Co-production and feasibility testing of an evidence-based psychological advocacy intervention for older women affected by domestic abuse

ISRCTN	ISRCTN16469112
DOI	https://doi.org/10.1186/ISRCTN16469112
Integrated Research Application System (IRAS)	360331
Central Portfolio Management System (CPMS)	69256
Sponsor	University College London
Funder	National Institute for Health and Care Research

Submission date: 31/10/2025
Registration date: 22/04/2026
Last edited: 16/10/2026

Recruitment status: Not yet recruiting
Overall study status: Ongoing
Condition category: Other

Prospectively registered

Protocol

Statistical analysis plan

Results

Individual participant data

Record updated in last year

Plain English summary of protocol

Background and study aims
At the moment, we know that older women, aged between 60 and 74, living in England and Wales, face high rates of domestic abuse. Domestic Abuse severely harms their physical and mental well-being. The reason we are doing this study is that existing support often misses the challenges that this population faces. An example is difficulties accessing online information and support. Another example is that the abuse may have lasted for many years, and the victim may be dependent on their abuser. The aim of the study is to develop a new psychological advocacy intervention based on existing evidence-based approaches and the needs and preferences of women over 60 with lived experience. Our aim is to support older women survivors' psychological well-being and aid their recovery.

Who can participate?
This study is intended for women above the age of 60, who have had or are currently experiencing domestic abuse, including physical, emotional, psychological, sexual, or financial abuse. The participant should be able to provide their consent to participating in the study and be able to engage in the study's intervention and assessments.

What does the study involve?
This study involves three connected workstreams:
1. The development of the psychological advocacy intervention and a training programme fit for current practice
2. The identification of suitable referral pathways for women over 60 affected by domestic abuse
3. The initial testing of our psychological advocacy intervention – looking at how acceptable it is and how well it works for older women as compared with the standard support offered.

What are the possible benefits and risks of participating?
Taking part in this study may not bring direct benefits to women personally. However, the information provided will help improve and test a support programme for older women affected by domestic abuse in a larger study. By making sure the voices of older women who have experienced unhealthy or harmful behaviour from a partner/husband are heard, we hope this research will lead to better government-funded services that meet their needs and help safeguard their wellbeing.

Talking about unhealthy or harmful behaviour can sometimes feel upsetting and may bring up feelings of fear, sadness, or shame. Participants are free to withdraw from the study at any time if the discussions become distressing or no longer feel useful to them. All information you share will be treated confidentially. However, confidentiality cannot be guaranteed in focus groups, as other participants will hear what is shared. Information may also need to be shared if there are concerns about a woman’s safety or risk of harm, in line with safeguarding procedures. Our priority is to keep women safe.

Where is the study run from?
University College London (UK)

When is the study starting, and how long is it expected to run for?
January 2027 to March 2029.

Who is funding the study?
National Institute for Health and Care Research (UK)

Who is the main contact?
Dr Vasiliki Orgeta, v.orgeta@ucl.ac.uk

Contact information

Dr Vasiliki Orgeta
Public, Scientific, Principal investigator

6th Floor, Wings A and B, Maple House, 149 Tottenham Ct Rd
London
W1T 7NF
United Kingdom

ORCID ID	0000-0001-8643-5061
Phone	+44 2076799294
Email	v.orgeta@ucl.ac.uk

Study information

Primary study design	Interventional
Study design	Interventional randomized controlled feasibility study
Secondary study design	Randomised controlled trial
Scientific title	Co-production and feasibility testing of an evidence-based psychological advocacy intervention for older women affected by domestic abuse
Study objectives	Current study objectives as of 15/10/2026: Our study aims to improve the mental health of older female survivors of domestic abuse and support their well-being and recovery. To achieve this, we will: 1. Develop a psychological advocacy intervention based on existing evidence-based approaches and the needs and preferences of older women with lived experience 2. Strengthen and tailor referral pathways to enhance accessibility with support services 3. Determine the feasibility and acceptability of our newly developed intervention and trial design _____ Previous study objectives: Our study aims to improve the mental health of older female survivors of domestic abuse and support their well-being and recovery. To achieve this, we will: 1. Adapt the core components of the existing PATH intervention to ensure they are tailored to the needs and preferences of older women 2. Strengthen and tailor referral pathways to enhance accessibility with support services 3. Determine the feasibility and acceptability of the adapted PATH intervention and trial design
Ethics approval(s)	Approved 12/03/2026, London Stanmore Research Ethics Committee (2 Redman Place, Stratford, London, E20 1JQ, United Kingdom; no telephone number provided; stanmore.rec@hra.nhs.uk), ref: 26/PR/0105
Health condition(s) or problem(s) studied	Domestic abuse
Intervention	Current interventions as of 15/10/2026: - Women randomised to our psychological advocacy intervention will be offered up to eight weekly or fortnightly sessions, followed by two booster sessions, 1 month and then 3 months post-intervention. The schedule will be flexible and revised according to participant preferences. The intervention will be designed to support women in recognising, and exploring psychological consequences related to experiences of DA, while developing coping strategies to manage distress. - Women in the control group will receive usual care in the form of DA advocacy support but will not participate in the psychological advocacy sessions. The advocacy support will include a package of legal, housing, financial, and safety advice, provided by our partner Hourglass, a leading national charity and experts in DA of older women. - We will follow-up all participants across all study arms for 4, 8 and 12 months. - We will consider how best to balance and stratify our randomisation (e.g., by age, co-habitation status, and site), with our sites chosen to increase diversity and serve both rural and urban areas. _____ Previous interventions: - Women randomised to A-PATH will be offered up to eight weekly or fortnightly sessions, followed by two booster sessions, 1 month and then 3 months post-intervention. The schedule will be flexible and revised according to participant preferences. A-PATH is designed to support women in recognising, and exploring psychological consequences related to experiences of DA, while developing coping strategies to manage conflict and other stressors. - Women in the control group will receive usual care in the form of DA advocacy support but will not participate in A-PATH sessions. The advocacy support will include a package of legal, housing, financial, and safety advice, provided by our partner Hourglass, a leading national charity and experts in DA of older women. - We will follow-up all participants across all study arms for 4, 8 and 12 months. - We will consider how best to balance and stratify our randomisation (e.g., by age, co-habitation status, and site), with our sites chosen to increase diversity and serve both rural and urban areas.
Intervention type	Behavioural
Primary outcome measure(s)	Feasibility outcomes: 1. Recruitment rate is measured using trial screening and enrolment logs at end of study 2. Retention rate is measured using participant follow-up completion records at end of study 3. Recruitment pathway feasibility is measured using qualitative interviews with trial staff and participants at end of study 4. Barriers and facilitators to recruitment are measured using qualitative interviews and participant questionnaires at end of study 5. Acceptability of intervention formats is measured using participant feedback questionnaires and interviews at end of study 6. Feasibility of collecting outcome data is measured using completion rates of study measures at end of study 7. Participant burden is measured using self-reported burden questionnaires and qualitative interviews at end of study 8. Time taken to complete measures is measured using participant-reported time logs or researcher observation at end of study 9. Difficulty in completing measures is measured using participant feedback questionnaires at end of study 10. Missing data rate is measured using analysis of completed outcome measures at end of study
Key secondary outcome measure(s)	Measured at 4, 8, and 12 months: 1. Psychological distress (Clinical Outcomes in Routine Evaluation–Outcome Measure, CORE-OM) 2. Depressive symptoms (Patient Health Questionnaire, PHQ) 3. Post-traumatic stress symptoms (Posttraumatic Stress Disorder Symptoms Scale) 4. Health-related quality of life (EQ-5D-5L)
Completion date	31/03/2029

Eligibility

Participant type(s)	Patient, Service user
Age group	Mixed
Lower age limit	60 Years
Upper age limit	120 Years
Sex	Female
Target sample size at registration	131
Key inclusion criteria	1. Women aged 60 years or older 2. Who have experienced domestic abuse, including physical, emotional, psychological, sexual, or financial abuse, either currently or in the past 3. Are able to provide informed consent to participate in the study 4. Have sufficient cognitive capacity to engage in the intervention and complete study assessments
Key exclusion criteria	Current key exclusion criteria as of 15/10/2026: 1. Women with a psychotic illness 2. Those living with a severe drug or alcohol problem 3. Those living with dementia 4. Individuals currently engaged in other structured psychotherapeutic treatments 5. Women considered to be at high or medium risk of experiencing severe harm _____ Previous key exclusion criteria: 1. Women with a psychotic illness 2. Those living with a severe drug or alcohol problem 3. Those living with dementia 4. Individuals currently engaged in other structured psychotherapeutic treatments 5. Older male victims
Date of first enrolment	01/01/2027
Date of final enrolment	30/09/2027

Locations

Countries of recruitment

United Kingdom
England
Wales

Study participating centres

University College London, Divison of Psychiatry

4th Floor, Wings A and B, Maple House, 149 Tottenham Ct Rd
London
W1T 7NF
England

University of Bristol, Centre for Academic Primary Care

39 Whatley Rd, Clifton
Bristol
BS8 2PS
England

Dewis Choice

Centre for Age, Gender and Social Justice
Aberystwyth University
Penglais
Aberystwyth
SY23 3FL
Wales

Results and Publications

Individual participant data (IPD) Intention to share	No

Editorial Notes

16/10/2026: The study acronym (A-PATH) was removed.
15/10/2026: The following changes were made to the study record:
1. The public title was changed from "A-PATH: A path towards healing and support for older women" to "Co-production and feasibility testing of an evidence-based psychological advocacy intervention for older women affected by domestic abuse".
2. The scientific title was changed from "A-PATH: Adapting Psychological Advocacy Towards Healing for older women affected by domestic abuse" to "Co-production and feasibility testing of an evidence-based psychological advocacy intervention for older women affected by domestic abuse".
3. The study objectives were changed.
4. The interventions were changed.
5. The key exclusion criteria were changed.
6. The study participating centres were updated.
7. The date of first enrolment was changed from 01/04/2026 to 01/01/2027.
8. The plain English summary was updated to reflect these changes.
31/10/2025: Trial's existence confirmed by the National Institute for Health and Care Research (NIHR) (UK).