Date of Award

Summer 8-8-2017

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Daniel Whitaker, Ph. D

Second Advisor

Matthew Hayat, Ph.D

Abstract

Annually, nearly 7 million women and 5.5 million men experience some form of intimate partner violence, which has serious health impacts. IPV has also been shown to limit the impact of early childhood home visiting interventions. Given the positive impacts of home visiting, reducing IPV in that setting could alleviate the negative impacts of IPV and improve mother and child outcomes as well. The analysis performed are from data from a randomized trial of an intimate partner violence intervention that was embedded into the Nurse Family Partnership, an evidence-based home visiting program. The intervention focused on identifying IPV, and for women without severe IPV, improving relationship skills including communication patterns and conflict resolution. The goal of this analysis is to examine how changes in partner and history of IPV moderate the relationship skills outcomes.

This study aims to fill the gap in knowledge regarding the relationship between a home visiting intervention and relationship skill outcomes in women enrolled in the home visiting program, the Nurse Family Partnership. The purpose of the study is to discover whether the relationship skills differ in participants with stable vs. unstable partnerships and with those who experienced IPV before the start of the study.

Women were randomized to NFP as usual (n=105) or NFP+, which included NFP plus the IPV intervention (n=133). Participants were surveyed at baseline, and at one and two-year follow-up with 81% retention over 2 years. Standardized assessment tools assessed relationship quality, communication, problem solving, partner support, relationship decision making, and psychological maltreatment. Marginal modeling was conducted to examine whether the intervention accounted for any change in relationship variables and whether the impact is moderated by history of IPV and changes in partnership.

Multilevel modeling of the outcome variables showed some main effects of time such that conflict resolution improves for the intervention group (p<0.05). There is one clinically significant three-way interaction showing reduced relationship danger in the intervention for women with a history of IPV (p<0.06). There were no significant interactions for the partnership change moderator.

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