title: The Interconnections Project: development and evaluation of a community-based depression program for African American violence survivors.
abstract: BACKGROUND
  Multi-faceted depression care programs based within the healthcare system have been found to be effective, but may not fully address the needs of African American Intimate Partner Violence (IPV) survivors, many of whom are not seeking depression care in healthcare settings.
  
  
  OBJECTIVE
  To develop and evaluate a multifaceted, community-based depression care program (the Interconnections Project) for African American women with a history of IPV.
  
  
  METHODS
  We used a community-based participatory research (CBPR) approach to develop, implement, and evaluate the intervention. Participants were African American women who had current depressive symptoms and a lifetime history of IPV. They participated in a 6-month intervention where a peer advocate provided education, skills training, and case management services, and used Motivational Interviewing to support self-management behaviors. We conducted pre-intervention and post-intervention assessments using quantitative and qualitative data.
  
  
  RESULTS
  Fifty-nine women participated, with 92 % attending any sessions and 51 % attending at least 6 h of intervention activities. Intervention changes made to better accommodate participants' unpredictable schedules improved participation rates. Participants noted high levels of satisfaction with the program. There were significant improvements in depression severity (PHQ-9 13.9 to 7.9, p < 0.001), self-efficacy, self-management behaviors, and self-esteem (all p < 0.001), but no increase in use of antidepressants. Common themes related to why the program was helpful included that the program was by and for African American women, that it fostered trust, and that it taught self-management strategies with practical, lasting value.
  
  
  CONCLUSIONS
  Culturally specific, community-based interventions led by peer advocates may be a promising way to help African American IPV survivors effectively address depression.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA. nicolaid@ohsu.edu
authors.forename: Christina
authors.initials: C
authors.lastname: Nicolaidis
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Wahab
authors.forename: Jammie
authors.initials: J
authors.lastname: Trimble
authors.forename: Angie
authors.initials: A
authors.lastname: Mejia
authors.forename: S Renee
authors.initials: SR
authors.lastname: Mitchell
authors.forename: Dora
authors.initials: D
authors.lastname: Raymaker
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Thomas
authors.forename: Vanessa
authors.initials: V
authors.lastname: Timmons
authors.forename: A Star
authors.initials: AS
authors.lastname: Waters
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D003156:Community Mental Health Services / Q000458:organization & administration*; D055812:Community-Based Participatory Research; D003863:Depression / Q000208:ethnology / Q000209:etiology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009922:Oregon; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D010865:Pilot Projects; D015397:Program Evaluation; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D013179:Spouse Abuse / Q000208:ethnology / Q000523:psychology*; D017741:Survivors / Q000523:psychology*; D055815:Young Adult