Abstract
BackgroundRigorous evaluations of health sector interventions addressing intimate partner violence (IPV) in low- and middle-income countries are lacking. We aimed to assess whether an enhanced nurse-delivered intervention would reduce IPV and improve levels of safety planning behaviors, use of community resources, reproductive coercion, and mental quality of life.MethodsWe randomized 42 public health clinics in Mexico City to treatment or control arms. In treatment clinics, women received the nurse-delivered session (IPV screening, supportive referrals, health/safety risk assessments) at baseline (T1), and a booster counselling session after 3 months (T2). In control clinics, women received screening and a referral card from nurses. Surveys were conducted at T1, T2, and T3 (15 months from baseline). Our main outcome was past-year physical and sexual IPV. Intent-to-treat analyses were conducted via three-level random intercepts models to evaluate the interaction term for treatment status by time.ResultsBetween April and October 2013, 950 women (480 in control clinics, 470 in treatment clinics) with recent IPV experiences enrolled in the study. While reductions in IPV were observed for both women enrolled in treatment (OR, 0.40; 95% CI, 0.28–0.55; P < 0.01) and control (OR, 0.51; 95% CI, 0.36–0.72; P < 0.01) clinics at T3 (July to December 2014), no significant treatment effects were observed (OR, 0.78; 95% CI, 0.49–1.24; P = 0.30). At T2 (July to December 2013), women in treatment clinics reported significant improvements, compared to women in control clinics, in mental quality of life (β, 1.45; 95% CI, 0.14–2.75; P = 0.03) and safety planning behaviors (β, 0.41; 95% CI, 0.02–0.79; P = 0.04).ConclusionWhile reductions in IPV levels were seen among women in both treatment and control clinics, the enhanced nurse intervention was no more effective in reducing IPV. The enhanced nursing intervention may offer short-term improvements in addressing safety planning and mental quality of life. Nurses can play a supportive role in assisting women with IPV experiences.Trial RegistrationClinicaltrials.gov (NCT01661504). Registration Date: August 2, 2012
Highlights
Rigorous evaluations of health sector interventions addressing intimate partner violence (IPV) in low- and middle-income countries are lacking
The current study aimed to address this important gap in the intervention literature through conducting a clinic-based randomized controlled trial (RCT) to assess the impact of a nurse-delivered intervention to women identified as experiencing recent IPV through screening within public health clinics in Mexico City
Differential attrition in past month physical and sexual IPV was observed between T2 and T3; control participants who were lost to follow-up from T2 to T3 reported more past month physical and sexual IPV at T2 than treatment participants; no other differences regarding attrition were observed
Summary
Rigorous evaluations of health sector interventions addressing intimate partner violence (IPV) in low- and middle-income countries are lacking. The healthcare sector has long been highlighted for its critical role in combating IPV This is due in part to the high prevalence of IPV among women who seek health services and because healthcare providers have access to this otherwise isolated population [3, 4]. Healthcare sector interventions within primary care settings that focus on intervening with women identified for IPV through screening have yielded mixed or sub-optimal findings regarding improvements in mental health, reduced experiences of IPV, and help seeking and safety planning behaviors [8,9,10,11]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
