Risk and Protective Factors for Batterer Intervention Treatment Program Attrition: How Completers Are Distinct From Dropouts and No-Shows

Intervention Program Dropout Among Perpetrators of Intimate Partner Violence: A Meta-Analysis of Correlated Variables

Dropout in perpetrator intervention programs (PIPs) is extensively documented in the literature, yet findings across various studies exhibit global inconsistency. This meta-analysis aimed to identify dropout rates among individuals attending PIPs and examine sociodemographic, violence-related, intrapersonal, interpersonal, and external variables related to dropout. A search was conducted across six databases, encompassing studies published between 2010 and 2022 in English, Spanish, or Portuguese. Thirty manuscripts, comprising data from 31 independent samples, were included. Dropout rates varied from 9% to 67%. Bivariate analysis results indicated that younger age (OR = 0.69), non-White ethnicity (OR = 1.54), unemployment (OR = 1.78), offender typology other than family only (OR = 2.45), substance abuse (OR = 1.78), presenting a personality disorder (OR = 1.21), engaging in problematic leisure activities (OR = 1.28), possessing a greater criminal history (OR = 1.47), and experiencing more adversity in childhood (OR = 1.44) were significantly correlated with dropout. Additionally, the inclusion of motivational strategies in treatment (OR = 0.44) significantly decreased the likelihood of dropout. Results from multivariate analyses revealed that younger age (OR = 0.63), presenting a personality disorder (OR = 1.73), and experiencing more adversity in childhood (OR = 2.16) were significantly associated with dropout. Notably, intimate partner violence characteristics established a significant negative relation with dropout (OR = 0.59). Findings indicate that variables associated with dropout align with those related to general and intimate partner violence recidivism, suggesting that individuals requiring more intensive intervention are those who derive less benefit from it.

Adapting the ADVANCE group program for digitally-supported delivery to reduce intimate partner violence by men in substance use treatment: a feasibility study

Introduction

COVID-19 restrictions created barriers to "business as usual" in healthcare but also opened the door to innovation driven by necessity. This manuscript (1) describes how ADVANCE, an in-person group perpetrator program to reduce intimate partner violence (IPV) against female (ex)partners by men in substance use treatment, was adapted for digitally-supported delivery (ADVANCE-D), and (2) explores the feasibility and acceptability of delivering ADVANCE-D to men receiving substance use treatment.

Methods

Firstly, the person-based approach and mHealth development framework were used to iteratively adapt ADVANCE for digitally-supported delivery including conceptualization, formative research, and pre-testing. Then, a non-randomized feasibility study was conducted to assess male participants' eligibility, recruitment, and attendance rates and uptake of support offered to their (ex)partners. Exploratory analyses on reductions in IPV perpetration (assessed using the Abusive Behavior Inventory; ABI) and victimization (using the revised ABI; ABI-R) at the end of the program were performed. Longitudinal qualitative interviews with participants, their (ex)partners, and staff provided an understanding of the program's implementation, acceptability, and outcomes.

Results

The adapted ADVANCE-D program includes one goal-setting session, seven online groups, 12 self-directed website sessions, and 12 coaching calls. ADVANCE-D includes enhanced risk management and support for (ex)partners. Forty-five participants who had perpetrated IPV in the past 12 months were recruited, forty of whom were offered ADVANCE-D, attending 11.4 (SD 9.1) sessions on average. Twenty-one (ex)partners were recruited, 13 of whom accepted specialist support. Reductions in some IPV perpetration and victimization outcome measures were reported by the 25 participants and 11 (ex)partners interviewed pre and post-program, respectively. Twenty-two participants, 11 (ex)partners, 12 facilitators, and 7 integrated support service workers were interviewed at least once about their experiences of participation. Overall, the program content was well-received. Some participants and facilitators believed digital sessions offered increased accessibility.

Conclusion

The digitally-supported delivery of ADVANCE-D was feasible and acceptable. Remote delivery has applicability post-pandemic, providing greater flexibility and access. Given the small sample size and study design, we do not know if reductions in IPV were due to ADVANCE-D, time, participant factors, or chance. More research is needed before conclusions can be made about the efficacy of ADVANCE-D.

Predicting attrition of men with a history of violence from randomised clinical trials

Preventing dropout (attrition) from clinical trials is vital for improving study validity. Dropout is particularly important in justice-involved populations as they can be very challenging to engage and recruit in the first instance. This study identifies factors associated with dropout in a double-blind, placebo-controlled randomised control trial of a selective serotonin reuptake inhibitor (SSRI) aimed at reducing reoffending in highly impulsive men with histories of violent offending. Age, education, social support, psychiatric history, and length of previous incarceration were identified as factors that predict attrition. These findings are consistent with previous research examining variables associated with attrition in clinical trials for community and offender populations. We also explored referral source and treatment allocation as attrition predictors. Although neither significantly predicted attrition, we identified that there are discernible differences in the median time to attrition among the referral source subgroups. Understanding factors that predict treatment completion and attrition will allow researchers to identify participants for whom additional provisions may optimise retention and inform development of targeted interventions.

Methodological Challenges in Group-based Randomised Controlled Trials for Intimate Partner Violence Perpetrators: A Meta-summary

Evidence for treatment effects of group-based Intimate Partner Violence (IPV) perpetrators programmes remains, at best, inconclusive. In the present review, systematic/meta-analytic reviews were used to identify randomised controlled trials and a meta-summary approach was employed to identify methodological challenges in the design and conduct of these trials. Of the fifteen studies identified, seven were comparative effectiveness trials. A range of methodological challenges were also identified by the trialists; source of outcome data, treatment modality, attrition and sample characteristics were the most frequently mentioned. Although there are only a few randomised controlled trials compared to non randomised studies, the findings of both highlight the need to invest in the development of innovative and/or combined IPV treatment programmes to address co-occurring issues such as substance use and trauma. The summary of methodological challenges will provide the first step in the development of methods guidance for researchers working in this area.

Factors impacting attrition of vulnerable women from a longitudinal mental health intervention study

OBJECTIVE

This study explored factors associated with attrition of vulnerable women from a community-based, longitudinal mental health intervention study.

DESIGN

The study employed a quasi-experimental, nonequivalent comparison group pretest-posttest design. The intervention consisted of six, 90-min meetings featuring education and support.

SAMPLE

One hundred and eighteen women aged 18-88 years enrolled from four urban neighborhoods.

MEASUREMENTS

The team used the Generalized Anxiety Disorder-7, the Primary Health Questionnaire-9, a self-care knowledge for anxiety and depression instrument, and demographics to measure variables.

INTERVENTION

Sessions occurred at trusted neighborhood sites. The team provided transportation, child care, and reminder calls or texts. Community health workers actively encouraged participants to continue in the study. The researchers did not offer financial incentives. Completion of the intervention involved attending four of six sessions.

RESULTS

The study had a 39% attrition rate. Results, using a Chi-square test for independence, indicated significant associations between attrition, neighborhood/homelessness, and family income. Additionally, there were significant associations between attrition, a past diagnosis of anxiety, and a lack of concurrent therapy for anxiety/depression.

CONCLUSIONS

This study identified social determinants and mental health factors linked to the attrition of urban, ethnically diverse, and impoverished women from longitudinal intervention studies.