Intimate partner violence (IPV) occurs at alarmingly high rates, with the highest risk of IPV exposure during pregnancy. IPV during this critical juncture is associated with postpartum depression, posttraumatic stress, disruption to the mother-infant relationship, and poor infant outcomes. Despite these deleterious effects to both the mother and infant, there is a lack of evidence-based interventions that have demonstrated effectiveness for this population. A critical need exists for a theoretically-driven intervention, rooted in translational research, that can demonstrate effectiveness in addressing the specific, developmental needs of IPV-exposed pregnant women and their children. In response to this need, the research team has created the Pregnant Moms? Empowerment Program (PMEP). Using a multi-site, randomized clinical trial design, the specific objectives of the current study are to evaluate the efficacy of the PMEP program in addressing (1) maternal mental health, resilience, re-victimization, and parenting sensitivity and (2) early infant development, including cognitive, language, and socioemotional functioning. We also seek to evaluate mechanisms of treatment change ? social support and empowerment. Participants will include 230 IPV-exposed pregnant women, half of whom will receive the PMEP and half of whom will be in a contact equivalent active control condition. Women in both conditions will participate in group-based treatment during 1, 2-hour session each week, for 5 weeks. Assessments will be administered at pre-treatment, post-treatment, 3 months postpartum (i.e., infants 3 months old), and 12 months postpartum (i.e., infants 1 year old). Assessments will include semi-structured interviews and observational data collection. We expect that providing the PMEP intervention during pregnancy will have positive effects for both mothers and infants across the perinatal period, addressing the negative intergenerational effects of IPV. Our central hypothesis is that the PMEP, developed based on previous empirical research, focus groups of community stakeholders, and pilot intervention data, will reduce re- victimization and improve maternal mental health, resilience, and parenting sensitivity. Analyses will be conducted using multilevel and structural equation modeling; pilot data support the adequacy of the proposed sample size to detect treatment effects for each study aim. This project is both innovative in its use of a multi- site, multi-method design and significant in that it addresses the needs of a vulnerable population that has few available treatment resources. It has the potential to improve both behavioral and mental health outcomes among not only pregnant women, but also their young children, which will reduce the public health burden of poor mental health during the prenatal period and improve the health and well-being of new mothers, their children, and their families. The proposed study will address a critical gap in both research and clinical work by creating an effective and sustainable intervention that can be readily implemented in community care settings.
Intimate partner violence (IPV) perpetrated during pregnancy is detrimental not only to the mental and physical health of the woman but also to her unborn child, yet there are currently no interventions that appropriately address the unique needs of this population. The proposed research has the potential for high public health impact because it provides a rigorous evaluation of an intervention program that may lead to improved maternal mental health, reduced IPV exposure, enriched maternal sensitivity, and better infant outcomes that can enhance the quality of life of thousands of IPV survivors and their children. Intervention during the prenatal period could be a key element to dismantling the corrosive intergenerational effects of violence; thus promoting a more positive, healthful, and productive future for both mother and child.
