MOSAIC (MOthers' Advocates In the Community): protocol and sample description of a cluster randomised trial of mentor mother support to reduce intimate partner violence among pregnant or recent mothers

Background : Intimate partner violence (IPV) is prevalent globally, experienced by a significant minority of women in the early childbearing years and is harmful to the mental and physical health of women and children. There are very few studies with rigorous designs which have tested the effectiveness of IPV interventions to improve the health and wellbeing of abused women. Evidence for the separate benefit to victims of social support, advocacy and non-professional mentoring suggested that a combined model may reduce the levels of violence, the associated mental health damage and may increase a woman's health, safety and connection with her children. This paper describes the development, design and implementation of a trial of mentor mother support set in primary care, including baseline characteristics of participating women.

Methods/Design : MOSAIC (MOtherS' Advocates In the Community) was a cluster randomised trial embedded in general practice and maternal and child health (MCH) nursing services in disadvantaged suburbs of Melbourne, Australia. Women who were pregnant or with infants, identified as abused or symptomatic of abuse, were referred by IPV-trained GPs and MCH nurses from 24 general practices and eight nurse teams from January 2006 to December 2007. Women in the intervention arm received up to 12 months support from trained and supported non-professional mentor mothers. Vietnamese health professionals also referred Vietnamese women to bilingual mentors in a sub-study. Baseline and follow-up surveys at 12 months measured IPV (CAS), depression (EPDS), general health (SF-36), social support (MOS-SF) and attachment to children (PSI-SF). Significant development and piloting occurred prior to trial commencement. Implementation interviews with MCH nurses, GPs and mentors assisted further refinement of the intervention. In-depth interviews with participants and mentors, and follow-up surveys of MCH nurses and GPs at trial conclusion will shed further light on MOSAIC's impact.

Discussion : Despite significant challenges, MOSAIC will make an important contribution to the need for evidence of effective partner violence interventions, the role of non-professional mentors in partner violence support services and the need for more evaluation of effective health professional training and support in caring for abused women and children among their populations.

Effect of erectile dysfunction medications on coexsisting dysfunctions in couples : Partner's Preference Study

There is sparse information on how treatments for erectile dysfunction (ED) affects couples. This study investigated the effects of ED treatments on 100 heterosexual couples' sexual functioning and whether function achieved using a short-acting versus a long-acting ED medication differed significantly. Couples were randomized to use tadalafil or sildenafil for each of two 12-week study phases; they completed questionnaires (International Index of Sexual Function and Female Sexual Function Index) and kept sexual event diaries. All participants experienced significant improvements over baseline sexual functioning, while the men used short- or long-acting ED medications with no significant differences related to the duration of drug action recorded for either the men or women. Despite this lack of difference in efficacy there was a strong preference by women (79%) and their partners (16%) for the longer-acting medication. The reasons for this warrant further investigation. Understanding the effects on couples of the use of ED medications is a necessary aspect of ensuring ongoing sexual satisfaction in couples treated for ED.

Examining partner experience in cross-sector collaborative projects focused on the commercialization of R & D

The paper reports key findings from a four year study of cross-sector collaborative R&D projects in Australia testing a theoretical model formulated to explain partner collaboration experience and perceived project success. The study contributes to the understanding of knowledge-intensive collaborations, and indicates how their benefits can be sustained under conditions of high uncertainty. The study was of cross-sector collaborative projects within the Australian Cooperative Research Centre (CRC) Program which involved multiple partners and which were focused on the commercialization of R&D. The model was empirically tested through a survey of project leaders and the results provided support for the three main effects hypothesized. The theoretical, methodological and practical implications of the study's findings for the field of interorganizational relations (IOR) are discussed, and a new construct of project management competence is proposed as a determinant of positive partner experiences at the project level. This study adds to the growing body of work on interorganizational collaborative arrangements by providing systematic empirical support for a theoretical model of cross-sector R&D collaboration at the project level and at the completion or near completion phase of project development.

Creating collaborative spaces : the pleasures and perils of doing multi-disciplinary, multi-partner qualitative research

This paper describes our experience of managing a two-year research project that involved University staff from two different disciplines and three industry partners. It describes the benefits we gained from the involvement of multiple parties, such as the ability to call upon diverse expertise, the capacity to study a complex issue and the ability to make a direct contribution to industry practice. It also describes some of the difficulties such as managing across University structures, maintaining the collaborators' interest in the project, gaining approval from multiple ethics committees and managing the expectations of various stakeholders. The paper concludes with a number of recommendations for senior University staff and for researchers and points to ways universities could better facilitate involvement in these types of complex research projects.

Community's attitudes towards intimate partner homicide

The thesis aimed to explore the Victorian Community's attitudes towards intimate partner homicide committed in the context of jealousy and domestic violence. Results revealed that the immediacy of the accused's actions, the gender of the accused, and the gender of the participant interacted to influence participants' verdict and blame responses. The portfolio explored the complexities and challenges that face mental health professionals in deciding the appropriate weighting of child's wishes in child protection assessments. The four case studies presented were chosen due to the attention that was paid to the child's wishes throughout the assessments.

Mothers' AdvocateS In the Community (MOSAIC)- non-professional mentor support to reduce intimate partner violence and depression in mothers: a cluster randomised trial in primary care

Background : Effective interventions to increase safety and wellbeing of mothers experiencing intimate partner violence (IPV) are scarce. As much attention is focussed on professional intervention, this study aimed to determine the effectiveness of non-professional mentor support in reducing IPV and depression among pregnant and recent mothers experiencing, or at risk of IPV.

Methods : MOSAIC was a cluster randomised trial in 106 primary care (maternal and child health nurse and general practitioner) clinics in Melbourne, Australia. 63/106 clinics referred 215 eligible culturally and linguistically diverse women between January 2006 and December 2007. 167 in the intervention (I) arm, and 91 in the comparison (C) arm. 174 (80.9%) were recruited. 133 (76.4%) women (90 I and 43 C) completed follow-up at 12 months.

Intervention: 12 months of weekly home visiting from trained and supervised local mothers, (English & Vietnamese speaking) offering non-professional befriending, advocacy, parenting support and referrals.

Main outcome measures: Primary outcomes; IPV (Composite Abuse Scale CAS) and depression (Edinburgh Postnatal Depression Scale EPDS); secondary measures included wellbeing (SF-36), parenting stress (PSI-SF) and social support (MOS-SF) at baseline and follow-up.

Analysis: Intention-to-treat using multivariable logistic regression and propensity scoring.

Results : There was evidence of a true difference in mean abuse scores at follow-up in the intervention compared with the comparison arm (15.9 vs 21.8, AdjDiff -8.67, CI -16.2 to -1.15). There was weak evidence for other outcomes, but a trend was evident favouring the intervention: proportions of women with CAS scores ≥7, 51/88 (58.4%) vs 27/42 (64.3%) AdjOR 0.47, CI 0.21 to 1.05); depression (EPDS score ≥13) (19/85, 22% (I) vs 14/43, 33% (C); AdjOR 0.42, CI 0.17 to 1.06); physical wellbeing mean scores (PCS-SF36: AdjDiff 2.79; CI -0.40 to 5.99); mental wellbeing mean scores (MCS-SF36: AdjDiff 2.26; CI -1.48 to 6.00). There was no observed effect on parenting stress. 82% of women mentored would recommend mentors to friends in similar situations.

Conclusion : Non-professional mentor mother support appears promising for improving safety and enhancing physical and mental wellbeing among mothers experiencing intimate partner violence referred from primary care.

The dance of trust in high risk multi-partner collaborations : an exploration of the antecedents of trust in cross-sector R&D projects

This paper explores the dance of trust in cross-sector R&D collaborations, and does so by drawing on a multi-method study (involving qualitative research, case studies and a survey of project leaders) of the Australian Cooperative Research Centre (CRC) Program. R&D collaborations formed under this Program involve two main types of risk, venture or performance-related and relational, and these are problematic given power, information and risk impact asymmetries among the partners. Within the CRCs these risks are addressed through formalisation, employing the “right people”, and through relationship building. Trust (theorised following Sako as a multi-dimensional construct) is central to these processes. Where trust is formed among CRC participants, and is reinforced over repeated interactions, then relational and performance risks cease to become a major concern for CRC managers. In the CRCs, trust is formed and sustained as a multi-level process. Engagement and relationship commitment is achieved at an organizational level, and partner reputation, credible commitments and the institutional context are important factors here. At the project level, trust, in conjunction with a task focus, leads to a positive collaboration experience and this is associated with positive project outcomes. Within CRC projects, capabilities for communication and cross-sector management are important for the formation and maintenance of trust. The paper concludes by discussing the managerial implications of the study’s findings and by identifying areas for further research and conceptual development.

Collaborative R&D project partner experience in the Australian CRC Program : a theoretical framework

The paper focuses on commercially-oriented cross-sector R&D collaborative projects carried out within Australian Cooperative Research Centres. A theoretical model is proposed to explain the participants’ experience of such collaborative projects, and the relationship between partner experience and project outcomes. It is hypothesized that collaborative projects that have both a strong relationship focus, in terms relational trust, and a strong task focus, in terms of project management capability, are more likely to be positively experienced by the participants. Four antecedent variables, derived from the literature and preliminary research, are proposed: credible commitments, previous collaboration experience, cross-sector management capability, and communication intensity. The model is to be empirically tested through a survey of CRC project leaders.

Dads doing it tough during partner's pregnancy : busting the blues

Baby blues aren't just about mothers; dads are doing it hard too.