RT Journal
A1 Tiwari A, Fong D, Yuen K, et al
T1 Effect of an advocacy intervention on mental health in chinese women survivors of intimate partner violence: A randomized controlled trial
JF JAMA
JO JAMA
YR 2010
FD August 4
VO 304
IS 5
SP 536
OP 543
DO 10.1001/jama.2010.1052
UL http://dx.doi.org/10.1001/jama.2010.1052
AB Context 
                  Intimate partner violence (IPV) against women can have negative mental health consequences for survivors; however, the effect of interventions designed to improve survivors' depressive symptoms is unclear.Objective 
                  To determine whether an advocacy intervention would improve the depressive symptoms of Chinese women survivors of IPV.Design, Setting, and Participants 
                  Assessor-blinded randomized controlled trial of 200 Chinese women 18 years or older with a history of IPV, conducted from February 2007 to June 2009 in a community center in Hong Kong, China.Intervention 
                  The intervention group (n = 100) received a 12-week advocacy intervention comprising empowerment and telephone social support. The control group (n = 100) received usual community services including child care, health care and promotion, and recreational programs.Main Outcome Measures 
                  Primary outcome was change in depressive symptoms (Chinese version of the Beck Depression Inventory II) between baseline and 9 months. Secondary outcomes were changes in IPV (Chinese Revised Conflict Tactics Scales), health-related quality of life (12-Item Short Form Health Survey), and perceived social support (Interpersonal Support Evaluation List) between baseline and 9 months. Usefulness of the intervention and usual community services was evaluated at 9 months.Results 
                  At 3 months, the mean change in depressive symptom score was 11.6 (95% CI, 9.5 to 13.7) in the control group and 14.9 (95% CI, 12.4 to 17.5) in the intervention group; respective changes at 9 months were 19.6 (95% CI, 16.6 to 22.7) and 23.2 (95% CI, 20.4 to 26.0). Intervention effects at 3 and 9 months were not significantly different (P = .86). The intervention significantly reduced depressive symptoms by 2.66 (95% CI, 0.26 to 5.06; P = .03) vs the control, less than the 5-unit minimal clinically important difference. Statistically significant improvement was found in partner psychological aggression (−1.87 [95% CI, −3.34 to −0.40]; mean change at 3 months, 1.5 [95% CI, −1.0 to 3.9] in the control group and 0.3 [95% CI, −0.7 to 1.4] in the intervention group; mean change at 9 months, −6.4 [95% CI, −7.8 to −5.0] and −8.9 [95% CI, −10.6 to −7.2]) and perceived social support (2.18 [95% CI, 0.48 to 3.89]; mean change at 3 months, 6.4 [95% CI, 4.9 to 7.8] and 9.2 [95% CI, 7.7 to 10.8]; mean change at 9 months, 12.4 [95% CI, 10.5 to 14.3] and 14.4 [95% CI, 12.7 to 16.1]) but not in physical assault, sexual coercion, or health-related quality of life. By end of study, more women in the intervention group found the advocacy intervention useful or extremely useful in improving intimate relationships vs those in the control group receiving usual community services (93.8% vs 81.7%; difference, 12.1% [95% CI, 2.1% to 22.0%]; P = .02) and in helping them to resolve conflicts with their intimate partners (97.5% vs 84.1%; difference, 13.4% [95% CI, 4.7% to 22.0%]; P = .001).Conclusion 
                  Among community-dwelling abused Chinese women, an advocacy intervention did not result in a clinically meaningful improvement in depressive symptoms.Trial Registration 
                  clinicaltrials.gov Identifier:NCT01054898