title: Mothers' AdvocateS In the Community (MOSAIC)--non-professional mentor support to reduce intimate partner violence and depression in mothers: a cluster randomised trial in primary care.
abstract: BACKGROUND
  Effective interventions to increase safety and wellbeing of mothers experiencing intimate partner violence (IPV) are scarce. As much attention is focussed on professional intervention, this study aimed to determine the effectiveness of non-professional mentor support in reducing IPV and depression among pregnant and recent mothers experiencing, or at risk of IPV.
  
  
  METHODS
  MOSAIC was a cluster randomised trial in 106 primary care (maternal and child health nurse and general practitioner) clinics in Melbourne, Australia. 63/106 clinics referred 215 eligible culturally and linguistically diverse women between January 2006 and December 2007. 167 in the intervention (I) arm, and 91 in the comparison (C) arm. 174 (80.9%) were recruited. 133 (76.4%) women (90 I and 43 C) completed follow-up at 12 months.
  
  
  METHODS
  12 months of weekly home visiting from trained and supervised local mothers, (English & Vietnamese speaking) offering non-professional befriending, advocacy, parenting support and referrals.
  
  
  METHODS
  Primary outcomes; IPV (Composite Abuse Scale CAS) and depression (Edinburgh Postnatal Depression Scale EPDS); secondary measures included wellbeing (SF-36), parenting stress (PSI-SF) and social support (MOS-SF) at baseline and follow-up.
  
  
  METHODS
  Intention-to-treat using multivariable logistic regression and propensity scoring.
  
  
  RESULTS
  There was evidence of a true difference in mean abuse scores at follow-up in the intervention compared with the comparison arm (15.9 vs 21.8, AdjDiff -8.67, CI -16.2 to -1.15). There was weak evidence for other outcomes, but a trend was evident favouring the intervention: proportions of women with CAS scores ≥ 7, 51/88 (58.4%) vs 27/42 (64.3%) AdjOR 0.47, CI 0.21 to 1.05); depression (EPDS score ≥ 13) (19/85, 22% (I) vs 14/43, 33% (C); AdjOR 0.42, CI 0.17 to 1.06); physical wellbeing mean scores (PCS-SF36: AdjDiff 2.79; CI -0.40 to 5.99); mental wellbeing mean scores (MCS-SF36: AdjDiff 2.26; CI -1.48 to 6.00). There was no observed effect on parenting stress. 82% of women mentored would recommend mentors to friends in similar situations.
  
  
  CONCLUSIONS
  Non-professional mentor mother support appears promising for improving safety and enhancing physical and mental wellbeing among mothers experiencing intimate partner violence referred from primary care.
  
  
  BACKGROUND
  ACTRN12607000010493http://www.anzctr.org.au.
authors.affiliation: Associate Professor, Mother and Child Health Research, La Trobe University, Melbourne, Vic 3000, Australia. a.taft@latrobe.edu.au
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Taft
authors.forename: Rhonda
authors.initials: R
authors.lastname: Small
authors.forename: Kelsey L
authors.initials: KL
authors.lastname: Hegarty
authors.forename: Lyndsey F
authors.initials: LF
authors.lastname: Watson
authors.forename: Lisa
authors.initials: L
authors.lastname: Gold
authors.forename: Judith A
authors.initials: JA
authors.lastname: Lumley
mesh_terms: D000328:Adult; D001315:Australia; D016000:Cluster Analysis; D003863:Depression / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D059012:Lost to Follow-Up; D008427:Maternal Health Services / Q000379:methods* / Q000458:organization & administration; D008611:Mentors; D009035:Mothers / Q000523:psychology*; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology; D011320:Primary Health Care / Q000379:methods* / Q000458:organization & administration; D012944:Social Support; D013179:Spouse Abuse / Q000517:prevention & control* / Q000523:psychology