Domestic Violence Enhanced Home Visitation Program (DOVE)
- Need: To reduce violence against pregnant women and women with infants in rural Missouri.
- Intervention: A tool for existing home visiting programs, DOVE is a brochure-based and safety planning intervention for women experiencing interpersonal violence.
- Results: Women receiving the DOVE intervention saw a larger average decrease in number of violent incidents than women in the control group.
The Domestic Violence Enhanced Home Visitation Program (DOVE) was a randomized controlled trial to determine the effectiveness of incorporating interpersonal violence (IPV) screening and safety plans into home visits. Pregnant women in the control group and DOVE intervention group received home visits before the baby was born until the baby was two years old.
The DOVE study served women from 12 Missouri counties, 9 of which are rural, and was funded by the National Institute of Nursing Research.
Every woman in the 2006-2012 study received 4-6 home visits before the baby was born and 6-12 visits in the two years after the baby was born. The DOVE intervention was delivered 3 times during pregnancy and 3 times postpartum. Women were eligible for the DOVE trial if they were:
- 14 years old or older
- Pregnant for less than 32 weeks
- Experiencing IPV by a current or past partner within the year before pregnancy
- Enrolled in a perinatal home visiting program
Participating women received a brochure during their regular home visits (about 15-25 minutes long). The brochure contained information about the cycle of violence, the Danger Assessment (assessing one's risk of being killed by a partner), safety planning, community resources like safe houses, and national hotline information.
Home visitors tailored the DOVE intervention to the participant's needs and sense of danger at each visit. Home visitors helped participants develop a safety plan.
The study measured levels of IPV against 239 women, from 13 rural health agencies in Missouri and the health department in Baltimore. In the Missouri sites, 67 women received usual care (IPV screening and referral) and 80 women received the DOVE intervention until 3 months postpartum. Women in the DOVE groups reported a larger decrease in IPV (an average of 20-40 fewer incidents of violence) than the usual care groups by 2 years into the study.
Researchers also found that the retention rate of study participants was higher at the rural sites, with the exception of the 12-month check-in.
% of Rural Respondents
% of Urban Respondents
|At the time of birth||88||86|
|3 months after birth||80||77|
|6 months after birth||74||73|
|12 months after birth||69||71|
|Source: Engaging and Retaining Abused Women in Perinatal Home Visitation Programs|
For more information about the program:
Sharps, P.W., Bullock, L.F., Campbell, J.C., Alhusen, J.L., Ghazarian, S.R., Bhandari, S.S., & Schminkey, D.L. (2016). Domestic Violence Enhanced Perinatal Home Visits: The DOVE Randomized Clinical Trial. Journal of Women's Health, 25(11), 1129-1138.
Sharps, P., Alhusen, J.L., Bullock, L., Bhandari, S., Ghazarian, S., Udo, I.E., & Campbell, J. (2013). Engaging and Retaining Abused Women in Perinatal Home Visitation Programs. Pediatrics, 132, Supplement 2.
Eddy, T., Kilburn, E., Chang, C., Bullock, L., & Sharps, P. (2008). Facilitators and Barriers for Implementing Home Visit Interventions to Address Intimate Partner Violence: Town and Gown Partnerships. Nursing Clinics of North America, 43(3), 419-435.
It can be hard to retain participants, so DOVE coordinators asked women to provide contact information of "safe contacts": trusted people like family or friends whom coordinators can call if they can't reach a participant.
During training, home visitors reported feeling inadequate in talking to women about IPV and helping them. Including role-playing and safety protocol into training sessions can help home visitors feel more confident.
Researchers used the Abuse Assessment Scale and the Women's Experience in Battering scale to screen women for IPV. Screening and referring patients is easier when home visitors have established a relationship with them.
The DOVE intervention can be provided by a nurse or a community health worker who may or may not work in an evidence-based home visiting program. Home visitors, regardless of education level, received 8 hours of training, including information about IPV, role-playing exercises, and safety protocol training (for example, what to do if the partner causing IPV joins the home visit).
For training plans, please reach out to the program contact below or Phyllis Sharps, PhD, RN, FAAN, Associate Dean for Community Programs at Johns Hopkins School of Nursing, at 410.614.5312 or firstname.lastname@example.org.
Contact InformationLinda Bullock, PhD, FAAN, Professor Emerita
University of Virginia
Abuse and violence
Prenatal care and obstetrics
December 13, 2018
Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.