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Sabri B, Perrin N, Hagos M. The being safe, health and positively empowered pilot randomized controlled trial: A digital multicomponent intervention for immigrant women with cumulative exposures to violence. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2024:2024-50863-001. [PMID: 38330368 PMCID: PMC11306415 DOI: 10.1037/cdp0000635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
OBJECTIVES Pre- and postmigration exposures to violence are significant social determinants of immigrant women's health, safety, and well-being, with Black immigrant women being at high risk because of many coming from conflict-zone countries. The existing literature does not report the development and testing of a multicomponent digital intervention to address safety and health issues among immigrant women with cumulative exposures to violence. This pilot randomized controlled trial evaluated preliminary efficacy of a multicomponent digital intervention (BSHAPE) to improve health and safety outcomes for immigrant women with cumulative violence exposures, posttraumatic stress disorder and/or depression symptoms, and human immune deficiency virus (HIV) risk behaviors. METHOD The intervention was developed based on formative qualitative work and input from women. In the randomized controlled trial, 144 Black immigrant women, average age being 33.6 years, were randomly assigned to either the BSHAPE arm (n = 72) or a control arm (n = 72). Data were collected at four time points over 12 months. A generalized estimating equation analysis was performed to examine group differences in change in outcomes over time. RESULTS Compared to the control arm, participants in BSHAPE showed significant improvement in multiple outcome measures (e.g., HIV/STI risk). CONCLUSION This pilot trial of BSHAPE showed promising results for immigrant women with lifetime exposures to violence, poor mental health, and HIV risk. The study also provided useful information to further improve BSHAPE for a full-scale efficacy trial. The digital BSHAPE can be especially advantageous for violence-affected immigrant women who face numerous barriers to accessing in-person care for their safety and health needs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Bushra Sabri
- Johns Hopkins University School of Nursing, Baltimore, MD
| | - Nancy Perrin
- Johns Hopkins University School of Nursing, Baltimore, MD
| | - Meron Hagos
- Johns Hopkins University School of Nursing, Baltimore, MD
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Hailemariam M, Johnson JE, Johnson DM, Sikorskii A, Zlotnick C. Computer-based intervention for residents of domestic violence shelters with substance use: A randomized pilot study. PLoS One 2023; 18:e0285560. [PMID: 37228153 DOI: 10.1371/journal.pone.0285560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/25/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Intimate Partner Violence (IPV) is a significant public health problem often associated with serious mental health and physical health implications. Substance use disorders (SUDs) are one of the most common comorbidities among women with IPV, increasing risk of subsequent IPV. METHODS The current study examined the feasibility, acceptability, and preliminary effectiveness of a brief computerized intervention to reduce alcohol and drug use among women with IPV. Fifty women with recent IPV and alcohol and drug use risk were recruited from domestic violence shelters and randomized to the experimental computerized intervention or to an attention and time control condition. The primary outcome was percent heavy drinking or drug using days in 3 month increments over the 6 months after leaving the shelter. Receipt of substance use services and IPV severity were evaluated as secondary outcomes. RESULTS The computerized intervention was feasible and acceptable, with high (n = 20, 80%) completion rates, engagement with the intervention, and satisfaction scores. As expected in this pilot trial, there were no significant differences between conditions in percent heavy drinking/drug using days or receipt of substance use services and large individual differences in outcomes. For example, receipt of substance use services decreased by a mean of 0.05 times/day from the baseline to the 6-month time period in the control condition (range -1.00 to +0.55) and increased by a mean of 0.06 times/day in the intervention condition (range -0.13 to +0.89). There were large decreases in IPV severity over time in both conditions, but directions of differences favored the control condition for IPV severity. CONCLUSION A computerized intervention to reduce the risk of alcohol/drug use and subsequent IPV is feasible and acceptable among residents of a domestic violence shelter. A fully powered trial is needed to conclusively evaluate outcomes.
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Affiliation(s)
- Maji Hailemariam
- Charles Stewart Mott Department of Public Health, Michigan State University, College of Human Medicine, Flint, Michigan, United States of America
- Department of Obstetrics Gynecology and Reproductive Biology, Michigan State University, College of Human Medicine, East Lansing, Michigan, United States of America
| | - Jennifer E Johnson
- Charles Stewart Mott Department of Public Health, Michigan State University, College of Human Medicine, Flint, Michigan, United States of America
- Department of Obstetrics Gynecology and Reproductive Biology, Michigan State University, College of Human Medicine, East Lansing, Michigan, United States of America
| | - Dawn M Johnson
- Department of Psychology, University of Akron, Akron, Ohio, United States of America
| | - Alla Sikorskii
- Department of Psychiatry, Michigan State University, College of Osteopathic Medicine, East Lansing, Michigan, United States of America
| | - Caron Zlotnick
- Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island, United States of America
- Department of Medicine at Women and Infants Hospital, Providence, Rhode Island, United States of America
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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Sabri B, Saha J, Lee J, Murray S. Conducting Digital Intervention Research among Immigrant Survivors of Intimate Partner Violence: Methodological, Safety and Ethnical Considerations. JOURNAL OF FAMILY VIOLENCE 2022; 38:447-462. [PMID: 35531064 PMCID: PMC9054112 DOI: 10.1007/s10896-022-00405-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/20/2022] [Indexed: 06/14/2023]
Abstract
Intimate partner violence, described as a global pandemic by the United Nations, has been found to disproportionately affect immigrant women. Many immigrant survivors of IPV are unable or unwilling to attend in-person services due to barriers related to immigration status, transportation, and social isolation. By providing remote support to women in abusive relationships, digital interventions can help address these barriers and ensure their health and safety. Research on safe and ethical approaches to digital service delivery for immigrant IPV survivors is a necessary first step to meeting these women's needs for remote support. The purpose of this qualitative study was to explore considerations and challenges of conducting digital intervention research (online, phone and text) with diverse groups of immigrant women. Data was collected via 5 focus groups and 46 in-depth interviews with immigrant survivors of IPV from different countries of origin. In addition, data was collected via key informant interviews with 17 service providers. Participants shared safety, ethical and methodological challenges to accessing interventions, such as their abusive partner being at home or lack of safe access to technology. Further, participants shared strategies for safe data collection, such as scheduling a contact time when participants are afforded privacy and deleting evidence of the intervention to retain personal safety. The findings will be informative for researchers conducting digital intervention studies or practitioners engaging in remote intervention approaches with marginalized populations such as immigrant women at high risk of violence.
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Affiliation(s)
- Bushra Sabri
- Johns Hopkins University School of Nursing, 525 North Wolfe Street, Room N530L, Baltimore, MD 21205 USA
| | - Jyoti Saha
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD USA
| | - Jennifer Lee
- Johns Hopkins University School of Nursing, 525 North Wolfe Street, Room N530L, Baltimore, MD 21205 USA
| | - Sarah Murray
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD USA
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Sabri B, Glass N, Murray S, Perrin N, Case JR, Campbell JC. A technology-based intervention to improve safety, mental health and empowerment outcomes for immigrant women with intimate partner violence experiences: it's weWomen plus sequential multiple assignment randomized trial (SMART) protocol. BMC Public Health 2021; 21:1956. [PMID: 34711182 PMCID: PMC8554998 DOI: 10.1186/s12889-021-11930-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 10/06/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) disproportionately affects immigrant women, an understudied and underserved population in need for evidence-based rigorously evaluated culturally competent interventions that can effectively address their health and safety needs. METHODS This study uses a sequential, multiple assignment, randomized trial (SMART) design to rigorously evaluate an adaptive, trauma-informed, culturally tailored technology-delivered intervention tailored to the needs of immigrant women who have experienced IPV. In the first stage randomization, participants are randomly assigned to an online safety decision and planning or a usual care control arm and safety, mental health and empowerment outcomes are assessed at 3-, 6- and 12-months post-baseline. For the second stage randomization, women who do not report significant improvements in safety (i.e., reduction in IPV) and empowerment from baseline to 3 months follow up (i.e., non-responders) are re- randomized to safety and empowerment strategies delivered via text only or a combination of text and phone calls with trained advocates. Data on outcomes (safety, mental health, and empowerment) for early non-responders is assessed at 6 and 12 months post re-randomization. DISCUSSION The study's SMART design provides an opportunity to implement and evaluate an individualized intervention protocol for immigrant women based on their response to type or intensity of intervention. The findings will be useful for identifying what works for whom and characteristics of participants needing a particular type or intensity level of intervention for improved outcomes. If found to be effective, the study will result in an evidence-based trauma-informed culturally tailored technology-based safety decision and planning intervention for immigrant survivors of IPV that can be implemented by practitioners serving immigrant women in diverse settings. TRIAL REGISTRATION This trial was registered with ClinicalTrials.gov as NCT04098276 on September 13, 2019.
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Affiliation(s)
- Bushra Sabri
- School of Nursing, Johns Hopkins University, 525 North Wolfe Street, Room S408, Baltimore, MD 21205 USA
| | - Nancy Glass
- Nancy Glass, Johns Hopkins University School of Nursing, Baltimore, MD 21205 USA
| | - Sarah Murray
- Sarah Murray, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205 USA
| | - Nancy Perrin
- Nancy Perrin, Johns Hopkins University School of Nursing, Baltimore, MD 21205 USA
| | - James R. Case
- James R. Case, Johns Hopkins University School of Nursing, Baltimore, MD 21205 USA
| | - Jacquelyn C. Campbell
- Jacquelyn C. Campbell, Johns Hopkins University School of Nursing, Baltimore, MD 21205 USA
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Gao L, Dahmen A, Keller FM, Becker P, Lippke S. The Mediation Effect of Phobic Anxiety on the Treatment Outcome of Activity and Participation across Age: Comparison between Online and Face-to-Face Rehabilitation Aftercare of an RCT. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10919. [PMID: 34682655 PMCID: PMC8536151 DOI: 10.3390/ijerph182010919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 11/24/2022]
Abstract
The efficacy of internet and mobile-based interventions (IMIs) has been demonstrated with different mental health disorders, but little is known about the mediating effect of phobic anxiety on activity and participation and the differential effect of age. The current study tested a moderated mediation model with short-term change in phobic anxiety mediating between treatment (IMI vs. face-to-face, F2F) and long-term change in activity and participation, and age of patients moderating this mediation. Participants (N = 142) were recruited from psychosomatic rehabilitation clinics and randomized into the IMI psychosomatic aftercare or F2F psychosomatic aftercare. Moderated mediation analyses were conducted using R software. Results showed that the long-term treatment effects of activity and participation (βc = -0.18, p = 0.034; βc' = -0.13, p = 0.145) were improved through the successful decrease of phobic anxiety (βa = -0.18, p = 0.047; βb = 0.37, p = 0.010). Older patients benefited equally from both IMI and F2F interventions regarding short-term treatment change in phobic anxiety, while younger participants benefited more from IMI (βAge*Treatment = 0.20, p = 0.004). IMIs targeting mental disorders can improve activity and participation along with phobic anxiety, especially in younger individuals. The needs of older patients should be considered with the development and improvement of IMIs.
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Affiliation(s)
- Lingling Gao
- Department of Psychology & Methods, Jacobs University Bremen, 28759 Bremen, Germany; (L.G.); (A.D.); (F.M.K.)
| | - Alina Dahmen
- Department of Psychology & Methods, Jacobs University Bremen, 28759 Bremen, Germany; (L.G.); (A.D.); (F.M.K.)
- Dr. Becker Klinikgruppe, 50968 Cologne, Germany;
- Klinikum Wolfsburg, 38440 Wolfsburg, Germany
| | - Franziska Maria Keller
- Department of Psychology & Methods, Jacobs University Bremen, 28759 Bremen, Germany; (L.G.); (A.D.); (F.M.K.)
| | - Petra Becker
- Dr. Becker Klinikgruppe, 50968 Cologne, Germany;
| | - Sonia Lippke
- Department of Psychology & Methods, Jacobs University Bremen, 28759 Bremen, Germany; (L.G.); (A.D.); (F.M.K.)
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Emezue CN, Enriquez M, Dougherty DS, Bullock LFC, Bloom TL. Rural young males' acceptance & receptiveness to technology-based interventions for dating violence prevention: A qualitative descriptive study. J Adolesc 2021; 92:137-151. [PMID: 34530185 DOI: 10.1016/j.adolescence.2021.08.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/19/2021] [Accepted: 08/24/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Rural youth are twice as likely as urban youth to experience some forms of teen dating violence (TDV), and significant barriers to accessing support services for physical, psychological, sexual violence. However, rural youth remain understudied and undersampled. Rural young men, in particular, are at risk for experiencing or perpetrating dating violence influenced by regional and sociocultural risk factors that promote male supremacy ideals while also impeding male help-seeking. Technology-based interventions circumvent some of these risk factors by offering confidential and reliable support. This study investigates rural young males' acceptability of technology-based interventions for fostering healthy relationships and preventing dating abuse, including their preferences for intervention content and features. METHODS Three online focus groups (n = 14) and phone interviews (n = 13) were conducted with rural young males. Participants were stratified by age (15-17 and 18-24 year-olds). Most were White (81%) from the United States Midwest (65%). Semi-structured interview data were analyzed using Qualitative Description (QD), guided by the Unified Theory of Acceptance and Use of Technology (UTAUT). RESULTS Three themes identified were (1) Scarcity of Useful Resources, (2) Socio-Structural Challenges for Intervention Uptake, with two subthemes (2a) Rural-Specific Structural Barriers and (2b) Rural Masculinity Disrupting Help-seeking; (3) Finally, participants discussed Functionality and Design Needs, itemizing their intervention "must-have" in terms of content, resources, and features. CONCLUSION This qualitative study identified obstacles and facilitators to using technology-based interventions for dating violence prevention among young rural males and offers pragmatic "ready-to-use" recommendations for the development of technology-based anti-dating violence interventions for rural youth.
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Affiliation(s)
- Chuka N Emezue
- Rush University College of Nursing, Department of Women, Children and Family Nursing Chicago, IL, USA.
| | - Maithe Enriquez
- Sinclair School of Nursing, University of Missouri-Columbia, Missouri, USA.
| | - Debbie S Dougherty
- College of Arts and Science Communication, University of Missouri-Columbia, Missouri, USA.
| | - Linda F C Bullock
- Sinclair School of Nursing, University of Missouri-Columbia, Missouri, USA.
| | - Tina L Bloom
- School of Nursing, Notre Dame of Maryland University, Baltimore, MD, USA.
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