Family Planning-based Partner Abuse Intervention to Reduce Unintended Pregnancy
Condition: Violence; Pregnancy
Study type: Interventional
Phase: Phase 3

Summary: 
      This is a community-based participatory study to test a brief intervention to reduce risk for
      intimate partner violence (IPV) and associated unintended pregnancy among young, medically
      underserved women attending family planning (FP) clinics. Women ages 16-29 years utilizing FP
      clinics report higher rates of IPV compared to their same-age peers, experiences associated
      with unintended pregnancy. A critical mechanism connecting IPV with poor reproductive health
      is abusive partners' control of women's reproduction through condom refusal, pressuring women
      to get pregnant, and birth control sabotage, a phenomenon described as reproductive coercion.
      In the investigative team's pilot intervention study 53% of young women using FP clinics
      reported ever experiencing IPV, and 25% reported reproductive coercion, the combination of
      which was strongly associated with unintended pregnancy. The proposed reproductive
      coercion/partner violence intervention was developed collaboratively by community-based
      practitioners, advocates, and researchers, with significant input from FP clients. Designed
      to be implemented within routine FP care, maximizing feasibility and sustainability of this
      program, the intervention provides 1) client education and assessment regarding IPV and
      reproductive coercion; 2) discussion of harm reduction behaviors to reduce risk for
      unintended pregnancy and IPV victimization, and 3) supported referrals to IPV victim
      services. This is a full-scale RCT to assess the effects of this innovative program on IPV,
      reproductive coercion and unintended pregnancy, major health threats for medically
      underserved women. Evaluation of this intervention will involve random assignment of 25 FP
      clinics (unit of randomization) in Western PA to either intervention or control (i.e.,
      standard-of-care) conditions. Female FP clients ages 16-29 (N=3600) will be assessed at
      baseline, 12-20 weeks (FU1), and 12 months (FU2) to assess intervention effects on knowledge
      and behaviors related to IPV, reproductive coercion and related harm reduction, as well as
      unintended pregnancy. Data will be collected via audio computer-assisted self-interview in
      English or Spanish. Chart extraction will track clinic utilization, pregnancy testing, and
      diagnosed pregnancies. Regression models appropriate for longitudinal data from
      cluster-randomized trials will be used to estimate intervention effects.
    


Intervention name(s): Family Planning-based Partner Violence Intervention
Intervention type(s): Behavioral
Intervention description(s): The intervention includes three major components:
Enhanced Screening and Education: scripted questions to assess for reproductive coercion and pregnancy risk combined with intimate partner violence (IPV) assessment and education regarding how IPV may affect women's reproductive health with the assistance of a safety/educational card created for this intervention.
Harm Reduction Counseling: assisting clients in identifying and planning strategies to reduce their risk for future unintended pregnancies and IPV.
Supported Referral: educating all clients regarding local resources for victims of IPV and problem-solving regarding barriers to acquisition of these resources as needed.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: intimate partner violence; gender-based violence; domestic violence; unintended pregnancy