A Mixed Method Evaluation of the Implementation of a Caregiver Intervention for Mothers who have Survived Intimate Partner Violence: The Mediational Intervention for Sensitizing Caregivers

Exposure to intimate partner violence (IPV) constitutes a traumatic stress environment and creates profound impacts on both mothers’ caregiving and children’s’ mental health outcomes. Sensitive and responsive caregiving has been identified as an important protective factor that may mitigate the negative impact of IPV exposure. The Mediational Intervention for Sensitizing Caregivers (MISC) has demonstrated positive effects on child mental health problems and has recently been adapted for African American IPV-exposed mothers and (1R01HD102436-01A1; PI: Sharp). However, no studies have examined factors related to MISC’s implementation with IPV-exposed populations. To this end, the present study used a mixed method implementation science approach to evaluate the scale-up potential of MISC with African American mothers and children in an IPV-community organization setting. For Aim 1, implementation factors were identified using qualitative interviews with MISC-Implementation experts. For Aim 2, characteristics for MISC scale-up suitability were assessed via quantitative survey of stakeholders in the IPV field. For Aim 3, contextual factors related to MISC implementation were evaluated at community agencies via focus groups with IPV caseworkers. Each aim identified barriers and facilitators to implementation related to implementation, with emphasis on cultural adaptations for African American families. Using a joint display, qualitative and quantitative data were integrated, and six meta-inferences created and used to produce comprehensive recommendations for future scale-up. The present study is the first to use implementation science to evaluate the of adoption of an evidence-based mentalization-based caregiver intervention for African American families in an IPV-community organization setting and extends the literature to consider multi-level factors in implementing community-based parenting intervention for marginalized populations. Findings suggest that MISC was feasible, appropriate, and acceptable to study participants. Specific implementation strategies, such as enhanced training for IPV caseworkers and involvement of senior caseworkers as MISC supervisors, were identified as useful in future adoption and scale-up. Barriers also emerged, including organizational barriers such as low financial resources and vacant staff positions. Agencies also varied in their mission alignment with MISC’s focus on parenting support and child mental health. Future work should build upon these findings in effectiveness-implementation hybrid study designs.

Name thesis:degree_name

Doctor of Philosophy

Discipline thesis:degree_discipline

Psychology, Clinical

Grantor

University of Houston

Year dc:date.issued

2026

Author dc:creator

• Allman, Madeleine Elise 1995-

Advisor dc:contributor.advisor

• Sharp, Carla

Committee members dc:contributor.committeemember

• Sales, Jessica
• Walton, Quenette
• Babcock, Julia

• Caregiving Intervention
• Implementation Science
• Intimate Partner Violence
• Children's Mental Health

Language dc:language.iso

English

Handle dc:identifier.uri

https://hdl.handle.net/10657/21582

OAI identifier oai:identifier

oai:uh-ir.tdl.org:10657/21582