Advocacy interventions for women who experience intimate partner abuse
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).
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