Healing Through Education, Advocacy and Law (HEAL) to Respond to Violence

Dates: 7/1/2016 - 12/31/2019


Role: Hugh F. Crean, PhD : Co-Investigator
Principal Investigator: Catherine Cerulli

Patients, an academic medical center, and community-based organizations partnered to address intimate partner violence (IPV) in a study evaluating a social work consult versus a community health worker to help patients prioritize and navigate care. As a public health crisis, IPV affects patients who suffer from poor health, increased depression, and poor quality of life. They have complex needs and many of their social, emotional, and legal concerns that impede their health remain unaddressed when seeking medical care, resulting in emergency department visits and increased medical burden. Project Rose-SAFE (Stop Abuse in the Family Environment), is a comparative effectiveness trial for health care patients with depression and IPV experiences. The longitudinal study will compare safety, depression, health function and quality of life for IPV patients referred to a social worker (CAU-SW) (n=100), to those who receive an augmentation with our previously tested intervention, Personalized Support for Progress (PSP)(n=100). PSP uses a community health worker (CHW) who guides patients through a prioritization tool to identify resources they value as important, including social, emotional, and legal assistance, and provides them with support to connect with those resources they choose. We chose these two evidence-based interventions after a multi-year process gaining patient, provider, and researcher insight. A Community Advisory Board (CAB) selected the outcomes and will remain involved in every aspect of the project. University of Rochester Medical Center’s Emergency, Obstetrics & Gynecology, Pediatric, and Psychiatry Departments and a Primary Care Network (27 locations) will screen patients for IPV per routine policies. Should a patient endorse violence, the healthcare provider will refer the patient to HEAL, a clinic where a social worker will offer safety planning and screening via Promote. This computer-assisted screening tool assesses for individual needs and provides a personalized referral printout. Following the routine care provided at HEAL, the social worker will invite patients to participate in Project Rose-SAFE if they screen positive for depression and have had an IPV event within 3 months. Those who agree to participate will sign an informed consent, complete baseline measures, and be randomized to CAU-SW alone or CHW-PSP; For patients assigned to CHW-PSP, CHWs will work with patients to address not just the physical, but also the social, emotional, and legal needs impacting their health and wellbeing. A Patient Leadership Team, comprised of IPV survivors and patient partners from the CAB, is involved in the design, conduct, analysis and dissemination of the findings. These study findings will be important to close the gap on how to best treat patients with comorbid IPV and depression. We can deploy our model to busy medical centers via a tool kit to allow for easy dissemination and implementation.