The authors of this meta-analysis discuss their research methodology and results, which indicate that intensive advocacy may improve everyday life for women in domestic violence shelters/refuges in the short term and reduce physical abuse one to two years after the intervention; they also note that it is unclear evidence that intensive advocacy reduces sexual, emotional, or overall abuse, or that it benefits women’s mental health, and it is also unclear whether brief advocacy is effective, although it may provide short‐term mental health benefits and reduce abuse, particularly in pregnant women and those suffering less severe abuse.
The authors’ objective was to assess the effects of advocacy interventions within or outside healthcare settings in women who have experienced intimate partner abuse. In April 2015, the authors searched 13 databases and examined relevant websites and reference lists with forward citation tracking of included studies. They also contacted first authors of eligible papers and experts in the field. Selection criteria included randomized or quasi‐randomized controlled trials comparing advocacy interventions for women with experience of intimate partner abuse versus no intervention or usual care. Two of the review authors independently assessed the risk of bias and undertook data extraction. Thirteen trials were included in their review, which involved 2141 participants aged 15 to 65 years, frequently having low socioeconomic status. The studies were heterogeneous in terms of methodology, study processes and design, including the duration of follow‐up (postintervention to three years), although this was not associated with differences in effect. The studies also had considerable clinical heterogeneity in relation to staff delivering advocacy; setting (community, shelter, antenatal, healthcare); advocacy intensity (from 30 minutes to 80 hours); and abuse severity. Three trials evaluated advocacy within multi‐component interventions. Eleven measured some form of abuse (eight scales), six assessed quality of life (three scales), and six measured depression (three scales). Countries and ethnic groups varied (one or more minority ethnic groups in the U.S. or U.K., and local populations in Hong Kong and Peru). Setting was associated with intensity and duration of advocacy. Risk of bias was high in five studies, moderate in five, and low in three. The quality of evidence (considering multiple factors such as risk of bias, study size, missing data) was moderate to low for brief advocacy and very low for intensive advocacy. Publisher Abstract Provided
Cochrane Database of Systematic Reviews