The proposed pilot study will support formative research for planning a domestic violence (DV) component of a multi- faceted intervention for low income, urban women at risk or living with HIV. The behavioral intervention, based on the Transtheoretical Model (TM) (also known as Stages of Change)and using peer advocates, will facilitate practicing safer sex, receiving treatment for substance abuse, and ending abusive relationships. The ultimate goal of the project is to conduct a randomized trial of a comprehensive intervention capable of effectively addressing these three intersecting health problems. The intervention will be delivered in a hospital-based clinic serving HIV-positive women and a community-based clinic serving HIV-negative women. Intervention strategies for safer sex and promoting referrals to substance abuse treatment have been developed in prior work of the investigators. However, additional resources, as requested in this proposal, are needed to design the DV component.
The specific aims of the proposed 9-month pilot study are to: 1) Conduct and summarize 12 key informant interviews with service providers in health care clinics to assess their current practices, preferences and concerns about DV screening protocols and tools; 2) Conduct and analyze in-depth interviews with 20 HIV-positive and 20 HIV-negative abused women about their experience with DV and their preferences for the peer advocate intervention; 3) Contribute new knowledge about the utility of the TM approach to measuring women's progress toward ending the abuse in a sample of low income, urban women; 4) Prepare DV intervention protocols and peer advocate counseling support materials for use in a clinical trial to be proposed. The women's interviews will contain both quantitative and qualitative measures, including: TM constructs (decisional balance, processes of change, stage of change); self- efficacy, barriers and facilitators for ending the abuse; and preferences for the delivery of a peer advocate intervention. The qualitative portions of the interview will be audiotaped, transcribed and coded for themes consistent with the constructs of interest. The results of this formative research will form the basis of a scholarly manuscript on the utility of applying TM concepts to understanding how low income, urban women at risk and living with HIV survive DV and the implications for interventions. An R01 grant fro a clinical trial to evaluate a comprehensive intervention approach to DV, substance abuse, and HIV sexual risk will also be prepared.
| Burke, Jessica G; Denison, Julie A; Gielen, Andrea Carlson et al. (2004) Ending intimate partner violence: an application of the transtheoretical model. Am J Health Behav 28:122-33 |
