In this study, various forms of coercive control were found to be reduced by about 30% when a nurse visited the home of mothers over the first two years of the baby’s life. The study used the Revised Conflict Tactics Scale to assess the level of psychological aggression, physical assault, sexual coercion and injury. On almost all scales, aggression was reduced by about 30%.
The study was conducted in Holland and worked with a group of 223 low-educated mothers, using the Dutch VoorZorg program. A trusting relationship was established by the nurses who addressed common factors, such as stress, known to increase incidents of domestic violence. Some of the mothers engaged in retributive aggression.
The VoorZorg program is a Dutch adaptation of the Nurse-Family Partnership (NFP) program. NFP studies found positive outcomes of aggression reduction, although much less than this Dutch study. The authors theorized the difference may be due to the fact that nurses in Holland are not mandatory reporters. Because of this, study participants may have been more willing to report abuse.
For studies on NFP, see for example, Olds DL, Eckenrode J, Henderson CR, Kitzman H, Powers J et al. (1997) Long-term effects of home visitation on maternal life course and child abuse and neglect – Fifteen-year follow-up of a randomized trial. J Am Med Assoc 278: 637-643. doi:10.1001/jama. 1997.03550080047038
CSI’s take
Home visits for at-risk groups, mindful of mandatory reporting issues, could be an important component of a local project to reduce domestic violence incidents and intensity. Judges may be able to order nurse, or other home visits, as part of a larger set of techniques in court orders.
Study
Mejdoubi, Jamila, Heijkant, Silvia, Leerdam, F.J.M., Heymans, Martijn, Hirasing, Remy, Crijnen, Alfons (2013), Effect of Nurse Home Visits vs. Usual Care on Reducing Intimate Partner Violence in Young High-Risk Pregnant Women: A Randomized Controlled Trial, PloS one, 8:10:e78185.
Link to full text of study
Abstract
Expectant mothers and mothers of young children are especially vulnerable to intimate partner violence (IPV). The nurse-family partnership (NFP) is a home visitation program in the United States effective for the prevention of adverse child health outcomes. Evidence regarding the effect of nurse home visiting on IPV is inconsistent. This study aims to study the effect of VoorZorg, the Dutch NFP, on IPV. A random sample of 460 eligible disadvantaged women <26 years, with no previous live births, was randomized. Women in the control group (C; n=223) received usual care; women in the intervention group (I; n=237) received usual care plus nurse home visits periodically during pregnancy and until the child’s second birthday. At 32 weeks of pregnancy, women in the intervention group self-reported significantly less IPV victimization than women in the control group in: level 2 psychological aggression (C: 56% vs. I: 39%), physical assault level 1 (C: 58% vs. I: 40%) and level 2 (C: 31% vs. I: 20%), and level 1 sexual coercion (C: 16% vs. I: 8%). Furthermore, women in the intervention group reported significantly less IPV perpetration in: level 2 psychological aggression (C: 60% vs. I: 46%), level 1 physical assault (C: 65% vs. I: 52%), and level 1 injury (C: 27% vs. I: 17%). At 24 months after birth, IPV victimization was significantly lower in the intervention group for level 1 physical assault (C: 44% vs. I: 26%), and IPV perpetration was significantly lower for level 1 sexual assault (C: 18% vs. I: 3%). Multilevel analyses showed a significant improvement in IPV victimization and perpetration among women in the intervention group at 24 months after birth. VoorZorg, compared with the usual care, is effective in reducing IPV during pregnancy and in the two years after birth among young high-risk women. Dutch Trial Register NTR854 http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=854.