Trauma and violence-informed cardio-boxing for female victim-survivors of intimate partner violence

Mixed methods approach utilising stepped-wedge design to gather data related to the acceptability, feasibility and preliminary effectiveness of an eight-week trauma and violence-informed (TVI), non-contact cardio-boxing intervention for women who have experienced intimate partner violence. Intervention: This in-person (group-based) TVI non-contact cardio-boxing program is multicomponent in design and will include elements of: • a mental health check-in at the start of each session • aerobic warm-up • teaching of cardio-boxing skills (safety and form) • moderate-vigorous non-contact cardio-boxing drills • psychoeducation around managing trauma symptoms, emotional regulation strategies • mindful cool-down / containment exercises Sessions will be conducted on a weekly basis for 8-weeks and the curriculum will be progressive in terms of skill development degree of difficulty. Each session will run for 90 minutes and comprise 60 minutes of physical activity with 30 minutes set aside for psycho-education and containment exercises / activities. Four groups of eight women per group will be exposed to the same intervention on a weekly basis for the duration of the intervention. Prior to the start of the intervention, each group will be randomly assigned to a different baseline (T -5 weeks - T -2 weeks) where women will be asked to complete the Kessler K6 to measure psychological distress each week throughout the baseline period and fortnightly throughout the intervention. The intervention will be run at an established TVI gender-sensitive martial arts gym. Groups will be co-facilitated by a TVI boxing instructor and a mental health clinician to support participant safety. The boxing instructor has a Bachelors in Exercise Science, 15+ years experience as martial artist including traditional boxing and black belt in Muay Thai, including a number of professional fights. She is the founder of a TVI, gender-sensitive mixed martial arts charitable organisation for women who have experienced gendered violence. The mental health clinician is an accredited and practicing Clinical Counsellor and Psychotherapist with a special interest on supporting women who have experienced a range of traumatic experiences, including but not limited to gender-based violence (GBV) and childhood sexual abuse using bottom-up trauma and violence-informed approaches. She has over 10 years experience in the field. To assess feasibility of the intervention recruitment and consent rates will be measured. In addition, feasibility will be assessed based on participant retention through the trial, measured in two ways (all de-identified): 1. the number of participants who remained in the group until program completion 2. the number of participants who completed all the post-intervention assessments / follow-ups Attendance records will be kept via a spreadsheet and will record participant / session / group across the eight-week duration to measure adherence to the program, including those participants who attend the PA component only, and those who attend the PA component and the additional psychoeducation / mindfulness component.

Mixed methods approach utilising interrupted time series to gather data related to the acceptability, feasibility and preliminary effectiveness of an eight-week trauma and violence-informed (TVI), non-contact cardio-boxing intervention for women who have experienced intimate partner violence. Intervention: This in-person (group-based) TVI non-contact cardio-boxing program is multicomponent in design and will include elements of: • a mental health check-in at the start of each session • aerobic warm-up • teaching of cardio-boxing skills (safety and form) • moderate-vigorous non-contact cardio-boxing drills • psychoeducation around managing trauma symptoms, emotional regulation strategies • mindful cool-down / containment exercises Sessions will be conducted on a weekly basis for 8-weeks and the curriculum will be progressive in terms of skill development degree of difficulty. Each session will run for 90 minutes and comprise 60 minutes of physical activity with 30 minutes set aside for psycho-education and containment exercises / activities. Four groups of eight women per group will be exposed to the same intervention on a weekly basis for the duration of the intervention. Prior to the start of the intervention, each group will be randomly assigned to a different baseline (T -5 weeks - T -2 weeks) where women will be asked to complete the Kessler K6 to measure psychological distress each week throughout the baseline period and fortnightly throughout the intervention. The intervention will be run at an established TVI gender-sensitive martial arts gym. Groups will be co-facilitated by a TVI boxing instructor and a mental health clinician to support participant safety. The boxing instructor has a Bachelors in Exercise Science, 15+ years experience as martial artist including traditional boxing and black belt in Muay Thai, including a number of professional fights. She is the founder of a TVI, gender-sensitive mixed martial arts charitable organisation for women who have experienced gendered violence. The mental health clinician is an accredited and practicing Clinical Counsellor and Psychotherapist with a special interest on supporting women who have experienced a range of traumatic experiences, including but not limited to gender-based violence (GBV) and childhood sexual abuse using bottom-up trauma and violence-informed approaches. She has over 10 years experience in the field. To assess feasibility of the intervention recruitment and consent rates will be measured. In addition, feasibility will be assessed based on participant retention through the trial, measured in two ways (all de-identified): 1. the number of participants who remained in the group until program completion 2. the number of participants who completed all the post-intervention assessments / follow-ups Attendance records will be kept via a spreadsheet and will record participant / session / group across the eight-week duration to measure adherence to the program, including those participants who attend the PA component only, and those who attend the PA component and the additional psychoeducation / mindfulness component.