Mothers' AdvocateS In the Community (MOSAIC)- non-professional mentor support to reduce intimate partner violence and depression in mothers: a cluster randomised trial in primary care

BMC Public Health

Research Article

Angela J Taft¹  Kelsey L Hegarty²  Rhonda Small³ 

[1] Associate Professor, Mother and Child Health Research, La Trobe University, 3000, Melbourne, Vic, Australia;Associate Professor, Primary Care Research Unit, Department of General Practice, University of Melbourne, 3053, Parkville, Vic, Australia;Professor, Mother and Child Health Research, La Trobe University, 3000, Melbourne, Vic, Australia;

关键词: Intimate Partner Violence;    Propensity Score;    Parenting Stress;    Edinburgh Postnatal Depression Scale;    Propensity Score Analysis;   

DOI  :  10.1186/1471-2458-11-178

 received in 2010-09-06, accepted in 2011-03-23,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundEffective interventions to increase safety and wellbeing of mothers experiencing intimate partner violence (IPV) are scarce. As much attention is focussed on professional intervention, this study aimed to determine the effectiveness of non-professional mentor support in reducing IPV and depression among pregnant and recent mothers experiencing, or at risk of IPV.MethodsMOSAIC was a cluster randomised trial in 106 primary care (maternal and child health nurse and general practitioner) clinics in Melbourne, Australia. 63/106 clinics referred 215 eligible culturally and linguistically diverse women between January 2006 and December 2007. 167 in the intervention (I) arm, and 91 in the comparison (C) arm. 174 (80.9%) were recruited. 133 (76.4%) women (90 I and 43 C) completed follow-up at 12 months.Intervention: 12 months of weekly home visiting from trained and supervised local mothers, (English & Vietnamese speaking) offering non-professional befriending, advocacy, parenting support and referrals.Main outcome measures: Primary outcomes; IPV (Composite Abuse Scale CAS) and depression (Edinburgh Postnatal Depression Scale EPDS); secondary measures included wellbeing (SF-36), parenting stress (PSI-SF) and social support (MOS-SF) at baseline and follow-up.Analysis: Intention-to-treat using multivariable logistic regression and propensity scoring.ResultsThere was evidence of a true difference in mean abuse scores at follow-up in the intervention compared with the comparison arm (15.9 vs 21.8, AdjDiff -8.67, CI -16.2 to -1.15). There was weak evidence for other outcomes, but a trend was evident favouring the intervention: proportions of women with CAS scores ≥7, 51/88 (58.4%) vs 27/42 (64.3%) AdjOR 0.47, CI 0.21 to 1.05); depression (EPDS score ≥13) (19/85, 22% (I) vs 14/43, 33% (C); AdjOR 0.42, CI 0.17 to 1.06); physical wellbeing mean scores (PCS-SF36: AdjDiff 2.79; CI -0.40 to 5.99); mental wellbeing mean scores (MCS-SF36: AdjDiff 2.26; CI -1.48 to 6.00). There was no observed effect on parenting stress. 82% of women mentored would recommend mentors to friends in similar situations.ConclusionNon-professional mentor mother support appears promising for improving safety and enhancing physical and mental wellbeing among mothers experiencing intimate partner violence referred from primary care.Trial registrationACTRN12607000010493http://www.anzctr.org.au

【 授权许可】

CC BY   
© Taft et al; licensee BioMed Central Ltd. 2011