333765
Testing an integrated motivational intervention for dual public health risks of intimate partner violence & heavy drinking: Preliminary results from a randomized controlled trial
Objective:Determine whether motivational intervention (MI) provided at the time of an ED visit reduces IPV and heavy drinking
Methods:We enrolled 600 female patients, age 18-64, with heavy drinking and recent IPV. Participants were randomized 2:2:1 to brief intervention group (BIG), assessed control group (ACG) or no-contact control group (NCCG). The intervention group received 20-30 minute manual-guided MI, recorded and monitored for fidelity, delivered by masters-level therapists and a phone booster at 10 days. Primary outcomes were days of heavy drinking and incidents of IPV, assessed weekly by Interactive Voice Response System for 12 weeks. Intent-to-treat analyses used hierarchical generalized linear models, adjusting for clustering of repeated measures.
Results:With 71% completing > 50% of weekly calls, there was an overall linear decrease in the odds of an IPV incident of 6% (95% CI: 5%-8%) with each week of follow-up in both groups. There were no within group changes in drinking days (ACG: p-value = 0.651; BIG: , p-value = 0.316 ) and no statistically significant treatment effect on either primary outcome over 12 weeks (p-value > 0.311), and no indication that assessment influenced results.
Conclusion: Results do not support ED implementation of MI for addressing co-morbid intimate partner violence or heavy drinking. Alternative settings or more intensive interventions may be needed to address the reciprocal relationship of these two public health problems.
Learning Areas:
Administer health education strategies, interventions and programsBasic medical science applied in public health
Planning of health education strategies, interventions, and programs
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health
Learning Objectives:
Describe preliminary evidence from a RCT of a brief motivational intervention provided in two emergency department settings on intimate partner violence and heavy drinking outcomes
Keyword(s): Violence & Injury Prevention, Emergency Medical Services
Qualified on the content I am responsible for because: Karin Rhodes, MD, MS (Health Studies) is an Associate Professor and Director of the Center of Emergency Care Policy Research in the Department of Emergency Medicine, with secondary appointments in Psychiatry and the School of Social Policy & Practice at the University of Pennsylvania.A former Robert Wood Johnson Clinical Scholar, her research focuses on developing effective patient-centered clinical responses to intimate partner violence and other psychosocial issues impacting individual and public health.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.