Advocacy interventions for women who experience intimate partner abuse
Evidence Summaries Level of Evidence = C
Intensive advocacy for women recruited in domestic violence shelters or refuges may reduce physical abuse one to two years after the intervention, but there is insufficient evidence on the effectiveness on quality of life and mental health. There is insufficient evidence on the effectiveness of less intensive interventions in healthcare settings for women who still live with the perpetrators of violence.
A Cochrane review 1 included 10 studies with a total of 1,527 subjects. Intensive advocacy (12 hours or more duration) may help terminate physical abuse in women leaving domestic violence shelters or refuges at 12-24 months follow-up (OR 0.43, 95% CI 0.23 to 0.80; 2 studies, n=295), but not at up to 12 months follow-up 3 (OR 0.62, 95% CI 0.35 to 1.09, 3 studies, n=215). The evidence indicates that intensive advocacy may improve quality of life at up to 12 months follow-up, but the confidence intervals included zero (WMD 0.23, 95% CI 0.00 to 0.46; 2 studies, n=343). Depression did not improve following intensive advocacy at up to 12 months follow-up (WMD -0.05, 95% CI -0.19 to 0.09; 2 studies, n=343), nor did psychological distress (SMD -0.16, 95% CI -0.39 to 0.06; 2 studies, n=298). Only two meta-analyses of brief advocacy interventions (less than 12 hours duration) were possible; an increased use of safety behaviours was consistent with the receipt of brief advocacy both at up to 12 months (WMD 0.60, 95% CI 0.14 to 1.06; 2 studies, n=468) and at 12-24 months (WMD 0.48, 95% CI 0.04 to 0.92; 2 studies, n=468) follow up.
Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment and unclear blinding) and by inconsistency (heterogeneity in interventions and outcomes).
1. Ramsay J, Carter Y, Davidson L, Dunne D, Eldridge S, Feder G, Hegarty K, Rivas C, Taft A, Warburton A. Advocacy interventions to reduce or eliminate violence and promote the physical and psychosocial well-being of women who experience intimate partner abuse. Cochrane Database Syst Rev 2009;(3):CD005043. [PMID:19588364]
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