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Cited by 140Intimate Partner and Family ViolenceMaternal Mental Health During Pregnancy and PostpartumSubstance Abuse Treatment and Outcomes

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

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Taft, Angela J, Small, Rhonda, Hegarty, Kelsey L, Watson, Lyndsey F, Gold, Lisa, Lumley, Judith A·2011·BMC Public Health
DOI 10.1186/1471-2458-11-178PMC PMC3074545
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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. INTERVENTION: 12 months of weekly home visiting from trained and supervised local mothers, (English & Vietnamese speaking) offering non-professional befriending, advocacy, parenting support and referrals. MAIN OUTCOME MEASURES: 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. ANALYSIS: 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. CONCLUSION: 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. TRIAL REGISTRATION: ACTRN12607000010493http://www.anzctr.org.au.

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  • Survivor-focused advocacy/case management interventions showed good to moderate evidence of positive impact on mental health outcomes and access to social support, and in a few studies a reduction in partner aggression or experience of IPV.

    “The studies showed good to moderate evidence of the positive impact of these interventions on mental health outcomes and also access to social support for the IPV survivors included in the study, and in a few studies, a reduction in partner aggression or experience of IPV (IPV scores) [15–23].”

    From A systematic review of intimate partner violence interventions focused on improving social support and/ mental health outcomes of survivors (2020) · cites this paper as [19]

    The Results (Changes in primary and secondary outcome measures; page unavailable) report lower partner-abuse scores among mentored women, although that evidence weakened after propensity-score adjustment. Depression and mental-wellbeing results favoured mentoring but were weak; the social-support comparison did not show an intervention benefit (adjusted difference −0.21, 95% CI −0.82 to 0.40). Thus this trial supports the IPV component, but not the claimed level of evidence for mental-health benefits or a positive impact on social support. (LLM, conf=0.88)

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  1. Warshaw C Taft A McCosker-Howard H Roberts G, Hegarty K, Feder G Educating health professionals: changing attitudes and overcoming barriers, in Intimate partner abuse and health professionals: new approaches to domestic violence 2006 Elsevier: London 61 78

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Authors
Taft, A. J., Small, R., Hegarty, K. L., Watson, L. F., Gold, L., & Lumley, J. A.
Affiliations
  • La Trobe University (AU)
  • The University of Melbourne (AU)
  • Deakin University (AU)
Corresponding author
Taft, Angela J
ORCID
Venue
BMC Public Health
Publisher
Springer Science and Business Media LLC
Published
2011-03-23
Volume
11
Issue
1
Pages
178-178
ISSN
1471-2458 (ISSN-L)
DOI
10.1186/1471-2458-11-178
PMC
PMC3074545
OpenAlex
W2098860901
Cited by
140
References
39
Citations by year
2026: 4 · 2025: 4 · 2024: 4 · 2023: 4 · 2022: 6 · 2021: 6 · 2020: 10 · 2019: 10 · 2018: 7 · 2017: 11 · 2016: 14 · 2015: 14 · 2014: 21 · 2013: 12 · 2012: 9
FWCI
15.23
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Public Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Minerva Access (University of Melbourne) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • State Government of Victoria
  • Medical Research Council
  • National Health and Medical Research Council
Topics
  • Social Sciences › Health › Intimate Partner and Family Violence
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
intimate partner violence, maternal depression, peer mentoring, home visiting, pregnant women, postpartum women, culturally and linguistically diverse women, primary care, maternal and child nursing, parental stress, social support, well-being, Composite Abuse Scale, Edinburgh Postnatal Depression Scale, mosaics, intervention effectiveness
MeSH terms
Adult, Australia, Depression, Female, Follow-Up Studies, Humans, Maternal Health Services, Mentors, Mothers, Pregnancy, Primary Health Care, Social Support, Spouse Abuse, Cluster Analysis, Outcome Assessment, Health Care, Pregnant People, Lost to Follow-Up

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