施虐者干预和物质使用治疗显示出前景。
探索在物质使用治疗中对过去一年中对女性（前）伴侣实施 IPA 的男性进行 ADVANCE 16 周干预以减少 IPA 的有效性和成本效益试验的可行性。进行了一项多中心、平行组、个体随机对照可行性试验和形成性评估。在三个时间周期内，104 名过去一年中对女性（前）伴侣实施 IPA 的男性被随机分配接受 ADVANCE 干预+物质使用治疗（TAU）（n=54）或仅 TAU（n=50），并在随机分组后 16 周进行评估。参与者的（前）伴侣获得了支持，其中 27 人提供了结果数据。31 名工作人员和 12 名参加干预的男性参加了焦点小组或访谈，使用框架方法进行了分析。预先规定的标准评估了向确定性试验推进的可行性：1）≥60%的合格男性参与者招募；2）工作人员和男性参与者接受干预；3）≥70%的参与者随访；4）物质使用水平；5）干预组中男性的 IPA 发生率没有从随机分组后 16 周的平均基线水平增加。
70.7%（104/147）名符合条件的男性被招募。形成性评估证实了干预的可接受性。治疗联盟和治疗满意度评价很高。14 次强制性治疗中，干预治疗的平均出席率中位数为 28.6%（第三次循环范围为 14.3-64.3%）。51%（51/104）名男性和 63.0%（17/27）名（前）伴侣在随机分组后 16 周进行了随访。到第三个周期，男性和女性的随访率均增加到 100%。随访时，干预组中男性的物质使用或 IPA 发生率均未恶化。
在物质使用治疗服务中提供 ADVANCE 干预是可行的，尽管从女性（前）伴侣那里收集数据很困难。虽然满足了一些进展标准，但其他标准没有满足，尽管在第三个周期有了改善。从中学到的经验教训将纳入 ADVANCE 干预的确定性试验的研究设计。
ISRCTN79435190 于 2018 年 5 月 22 日前瞻性注册。
