Program Profile: Community Advocacy Project

This community-based advocacy intervention seeks to extend and improve social support to women experiencing domestic/intimate partner violence. The program is rated Promising. Participants showed a statistically significant increase in accessing community resources, engaging in activities to meet their needs, in quality of life, and a reduction in re-abuse. However, there were no statistically significant impacts on continued involvement with their assailants, and perceived social support.

A Promising rating implies that implementing the program may result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

Program Goals/Target Population

The Community Advocacy Project (CAP) is a community-based advocacy intervention designed for women who have experienced domestic/intimate partner violence and who are leaving a domestic violence shelter program. CAP’s goals are to 1) enhance an individual’s inherent competencies, talents, and strengths; and 2) to mobilize the community to adequately respond to the individual’s need for resources, services, and opportunities.

Program Components

CAP uses strengths-based modeling to provide community-based advocacy services to women, to help them develop safety plans, as needed, for free. Women are assigned an advocate to assist them during the 10-week program. This intervention model requires that women provide guidance on the types of services they should receive and that their natural support networks are involved in the advocacy process.

Advocates meet weekly with the women for 4 to 6 hours. Advocates are required to follow strict guidelines that concentrate on a woman’s strengths rather than her weaknesses, on issues that are important to her, and on making the community responsive to her needs. They work with each woman in her own environment and teach her skills to increase her chances for success. Advocacy services consist of five distinct phases (described below). These phases are often not distinct from one another but are ongoing and sometimes overlap throughout the program.

1. Assessment. The advocate becomes acquainted with the woman and significant others in her life, such as family and friends, and gathers important information regarding her needs and goals. During this phase, the woman informs the advocate about what she would like to accomplish during receipt of services.
2. Implementation. The woman is connected to appropriate, available community resources to meet her previously established needs. Referrals to various community resources are made during this phase.
3. Monitoring. The advocate and woman (after referrals are made) monitor whether community resources are successfully obtained and if they are satisfactory in meeting the woman’s current needs.
4. Secondary Implementation. The advocate re-analyzes services and the needs of the woman, making new referrals if needed. This phase is conditional to the monitoring phase in which the woman reports whether resources were unsuccessfully obtained or unsatisfactory in meeting her needs.
5. Termination. The advocate strengthens the woman’s newfound skills and knowledge from the course to ensure that she will continue using them and accessing resources on her own.

Key Personnel

Advocates are instrumental to the implementation of CAP. They are trained professionals who work with women in their own environments to maximize the likelihood of creating lasting change (Bybee and Sullivan 2002).

Study

Tan and colleagues (1995) conducted a randomized controlled trial in a medium-sized midwestern city, to examine the impacts of the Community Advocacy Project (CAP). The study consisted of 141 women recruited from a domestic violence shelter who were eligible (i.e., they had stayed at the shelter at least 1 night and had not moved out of the general area, regardless of whether they returned to their assailants). Participants were randomly assigned to either receive free services from trained advocates for the first 10 weeks through CAP after leaving the shelter (intervention group, n = 71) or to no services at all (control group, n = 70). Participants were interviewed upon leaving the shelter (preintervention), after the intervention period (10 weeks), and 6 months postintervention.

Of the 141 participants, 46 percent were white, 43 percent were Black, 8 percent were Hispanic, 1 percent were Asian, and the remainder were Native American, Arab American, or of mixed heritage. The women had an average age of 28.5 years, and 78 percent had at least one dependent child living with them. Prior to living at the shelter, 33 percent of battered women were married and living with their assailants, 45 percent lived with their assailants but were not married, 6 percent were romantically involved with their assailants but were not living with them, and 15 percent were no longer involved with their assailants at the time of the last assault (i.e., separated, divorced, or no longer dating). On average, participants’ length of stay at the shelter was 17 days. There were no statistically significant differences between the intervention and control groups on baseline characteristics.

Outcomes of interest included the women’s relationships with their assailants, satisfaction with social support, experience of further violence, and effectiveness in obtaining resources. This CrimeSolutions review of this study focused on all outcomes at the 6-month follow up, except for the outcome measuring effectiveness in obtaining resources (data for this outcomes was only available at postintervention). Relationship with assailant was measured through a woman’s current level of involvement as follows: 1) married and living together; 2) living together, unmarried; 3) romantically involved, not living together; or 4) dating. Social support was measured using a 9-item scale instrument with a 7-point Likert-scale (1 = terrible, 7 = extremely pleased) that focused on two dimensions of social support (functional and structural). Experience of physical abuse was measured using the modified Conflict Tactics Scale. Study authors found that the scale results were highly skewed at postintervention and 6-month follow up; thus, they dichotomized values to reflect the existence or absence of further abuse. Effectiveness in obtaining resources was measured using a Likert-type scale (1 = very ineffective, 4 = very effective) that concentrated on types of resources such as housing, employment, material goods and resources, child care, social support, and finances. Multivariate analyses of variance (ANOVAs) and a bivariate analysis (chi-square) were used to compare treatment and control groups on outcomes of interest. The study authors did not conduct subgroup analyses.

Study

Bybee and Sullivan (2002) conducted a randomized controlled trial that recruited and randomly assigned 278 women from a midwestern domestic violence shelter to either the free advocacy service intervention group (n = 143) or the control group (n = 135), which received no services at all. To be eligible, women had to spend at least 1 night at the shelter, agree to stay in the area for the first 3 months after leaving the shelter, and agree to participate in the study for at least 3 weeks. Women in the advocacy intervention group received free advocacy services through CAP for 10 weeks immediately after leaving the shelter, for about 4 to 6 hours a week. All participants were interviewed six times in 2 years: immediately (i.e., within a week) upon leaving the shelter; at 10 weeks after leaving the shelter; and then at 6-, 12-, 18-, and 24-month follow ups. The CrimeSolutions review focused on intervention effects at the 24-month follow up.

In terms of race/ethnicity, 45 percent of the women were African American, 42 percent were European American, 7 percent were Latina, 2 percent were Asian American, and the remainder were Native American, Arab American, or of mixed heritage. The average age was 29 years, and 74 percent had at least one child living with them. Twenty-seven percent were married to the men who had abused them, 42 percent had been living with but not married to their assailants at the time of the abuse, 7 percent had been intimately involved with the men who had abused them but were no longer living together, and 20 percent were no longer involved with their partners at the time of the last assault (i.e., separated, divorced, or no longer dating). On average, the women’s length of stay at the shelter was 19 days. In the 6 months prior to entering the shelter, the women had experienced violence that led to such injuries as cuts and bruises (85 percent), broken bones (19 percent), dislocations (10 percent), and miscarriages or pregnancy complications due to abuse (11 percent). There were no statistically significant differences between the intervention and control groups on baseline characteristics.

Outcomes of interest included perceived social support, access to community resources, re-abuse by partners or ex-partners, and quality of life. Quality of life measured the respondents’ feelings about themselves, their interpersonal relationships, neighborhoods, and overall well-being through a 25-item assessment that was selected to predict overall quality of life. Longitudinal latent structural equation modeling was used to compare treatment and control groups for the outcomes of interest. The study authors did not conduct subgroup analyses.

Study

Allen and colleagues (2004) conducted a randomized controlled trial with the same sample population from Study 2 (Bybee and Sullivan 2002) but looked at the variety of needs that the women reported 6 months after they left the domestic shelter and what they did to address those needs. Participants were demographically the same as those described in Study 2.

At the first interview, researchers looked at types of resources needed by selecting from a list that concentrated on items such as housing, education, employment, transportation, legal assistance, health care, social support, financial support, material goods and services (e.g., furniture), child care, and issues related to their children. Women were also asked if they had other needs not listed. A posttest interview (10 weeks after the initial interview) was conducted, during which the women were asked which of the 11 needs they had worked on without being reminded of the needs they had indicated previously. Outcomes of interest at the posttest included the number of activities that the women engaged in and their effectiveness in accessing resources. The number of engaged activities was measured through activity-level scores, which ranged from 0 to 7, for the 11 types of resources (asked at the initial interview) that women engaged in to address their needs. The effectiveness in accessing resources was determined using the Effectiveness in Obtaining Resources (EOR) Scale, which measured how efficient the women had been in obtaining the resources they needed (1 = very ineffective, 4 = very effective) across all the areas they had worked on. General linear models were used to compare program effects between women in the intervention and control groups. Subgroup analyses were conducted to determine the differences in amount of activity between the intervention and control groups.

The Community Advocacy Project used female undergraduates from a large midwestern university, who earned college credit for their participation as advocates (Tan et al. 1995). They were trained for 10 weeks on information regarding the prevalence and severity of battering and the difficulties women face after leaving a shelter. They received empathy training and were also trained to generate and mobilize many different community resources. Advocates assessed the women’s unmet needs and provided them access with the resources to fulfill those needs. A major component of the advocates’ work was to expand the women’s social networks (if desired), in addition to providing them with social support. From the postintervention interviews, Tan and colleagues (1995) found that advocates spent an average of 6.9 hours per week with or on behalf of their clients in person and an additional 2.5 hours per week on the phone.

Subgroup Analysis

Allen and colleagues (2004) conducted stratified cluster analyses grouping women in the Community Advocacy Project (CAP) intervention and control groups. Cluster groups were formed based on the 11 types of resources included in the study to examine survivors’ level of activity to acquire community resources. The study authors chose to use a five-group solution defined by mean levels of activity across clusters in each activity domain. The five-group solution grouped women into the following clusters: 1) housing, 2) low activity, 3) legal, 4) education/ employment, and 5) high activity.

Overall, univariate ANOVAs showed that CAP women clusters engaged in a statistically significant greater number of activities to address education needs, legal issues, acquiring material goods and services, compared with women in the control clusters. However, control women in the high-activity cluster engaged in a statistically significant greater number of activities to address child care and other issues related to their children, compared with intervention group women. Thus, there was a statistically significant greater effect for CAP women in all clusters, except for the high-activity cluster.

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Following are CrimeSolutions-rated programs that are related to this practice:

Advocacy Interventions for Women Who Experience Intimate Partner Violence

This practice uses advocacy interventions to empower women who have experienced intimate partner violence. The goals of advocacy interventions include helping abused women to access necessary services, reducing or preventing incidents of abuse, and improving women’s physical and psychological health. The practice is rated No Effects for reducing physical abuse. (This Practice was originally rated Promising. See “Other Information” in the practice profile for further discussion of that change).

Evidence Ratings for Outcomes

Victimization - Domestic/intimate partner/family violence

Why might a practice's outcome ratings differ from the ratings of specific programs encompassed by that practice?