Data from PATH trial (03-2018)

  • Paige Lacesso (Creator)
  • Gene S Feder (Creator)
  • Giulia Ferrari (Creator)



Design: Pragmatic parallel group individually randomized controlled trial of normal DVA
advocacy vs. advocacy + psychological intervention.
Setting: specialist DVA agencies; two UK cities.
Participants: Women aged 16 years
and older accessing DVA services.
Intervention: Eight specialist psychological advocacy (SPA) sessions
Primary outcomes at 12 months: depression symptoms (PHQ-9) and psychological
distress (CORE-OM).
Primary analysis: intention to treat regression model.
Secondary analyses: pre-specified subgroup analyses; multiple imputation by
chained equation models (mice); complier-average
causal effects (CACE) using instrumental variables
Results: 263 women recruited (78 in shelter/refuge, 185 in community), 3 withdrew (2
community, control group; 1 intervention, refuge group), 130 in intervention and 130 in
control groups. Recruitment ended June 2013. 12-month follow up: 65%.
Primary outcomes
At 12-month follow up, greater improvement in mental health of women in the
intervention group. Difference in average CORE-OM score between intervention and
control groups: -3.3 points (95% CI -5.5 to -1.2). Difference in average PHQ-9 score
between intervention and control group: -2.2 (95% CI -4.1 to -0.3). At 12 months, 35%
of the intervention group and 55% of the control group were above the CORE-OM
clinical threshold (OR 0.32, 95% CI 0.16 to 0.64); 29% of the intervention group and
46% of the control group were above the PHQ-9 clinical threshold (OR 0.41, 95% CI
0.21 to 0.81).
This study provides evidence that DVA advocacy can be enhanced in relation to
mental health outcomes by relatively brief training of advocates in psychological
methods. An eight-session psychological intervention delivered by DVA advocates
produced clinically relevant improvement in mental health outcomes compared with
normal advocacy care for female survivors of domestic violence.
Date made available4 Mar 2018
PublisherUniversity of Bristol

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