Living with an abusive partner has many negative impacts on women's health, safety and the quality of their lives. These issues often continue when women separate, or take steps to separate, from an abusive partner, and can make it more difficult to create a new life. However, few supports are available to help women manage their health and other challenges around the time of separation. The Intervention for Health Enhancement and Living (iHEAL) was specifically developed to support women at this time. In iHEAL, women work with a Registered Nurse on issues that affect that their health and well-being in 10 and 18 visits that take place in a safe, private location over a 6 month period. The woman decides which issues she would like to work on, with nurses providing personalized help and support that fits with the woman's needs, goals and wishes. This includes helping her connect to local services if she chooses. The purpose of this study is to learn whether iHEAL can improve the health and quality of life of women who have separated, or are taking steps to separate, from an abusive partner. To do this, 280 Canadian women from 3 provinces will be offered either iHEAL nurse visits or information about community services that they can use on their own. All participants will complete online surveys when they first start the study and 6 12, and 18 months later to examine whether there are changes in their health, quality of life, confidence and/or control. We also want to learn whether iHEAL is more helpful for some groups of women and whether any benefits to women that are identified outweigh the costs of providing the intervention. A small group of \~30-40 women will be asked to take part in an interview about what is was like to take part in this study when they complete the trial so that we can learn how to further improve iHEAL.
For a detailed description of the study rationale, hypotheses, research questions and methods, please see: Ford-Gilboe, M., Varcoe, C., Scott-Storey, K. et al. Longitudinal effectiveness of a woman-led, nurse delivered health promotion intervention for women who have experienced intimate partner violence: iHEAL randomized controlled trial. BMC Public Health 24, 398 (2024). https://doi.org/10.1186/s12889-023-17578-4.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
331
Women work with a Registered Nurse in 10-18 visits (over 6 months) that focus on 6 inter-related 6 components (areas): Safeguarding, Managing Symptoms, Getting Basics, Cautiously Connecting, Regenerating Family, Renewing Self. Using a standard 3 phase process, and guided by 5 principles, the nurse discusses each of these components with the woman in order to identify the woman's needs, experiences and priorities. The nurse then provides personalized support to assist the woman in address the concerns that she sees as most important for her health and well-being; this support includes linking women to existing services if she chooses.
Women are provided with information about community services appropriate for women experiencing intimate partner violence and consistent with what service providers might recommend (usual care). Women are encouraged to use this information as they see fit.
University of British Columbia
Vancouver, British Columbia, Canada
University of New Brunswick
Fredericton, New Brunswick, Canada
Western University
London, Ontario, Canada
Changes in Quality of Life on the Quality of Life Scale (Sullivan)
9 item self-report measure developed to assess quality of life across domains important to women who have experienced intimate partner violence. Total scores range from 9 to 63. Higher scores reflect higher levels of quality of life.
Time frame: baseline, 6 months
Changes in PTSD Symptomology on the PTSD Checklist (Civilian Version)
17 item self-report measure of PTSD symptoms designed for use in community samples and to assess probability of meeting diagnostic criteria for PTSD.
Time frame: baseline, 6 months
Changes in Quality of Life on the Quality of Life Scale (Sullivan)
9 item self-report measure developed to assess quality of life across domains important to women who have experienced intimate partner violence
Time frame: baseline, 12 months
Changes in Quality of Life on the Quality of Life Scale (Sullivan)
9 item self-report measure developed to assess quality of life across domains important to women who have experienced intimate partner violence
Time frame: Baseline, 18 months
Changes in PTSD Symptomology on the PTSD Checklist (Civilian Version)
17 item self-report measure of PTSD symptoms designed for use in community samples and to assess probability of meeting diagnostic criteria for PTSD
Time frame: Baseline, 12 months
Changes in PTSD Symptomology on the PTSD Checklist (Civilian Version)
17 item self-report measure of PTSD symptoms designed for use in community samples and to assess probability of meeting diagnostic criteria for PTSD
Time frame: Baseline, 18 months
Changes in Depressive Symptoms on the Center for Epidemiologic Studies Depression Scale, Revised (CESD-R).
20 item self-report measure of depressive symptoms in community samples, including probability of meeting criteria for major depressive disorder. Total scores range from 0 to 60. Higher scores reflect higher levels of depressive symptoms.
Time frame: Baseline, 6 months
Changes in Depressive Symptoms on the Center for Epidemiologic Studies Depression Scale, Revised
20 item self-report measure of depressive symptoms in community samples, including probability of meeting criteria for major depressive disorder
Time frame: Baseline, 12 months
Changes in Depressive Symptoms on the Center for Epidemiologic Studies Depression Scale, Revised
20 item self-report measure of depressive symptoms in community samples, including probability of meeting criteria for major depressive disorder
Time frame: Baseline, 18 months
Changes in Chronic Pain Disability on the Chronic Pain Grade (van Korff)
7 item self-report measure of chronic pain intensity and disability, including 4 "grades" that capture level of disability (from no to high)
Time frame: Baseline, 6 months
Changes in Chronic Pain Disability on the Chronic Pain Grade (van Korff)
7 item self-report measure of chronic pain intensity and disability, including 4 "grades" that capture level of disability (from no to high)
Time frame: Baseline, 12 months
Changes in Chronic Pain Disability on the Chronic Pain Grade (van Korff)
7 item self-report measure of chronic pain intensity and disability, including 4 "grades" that capture level of disability (from no to high)
Time frame: Baseline, 18 months
Changes in Personal Control on the Personal Agency Scale (Smith)
8 item self-report scale that measures an individual's sense of control and efforts to act on their own behalf. Total scores range from 8 to 32. Higher scores reflect higher levels of personal agency.
Time frame: Baseline, 6 months
Changes in Personal Control on the Personal Agency Scale (Smith)
8 item self-report scale that measures an individual's sense of control and efforts to act on their own behalf. Total scores range from 8 to 32. Higher scores reflect higher levels of personal agency.
Time frame: Baseline, 12 months
Changes in Personal Control on the Personal Agency Scale (Smith)
8 item self-report scale that measures an individual's sense of control and efforts to act on their own behalf. Total scores range from 8 to 32. Higher scores reflect higher levels of personal agency.
Time frame: Baseline, 18 months
Changes in Confidence (self-efficacy) on investigator-developed scale
10 item self-report scale that measures women's confidence in engaging in a set of actions that fit with key goals of the iHEAL on 100 mm visual analogue scales. total scores range from 0 to 100. Higher scores reflect higher levels of confidence.
Time frame: Baseline, 6 months
Changes in Confidence (self-efficacy) on investigator-developed scale
10 item self-report scale that measures women's confidence in engaging in a set of actions that fit with key goals of the iHEAL on 100 mm visual analogue scales. Total scores range from 0 to 100. Higher scores reflected higher levels of confidence.
Time frame: Baseline, 12 months
Changes in Confidence (self-efficacy) on investigator-developed scale
10 item self-report scale that measures women's confidence in engaging in a set of actions that fit with key goals of the iHEAL on 100 mm visual analogue scales. Total scores range from 0 -100. Higher scores reflect higher levels of confidence.
Time frame: Baseline, 18 months
Changes in Coercive Control on the Women's Experiences of Battering Scale (WEB)
10 item self-report measure of the intensity of coercive control experienced by women in response to intimate partner violence. Total scores range from 10 to 60. Higher scores reflect higher levels of experiences of coercive control.
Time frame: Baseline, 6 months
Changes in Coercive Control on the Women's Experiences of Battering Scale (WEB)
10 item self-report measure of the intensity of coercive control experienced by women in response to intimate partner violence. Total scores range from 10 to 60. Higher scores reflect higher levels of experiences of coercive control.
Time frame: Baseline, 12 months
Changes in Coercive Control on the Women's Experiences of Battering Scale (WEB)
10 item self-report measure of the intensity of coercive control experienced by women in response to intimate partner violence. Total scores range from 10-60. Higher scores reflect higher levels of experiences of coercive control.
Time frame: Baseline, 18 months
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