Lead/Presenter: Katherine Iverson, COIN - Bedford/Boston
All Authors: Iverson KM (National Center for PTSD & CHOIR, VA Boston Healthcare System), Driscoll M (Pain Research, Informatics, Multi-morbidities, and Education (PRIME), , VA Connecticut Healthcare System) Gerber MR (VA Boston Healthcare System) Danitz S (National Center for PTSD, VA Boston Healthcare System) Hamilton A (Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles Healthcare System) Dichter ME (VA Center for Health Equity Research and Promotion (CHERP), Crescenz VA Medical Center) Grillo A (National Center for PTSD, VA Boston Healthcare System) Wiltsey-Stirman S (National Center for PTSD, VA Palo Alto Healthcare System)
Objectives:
VHA's Intimate Partner Violence (IPV) Assistance Program is implementing IPV screening programs. There is an urgent need for an evidence-based interventions for women who disclose IPV. With extensive input from women Veterans, we developed "Recovering from IPV through Strengths and Empowerment" (RISE), a brief (30-60 min), innovative individual counseling intervention for women with IPV. RISE is rooted in motivational-interviewing and consists of 6 modules (e.g., safety planning, enhancing social support, coping and self-care) delivered in up to 6 sessions. Women prioritize and select modules based on their unique needs. We present preliminary results of an initial VHA trial.
Methods:
Women with past-year IPV were recruited to participate in an open trial. Social workers and psychologists delivered RISE, evaluation was conducted using a mixed methods approach. We collected pre- and post-treatment measures of psychosocial health (general self-efficacy [GSE], patient activation measure [PAM], valued living [VLQ], and depression [CES-D]). We also conducted semi-structured exit interviews after RISE receipt.
Results:
To date, 10 WVs completed the trial (mean age = 29, SD = 12). The sample was 50% White, 40% Black, and 10% Latina. 80% opted to receive at least 5 sessions, and 60% of the sample chose to receive all 6 RISE sessions. From pre- to posttreatment, participants showed significant reductions in depressive symptoms and increases in self-efficacy, patient activation, and valued living, with medium effect size outcomes (Cohen's D: 0.54 - 0.72). Women expressed high satisfaction with RISE, they 1) liked ability to choose the content delivered, 2) felt RISE provided validation of their IPV experiences, 3) were empowered to be more assertive, and 4) expressed that RISE improved understanding of the impact of IPV on their health, which promoted confidence in accessing additional services, congruent with increased PAM scores.
Implications:
Preliminary findings support the clinical utility and acceptability of RISE. Increases in self-efficacy, patient activation, and valued living suggest RISE may promote self-efficacy, quality of life, and even health equity as women are enabled to engage in care and access services. We anticipate a larger sample by Summer 2019. Future work includes an RCT.
Impacts:
RISE shows initial promise to fill an essential unmet need for women Veterans.