Compendium of Research Related to Mental Health (continued)


Tools

Contractor: The MEDSTAT Group
Contract No: 290-96-0005
Contract Period: 9/30/96-3/13/98
Title: Quality Measurement Network

Description: The purpose of this contract was to develop the Quality Measurement Network (QMNet), a project to create a quality measurement information resource through a collaboration between the public and private sectors. QMNet maximizes the capabilities of the Computerized Needs-Oriented Quality Measurement Evaluation SysTem (CONQUEST). It provides more detailed and comprehensive information on a wider range of clinical performance measures and a greater number of medical conditions, including age groups affected, prevalence, utilization and costs, potentially preventable adverse outcomes, comorbidities, risk factors, and clinical services recommended or not recommended on the basis of scientifically based guidelines. The goals were for QMNet to become a comprehensive, publicly accessible quality measurement resource that helps both the public and private sectors to improve health care quality and for QMNet to help create a free-standing quality network.

Findings: QMNet, CONQUEST's technical assistance program, successfully modified the quality improvement tool in order to maximize its capabilities. CONQUEST users can obtain free technical assistance through AHRQ's QMNet contractor by calling 800-865-5380.

PI: Heather Palmer, M.B., B.Ch., S.M., Harvard University
Contract No: 290-91-0070
Contract Period: 9/25/91-2/29/96
Title: Development of Medical Treatment Guidelines

Description: The purpose of this contract was to facilitate the development of guidelines, standards, performance measures, and review criteria by panels of appropriately qualified experts and consumers of health services. This contract was to provide for the preparation of appropriate substantive premeeting information and background materials and for all the logistical, administrative, and other support required to prepare for, conduct, and report on panel meetings and other activities associated with the development, review, and updating of guidelines for AHRQ.

Findings: CONQUEST (COmputerized Needs-Oriented QUality Measurement Evaluation SysTem) 1.0 was developed under this contract. CONQUEST is a quality improvement software tool that uses a common structure and language to help users identify, understand, compare, evaluate, and select measures to assess and improve clinical performance. CONQUEST is comprised of two databases—one for clinical performance measures and one for conditions. Among other areas of concentration, CONQUEST includes measures linked to conditions such as anxiety disorder, depression, behavioral problems, and panic disorder; measures linked to procedures such as electroconvulsive therapy; measures adaptable for use with Alzheimer's disease, bipolar disorder, bulimia nervosa, schizophrenia, and substance abuse; and condition reports for Alzheimer's disease, depression, substance abuse, and schizophrenia. The development of CONQUEST was funded by AHRQ. Users are referred to the National Quality Measures Clearinghouse™ for the most current evidence-based quality measures and measure sets available to evaluate and improve the quality of health care. Go to: http://www.qualitymeasures.ahrq.gov .

PI: Bruce L. Rollman, M.D., M.P.H., University of Pittsburgh
Grant No.: R01 HS09421
Grant Period: 9/30/96-3/31/00
Title: Depression Care Using Computerized Decision Support

Description: The objective of this research was to develop and implement a computerized decision-support system that prompts primary care physicians (PCPs) to implement treatment recommendations based on the AHRQ-sponsored practice guideline on depression in primary care and, subsequently, to conduct a randomized clinical trial of the clinical outcomes and costs of providing care this way. The researchers studied 240 patients with a current episode of major depression, as evaluated by the Primary Care Evaluation of Mental Disorders (PRIME-MD), and presenting to an urban academic medical center. Researchers also hoped to evaluate the effects of disseminating the depression guideline by computer on physicians' knowledge, attitudes, and practices.

Findings: The electronic medical record (EMR) is an efficient method by which to disseminate clinical practice guidelines and to direct utilization by PCPs. The PRIME-MD is an efficient method by which to screen and identify patients with major depression in a busy primary care practice. Once patients have been screened for major depression using the PRIME-MD, disseminating a treatment guideline via an EMR system to those PCPs who agree with the diagnosis is helpful but may be insufficient for improving treatment outcomes for psychiatric illness, especially when compared to more labor-intensive interventions. However, electronic notification of the diagnosis of major depression can increase the likelihood that a PCP will initiate a clinical response. Busy PCPs will respond to electronic notification messages concerning the psychiatric morbidity of their patients and recommend a mental health intervention. PCPs agreeing with the diagnosis were found to initiate pharmacotherapy treatment more quickly when given electronic reminders, although rates of referral to mental health specialists were not affected.

PI: Barbara Starfield, M.D., M.P.H., Johns Hopkins University
Grant No.: R01 HS07045
Grant Period: 2/1/92-1/31/96
Title: Development of an Adolescent Health Status Measure

Description: This study refined a previously developed health status measure, the Child Health and Illness Profile (CHIP), for adolescents. The CHIP-Adolescent Edition (CHIP-AE™) was intended as a self-administered comprehensive health status measure, examining health, well-being, and functional status. The researchers assessed the reliability and validity of the instrument by testing it on samples of adolescents aged 11-17 years from eight urban middle and high schools in Appalachia and the rural South and from three hospital clinics for children with chronic illness and two acute illness clinics of two hospitals.

Findings: The study was successful in developing, validating, and making available a feasible and practical tool (the CHIP-AE™) for assessing the health status of 11- to 17-year-olds across a comprehensive range of domains. The six domains address health-related characteristics, including functional status and quality of life. They are discomfort, disorders, satisfaction with health, achievement of social expectations (development appropriate to age), resilience, and risks. The discomfort domain includes a number of internalizing mental health components, and the disorders domain includes psychosocial components. Many of the other domains incorporate both mental and physical health together to assess health status. The CHIP-AE™ is designed for self-administration in both community and clinical settings, is person focused rather than disease focused, and can be used to assess changes occurring over time or in response to health services interventions targeted at groups of adolescents. The executive summary and final report are available for a fee from the National Technical Information Service, 800-553-NTIS. The NTIS accession no. is PB96-182563.

PI: Pamela G. Williams-Russo, M.D., Hospital for Special Surgery, New York
Grant No.: R01 HS06530
Grant Period: 1/1/92-12/31/95
Title: Assessment-Validation of Cognitive Function Scale

Description: The purpose of this study was to develop a multi-item scale of cognitive functional status that can be used in practice and research to evaluate change in cognitive function in the elderly and that can be integrated with other patient-centered measurements of functional status and well-being. The researchers tested the reproducibility, validity, and responsiveness of the scale and integrated the results with those obtained using the Medical Outcomes Study instrument (SF-36) and results from formal neuropsychologic testing. The researchers compared interviews of patients with a low comorbidity index, patients with a high comorbidity index, and patients pre- and post-coronary artery bypass surgery. All patients were over the age of 65.

Findings: No findings are available at this time.

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Trauma

PI: Edward E. Cornwell III, M.D., Howard University (Small Conference Grant)
Grant No.: R13 HS07854
Grant Period: 6/1/93-5/31/94
Title: Urban Trauma: Prevention, Acute Care, Economic Impact

Description: The purpose of this conference was to examine issues in traumatic injuries, especially intentional injuries and those secondary to interpersonal violence. These issues were discussed at length by experts and were the subject of questions for further research and of strategies for addressing the problem. The results of the conference were to be distributed to a specific target audience including health care providers and others with interest in intentional injury.

Findings: No findings are available at this time.

PI: Sureyya S. Dikmen, Ph.D., University of Washington
Grant No.: R01 HS06497
Grant Period: 8/1/91-7/31/95
Title: Head Injury Outcome

Description: This study examined the determinants of head injury outcome and the factors that predict outcomes. The factors considered include severity of the injury, source of payment, basic demographics, pre-existing conditions, and use of rehabilitation services. The study analyzed results of three longitudinal studies of head injury outcomes, involving 500 adult head-injured cases and 280 comparison subjects followed for 1 to 2 years prior to injury.

Findings: Outcomes are closely related to the severity of the brain injury and also to pre-injury characteristics of the individual, as well as other injuries sustained in the same accident. Disruptions are most prevalent early on, but with recovery, most of the mildly injured do well by 1 year; with increasing severity, the probability of permanent disability and partial or complete dependence on others increases. Pre-injury alcohol abuse was frequent, with 42 percent of the patients legally intoxicated while in the emergency department. Alcohol problems had decreased sharply 1 month after injury, but after 1 year, drinking was almost to the level of the year preceding injury. The researchers suggest the 1-month period immediately after injury may be a natural window of opportunity in which to treat alcohol problems. Within the study, patients who received treatment for alcohol abuse after head trauma decreased the amount they drank per sitting from 6.4 to 3.0 drinks, compared with a decrease of 3.5 to 2.0 drinks for patients who did not receive treatment.

PI: Troy L. Holbrook, Ph.D., University of California, San Diego
Grant No.: R01 HS07611
Grant Period: 8/1/93-7/31/99
Title: Prospective Study of Functional Limitation After Trauma

Description: Using the computerized San Diego County Regional Trauma System Registry (TREG) trauma patient database, this prospective epidemiologic study determined the incidence and predictors of functional limitation after major trauma in approximately 1,200 men and women admitted to the University of California, San Diego (UCSD) Trauma Center. Functional limitation after major trauma was measured using the Quality of Well-Being (QWB) scale at four time points; at discharge and 6, 12, and 18 months after discharge. Predictors measured include: (1) injury severity and body area(s) injured, (2) clinical course and treatment of the trauma, (3) sociodemographic characteristics, (4) social support, and (5) post-injury psychological sequelae, including depression and post-traumatic stress disorder.

Findings: Victims of major trauma as a whole are a significantly disabled group 6 months after the trauma, with only 11 percent back to the quality of well-being (QWB) they had prior to the traumatic injury. Those most likely to have lower quality of life 6 months after injury are those who suffered post-injury depression, post-traumatic stress disorder, or serious extremity injury and those who had a longer hospital stay. QWB scores (which measure mobility, physical activity, and social activity) before injury reflected the norm for a healthy adult population (mean of 0.81). However, QWB scores reflected significant functional limitation at discharge (mean of 0.401) and at 6-month followup (0.633). In fact, only 11 percent of patients 6 months after injury had QWB scores above 0.800. In contrast, activities of daily living (ADL) scores showed only moderate dysfunction at discharge (mean of 30) and at 6-month followup (mean of 15). The authors conclude that the QWB yields a more sensitive assessment of functional status of trauma victims than traditional ADL instruments.

PI: Troy L. Holbrook, Ph.D., University of California, San Diego
Grant No.: R01 HS09707
Grant Period: 9/30/98-9/29/03
Title: Study of Functional Outcome After Trauma in Adolescents

Description: This study seeks to determine the incidence and determinants of functional limitation following major trauma in adolescents. This prospective epidemiologic study utilizes the trauma patient database of the San Diego County Regional Trauma System Registry to determine the incidence and factors influencing functional limitation in 525 male and female adolescents aged 12-17 years admitted to six trauma centers in San Diego County. Functional limitation is measured using the Quality of Well-Being (QWB) scale. Possible predictors of functional limitation include post-injury psychological sequelae such as depression and post-traumatic stress disorder.

Findings: No findings are available at this time.

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Violence

PI: Jacqueline S. Dienemann, Ph.D., R.N., Georgetown University School of Nursing
Grant No.: R03 HS10731
Grant Period: 9/30/99-3/30/01
Title: Domestic Violence Assessment and Intervention

Description: The purpose of this study was to: (1) determine the validity and reliability of the Domestic Violence Survivor Assessment (DVSA) tool, which profiles a survivor's perceptions of her relationship, the violence, and herself, and identifies a survivor's primary motivation for change; (2) identify survivor preferences for clinical intervention; and (3) develop a domestic violence clinical pathway.

Findings: The researchers have validated the DVSA screening tool. The DVSA instrument is being used as part of assessment in other research on battered women. The Montgomery County, M.D., Department of Abused Persons and the House of Ruth in Baltimore arranged to use the DVSA for their counseling and victim assistance outcomes and shelter outcomes, respectively. The researchers also developed a clinical pathway, formatted as a 2-page foldout, for treatment after disclosure of intimate partner violence. Copies of the pathway have been sent to a review panel and members of Nursing Network on Violence Against Women International. The tool is fully described in the March 2002 Patient Education and Counseling Journal (46(3):221-8). Information can also be obtained on the AHRQ Web site.

PI: Emalee G. Flaherty, M.D., Children's Memorial Hospital, Chicago
Grant No.: R03 HS09811
Grant Period: 3/1/98-2/28/99
Title: Childhood Injuries Evaluated in the Office Setting

Description: This study examined instruments for assessing pediatric office management of injuries in children and recognition, reporting, and management of suspected child abuse by pediatricians in the office setting. This effort focused on three goals: (1) determining the incidence of suspected child abuse injuries seen in an office setting, (2) determining management and scope of childhood injuries seen in an office setting, and (3) testing the feasibility of the research design and instruments for a nationwide study. Health care providers in a regional practice-based network completed written survey forms about their experience in treating child abuse. The same providers then collected information prospectively about consecutive office encounters. They recorded detailed information about injury-related visits involving about 659 injuries treated during 12,510 office encounters.

Findings: Primary care physicians (PCPs) had "some suspicion" that 21 percent of the childhood injuries they evaluated were caused by abuse. Injuries not compatible with the child's medical history and parental delays in seeking medical care for the injury were red flags that raised doctors' suspicions of abuse. Suspicion of abuse was also more likely to be associated with higher injury severity, age less than 6 or 7 years old, Medicaid or self-pay health care, family risk factors for abuse such as domestic violence or substance abuse, and more recent physician education about child abuse. PCPs were more likely to suspect abuse of Hispanic or black children and children whose mothers had less than a college education. Most but not all cases were reported. PCPs cited past negative experiences with child protection agencies and perceived lack of benefit for the child as reasons for not reporting.

PI: Emalee G. Flaherty, M.D., Children's Memorial Hospital, Chicago
Grant No.: R01 HS10746
Grant Period: 9/30/01-9/29/05
Title: Child Abuse Reporting Experience Study (CARES)

Description: This prospective study of practitioner management will provide the first comprehensive description and analysis of the management of suspected child abuse (SCAN) in primary care practices. Data will be collected on 16,000 childhood injuries in the Pediatric Research in Office Setting (PROS) Network using a protocol that is derived from one that was piloted in a regional practice-based research network. The data collected will be used to address the following specific aims concerning the care of SCAN by primary care providers (PCPs): (1) identify PCP-related factors that affect identification of maltreatment, (2) identify PCP-related factors that affect management of any suspicious injuries, and (3) assess the validity of PCP management of childhood injuries.

Multivariate logistic regression modeling will be used to develop a robust model of PCP decisionmaking concerning SCAN. This study will provide the most thorough description ever of SCAN in primary care, thus providing important data needed for both research and policy in the area of child abuse identification and management.

Findings: No findings are available at this time.

PI: Lise E. Fried, Health and Hospitals of the City of Boston (Dissertation Grant)
Grant No.: R03 HS08008
Grant Period: 9/30/93-9/29/96
Title: Violence Against Pregnant Women and Pregnancy Outcomes

Description: The purpose of this study was to investigate the relationship between battering during pregnancy and the neonatal outcomes of the pregnancy, such as incidence of low-birth-weight babies and infant mortality. The study also sought to investigate the lives of abused women to achieve a greater understanding of the violence and its impacts.

Findings: This dissertation is not available to date.

PI: Janet Y. Groff, M.D., Ph.D., University of Texas Health Sciences Center, Houston
Grant No.: R01 HS11079
Grant Period: 9/30/00-8/31/04
Title: Treatment Outcomes for Abused Women in Public Clinics

Description: The objectives of this study are to create, administer, and test the proficiency of nurse case management and group education for African-American, Hispanic, and white abused women in inner-city primary care clinics and to analyze the effect of such intervention on the health and medical utilization of abused women's children.

Findings: No findings are available at this time.

PI: S. Paige Hall, M.S.P.H., Durham, NC (Dissertation Grant)
Grant No.: R03 HS06944
Grant Period: 8/1/91-5/31/93
Title: Intimate Relationship Abuse Perception Scale

Description: This research attempted to create and validate an Intimate Relationship Abuse Perception (IRAP) Scale by which the researchers could measure the degree to which battered women believe they have experienced intimate relationship abuse, including not just physical abuse but also sexual and psychological abuse. The scale was incorporated into a women's health survey and distributed to 150 women, both abused and nonabused, allowing the women themselves to rate their own health status including the IRAP measures.

Findings: No findings are available at this time.

PI: Laurel K. Leslie, M.D., Children's Hospital Research Center (Small Meeting Grant)
Grant No.: R03 HS09563
Grant Period: 9/30/97-9/29/99
Title: Medicaid Changes: Impact on At-Risk Children

Description: The goal of this study was to assess the impact of enrollment in Medicaid managed care on families at risk for child abuse and neglect concerning their access to primary care services as well as the effectiveness of the protective effect offered by home visitation services. The study sampled 448 mothers and their infants identified at delivery as at-risk who participated in a trial of home visitation services in San Diego County.

Findings: No findings are available at this time.

PI: Wendy Levinson, M.D., University of Chicago
Grant No.: R01 HS11096
Grant Period: 9/30/00-8/31/03
Title: An RCT of Computer Screening for Domestic Violence

Description: This randomized controlled trial aims to test the use of a self-administered computer health risk assessment of domestic violence (ED Prevent) to alert physicians of patients' high-risk behaviors. The study is being conducted in two emergency departments, one urban and one suburban, and will screen 800 women patients. The study also examines the outcomes of the utilization of ED Prevent concerning communication, discussion, and referral of domestic violence.

Findings: No findings are available at this time.

PI: Laura McCloskey, Ph.D., Harvard University School of Public Health
Grant No.: R01 HS11088
Grant Period: 9/30/00-8/31/05
Title: The Cost and Benefits of Intervening: Battered Women's Health Over Time

Description: The purpose of this study is to compare the impact of interventions, either by staff training or by in-house service programs, on the mental and physical health of abused women, as well as to assess the long-term health care utilization of the women. The study will track at least 400 women from several hospitals in Boston over a period of 4 years. The study will compare the medical costs of violence to both the cost to the physical and mental health of the women and the potential cost to society as a whole.

Findings: No findings are available at this time.

PI: Naomi Pless, M.D., University of Rochester
Grant No.: R03 HS11490
Grant Period: 9/1/01-8/31/02
Title: Domestic Violence: Pilot Detailing of Physicians

Description: Multimodal educational outreach, which has been shown to improve physician performance in areas other than domestic violence (DV), may be an effective tool for training physicians to screen and manage DV in primary care. Therefore, this study will: (1) evaluate the feasibility of an onsite multimodal intervention designed to improve physician screening and management of DV in primary care; (2) evaluate the impact of the intervention on physician attitudes, knowledge, behavior, and office systems regarding detection and management of DV; and (3) evaluate the feasibility of using simulated patients (SPs) to assess physician skills for screening and managing DV. This team will use multimodal educational outreach to four family practice physicians regarding appropriate screening and management of DV. A trained DV detailer will make periodic office visits to educate the physician and staff on appropriate screening and management of DV. The feasibility of this approach will be evaluated using quantitative and qualitative methods, including physician and patient surveys, chart reviews, simulated patients, semi-structured interviews with physicians and staff, DV detailer notes, and review of audiotapes of detailing sessions, SP visits, and physician and staff interviews.

Findings: No findings are available at this time.

PI: Michael Rodriguez, M.D., M.P.H., University of California, San Francisco
Grant No.: R01 HS11104
Grant Period: 9/30/00-9/29/04
Title: Outcomes for IPV: Patient and Provider Perspectives

Description: The aims of this project are to quantify patient preference for potential health care outcomes for intimate partner violence (IPV) interventions, to quantify provider preference for potential health care outcomes for IPV interventions for their patients, and to determine the preference differences between patients and their providers. The project aims broadly to determine the short- and long-term health care outcomes for IPV interventions within the health care settings. The study will focus primarily on women of low socioeconomic status and minority women, specifically Latina women, who are receiving prenatal care from the public sector.

Findings: No findings are available at this time.

PI: Diana Shye, Ph.D., Kaiser Foundation Research Institute
Grant No.: R03 HS09525
Grant Period: 6/1/97-5/31/99
Title: Domestic Abuse, Health Status, and HMO Health Care Use

Description: The purpose of this research was to analyze existing data sets of adult and child health maintenance organization (HMO) members to examine the relationship among exposure to domestic violence, health status, and the utilization and costs of health care services. The researchers used data from the Kaiser Permanente Northwest Region, a not-for-profit prepaid group practice HMO consisting of about 400,000 members. Researchers compared three populations: adults aged 18 years or more; women aged 18-49 years; and children aged 4-17 years.

Findings: A little over 12 percent of participants reported exposure to either verbal or physical abuse by someone close within the prior year, although only 2.3 percent reported any physical abuse. Both types of abuse were more common for women than for men, especially those aged 18-49 years. Abuse was also more common for the unmarried and those living without partners than for the married or those living with partners. Participants exposed to abuse were significantly more likely to report high levels of ill health and functional limitations and less likely to report high levels of good health and absence of functional limitations. Participants exposed to abuse were also 3 to 4 times more likely to report high levels of depressive symptoms. Participants exposed to domestic violence (DV) were more likely to use outpatient specialty mental health care, to obtain prescriptions for antidepressants and anxiolytic medications, and to make outpatient visits and use emergency room or urgent care services. DV-exposed adults had higher primary care costs (5 percent) than non-exposed participants, and DV-exposed women aged 18-49 years had higher overall utilization costs (12 percent) than those not exposed to DV. The results of the child sample were inconclusive.

PI: Meredith N. Silverstein, M.S., University of Colorado Health Science Center (Dissertation Grant)
Grant No.: R03 HS11269
Grant Period: 9/30/00-9/29/02
Title: Intimate Partner Violence and Pregnancy in Primary Care

Description: The purpose of this research is to determine the prevalence of and factors contributing to interpersonal physical violence during pregnancy in a primary care population. The study proposes to administer surveys to about 1,600 pregnant women presenting for care in a primary-care-practice-based research network. The study also proposes to establish a set of easily detectable markers of an increased risk of abuse during pregnancy to be provided to primary care practitioners.

Findings: No findings are available at this time.

PI: Ellen Taliaferro, M.D., Parkland Foundation, Dallas, TX
Grant No.: R13 HS11837
Project Period: 6/1/01-5/31/02
Title: First National Conference on Medical Care and Domestic Violence

Description: This conference will provide a forum for discussion and dissemination of current research on the treatment of domestic violence in areas of medical and psychiatric care. The goals of the meeting are to improve the quality and effectiveness of general medical and psychiatric care delivered to victims and the health care system's ability to provide high-quality care. An integrated research agenda framework will be developed.

Findings: No findings are available at this time.

PI: Robert Thompson, M.D., Center for Health Studies, Seattle
Grant No.: R01 HS07568
Grant Period: 3/1/95-5/17/98
Title: Domestic Violence Identification: Outcomes/Effectiveness

Description: This study was designed to help primary care providers identify and treat victims of domestic violence (DV). The researchers tested a clinic-level intensive educational campaign to help physicians and other caregivers recognize adult patient injuries and other medical conditions, such as depression or chronic pain syndromes, that may be the result of DV. Another goal of the project was to identify ways to improve the overall management of cases involving DV. The project was conducted in four outpatient clinics of Group Health, a large staff-model health maintenance organization serving Washington State and Idaho, with special training provided in two of the clinics (ICs), while the other two clinics served as controls (CCs). The effects of the program on uncovering DV and the costs for implementing the DV intervention program were assessed.

Findings: A high percentage of clinicians and nurses/assistants believed that incidence of DV in their practices was low, and many had never identified an abused person. Forty-five percent of clinicians either never or seldom asked about DV when examining a patient, and all participants were more confident in asking about smoking habits or consumption of alcohol than about DV. Many participants believed that they lacked the strategies and management information to deal with DV and abused persons. The intervention had very positive effects on providers' self-efficacy and three other domains at 9 months, with sustained positive effects on self-efficacy, fear of offense, and safety concerns at 21 months. Record-based results at 1 year of followup were as follows: recorded asking about DV increased by 14.3 percent absolute, which was fourfold higher than the CC change; case-finding increased 1.3-fold in the ICs compared with the CCs; and quality of recorded management did not change.

PI: Robert Thompson, M.D., Center for Health Studies, Seattle
Grant No.: R01 HS10909-01
Grant Period: 4/1/02-3/31/06
Title: Long-term Health Care Effects of Domestic Violence

Description: These researchers will assess the longitudinal impact of domestic violence (DV) on the health care cost and utilization of women and their children over an 11-year period. The main outcomes to be examined are health care costs, utilization rates and patterns (from International Classification of Diseases codes), physical health status, mental health status, social functioning, and risk profiles. The methodology includes a population-based telephone survey of a random sample of 6,667 women 18-64 years who have been Group Health Cooperative enrollees over the last 3 years to establish the presence or absence of DV.

Findings: No findings are available at this time.

PI: Mary Zachary, M.D., Montefiore Medical Center
Grant No.: 1 K08 HS011297
Grant Period: 10/1/02-9/30/07
Title: Cost Effectiveness of Domestic Violence Interventions

Description: The goals of this project are to: (1) investigate the effectiveness of domestic violence intervention components; (2) establish a methodology to define outcome measures for domestic violence interventions that incorporate patient, community, and expert viewpoints; (3) explore the feasibility of monitoring these outcomes measures with a longitudinal cohort study; (4) based on outcomes of the first three goals, create a methodology for a cost-benefit analysis of domestic violence interventions; and (5) use the results of this project as the basis for an R0l application to investigate the cost effectiveness of primary-care-based domestic violence interventions in a controlled clinical trial. Accomplishment of Goal 5 will provide the foundation for the candidate's career development as an independent investigator.

Findings: No findings are available at this time.

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