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The online version of this article (doi:10.1186/1472-6963-12-50) contains supplementary material, which is available to authorized users.
An erratum to this article is available at http://dx.doi.org/10.1186/s12913-016-1682-1.
The authors declare that they have no competing interests.
The overall study was conceived by HLM, JC, DLO. SJ designed and coordinated the qualitative case study, participated in data collection and analysis, and led the development of the NFP IPV intervention. MFG participated in data analysis and interpretation and co-led the development of the intervention. DD co-facilitated four focus groups; both DD and DBM participated in the qualitative data analysis. CNW, JC, DLO provided feedback on the emerging intervention. The manuscript was drafted by SJ, MFG, CNW and HM. All authors read and approved the final manuscript.
Despite an increase in knowledge about the epidemiology of intimate partner violence (IPV), much less is known about interventions to reduce IPV and its associated impairment. One program that holds promise in preventing IPV and improving outcomes for women exposed to violence is the Nurse-Family Partnership (NFP), an evidence-based nurse home visitation program for socially disadvantaged first-time mothers. The present study developed an intervention model and modification process to address IPV within the context of the NFP. This included determining the extent to which the NFP curriculum addressed the needs of women at risk for IPV or its recurrence, along with client, nurse and broader stakeholder perspectives on how best to help NFP clients cope with abusive relationships.
Following a preliminary needs assessment, an exploratory multiple case study was conducted to identify the core components of the proposed IPV intervention. This included qualitative interviews with purposeful samples of NFP clients and community stakeholders, and focus groups with nurse home visitors recruited from four NFP sites. Conventional content analysis and constant comparison guided data coding and synthesis. A process for developing complex interventions was then implemented.
Based on data from 69 respondents, an IPV intervention was developed that focused on identifying and responding to IPV; assessing a client's level of safety risk associated with IPV; understanding the process of leaving and resolving an abusive relationship and system navigation. A need was identified for the intervention to include both universal elements of healthy relationships and those tailored to a woman's specific level of readiness to promote change within her life. A clinical pathway guides nurses through the intervention, with a set of facilitators and corresponding instructions for each component.
NFP clients, nurses and stakeholders identified the need for modifications to the existing NFP program; this led to the development of an intervention that includes universal and targeted components to assist NFP nurses in addressing IPV with their clients. Plans for feasibility testing and evaluation of the effectiveness of the IPV intervention embedded within the NFP, and compared to NFP-only, are discussed.