A Community Support Network Rehabilitation Intervention for Improving Resiliency, Quality of Life and Neurocognitive Function in Survivors of Intimate Partner Violence-caused Brain Injury: Protocol for a Feasibility Study (Preprint)

Abstract

Globally, about 1 in 3 women experience intimate partner violence (IPV) in their lifetime. Brain injury (BI) is a common, yet often unrecognized, consequence of IPV. BIs from IPV tend to be mild, occur repetitively over the course of months or years, are remote in time, and result in chronic symptoms. Similar to BI from other causes, therapeutic treatment for women with IPV-BI is crucial to help resolve any physical or cognitive impairments, enhance Quality of Life (QoL) and minimize longer-term neurodegeneration.

The objective of this study is to investigate the feasibility and efficacy of a community support network rehabilitation intervention in terms of its impact on resiliency, QoL and neurocognitive functions.

In this pre-post experimental design, women (age 18-50 years) who are survivors of IPV (disclosed) and IPV-BI (Brain Injury Severity Assessment score 1) will be recruited from various community organizations serving survivors of IPV. Exclusion criteria will include current pregnancy, and any diagnosed neurological disorder known to affect cerebrovascular, neurocognitive, and/or sensorimotor function. A community support network (CSN) rehabilitation intervention, which includes aerobic exercise, cognitive training, mindfulness meditation and counseling will be administered. A trauma-informed approach will be integrated into the design and implementation of the programs. The program also includes a participant navigator who will provide trauma- and violence-informed advocacy and systems navigation support to participants, and will also facilitate a monthly peer support group discussion. The intervention will be provided 3 hours a day, two days a week for 3 months. Participants will complete psychological assessment and provide clinic-demographic information in the first assessment. In the 2nd (before intervention), 3rd (after intervention) and 4th (at follow up) sessions, they will complete tests of resiliency, QoL, and neurocognition. The estimated sample size is 100. The objective of this study will be accomplished by quantitatively measuring resiliency, QoL, and neurocognition before and immediately after the intervention. A follow-up assessment will occur three months after completion of the intervention to evaluate maintenance of any gains in function. One-way ANOVAs will be used to evaluate the intervention outcome across the testing times. Relationships among various variables will be explored using the regression analysis.

We anticipate the CSN rehabilitation intervention will be effective in improving resiliency, QoL and neurocognitive function in women who have experienced IPV-BI. We also anticipate this intervention will be feasible in terms of study recruitment, deliverability, adherence and retention.

The CSN rehabilitation intervention will be effective in terms of its impact on resiliency, QoL and neurocognitive functions in survivors of IPV-BI. Subsequently, a comparative study will be conducted by recruiting a control group receiving usual care.