Violence Prevention Training for Maternal Death Reduction

Overseen By Ashley Roark, BS

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Kentucky

Disqualifiers: Not in helping program, Age, No patient interaction

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

2800 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment for reducing maternal deaths due to violence?

Research shows that broad violence prevention efforts can help reduce maternal deaths from both obstetric and violent causes. Studies have found that states with higher violent crime rates have higher maternal mortality, suggesting that violence prevention could be beneficial. ^{1 2 3 4 5}

How does the violence prevention training treatment differ from other treatments for reducing maternal deaths?

This treatment is unique because it focuses on preventing violence, such as homicide and suicide, which are significant contributors to maternal deaths. Unlike traditional medical treatments that address obstetric causes, this approach involves collaboration with social services and the criminal justice system to address social determinants of health and prevent violence. ^{1 3 4 5 6}

What is the purpose of this trial?

The goal of this observational study is to create and rigorously evaluate a violence intervention and prevention corps (VIP Corps) training using a randomized controlled trial among undergraduate and professional students; and to develop a novel maternal injury surveillance system (MISS) to complement an existing maternal violent death registry in Kentucky.

Research Team

Ann L. Coker, PhD, MPH

Principal Investigator

University of Kentucky

Eligibility Criteria

This trial is for students aged 18-30 who are in their senior year of a helping professions program and will interact with patients or clients that may experience interpersonal violence. It's not open to those outside this age range, not enrolled in such programs, or without direct patient interaction.

Inclusion Criteria

I am a senior student in a helping professions program.

Students whom will have direct interaction with patients or clients that may experience interpersonal violence (IPV)

Exclusion Criteria

I am a student and either younger than 18 or older than 30.

Students not enrolled in a helping professions program

Students with no direct interaction with patients or clients

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training Intervention

Participants undergo VIP Corps online training to identify, intervene, and prevent maternal injuries from interpersonal violence and substance use/disorder.

2 years

Surveillance System Development

Development of a novel Maternal Injury Surveillance System (MISS) to complement the existing maternal mortality surveillance.

2 years

Follow-up

Participants are monitored for changes in knowledge and attitudes toward intimate partner violence, substance use, and anxiety or depression.

2 years

Treatment Details

Interventions

• Implementation and Effectiveness of VIP Corps Training
• Kentucky Violent Death Reporting System

Trial Overview The study is testing the implementation and effectiveness of Violence Intervention and Prevention (VIP) Corps Training among undergraduate and professional students. Additionally, it aims to develop a Maternal Injury Surveillance System alongside Kentucky's maternal death registry.

Participant Groups

Group I: Maternal Injury and Death Intervention Experimental Treatment 1 Intervention

Our research team created a VIP Corps online, interactive learning management system (LMS) training. This VIP Corps online training will be offered to students enrolled in a helping profession. Students are randomized to this experimental intervention arm. This training seeks to provide helping professionals with information and resources to identify, intervene, and prevent maternal injuries from interpersonal violence, substance use/disorder (IPV and SU/D). This training will provide students with the knowledge, skills, and efficacy to intervene and build capacity for prevention of maternal injuries and death due to violence.

Group II: Development of a Maternal Injury Surveillance System Active Control 1 Intervention

Proposal of a novel Maternal Injury Surveillance System (MISS) as a complement to the existing maternal mortality surveillance available within Kentucky Violent Death Reporting System (KVDRS)

Who Is Running the Clinical Trial?

University of Kentucky

Lead Sponsor

Trials

198

Recruited

224,000+

Ann Coker

Lead Sponsor

Trials

3

Recruited

8,200+

Department of Health and Human Services

Collaborator

Trials

240

Recruited

944,000+

Findings from Research

In a study of 309 pregnancy-associated deaths in Virginia from 1999-2005, nearly 30% were due to violent causes, with homicide being the leading cause of death, especially among Black women who experienced homicide at a rate 4.5 times higher than White women.

The findings highlight the urgent need for improved maternal death surveillance, initiatives to combat violence against women, and universal screenings for domestic or interpersonal violence to enhance safety for pregnant individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pregnancy-Associated Deaths in Virginia Due to Homicides, Suicides, and Accidental Overdoses Compared With Natural Causes. Bronson, J., Reviere, R.[2019]

In a study of 41 injury-related maternal deaths, over half (51.2%) of the women were known or suspected to have experienced domestic violence, highlighting a significant issue in maternal health.

Obstetric providers were often unaware of the domestic violence and depression affecting these women, with only one third of intimate partner homicides recognized as related to abuse, indicating a need for better screening and awareness in maternal care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Violent maternal deaths in North Carolina. Parsons, LH., Harper, MA.[2019]

The study found that higher rates of violent crime in 17 states were associated with increased rates of both pregnancy-related mortality and pregnancy-associated homicide, indicating a potential link between community violence and maternal health risks.

Implementing broad violence prevention strategies could be an effective approach to reduce maternal mortality from both obstetric-related causes and violent deaths during and after pregnancy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Violence As a Direct Cause of and Indirect Contributor to Maternal Death. Wallace, ME., Friar, N., Herwehe, J., et al.[2021]

Maternal homicide is a significant contributor to maternal mortality, with reported rates ranging from 0.97 to 10.6 per 100,000 live births, and is particularly high in the US compared to other countries.

Women at risk of maternal homicide are often younger, from minority ethnic groups, and unmarried, with domestic violence being a major risk factor, highlighting the need for effective screening and identification of vulnerable individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Homicide in pregnant and postpartum women worldwide: a review of the literature. Cliffe, C., Miele, M., Reid, S.[2019]

In Illinois, homicide, suicide, and substance abuse accounted for nearly 25% of pregnancy-associated deaths from 2002 to 2013, highlighting a significant public health issue that has been under-researched compared to obstetric and medical causes.

A new maternal mortality review committee was established to focus on violent deaths, incorporating diverse expertise and additional data sources to identify preventable factors and improve prevention strategies, demonstrating a proactive approach to addressing these tragic outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Addressing maternal deaths due to violence: the Illinois experience. Koch, AR., Geller, SE.[2018]

From 2003 to 2007, the study found that pregnancy-associated homicide and suicide rates were 2.9 and 2.0 deaths per 100,000 live births, respectively, highlighting their significant contribution to maternal mortality.

A notable percentage of these deaths were linked to intimate partner violence, with 54.3% of suicides and 45.3% of homicides associated with such conflicts, indicating a critical area for intervention and support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Homicide and suicide during the perinatal period: findings from the National Violent Death Reporting System. Palladino, CL., Singh, V., Campbell, J., et al.[2023]

References

1. United States pubmed.ncbi.nlm.nih.gov

Pregnancy-Associated Deaths in Virginia Due to Homicides, Suicides, and Accidental Overdoses Compared With Natural Causes. [2019]

2. United States pubmed.ncbi.nlm.nih.gov

Violent maternal deaths in North Carolina. [2019]

3. United States pubmed.ncbi.nlm.nih.gov

Violence As a Direct Cause of and Indirect Contributor to Maternal Death. [2021]

4. England pubmed.ncbi.nlm.nih.gov

Homicide in pregnant and postpartum women worldwide: a review of the literature. [2019]

5. United States pubmed.ncbi.nlm.nih.gov

Addressing maternal deaths due to violence: the Illinois experience. [2018]

6. United States pubmed.ncbi.nlm.nih.gov

Homicide and suicide during the perinatal period: findings from the National Violent Death Reporting System. [2023]