Reducing maternal intimate partner violence after the birth of a child: a randomized controlled trial of the Hawaii Healthy Start Home Visitation Program.
OBJECTIVE
To estimate whether home visitation beginning after childbirth was associated with changes in average rates of mothers' intimate partner violence (IPV) victimization and perpetration as well as rates of specific IPV types (physical assault, verbal abuse, sexual assault, and injury) during the 3 years of program implementation and during 3 years of long-term follow-up.


METHODS
Randomized controlled trial.


METHODS
Oahu, Hawaii.


METHODS
Six hundred forty-three families with an infant at high risk for child maltreatment born between November 1994 and December 1995. Intervention Home visitors provided direct services and linked families to community resources. Home visits were to initially occur weekly and to continue for at least 3 years.


METHODS
Women's self-reports of past-year IPV victimization and perpetration using the Conflict Tactics Scale. Blinded research staff conducted maternal interviews following the child's birth and annually when children were aged 1 to 3 years and then 7 to 9 years.


RESULTS
During program implementation, intervention mothers as compared with control mothers reported lower rates of IPV victimization (incidence rate ratio [IRR], 0.86; 95% confidence interval [CI], 0.73-1.01) and significantly lower rates of perpetration (IRR, 0.83; 95% CI, 0.72-0.96). Considering specific IPV types, intervention women reported significantly lower rates of physical assault victimization (IRR, 0.85; 95% CI, 0.71-1.00) and perpetration (IRR, 0.82; 95% CI, 0.70-0.96). During long-term follow-up, rates of overall IPV victimization and perpetration decreased, with nonsignificant between-group differences. Verbal abuse victimization rates (IRR, 1.14, 95% CI, 0.97-1.34) may have increased among intervention mothers.


CONCLUSIONS
Early-childhood home visitation may be a promising strategy for reducing IPV.
Bair-Merritt
Megan H
MH
Division of General Pediatrics and Adolescent Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA. mbairme1@jhmi.edu
Jennings
Jacky M
JM
Chen
Rusan
R
Burrell
Lori
L
McFarlane
Elizabeth
E
Fuddy
Loretta
L
Duggan
Anne K
AK
D000293:Adolescent; D000328:Adult; D002648:Child; D002649:Child Abuse / Q000517:prevention & control; D002669:Child Welfare; D017579:Domestic Violence / Q000517:prevention & control / Q000706:statistics & numerical data*; D005163:Factor Analysis, Statistical; D005260:Female; D006254:Hawaii; D006293:Health Promotion; D006699:Home Care Services / Q000458:organization & administration; D006792:House Calls; D006801:Humans; D008429:Maternal Welfare; D009035:Mothers / Q000706:statistics & numerical data*; D012044:Regression Analysis; D055815:Young Adult