Tiwari and colleagues (2005) conducted a randomized controlled trial from May 2002 to July 2003 to evaluate the impact of the empowerment intervention. The women selected were over the age of 18 and were at less than 30 weeks’ gestation. They were informed of the study at their first antenatal appointment at a public hospital in Hong Kong.
The women were assessed using the Abuse Assessment Screen to determine the extent of their abuse. With this screening tool, women who answered “yes” to being emotionally or physically abused by their male partner were selected to be involved in the program. Tiwari and colleagues chose 110 women to participate in the study, who were randomly assigned to the experimental or control group, comprising 55 women each. The experimental group had an average age of 30 years. Of this group, 26 reported that the pregnancy was planned, 6 were smokers, 4 used alcohol, and 1 abused drugs. Twenty-four of the women were first-time mothers, and 48 were married, with the average length of marriage reported to be 4.3 years. Five women were single, and two were divorced. The control group had an average age of 31. Of this group, 28 reported that the pregnancy was planned, 6 were smokers, 2 used alcohol, and 2 abused drugs. Twenty-five of the women were first-time mothers, and 52 were married, on average for 5.4 years. Three women were single, and none were divorced. The experimental group received the full range of services from the program. The control group received standard care for abused women, which involved distributing a wallet-sized card on community resources for abused women, such as hotlines for women’s shelters, and contact information for law enforcement, social services, and nongovernmental organizations. The entire study was conducted without the presence of the woman’s partner.
Follow-up was done 6 weeks after delivery of the woman’s baby and was conducted via telephone. Four women were not available for the follow-up, so a total of 106 women completed the study. The main focus of the follow-up interview was how conflicts between the couple were handled since the administration of the program. The researchers examined the level of intimate partner violence as the primary outcome of the study; they examined health-related quality of life and levels of postnatal depression as secondary outcomes. The mean values for these measures were compared to their preintervention and postintervention measures for both groups.
The level of intimate partner violence was assessed through the Conflict Tactics Scale, a self-report scale listing 19 behaviors that may occur during conflicts. The questionnaire included questions about reasoning, psychological abuse, and physical violence. For this particular study, a question on sexual abuse was added, and physical violence was divided into two categories, distinguishing between minor and severe violence. The women were asked to report the frequency of these behaviors with their partner over the past year. A seven-point scale was used, where
- 0 = never
- 1 = once
- 2 = twice
- 3 = 3–5 times
- 4 = 6–10 times
- 5 = 11–20 times
- 6 = 20 or more times
Health-related quality of life was assessed using the Short Form Health Survey, which had questions divided into eight categories: physical functioning, role limitation due to physical health problems, bodily pain, general health, vitality, social functioning, role limitation due to emotional health problems, and mental health. These scores were graded on a scale from 0 to 100, where higher scores indicated a higher health-related quality of life.
Postnatal depression was assessed using the Edinburgh Postnatal Depression Scale. A cutoff score of 9 out of 10 was recommended for screening depressive illness in a Chinese postnatal population.