Abstract
Objective
We assessed the effectiveness of a provider-delivered intervention targeting reproductive
coercion, an important factor in unintended pregnancy.
Study Design
We randomized 25 family planning clinics (17 clusters) to deliver an education/counseling
intervention or usual care. Reproductive coercion and partner violence victimization
at 1 year follow-up were primary outcomes. Unintended pregnancy, recognition of sexual
and reproductive coercion, self-efficacy to use and use of harm reduction behaviors
to reduce victimization and contraception nonuse, and knowledge and use of partner
violence resources were secondary outcomes. Analyses included all available data using
an intention-to-treat approach.
Results
Among 4009 females ages 16 to 29 years seeking care, 3687 completed a baseline survey
prior to clinic visit from October 2011 to November 2012; 3017 provided data at 12–20 weeks post-baseline (T2) and 2926 at 12 months post-baseline (T3) (79% retention). Intervention effects were not significant
for reproductive coercion [adjusted risk ratio (ARR) 1.50 (95% confidence interval
0.95–2.35)] or partner violence [ARR 1.07 (0.84–1.38)]. Intervention participants
reported improved knowledge of partner violence resources [ARR 4.25 (3.29–5.50)] and
self-efficacy to enact harm reduction behaviors [adjusted mean difference 0.06 (0.02–0.10)].
In time point-specific models which included moderating effects of exposure to reproductive
coercion at baseline, a higher reproductive coercion score at baseline was associated
with a decrease in reproductive coercion 1 year later (T3). Use and sharing of the
domestic violence hotline number also increased.
Conclusion
This brief clinic intervention did not reduce partner violence victimization. The
intervention enhanced two outcomes that may increase safety for women, specifically
awareness of partner violence resources and self-efficacy to enact harm reduction
behaviors. It also appeared to reduce reproductive coercion among women experiencing
multiple forms of such abuse.
Keywords
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Article info
Publication history
Published online: February 15, 2016
Accepted:
February 7,
2016
Received in revised form:
February 1,
2016
Received:
December 19,
2015
Footnotes
☆Funding Source: National Institute of Child Health and Human Development (R01HD064407)
☆☆Conflicts of Interest: None.
★Clinical Trial Registration: ClinicalTrials.gov (identifier NCT01459458; closed)
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
