Shreya Bhandari

Engaging and retaining abused women in perinatal home visitation programs.

OBJECTIVES: Intimate partner violence (IPV) during pregnancy affects 0.9% to 17% of women and affects maternal health significantly. The impact of IPV extends to the health of children, including an increased risk of complications during pregnancy and the neonatal period, mental health problems, and cognitive delays. Despite substantial sequelae, there is limited research substantiating best practices for engaging and retaining high-risk families in perinatal home visiting (HV) programs, which have been shown to improve infant development and reduce maltreatment. METHODS: The Domestic Violence Enhanced Home Visitation Program (DOVE) is a multistate longitudinal study testing the effectiveness of a structured IPV intervention integrated into health department perinatal HV programs. The DOVE intervention, based on an empowerment model, combined 2 evidence-based interventions: a 10-minute brochure-based IPV intervention and nurse home visitation. RESULTS: Across all sites, 689 referrals were received from participating health departments. A total of 339 abused pregnant women were eligible for randomization; 42 women refused, and 239 women were randomly assigned (124 DOVE; 115 usual care), resulting in a 71% recruitment rate. Retention rates from baseline included 93% at delivery, 80% at 3 months, 76% at 6 months, and 72% at 12 months. CONCLUSIONS: Challenges for HV programs include identifying and retaining abused pregnant women in their programs. DOVE strategies for engaging and retaining abused pregnant women should be integrated into HV programs’ federal government mandates for the appropriate identification and intervention of women and children exposed to IPV.

Impact of intimate partner violence on pregnant women's mental health: mental distress and mental strength

The mental health consequences of living with intimate partner violence (IPV) are substantial. Despite the growing awareness of the incidence of depression and PTSD in women experiencing IPV, few studies have examined prospectively the experience of IPV during pregnancy and the impact of the abuse on womens mental health. As a component of a larger clinical trial of an intervention for pregnant abused women, 27 women participated in a qualitative study of their responses to the abuse in the context of pregnancy and parenting. Results indicate that womens changing perceptions of self was related to mental distress, mental health, or both mental distress and mental health.

Pregnancy and Intimate Partner Violence: How Do Rural, Low-Income Women Cope?

We conducted 32 in-depth interviews with 20 rural, low-income, women residing in the United States who were pregnant (n = 12) or 3 months postpartum (n = 8) and had experienced intimate partner violence (IPV). Using purposive sampling and the grounded theory method, we generated a conceptual model of coping. The urge to protect the unborn baby was the primary influence for participants’ decisions about separating from or permanently leaving an abusive relationship. Implications include universal screening for IPV in child-bearing women, inquiry into maternal identity development during pregnancy, and improved resource access for rural, low-income women.

Pregnant women experiencing IPV: impact of supportive and non-supportive relationships with their mothers and other supportive adults on perinatal depression: a mixed methods analysis.

The current study explored the views of women experiencing interpersonal violence (IPV) and their relationship with their mothers or other supportive adult, and determines how this relationship affected perinatal depressive symptoms. The sample consisted of 30 urban and rural pregnant women enrolled in a larger ongoing randomized controlled trial. Data from quantitative instruments that measured depressive symptoms were examined in combination with qualitative interview data collected at baseline and six months post-natal. Women describing positive relationships with their mothers or another supportive adult reported statistically significant lower depressive symptoms scores (p < .05).

Comparison of Abuse Experiences of Rural and Urban African American Women During Perinatal Period

A subsample of 12 African American women (6 urban and 6 rural) were selected from a larger longitudinal, randomized control trial, Domestic Violence Enhanced Home Visitation (DOVE-R01 900903 National Institute of Nursing Research [NINR]/National Institutes of Health [NIH]). All African American women were chosen to control for any racial- and/or race-related cultural differences that may exist among women across geographical areas. The experiences of abuse during the perinatal period are drawn from in-depth interviews conducted at five points in time during pregnancy and the post-partum period. The analysis describes three major themes that highlight the similarities and differences among rural and urban women. The main themes found were (1) types of abuse, (2) location of abuse, and (3) response to abuse. In addition, two sub-themes (a) defiance and compliance and (b) role of children were also identified. Implications for universal screening for women of reproductive age, safer gun laws, and the need for further research are discussed.

Lived Experiences of South Asian Women Facing Domestic Violence in the United States

ABSTRACT This article describes the lived experiences of domestic violence among a convenience sample of 20 South Asian women. The experiences of abuse are drawn from in-depth telephonic interviews conducted all across the United States. The analysis describes four major categories of abuse: (a) types of abuse; (b) abuse involving children; (c) family involvement in abuse; and (d) formal and informal support. Implications for social workers working with South Asian women are shared.

South Asian women's coping strategies in the face of domestic violence in the United States

ABSTRACT We conducted in-depth telephone interviews with a convenience sample of 20 South Asian women experiencing domestic violence in the United States. Utilizing the emotion-focused and problem-focused coping framework, the researchers analyzed the narratives of abused South Asian women. Emotion-focused coping strategies include (a) spirituality and/or religion and (b) the role of children. Problem-focused coping strategies include (c) informal and formal support and (d) strategies of resisting, pacifying, safety planning. Implications for practice and future research in the United States and internationally are discussed.

Patterns of abuse among South Asian women experiencing domestic violence in the United States

This qualitative study was conducted with a convenience sample of 20 South Asian women experiencing domestic violence in the United States. The results explore the patterns of abuse as well as the factors and circumstances (i.e. turning points) that motivated South Asian women to change in the context of the stage that they were in as per the Landenburger model (binding, enduring, disengaging, and recovery). The four themes that emerged from the interviews and analysis are (1) ‘Timing and Frequency of abuse’, (2) ‘Methods of control – financial, isolation and suspicion’, (3) ‘Cycle of Abuse’, and (4)’ Turning Points – motivation to change’. Implications for practice and policy-level changes for abused South Asian women in the United States are discussed.