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Article: Effect of an advocacy intervention on mental health in Chinese women survivors of intimate partner violence: A randomized controlled trial

TitleEffect of an advocacy intervention on mental health in Chinese women survivors of intimate partner violence: A randomized controlled trial
Authors
Issue Date2010
PublisherAmerican Medical Association. The Journal's web site is located at http://jama.ama-assn.org/index.dtl
Citation
Jama - Journal Of The American Medical Association, 2010, v. 304 n. 5, p. 536-543 How to Cite?
AbstractContext: Intimate partner violence (IPV) against women can have negative mental health consequences for survivors; however, the effect of interventions designed to improve survivors' depressive symptoms is unclear. Objective: To determine whether an advocacy intervention would improve the depressive symptoms of Chinese women survivors of IPV. Design, Setting, and Participants: Assessor-blinded randomized controlled trial of 200 Chinese women 18 years or older with a history of IPV, conducted from February 2007 to June 2009 in a community center in Hong Kong, China. Intervention: The intervention group (n=100) received a 12-week advocacy intervention comprising empowerment and telephone social support. The control group (n=100) received usual community services including child care, health care and promotion, and recreational programs. Main Outcome Measures: Primary outcome was change in depressive symptoms (Chinese version of the Beck Depression Inventory II) between baseline and 9 months. Secondary outcomes were changes in IPV (Chinese Revised Conflict Tactics Scales), health-related quality of life (12-Item Short Form Health Survey), and perceived social support (Interpersonal Support Evaluation List) between baseline and 9 months. Usefulness of the intervention and usual community services was evaluated at 9 months. Results: At 3 months, themeanchange in depressive symptom score was 11.6(95%CI, 9.5 to 13.7) in the control group and 14.9(95%CI, 12.4 to 17.5) in the intervention group; respective changes at 9 months were 19.6 (95% CI, 16.6 to 22.7) and 23.2 (95% CI, 20.4 to 26.0). Intervention effects at 3 and 9 months were not significantly different (P=.86). The intervention significantly reduced depressive symptoms by 2.66(95%CI, 0.26 to 5.06; P=.03) vs the control, less than the 5-unit minimal clinically important difference. Statistically significant improvement was found in partner psychological aggression (-1.87[95% CI, -3.34 to -0.40]; mean change at 3 months, 1.5 [95% CI, -1.0 to 3.9] in the control group and 0.3 [95% CI, -0.7 to 1.4] in the intervention group; mean change at 9 months, -6.4 [95% CI, -7.8 to -5.0] and -8.9 [95% CI, -10.6 to -7.2]) and perceived social support (2.18[95%CI, 0.48 to 3.89]; meanchange at 3 months, 6.4[95%CI, 4.9 to 7.8] and 9.2 [95% CI, 7.7 to 10.8]; mean change at 9 months, 12.4 [95% CI, 10.5 to 14.3] and 14.4 [95% CI, 12.7 to 16.1]) but not in physical assault, sexual coercion, or health-related quality of life. By end of study, more women in the intervention group found the advocacy intervention useful or extremely useful in improving intimate relationships vs those in the control group receiving usual community services (93.8%vs81.7%;difference,12.1% [95% CI, 2.1% to 22.0%]; P=.02) and in helping them to resolve conflicts with their intimate partners (97.5% vs 84.1%; difference,13.4%[95%CI,4.7%to 22.0%];P=.001). Conclusion: Among community-dwelling abused Chinese women, an advocacy intervention did not result in a clinically meaningful improvement in depressive symptoms. Trial Registration: clinicaltrials.gov Identifier: NCT01054898. ©2010 American Medical Association. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/129851
ISSN
2015 Impact Factor: 37.684
2015 SCImago Journal Rankings: 6.440
ISI Accession Number ID
Funding AgencyGrant Number
Food and Health Bureau of the Hong Kong SAR Government04060741
Funding Information:

This study was supported by the Health and Health Services Research Fund awarded by the Food and Health Bureau of the Hong Kong SAR Government (project 04060741).

References
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DC FieldValueLanguage
dc.contributor.authorTiwari, Aen_HK
dc.contributor.authorFong, DYTen_HK
dc.contributor.authorYuen, KHen_HK
dc.contributor.authorYuk, Hen_HK
dc.contributor.authorPang, Pen_HK
dc.contributor.authorHumphreys, Jen_HK
dc.contributor.authorBullock, Len_HK
dc.date.accessioned2010-12-23T08:43:03Z-
dc.date.available2010-12-23T08:43:03Z-
dc.date.issued2010en_HK
dc.identifier.citationJama - Journal Of The American Medical Association, 2010, v. 304 n. 5, p. 536-543en_HK
dc.identifier.issn0098-7484en_HK
dc.identifier.urihttp://hdl.handle.net/10722/129851-
dc.description.abstractContext: Intimate partner violence (IPV) against women can have negative mental health consequences for survivors; however, the effect of interventions designed to improve survivors' depressive symptoms is unclear. Objective: To determine whether an advocacy intervention would improve the depressive symptoms of Chinese women survivors of IPV. Design, Setting, and Participants: Assessor-blinded randomized controlled trial of 200 Chinese women 18 years or older with a history of IPV, conducted from February 2007 to June 2009 in a community center in Hong Kong, China. Intervention: The intervention group (n=100) received a 12-week advocacy intervention comprising empowerment and telephone social support. The control group (n=100) received usual community services including child care, health care and promotion, and recreational programs. Main Outcome Measures: Primary outcome was change in depressive symptoms (Chinese version of the Beck Depression Inventory II) between baseline and 9 months. Secondary outcomes were changes in IPV (Chinese Revised Conflict Tactics Scales), health-related quality of life (12-Item Short Form Health Survey), and perceived social support (Interpersonal Support Evaluation List) between baseline and 9 months. Usefulness of the intervention and usual community services was evaluated at 9 months. Results: At 3 months, themeanchange in depressive symptom score was 11.6(95%CI, 9.5 to 13.7) in the control group and 14.9(95%CI, 12.4 to 17.5) in the intervention group; respective changes at 9 months were 19.6 (95% CI, 16.6 to 22.7) and 23.2 (95% CI, 20.4 to 26.0). Intervention effects at 3 and 9 months were not significantly different (P=.86). The intervention significantly reduced depressive symptoms by 2.66(95%CI, 0.26 to 5.06; P=.03) vs the control, less than the 5-unit minimal clinically important difference. Statistically significant improvement was found in partner psychological aggression (-1.87[95% CI, -3.34 to -0.40]; mean change at 3 months, 1.5 [95% CI, -1.0 to 3.9] in the control group and 0.3 [95% CI, -0.7 to 1.4] in the intervention group; mean change at 9 months, -6.4 [95% CI, -7.8 to -5.0] and -8.9 [95% CI, -10.6 to -7.2]) and perceived social support (2.18[95%CI, 0.48 to 3.89]; meanchange at 3 months, 6.4[95%CI, 4.9 to 7.8] and 9.2 [95% CI, 7.7 to 10.8]; mean change at 9 months, 12.4 [95% CI, 10.5 to 14.3] and 14.4 [95% CI, 12.7 to 16.1]) but not in physical assault, sexual coercion, or health-related quality of life. By end of study, more women in the intervention group found the advocacy intervention useful or extremely useful in improving intimate relationships vs those in the control group receiving usual community services (93.8%vs81.7%;difference,12.1% [95% CI, 2.1% to 22.0%]; P=.02) and in helping them to resolve conflicts with their intimate partners (97.5% vs 84.1%; difference,13.4%[95%CI,4.7%to 22.0%];P=.001). Conclusion: Among community-dwelling abused Chinese women, an advocacy intervention did not result in a clinically meaningful improvement in depressive symptoms. Trial Registration: clinicaltrials.gov Identifier: NCT01054898. ©2010 American Medical Association. All rights reserved.en_HK
dc.languageengen_US
dc.publisherAmerican Medical Association. The Journal's web site is located at http://jama.ama-assn.org/index.dtlen_HK
dc.relation.ispartofJAMA - Journal of the American Medical Associationen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshAdult-
dc.subject.meshDepression - ethnology - etiology - prevention and control-
dc.subject.meshDomestic Violence - ethnology - psychology-
dc.subject.meshPatient Advocacy-
dc.subject.meshSurvivors - psychology-
dc.titleEffect of an advocacy intervention on mental health in Chinese women survivors of intimate partner violence: A randomized controlled trialen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0098-7484&volume=304&issue=5&spage=536&epage=543&date=2010&atitle=Effect+of+an+advocacy+intervention+on+mental+health+in+Chinese+women+survivors+of+intimate+partner+violence:+a+randomized+controlled+trial-
dc.identifier.emailTiwari, A: tiwari@hku.hken_HK
dc.identifier.emailFong, DYT: dytfong@hku.hken_HK
dc.identifier.emailYuen, KH: fkhyuen@hku.hken_HK
dc.identifier.authorityTiwari, A=rp00441en_HK
dc.identifier.authorityFong, DYT=rp00253en_HK
dc.identifier.authorityYuen, KH=rp00456en_HK
dc.description.naturepostprint-
dc.identifier.doi10.1001/jama.2010.1052en_HK
dc.identifier.pmid20682933-
dc.identifier.scopuseid_2-s2.0-77955301060en_HK
dc.identifier.hkuros176531en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77955301060&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume304en_HK
dc.identifier.issue5en_HK
dc.identifier.spage536en_HK
dc.identifier.epage543en_HK
dc.identifier.eissn1538-3598-
dc.identifier.isiWOS:000280525700021-
dc.publisher.placeUnited Statesen_HK
dc.relation.projectA RCT to test the effectiveness of a telephone intervention to improve the mental health of community dwelling women abused by their intimate partners-
dc.identifier.scopusauthoridTiwari, A=7101772273en_HK
dc.identifier.scopusauthoridFong, DYT=35261710300en_HK
dc.identifier.scopusauthoridYuen, KH=8639606900en_HK
dc.identifier.scopusauthoridYuk, H=36239471600en_HK
dc.identifier.scopusauthoridPang, P=36239151600en_HK
dc.identifier.scopusauthoridHumphreys, J=35511360800en_HK
dc.identifier.scopusauthoridBullock, L=7006740637en_HK

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