Enhanced Nurse Home Visitation to Prevent Intimate Partner Violence
Condition: Violence; Emotional Abuse; Pregnancy; Parenting
Study type: Interventional

Summary: 
      An Enhanced Nurse Home Visitation Program To Prevent Intimate Partner Violence; This
      randomized trial of an intervention to assess and prevent intimate partner violence during
      pregnancy and the post-partum builds upon the David Olds model of nurse home visitation
      (Nurse Family Partnership or NFP) for high risk mothers and infants that has shown to be
      effective in multiple settings in preventing child abuse and enhancing maternal and child
      health and psychosocial outcomes. However, prior research has shown that the NFP intervention
      is not as effective in homes where there is intimate partner violence (IPV). Although the NFP
      by itself has reduced IPV in one setting, it has not in another. The proposed study will test
      the efficacy of an enhanced NFP intervention, the ECI or Enhanced Choice Intervention among
      women referred to an existing NFP program in Portland, Oregon. The ECI is based on a choice
      or empowerment model whereby women can choose among interventions related to her goal for her
      current intimate relationship. If IPV or emotional abuse or controlling behaviors are
      assessed, the intervention is based on two interventions shown to be effective in assessing
      for and reducing repeat IPV (the Sullivan Advocacy Intervention and the McFarlane and Parker
      brochure driven intervention). For women desiring to enhance marital quality, the Markman and
      Stanley PREP model that has been shown to enhance relationship quality will be offered. The
      PREP model also has some preliminary evidence of preventing IPV. For women with other risk
      factors for IPV in their own or their partners' history (e.g. exposure to parental IPV, child
      abuse, substance abuse), community resource linkage (beyond referral) strategies as with the
      NFP model will be used to obtain community resources to address these risk factors. 250 women
      referred to the Multnomah County Health Department will be randomized to the experimental
      (NFP plus ECI) or control condition (NFP) and visited according to the regular NFP schedule
      during pregnancy and until the infant is 24 months old. The intervention will concentrate on
      the prenatal and immediate (first 6 months) post partum period with regular IPV, emotional
      abuse and controlling behavior assessments throughout the NFP period. Baseline and outcome
      measurement (CTS2, WEB, TPMI, depression - Edinborough, & parenting stress), will occur at 3
      months before delivery, 9 months & 21 months post-partum with multivariate MANOVA, SEM and
      growth curve analyses.
    


Intervention name(s): Enhanced NFP (NFP+); NFP as usual
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Women in the experimental group received three possible interventions. First they received regular and periodic structured intimate partner violence (IPV) assessments from their nurse. Those who indicted any IPV - whether physical violence or emotional abuse or controlling behavior - were then given the Parker-McFarlane Brochure Intervention. Finally, all women were provided the Markman and Stanley Within My Reach curriculum according to their needs and interests.; The Nurse Family Partnership is a well-known and widely used nurse home visit program developed by David Olds. It has been rigorously tested and replicated and is now considered a best practice.
Other intervention name(s): Markman and Stanley Within My Reach Training Curriculum; McFarlane and Parker Brochure Driven Intervention; Nurse Family Partnership
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: Intimate Partner Physical Violence; Intimate Partner Emotional Abuse; Intimate Partner Controlling Behaivor; Pregnancy Outcomes; Quality of Parental Care Giving; Maternal Life Course