CBPR to Improve Depression Care for African-American Domestic Violence Survivors

Oregon Health & Science University, Portland OR

Investigators

Linked publications & trials

Abstract

African-Americans receive less guideline-appropriate depression care than Whites. likewise, women with histories of intimate partner violence (IPV) have increased rates of depression and greater mistrust of mental health care. However, few mental health treatment programs specifically address the complex needs of African-American abuse survivors. We plan to use Community-Based Participatory Research (CBPR) to develop and test a community-based multi-faceted intervention to reduce depression disparities in AfricanAmerican women who have experienced IPV. The pUrPOse of this proposal is to strengthen our communityacademic partnership and to acquire the skills, tools, and preliminary data necessary to conduct a large-scale controlled trial. Our partnership consists of African-American IPV survivors, community leaders, domestic violence advocates, mental health providers and researchers who have already been working together to understand the beliefs and needs of depressed African-American IPV survivors. We are now developing a depression care model based within the Healing Roots Center, a community-based African-American domestic violence program. Our intervention incorporates many of the same principles included in the health systembased Chronic Care Model, but it places the community and its resources at the core of the program. AfricanAmerican domestic violence advocates will serve in a role similar to that of care managers, providing care coordination and patient education. They will link IPV survivors into the health care system and empower them to have more effective interactions with both on-site and clinic-based providers. Advocates will use motivational interviewing techniques to help women make behavior changes they wish to make in a culturallyappropriate manner. Finally, we will incorporate creative, arts-based programs as a way to recruit and retain women who might otherwise be hesitant to access mental health services or recognize their IPV. We will strengthen the partnership between our academic and community groups, build capacity for CBPR among all members, and monitor the success of the process. We will adapt, prioritize and pilot test assessment instruments that will be used to measure the effectiveness of our intervention. We will pilot test our intervention to assess its feasibility and acceptability and collect preliminary effectiveness data. Moreover, we will engage the community in designing and preparing an acceptable large-scale intervention study. Our project is strongly grounded in principles of Empowerment Theory on both micro and macro levels. On an individual level, our project will empower women to address the violence in their relationships, to use selfmanagement support tools and self-care practices to control their depression, and to become involved, informed consumers of mental health services. At a community level, the project will enable community members to partner with researchers to design and conduct research that is relevant to their needs and respectful of their expertise, which leaves lasting resources in place, and leads directly to social change.