Domestic Violence Enhanced Home Visitation Program (DOVE)

Evidence-level

Evidence-Based (About evidence-level criteria)

Description

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 the 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.

Services offered

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:

• English-speaking (now, all DOVE materials are also available in Spanish)
• 14 years old or older
• Low-income
• 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.

Results

The study measured levels of IPV against 239 women, from 13 rural health agencies in Missouri and the health department in Baltimore, Maryland. 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.

For more information about the program:

Burnett, C., Crowder, J., Bacchus, L.J., Schminkey, D., Bullock, L., Sharps, P., & Campbell, J. (2021). "It Doesn't Freak Us Out the Way It Used to": An Evaluation of the Domestic Violence Enhanced Home Visitation Program to Inform Practice and Policy Screening for IPV. Journal of Interpersonal Violence, 36, 13-14. Article Abstract

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), 1129-38.

Burnett, C., Schminkey, D., Milburn, J., Kastello, J., Bullock, L., Campbell, J., & Sharps, P. (2016). Negotiating Peril: The Lived Experience of Rural, Low-Income Women Exposed to IPV during Pregnancy and Postpartum. Violence Against Women, 22(8), 943-65.

Bacchus, L.J., Bullock, L., Sharps, P., Burnett, C., Schminkey, D.L., Buller, A.M., & Campbell, J. (2016). Infusing Technology Into Perinatal Home Visitation in the United States for Women Experiencing Intimate Partner Violence: Exploring the Interpretive Flexibility of an mHealth Intervention. Journal of Medical Internet Research, 18(11), e302.

Bhandari, S., Bullock, L.F.C., Richardson, J.W., Kimeto, P., Campbell, J.C., & Sharps, P.W. (2015). Comparison of Abuse Experiences of Rural and Urban African American Women during Perinatal Period. Journal of Interpersonal Violence, 30(12), 2087-2108.

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), S134–39.

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), 419-35.

Challenges

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.

Replication

Researchers used the Abuse Assessment Screen and the Women's Experience with 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).

A DOVE Information Packet is also available online.

For training plans, please reach out to the program contact below or Phyllis Sharps, PhD, RN, FAAN, Professor Emerita at Johns Hopkins School of Nursing, at 410.382.2917 or psharps1@jhu.edu.

Contact Information

Linda Bullock, PhD, RN, FAAN, Professor Emerita
University of Virginia School of Nursing
573.864.2865
lbullock@virginia.edu