Volunteer and user evaluation of the National Sexual Assault Online Hotline

EHealth for Sexual Assault: A Systematic Scoping Review

Providing efficient psychosocial support for survivors of sexual assault is of critical societal importance. Around the globe, technology-based solutions (eHealth) are increasingly being used to accomplish this task, especially following COVID-19. Despite increased importance and reliance on eHealth for sexual assault, minimal efforts have been made to systematically synthesize research in this area. The present study therefore sought to synthesize what is known about eHealth targeting sexual assault survivors' psychosocial needs using a systematic scoping review methodology. To this end, five databases (CINAHL, Embase, PsycINFO, MEDLINE, and Scopus) were systematically searched for studies published from 2010 onwards using terms such as "sexual assault", "eHealth", "digital health", "telehealth", and variations thereof. Of the 6,491 records screened for eligibility, 85 studies were included in the review. We included empirical studies from all countries pertaining to eHealth for sexual assault for survivors 13 years or older. Many innovative eHealth applications for sexual assault exist today, and the included studies suggested that survivors generally experience eHealth positively and seem to benefit from it. Nevertheless, much more clinical and empirical work is needed to ensure accessible and effective solutions for all.

Creating a Digital Trauma Informed Space: Chat and Text Advocacy for Survivors of Violence

There is little research on virtual service models like chat and text services in agencies that work with survivors of intimate partner violence (IPV) and sexual assault (SA). This study fills a gap in the research by exploring how chat and text services are provided in one IPV and SA-focused community organization. We analyzed chat and text transcripts (n = 392) from a large multiservice, multivictimization focused agency, and conducted interviews with 11 advocates providing chat and text services through the agency hotline. Staff interviews were analyzed using grounded theory and transcripts were analyzed using content analysis. Results indicate chat/text services provide a space for connection, resource provision, education, and access to resource gain in a timely, concise, and survivor-centered way. The five major goals for chat/text advocacy models include the following: (1) rapid access to support and connection; (2) identification of options and needs for each service user; (3) increased access to resources and supports; (4) expanded understanding of violence, abuse, and harm; and (5) improvement of survivor safety. The research team identified 15 general advocacy skills and 4 chat and text specific skills used by chat/text advocates to reach program goals. Findings highlight the utility of chat/text services for increasing access to support services for survivors of violence, particularly adolescents, emerging adults, those living with an abusive individual, and during times of emergency. Future research should continue to explore the promising practice modality of chat/text services for providing advocacy to underserved and hard-to-reach populations.

The United Nations Victim Approach Revisited: A Review of the Literature on Sexual Assault and Gender-Based Violence Hotlines

In 1985, the United Nations General Assembly adopted the Principles of Justice for Victims of Crime and Abuse of Power, to protect and promote victim rights when navigating the criminal justice system. Today, technology, such as online and telephone hotlines, are changing how victims seek and receive support. Our review of the emerging gender-based violence and sexual assault hotline literature outlines where and how international initiatives can practically address complex experiences that shape how victims of violence (VOV) interact with criminal justice settings. In the literature, we identified common themes that revealed VOV demographics and contextual factors that complicate the implementation of victim-based criminal justice procedures. Our findings reveal that gender, age, and contextual factors, like the length of time before someone discloses their victimization, impact the experience of VOV. Our review suggests that the Principles of Justice for Victims of Crime and Abuse of Power should be updated to address individuals' diverse experiences when choosing to report their victimization.

Developing a WhatsApp hotline for female entertainment workers in Cambodia: a qualitative study

BACKGROUND

Female entertainment workers (FEWs) in Cambodia experience high levels of stress due to economic hardship, exposure to violence, and harassment by law enforcement due to their employment. This study aims to gather qualitative data on stressors, coping strategies, and preferences for chatline functions to inform the development of a WhatsApp hotline (chatline) for FEWs in Cambodia.

METHODS

This qualitative study includes data from 5 focus groups and 10 in-depth interviews (IDIs), at which point data collectors felt we approached saturation. Participants were asked to respond to open-ended questions, a comic strip showing how the hotline might work and an audio recording of a hypothetical hotline conversation. Primary structural coding was used to identify the preferred functions and type of support participants want to receive from hotline staff. As more secondary themes arose during codebook development, an inductive thematic analytical approach was selected to categorize these data.

RESULTS

Participants identified several stressors associated with female entertainment work, including concerns about physical and mental health, fear related to experiences with the police or threat of arrest, and exposure to violence. Passive/avoidance and active coping strategies were also identified. Participants preferred a 24 h chatline that provides emotional support from a kind and comforting female staff person. The types of support participants were looking for were advice about personal problems, encouragement to achieve their goals and address depression, and immediate help for violence. Most participants felt that the hotline could bring them a sense of relief and safety and improve their mood. Some stated that the hotline alone would not alleviate the stressors they were exposed to, particularly related to violence and called for more transformational change.

CONCLUSIONS

This study offers textured evidence to inform the WhatsApp hotline development and staff training tailored to meet the needs of this specific population. Linking this hotline with crisis response, legal support, and longer-term in-depth counseling and using information gathered from this project to inform more extensive structural and policy-level changes should also be part a foundational part of this project.

Sexual assault reporting amongst users of online sexual health services

Sexual assault (SA) survivors often attend sexual health clinics (SHC) for care relating to their assault. Reported rates of SA amongst SHC attendees can be high. Online sexual health services are becoming increasingly popular. Sexual Health London (SHL) is a large online sexual transmitted infection (STI) screening service. Between 1.1.20– 8.2.20, 0.5% (242/45841) (54% female, 45.6% male) of adults disclosed a recent SA when ordering an online STI testing kit. 79% (192/242) users engaged in a call back discussion initiated by the SHL team: 45% (87/192) users confirmed a SA had occurred and 53% (101/242) users denied an assault (particularly men) stating they had reported this in error. 18% (16/87) users had already reported their SA to the police/sexual assault centre, and one user accepted an onward referral. This study found a low reporting rate of SA amongst SHL users, but despite a high response rate to call backs, >50% cited they reported in error, 25% (22/87) didn’t want to discuss their SA and few accepted onward referrals. Using e-triage to screen for SA followed by service-initiated telephonic support to everyone who discloses, may not be acceptable or offer utility to all. Further evaluation of ways to engage these individuals is required.

“Even crap can be fertilizer”: The experience of volunteering at sexual assault crisis centers for women survivors of sexual assault

This qualitative study illuminates the experience of volunteering at sexual assault crisis centers among women survivors of sexual assault. In-depth interviews were conducted with 11 women who had been volunteering at four different sexual assault crisis centers across Israel for 1 to 17 years. The findings reveal three main themes. First, there are five types of motivation to volunteer at such centers, all grounded in the participants’ experience of sexual assault. Second, volunteering fosters recovery by promoting an empowered identity reconstruction and social integration. Third, both challenges and risks to recovery, such as exposure to sexual-assault triggers, arise from the experiences of sexual assault and volunteering at the centers. Moreover, the findings indicate various mechanisms that shape the risks–benefits dynamic involved in volunteering, such as the demands of the volunteering role. Thus, this study shifts the understanding of prosocial behavior by sexual-assault survivors from a binary assessment of “positive” or “negative” to a more comprehensive appraisal at the individual, role, and organizational levels.

Public Awareness for a Sexual Assault Hotline Following a Grey's Anatomy Episode

This study examines a rise in telephone calls to the Rape, Abuse, and Incest National Network rape crisis hotline in the wake of an episode of the television show Grey’s Anatomy focused on rape and ending with the hotline number.

Chat-based hotlines for health promotion: a systematic review

BACKGROUND

Chat-based hotlines use online messaging services or popular chat applications such as WhatsApp, Facebook Messenger, and WeChat, to connect users to trained health providers or staff. Chat-based hotlines can provide real-time communication between health providers and patients.

METHODS

The evidence for chat-based hotlines for health promotion has not been reviewed systematically. Electronic databases (PubMed, Cochrane Database, Google Scholar) were searched to identify English-language studies describing original research published from 2009 to 2020. This review was registered with Prospero Register of Systematic Reviews (ID: CRD42020156670).

RESULTS

Twelve publications met our criteria. Ten studies reported on user characteristics, eight on comparing use of chat-based hotlines with different modes of support, six on health outcomes and six on user satisfaction. Included studies report that chat-based hotlines have been used primarily for crisis and emotional support in high-income countries. Chat-based hotlines using instant messenger applications were preferred over other modes of services such as email, text messaging, voice calls, and face-to-face counselling. Evaluations of health outcomes, although limited in rigor due to mostly observational study designs, indicate mostly positive and statistically significant effects on mental health outcomes such as anxiety, depression, well-being and suicidality. User satisfaction with chat-based hotlines were moderately high.

CONCLUSIONS

Chat-based hotlines may be effective ways to deliver crisis support services in high income settings. They may have the potential to be effective in low- and middle-income countries to expand the reach of mental health and crisis support services although such services have not yet been publicly evaluated.

Comparing Help-Seeking Behavior of Male and Female Survivors of Sexual Assault: A Content Analysis of a Hotline

This content analysis examines written documentation of telephone calls to a regional sexual assault hotline over a 5-year period. All male callers identified as primary victims were selected for analysis ( n = 58) and a corresponding sample of female primary victims ( n = 58) were randomly selected for comparison to better understand the help-seeking behavior of sexual assault survivors and inform services accordingly. A summative content analysis revealed significant contrasting themes between male and female victims, including females significantly receiving more referrals and males accessing the hotline to tell their experience of being sexually assaulted due to perceived limited support. Implications for training, practice, and future research are discussed.

Expanding Suicide Crisis Services to Text and Chat

Abstract. Background: Crisis support services have historically been offered by phone-based suicide prevention hotlines, but are increasingly becoming available through alternative modalities, including Internet chat and text messaging. Aims: To better understand differences in the use of phone and chat/text services. Method: We conducted semistructured interviews with call responders at the Veterans Crisis Line who utilize multimodal methods to respond to veterans in crisis. Results: Responders indicated that veterans may access the chat/text service primarily for reasons that included a desire for anonymity and possible inability to use the phone. Responders were divided on whether callers and chatters presented with different issues or risk of suicide; however, they suggested that veterans frequently use chat/text to make their first contact with mental health services. Limitations: We spoke with call responders, not the veterans themselves. Additionally, as this is qualitative research, applicability to other settings may be limited. Conclusion: While new platforms offer promise, participants also indicated that chat services can supplement phone lines, but not replace them.

An Exploratory Case Study of a Sexual Assault Telephone Hotline: Training and Practice Implications

Using archival data, this case study systematically examines telephone calls received by a regional sexual assault hotline in the Southeastern United States over a 5-year period. A stratified random sample ( n = 383) reveals that hotline staff require diversity and depth in knowledge and skills, demonstrated by the hotline’s primary use as a crisis service, combined with notable use by long-term survivors. Findings include the utility of the hotline by survivors and community stakeholders, categories of assault, the time gap between incidents occurring and contacting the hotline, call severity and urgency, and services and referrals provided. Implications for training, practice, and future research are discussed.

Self-presentation on the Web: agencies serving abused and assaulted women

OBJECTIVES

We examined the content and usability of the Web sites of agencies serving women victims of violence.

METHODS

We entered the names of a systematic 10% sample of 3774 agencies listed in 2 national directories into a search engine. We took (in April 2012) and analyzed screenshots of the 261 resulting home pages and the readability of 193 home and first-level pages.

RESULTS

Victims (94%) and donors (68%) were the primary intended audiences. About one half used social media and one third provided cues to action. Almost all (96.4%) of the Web pages were rated "fairly difficult" to "very confusing" to read, and 81.4% required more than a ninth-grade education to understand.

CONCLUSIONS

The service and marketing functions were met fairly well by the agency home pages, but usability (particularly readability and offer of a mobile version) and efforts to increase user safety could be improved. Internet technologies are an essential platform for public health. They are particularly useful for reaching people with stigmatized health conditions because of the anonymity allowed. The one third of agencies that lack a Web site will not reach the substantial portion of the population that uses the Internet to find health information and other resources.