Domestic Violence Enhanced
Home Visitation Intervention(DOVE) Project

Abstract

Children witnessing the intimate partner violence (IPV) of their mothers are known to have serious long term physical health, mental health and behavioral consequences. Half of child witnesses to IPV are less than six years old. Little is known about appropriate interventions for infants/toddlers and their abused mothers. This study will rigorously test the effectiveness of the structured IPV intervention (DOVE intervention) in 360 mothers and infants, in three different settings using three different designs.

There are two experimental designs: 1) random assignment to DOVE or Usual Care in urban Baltimore City Health Department and 2) random assignment by health departments, six to DOVE and six to Usual Care in rural Missouri. In urban Baltimore and rural Missouri, 160 families at each site will receive either DOVE or Usual Care. In the third setting, Kansas City, Missiouri, a cohort design with matched control analysis will be implemented. Twenty families will receive DOVE enhanced Nurse Family Partnership (NFP-DOVE) (based on David Olds' nurse home visitation research) and outcomes compared to a group of 20 families selected from the national NFP database and matched on key demographic variables.

Health department home visitor teams will be trained to deliver the DOVE intervention. Mothers and infants/toddlers will be assessed at birth, 3, 6, 12, 18, and 24 months postpartum. Maternal outcome measures include history of IPV, level of danger, adopted safety behaviors, resources used, mental health (depression, PTSD) parenting (knowledge, attitudes, practices), and parenting stress (high risk parenting, attachment, and perceived adaptability of the infant/toddler). The infant/toddler dependent measures are physical and mental development as well as physical and mental health problems, including injury.

Analyses will include mixed linear models, ANCOVA, MANOVA procedures and logistic regression with generalized estimating equations. Outcomes will provide intervention efficacy data and prospective information about patterns of IPV, maternal health, and infant/toddler development in homes where there is IPV. This innovative intervention designed to reduce maternal IPV and infant/toddler exposure has the potential to improve the health of the more than 15% of women who experience IPV during pregnancy and the 3-10 million children who witness this violence each year.