142nd APHA Annual Meeting and Exposition

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DOVE- A Nurse Home Visitation Intervention to Reduce Violence Against Pregnant Women: A Randomized Clinical Trial

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 1:10 PM - 1:30 PM

Phyllis Sharps, PhD, RN, FAAN , Department of Community and Public Health, Johns Hopkins University School of Nursing, Baltimore, MD
Linda Bullock, PhD, RN, FAAN , School of Nursing, University of Virginia, Charlottesville, VA
Jeanne Alhusen, PhD, CRNP, RN , Department of Community and Public Health, Johns Hopkins University School of Nursing, Baltimore, MD
Sharon Ghazarian, PhD , Johns Hopkins University, Baltimore, MD
Donna Schminkey, PhD, MPH, CNM , School of Nursing, University of Virginia, Charlottesville, VA
Jacquelyn Campbell, PhD, RN, FAAN , Johns Hopkins University School of Nursing, Baltimore, MD
Audio (mp3) recording Recorded Presentation (mp4)
Importance:  Intimate partner violence (IPV) during pregnancy is associated with adverse health outcomes for mothers and infants. There are few evidence-based interventions available for reducing IPV.

Objective: To determine the effectiveness of an IPV intervention in reducing violence among abused women enrolled in perinatal home visiting programs.

Design, Setting, and Participants: Assessor-blinded multi-site randomized controlled trial of 239 pregnant women 14 years or older, less than 32 weeks gestation and experiencing perinatal IPV, conducted from 2006-2011 in urban and rural settings in the United States.

Intervention:  The intervention group (n = 124) received DOVE, a structured abuse assessment and six empowerment sessions delivered by home visitors, during the perinatal period. All participants received IPV screening and appropriate referrals.

Results:   Hypothesis testing models demonstrated a significant decrease in IPV over time (β = -0.25, p < .001) in both groups controlling for maternal age, depression, and location. The DOVE intervention group experienced a significantly lower level of IPV than controls at 24 months (p < .01). 

Conclusions and Relevance:  All participants reported a reduction in IPV. However, for those participating in the DOVE intervention, there was a significant reduction in IPV at 24 months postpartum and evidence of a larger decrease in IPV. Recognizing the importance of screening and intervening for IPV, the DOVE intervention is  brief and can be easily incorporated within well-woman and well-child care visits, as well as home visiting programs, satisfying recommendations in the Affordable Care Act for IPV screening and brief counseling.

Learning Areas:

Public health or related research

Learning Objectives:
Describe the effects of IPV on the physical and mental health of pregnant women and children. Discuss the components of the DOVE intervention and its role in reducing IPV among abused women. Understand the implications of the mandates set forth in the Affordable Care Act/MIECHV funding for screening and reducing IPV in pregnant women participating in home visiting programs. Discuss how to effectively implement an evidence-based program (i.e. DOVE) into an existing home visiting program.

Keyword(s): Maternal and Child Health, Violence & Injury Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have over 40 years of experience in Maternal-Child Health nursing with a focus on intimate partner violence. Also, I was the PI on the NIH funded grant that funded the RCT to be presented.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5179.0: Violence Prevention: Risk factors and interventions to prevent violence against adolescents and women