Health Services Research & Development

Veterans Crisis Line Badge
Go to the ORD website
Go to the QUERI website

IIR 16-062 – HSR&D Study

New | Current | Completed | DRA | DRE | Portfolios/Projects | Centers | Career Development Projects

IIR 16-062
Recovering from Intimate Partner Violence Through Strengths and Empowerment (RISE): Tailoring and Evaluating a Patient-Centered Counseling Intervention for Women Veterans
Katherine M. Iverson PhD MA BA
VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA
Boston, MA
Funding Period: October 2017 - September 2020

BACKGROUND/RATIONALE:
The US Preventive Services Task Force and Institute of Medicine recommend intimate partner violence (IPV) screening and counseling as standard preventative care for women. However, an intervention is needed for women who disclose IPV. The PI has developed a brief counseling intervention called Recovering from IPV through Strengths and Empowerment (RISE).

OBJECTIVE(S):
The purpose of this multi-phase project is to refine and formally evaluate RISE for use with female VA patients who have experienced IPV. The study's three specific aims are to: 1) tailor and refine RISE for use in VA (Phase 1); 2) conduct a small open trial of RISE with female VA patients to inform the development of a user-friendly, tailored intervention manual (Phase 2); 3) examine the effects of RISE on women Veterans' psychosocial outcomes, and 3a) determine feasibility and acceptability of RISE (Phase 3).

METHODS:
This multi-site project takes place at VA Boston and VA Connecticut. This study includes observational and interventional components, and it uses a mixed methods analytic approach. In Phase 1 we conducted focus groups with female VA patients and qualitative telephone interviews with VA providers to inform alterations to the RISE manual. Focus groups and provider interviews were recorded, transcribed, and qualitatively analyzed using rapid content analysis. In Phase 2, the modified RISE intervention is being tested in an open-trial with female VA patients and RISE providers using formative evaluation methods (i.e., qualitative interviewing and rapid content analysis) for further refinement of RISE. Phase 3 is an effectiveness-implementation Hybrid Type I RCT to compare RISE to an information/referral on women's psychosocial outcomes and assess feasibility/acceptability. Pre, post (10 weeks), and follow up (14 weeks) self-report assessments among women Veterans, and post-intervention interviews with VA patients and interventionists, will be collected. Data from RCT will inform final recommendations of RISE implementation into VHA.

FINDINGS/RESULTS:
Phase 1 is complete, with five focus groups (n=25 women) and 23 VA provider interviews conducted and analyzed. Phase 1 participants found RISE highly acceptable and appropriate, noting strengths including RISE's nonjudgmental, empowering stance, and patient-centered agenda. Content and context modifications were identified and RISE was modified accordingly (e.g., including safety assessments in each session, expanding session 1 from 30 to 60 minutes, adding provider tips and additional resources).

IMPACT:
Despite VHA recommendations to screen female patients for IPV, there is a lack of empirically supported brief counseling interventions for those who disclose IPV. This project fills this gap by evaluating an innovative, patient-centered brief counseling intervention for IPV that is tailored to women's unique healthcare needs and preferences. Findings from the current study will inform recommendations of RISE implementation into VHA, filling an unmet need.

PUBLICATIONS:

Journal Articles

  1. Grillo AR, Danitz SB, Dichter ME, Driscoll MA, Gerber MR, Hamilton AB, Wiltsey-Stirman S, Iverson KM. Strides Toward Recovery From Intimate Partner Violence: Elucidating Patient-Centered Outcomes to Optimize a Brief Counseling Intervention for Women. Journal of interpersonal violence. 2019 Apr 17.
  2. Dardis CM, Dichter ME, Iverson KM. Empowerment, PTSD and revictimization among women who have experienced intimate partner violence. Psychiatry Research. 2018 Aug 1; 266:103-110.


DRA: Health Systems
DRE: Technology Development and Assessment, Treatment - Efficacy/Effectiveness Clinical Trial, TRL - Development
Keywords: Intimate Partner Violence, Organizational Structure, Outcomes - Patient
MeSH Terms: none