A-PATH Trial, Domestic Abuse Support, Women 60+, Recruiting

A-PATH: A path towards healing and support for older women

Submission date 31/10/2025 Registration date 22/04/2026 Last edited 22/04/2026 Recruitment status 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 adapt an existing support system which is called PATH (Psychological Advocacy Towards Healing). We aim to alter this to make it right for older women survivors to help 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 capable of engaging in the study's intervention and assessments.

What does the study involve?
This study involves three connected workstreams:
1. The adaptation and development of A-PATH
2. The identification of suitable referral pathways for those affected by domestic abuse
3. The initial testing of A-PATH – looking at how acceptable it is and how well it works for older people 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 participants personally. However, the information provided will help improve and test a support programme for older women 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 from a husband or partner 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 the information provided will be kept confidential, except in focus groups, where confidentiality cannot be guaranteed because other participants will also hear what is shared.

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

When is the study starting, and how long is it expected to run for?
April 2026 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

Study information

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 | - 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.
4. 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.
5. We will follow-up all participants across all study arms for 4, 8 and 12 months.
6. 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:
7. Recruitment rate is measured using trial screening and enrolment logs at end of study
8. Retention rate is measured using participant follow-up completion records at end of study
9. Recruitment pathway feasibility is measured using qualitative interviews with trial staff and participants at end of study
10. Barriers and facilitators to recruitment are measured using qualitative interviews and participant questionnaires at end of study
11. Acceptability of intervention formats is measured using participant feedback questionnaires and interviews at end of study
12. Feasibility of collecting outcome data is measured using completion rates of study measures at end of study
13. Participant burden is measured using self-reported burden questionnaires and qualitative interviews at end of study
14. Time taken to complete measures is measured using participant-reported time logs or researcher observation at end of study
15. Difficulty in completing measures is measured using participant feedback questionnaires at end of study
16. 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:
17. Psychological distress (Clinical Outcomes in Routine Evaluation–Outcome Measure, CORE-OM)
18. Depressive symptoms (Patient Health Questionnaire, PHQ)
19. Post-traumatic stress symptoms (Posttraumatic Stress Disorder Symptoms Scale)
20. Health-related quality of life (EQ-5D-5L) | | Completion date | 31/03/2029 |

Eligibility

1. Who have experienced domestic abuse, including physical, emotional, psychological, sexual, or financial abuse, either currently or in the past
2. Are able to provide informed consent to participate in the study
3. Have sufficient cognitive capacity to engage in the intervention and complete study assessments | | Key exclusion criteria | 1. Women with a psychotic illness
4. Those living with a severe drug or alcohol problem
5. Those living with dementia
6. Individuals currently engaged in other structured psychotherapeutic treatments
7. Older male victims | | Date of first enrolment | 01/04/2026 | | Date of final enrolment | 30/09/2027 |

Locations

Countries of recruitment

• United Kingdom
• England
• Wales

Study participating centres

University College London, Divison of Psychiatry 6th 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 Swansea University, Department of Criminology Sociology and Social Policy School of Social Sciences, Swansea University, Singleton Park
Swansea
SA2 8PP
Wales North Devon Against Domestic Abuse Barnstaple
North Devon
EX32 7YN
England

Results and Publications

Editorial Notes

31/10/2025: Trial's existence confirmed by the National Institute for Health and Care Research (NIHR) (UK).