Problem solving therapy (PST) tailored for intimate partner violence (IPV) versus standard PST and enhanced usual care for pregnant women experiencing IPV in rural Ethiopia: protocol for a randomised controlled feasibility trial

dc.contributor.authorKeynejad, Roxanne C
dc.contributor.authorBitew, Tesera
dc.contributor.authorSorsdahl, Katherine
dc.contributor.authorMyers, Bronwyn
dc.contributor.authorHonikman, Simone
dc.contributor.authorMedhin, Girmay
dc.contributor.authorDeyessa, Negussie
dc.contributor.authorSevdalis, Nick
dc.contributor.authorTol, Wietse A
dc.contributor.authorHoward, Louise
dc.contributor.authorHanlon, Charlotte
dc.date.accessioned2020-06-10T09:04:39Z
dc.date.available2020-06-10T09:04:39Z
dc.date.issued2020-06-01
dc.date.updated2020-06-07T03:46:21Z
dc.description.abstractBackground In rural Ethiopia, 72% of women are exposed to lifetime intimate partner violence (IPV); IPV is most prevalent during pregnancy. As well as adversely affecting women’s physical and mental health, IPV also increases the risk of child morbidity and mortality associated with maternal depression, thus making antenatal care an important opportunity for intervention. Adapting generic, task-shared, brief psychological interventions for perinatal depression and anxiety to address the needs and experiences of women affected by IPV may improve acceptability to women and feasibility for health workers. This randomised controlled feasibility trial will compare brief problem solving therapy (PST) specifically adapted for pregnant women experiencing IPV (PST-IPV) with standard PST and enhanced usual care to determine the feasibility of a future fully powered randomised controlled trial. Methods Seventy-five pregnant women scoring five or more on the Patient Health Questionnaire, endorsing a tenth question about functional impact and reporting past-year IPV, will be recruited from antenatal care clinics in predominantly rural districts in Ethiopia. Consenting participants will be randomised to either four sessions of PST-IPV, four sessions of standard PST or information about sources of support (enhanced usual care) in a three-arm design. The interventions will be delivered by trained, supervised antenatal care staff using a task-sharing model. Assessments will be made at baseline and after 9 weeks by masked outcome assessors and will include measures of depression symptoms (primary outcome), post-traumatic stress, anxiety symptoms, functional impact, past-month IPV and hypothesised mediators (secondary outcomes). A mixed-method process evaluation will determine the feasibility of a future randomised controlled trial, assess the feasibility, acceptability, fidelity and quality of implementation of PST-IPV, generate testable hypotheses about causal mechanisms, and identify potential contextual factors influencing outcomes. Discussion Despite mental health being a critical concern for women experiencing IPV, there is limited evidence for brief, task-shared psychological interventions adapted for their needs in low- and middle-income countries. Contextually tailored interventions for pregnant women experiencing IPV in low- and middle-income countries require development and process evaluation. This randomised controlled feasibility trial will yield results on the feasibility of conducting a fully powered trial, relevant to researchers, primary and antenatal care clinicians in resource-limited settings. Trial registration Pan-African clinical trials registry: PACTR202002513482084. Prospectively registered on 13 December 2019.
dc.identifier.apacitationKeynejad, R. C., Bitew, T., Sorsdahl, K., Myers, B., Honikman, S., Medhin, G., ... Hanlon, C. (2020). Problem solving therapy (PST) tailored for intimate partner violence (IPV) versus standard PST and enhanced usual care for pregnant women experiencing IPV in rural Ethiopia: protocol for a randomised controlled feasibility trial. 21(1), 454. http://hdl.handle.net/11427/32060en_ZA
dc.identifier.chicagocitationKeynejad, Roxanne C, Tesera Bitew, Katherine Sorsdahl, Bronwyn Myers, Simone Honikman, Girmay Medhin, Negussie Deyessa, et al "Problem solving therapy (PST) tailored for intimate partner violence (IPV) versus standard PST and enhanced usual care for pregnant women experiencing IPV in rural Ethiopia: protocol for a randomised controlled feasibility trial." 21, 1. (2020): 454. http://hdl.handle.net/11427/32060en_ZA
dc.identifier.citationKeynejad, R.C., Bitew, T., Sorsdahl, K., Myers, B., Honikman, S., Medhin, G., Deyessa, N. & Sevdalis, N. et al. 2020. Problem solving therapy (PST) tailored for intimate partner violence (IPV) versus standard PST and enhanced usual care for pregnant women experiencing IPV in rural Ethiopia: protocol for a randomised controlled feasibility trial. 21(1):454. http://hdl.handle.net/11427/32060en_ZA
dc.identifier.risTY - Journal Article AU - Keynejad, Roxanne C AU - Bitew, Tesera AU - Sorsdahl, Katherine AU - Myers, Bronwyn AU - Honikman, Simone AU - Medhin, Girmay AU - Deyessa, Negussie AU - Sevdalis, Nick AU - Tol, Wietse A AU - Howard, Louise AU - Hanlon, Charlotte AB - Background In rural Ethiopia, 72% of women are exposed to lifetime intimate partner violence (IPV); IPV is most prevalent during pregnancy. As well as adversely affecting women’s physical and mental health, IPV also increases the risk of child morbidity and mortality associated with maternal depression, thus making antenatal care an important opportunity for intervention. Adapting generic, task-shared, brief psychological interventions for perinatal depression and anxiety to address the needs and experiences of women affected by IPV may improve acceptability to women and feasibility for health workers. This randomised controlled feasibility trial will compare brief problem solving therapy (PST) specifically adapted for pregnant women experiencing IPV (PST-IPV) with standard PST and enhanced usual care to determine the feasibility of a future fully powered randomised controlled trial. Methods Seventy-five pregnant women scoring five or more on the Patient Health Questionnaire, endorsing a tenth question about functional impact and reporting past-year IPV, will be recruited from antenatal care clinics in predominantly rural districts in Ethiopia. Consenting participants will be randomised to either four sessions of PST-IPV, four sessions of standard PST or information about sources of support (enhanced usual care) in a three-arm design. The interventions will be delivered by trained, supervised antenatal care staff using a task-sharing model. Assessments will be made at baseline and after 9 weeks by masked outcome assessors and will include measures of depression symptoms (primary outcome), post-traumatic stress, anxiety symptoms, functional impact, past-month IPV and hypothesised mediators (secondary outcomes). A mixed-method process evaluation will determine the feasibility of a future randomised controlled trial, assess the feasibility, acceptability, fidelity and quality of implementation of PST-IPV, generate testable hypotheses about causal mechanisms, and identify potential contextual factors influencing outcomes. Discussion Despite mental health being a critical concern for women experiencing IPV, there is limited evidence for brief, task-shared psychological interventions adapted for their needs in low- and middle-income countries. Contextually tailored interventions for pregnant women experiencing IPV in low- and middle-income countries require development and process evaluation. This randomised controlled feasibility trial will yield results on the feasibility of conducting a fully powered trial, relevant to researchers, primary and antenatal care clinicians in resource-limited settings. Trial registration Pan-African clinical trials registry: PACTR202002513482084. Prospectively registered on 13 December 2019. DA - 2020-06-01 DB - OpenUCT DP - University of Cape Town IS - 1 KW - Global mental health KW - Pregnancy KW - Perinatal mental health KW - Intimate partner violence KW - Psychological interventions KW - Task sharing KW - Low- and middle-income countries KW - Feasibility studies KW - Implementation research LK - https://open.uct.ac.za PY - 2020 T1 - Problem solving therapy (PST) tailored for intimate partner violence (IPV) versus standard PST and enhanced usual care for pregnant women experiencing IPV in rural Ethiopia: protocol for a randomised controlled feasibility trial TI - Problem solving therapy (PST) tailored for intimate partner violence (IPV) versus standard PST and enhanced usual care for pregnant women experiencing IPV in rural Ethiopia: protocol for a randomised controlled feasibility trial UR - http://hdl.handle.net/11427/32060 ER -en_ZA
dc.identifier.urihttps://doi.org/10.1186/s13063-020-04331-0
dc.identifier.urihttp://hdl.handle.net/11427/32060
dc.identifier.vancouvercitationKeynejad RC, Bitew T, Sorsdahl K, Myers B, Honikman S, Medhin G, et al. Problem solving therapy (PST) tailored for intimate partner violence (IPV) versus standard PST and enhanced usual care for pregnant women experiencing IPV in rural Ethiopia: protocol for a randomised controlled feasibility trial. 2020;21(1):454. http://hdl.handle.net/11427/32060.en_ZA
dc.language.rfc3066en
dc.rights.holderThe Author(s)
dc.sourceTrials
dc.source.journalissue1
dc.source.journalvolume21
dc.source.pagination454
dc.source.urihttps://trialsjournal.biomedcentral.com/
dc.subjectGlobal mental health
dc.subjectPregnancy
dc.subjectPerinatal mental health
dc.subjectIntimate partner violence
dc.subjectPsychological interventions
dc.subjectTask sharing
dc.subjectLow- and middle-income countries
dc.subjectFeasibility studies
dc.subjectImplementation research
dc.titleProblem solving therapy (PST) tailored for intimate partner violence (IPV) versus standard PST and enhanced usual care for pregnant women experiencing IPV in rural Ethiopia: protocol for a randomised controlled feasibility trial
dc.typeJournal Article
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