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Recent research suggests that the transtheoretical model of behavior change is a promising approach for interventions addressing women's experiences of intimate partner violence. This study explores the distribution of abused women across the stages of change for (a) staying safe from intimate partner violence and (b) leaving an abusive relationship. It explores the relationship between stage assignment and other indicators of a woman's stage (i.e., safety behaviors and desire for services). Quantitative surveys were conducted with 96 low-income, urban abused women recruited from six health care clinics. The findings call into question the appropriateness of using a staging algorithm that uses one "global" question about keeping safe and suggest that staging questions focused on a single action stage (e.g., leaving) are also problematic. In conclusion, additional work remains to be done to develop and validate quantitative measures of stages of change for survivors of intimate partner violence and to design, implement, and evaluated stage-based, tailored intimate partner violence interventions.
Keywords: intimate partner violence; stage of change; transtheoretical model; abuse; safety behaviors
It is estimated that more than 5 million women are affected by intimate partner violence (IPV) each year in the United States and that close to 1.5 million women are raped or physically assaulted by an intimate partner (Tjaden & Thoennes, 2000 ). A national study found that close to one-quarter of the women surveyed reported having experienced IPV during their lifetime (Coker et al., 2002 ). Other research among subpopulations of women has found even higher rates. For example, Gielen and her colleagues (Gielen, O'Campo, & McDonnell, 2002; McDonnell, Gielen, & O'Campo, 2003), working with a low-income, mainly African American sample, found that more two-thirds of the women reported any lifetime IPV, and 62% reported any abuse within the past year. While the exact estimates of rates of IPV vary depending on the measurement tool employed and the population sampled, there is no doubt that it is a significant public health problem in the United States (Thompson et al., 2006 ). Experiences of IPV, defined as actual or threatened psychological, physical, or sexual abuse (Crowell & Burgess, 1996 ), have been shown to have profoundly negative consequences on women's physical and mental health (Campbell, 2002; Campbell et al., 2002; Carbone-Lopez, Kruttschnitt, &...