# A Pilot Feasibility Study of a Patient-Directed Computerized Intervention to Address Reproductive Coercion

> **NIH NIH R21** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2022 · $244,989

## Abstract

Intimate partner violence (IPV) is a significant public health problem in the United States, especially among
women of reproductive age (15-49 years). One third of women age 18 and older experience IPV, with 70% first
experiencing violence prior to age 25. Women in violent relationships are at greater risk of unintended pregnancy
and sexually transmitted infections (STIs), due in part to reproductive coercion (RC). RC includes pregnancy
coercion - a male partner’s attempts to pressure a female partner to become pregnant or to end a pregnancy, and
contraceptive sabotage. One in four women attending family planning (FP) clinics has experienced RC, and this
is even higher for African American (37%) and multiracial (29%) women and women who have experienced IPV
(35%). FP clinics are often the sole source of health care for racial minority women, who are less likely to have
primary care providers, and therefore has the potential to act as an intervention point for RC. One of the few
interventions that addresses both IPV and RC within a FP setting is ARCHES, a brief, provider-dependent
education intervention. ARCHES includes IPV and RC screening and education for all female FP patients, harm
reduction behavioral strategies, resources, and referrals. While ARCHES demonstrated potential for reducing
IPV and RC, new delivery methods that address structural barriers, such as providers’ limited time, are needed
for successful delivery. In this study, we first propose to adapt the provider-dependent ARCHES into a patient-
directed computerized version of ARCHES (C-ARCHES). The provision of ARCHES via a computerized platform
will not rely on the limited time of providers to deliver the intervention, but still allows providers an opportunity
to talk about IPV/RC through patient-directed initiation based on information they read in the computerized
version. Adaptation will involve solicitation of recommendations for developing and implementing the patient-
directed computerized version of ARCHES via focus groups with female FP patients and interviews with
providers and topical experts, production of C-ARCHES, review by topical experts, pre-testing by patients,
integration of feedback, and final production. Second, we will conduct a pilot cluster randomized controlled trial
(RCT) focused on the feasibility of C-ARCHES: acceptability, demand/use, practicality, and safety. Two clinics
will receive C-ARCHES and two clinics will continue with standard of care (i.e., IPV screening). The providers in
the C-ARCHES clinic will receive training prior to the intervention. Participants in both arms will include female
FP patients ages 18-29. Data will be collected via surveys at baseline (pre- and post-clinic visit) and at a 3-month
follow up. Surveys will collect demographic information and IPV/RC knowledge, self-efficacy, and behavior.
Patients who receive C-ARCHES will also be asked questions about the feasibility of C-ARCHES. The proposed
adaptation of a provider-depen...

## Key facts

- **NIH application ID:** 10373157
- **Project number:** 1R21HD107619-01A1
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Yasamin Kusunoki
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $244,989
- **Award type:** 1
- **Project period:** 2022-07-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10373157

## Citation

> US National Institutes of Health, RePORTER application 10373157, A Pilot Feasibility Study of a Patient-Directed Computerized Intervention to Address Reproductive Coercion (1R21HD107619-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10373157. Licensed CC0.

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