Data from PATH trial (03-2018)

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Design: Pragmatic parallel group individually randomized controlled trial of normal DVA advocacy vs. advocacy + psychological intervention. Setting: specialist DVA agencies; two UK cities. Participants: Women aged 16 years and older accessing DVA services. Intervention: Eight specialist psychological advocacy (SPA) sessions Primary outcomes at 12 months: depression symptoms (PHQ-9) and psychological distress (CORE-OM). Primary analysis: intention to treat regression model. Secondary analyses: pre-specified subgroup analyses; multiple imputation by chained equation models (mice); complier-average causal effects (CACE) using instrumental variables Results: 263 women recruited (78 in shelter/refuge, 185 in community), 3 withdrew (2 community, control group; 1 intervention, refuge group), 130 in intervention and 130 in control groups. Recruitment ended June 2013. 12-month follow up: 65%. Primary outcomes At 12-month follow up, greater improvement in mental health of women in the intervention group. Difference in average CORE-OM score between intervention and control groups: -3.3 points (95% CI -5.5 to -1.2). Difference in average PHQ-9 score between intervention and control group: -2.2 (95% CI -4.1 to -0.3). At 12 months, 35% of the intervention group and 55% of the control group were above the CORE-OM clinical threshold (OR 0.32, 95% CI 0.16 to 0.64); 29% of the intervention group and 46% of the control group were above the PHQ-9 clinical threshold (OR 0.41, 95% CI 0.21 to 0.81). Conclusions This study provides evidence that DVA advocacy can be enhanced in relation to mental health outcomes by relatively brief training of advocates in psychological methods. An eight-session psychological intervention delivered by DVA advocates produced clinically relevant improvement in mental health outcomes compared with normal advocacy care for female survivors of domestic violence.

Creator(s) Paige Lacesso, Gene Feder, Giulia Ferrari
Language eng
Publisher University of Bristol
Licence Non-Commercial Government Licence for public sector information
DOI 10.5523/bris.1yng1al60vsnr282q4rmc5atxg
Total size 4.8 MiB