Intimate partner violence: a review of online interventions

Stalking Discourse on Reddit: A Comparative Analysis of Pre- and Post-COVID-19 Pandemic Using Big Data

Stalking, a widespread and distressing phenomenon, has recently garnered considerable attention. The advent of digital platforms has revolutionized the landscape of stalking, presenting new avenues and challenges for research. However, the impact of the coronavirus disease (COVID)-19 pandemic on stalking remains underexplored, despite extensive studies on similar crimes such as intimate partner violence and domestic violence. To address this gap, our study focused on Reddit, a prominent online platform with a diverse user base and open discussion. Through an analysis of posts from the subreddit (https://www.reddit.com/r/Stalking/), we sought to compare the discourse on stalking before and after the COVID-19 pandemic. We found notable shifts in stalking-related posts before and after the COVID-19 pandemic, particularly with the emergence of new topics centered on cyberstalking. We also observed that the experiences of stalking victims have significantly changed following the COVID-19 pandemic. Based on our findings, we discussed the implications for policies to help stalking victims.

Efficacy of Psychosocial Interventions for Survivors of Intimate Partner Violence: A Systematic Review and Meta-Analysis

Survivors of intimate partner violence (IPV) face serious health-related, social and economic consequences. Prior meta-analyses indicate efficacy of psychosocial interventions for support of IPV survivors, but their results are affected by methodological limitations. Extensive subgroup analyses on the moderating effects of intervention and study characteristics are lacking. To address these limitations in an up-to-date and comprehensive meta-analytic review, four literature databases (PsycInfo, Medline, Embase, and CENTRAL, March 23, 2022) were searched for randomized-controlled trials examining the efficacy of psychosocial interventions compared to control groups in improving safety-related, mental health, and psychosocial outcomes in IPV survivors. Weighted effects on IPV, depression, posttraumatic stress disorder (PTSD), and psychosocial outcomes were calculated under random-effects assumption. Subgroup analyses were performed to investigate moderating effects of predefined intervention and study characteristics. Study quality was rated. In all, 80 studies were included in qualitative synthesis, and 40 studies in meta-analyses. Psychosocial interventions significantly reduced symptoms of depression (SMD: -0.15 [95% confidence interval, CI [-0.25, -0.04]; p = .006], I2 = 54%) and PTSD (SMD: -0.15 [95% CI [-0.29, -0.01]; p = .04], I2 = 52%), but not IPV reexperience (SMD: -0.02 [95% CI [ -0.09, 0.06]; p = .70], I2 = 21%) compared to control conditions at post. High-intensive and integrative interventions, combining advocacy-based and psychological components, were favorable subgroups. Yielded effects were modest and not maintained long term. The quality of evidence was low and potential harms remain unclear. Future research should adopt higher standards of research conduct and reporting and must account for the complexity and diversity of IPV experiences.

A Review of Intimate Partner Violence Interventions Relevant to Women During the COVID-19 Pandemic

Women have experienced increased rates of intimate partner violence (IPV) since the onset of the COVID-19 global pandemic, and at the same time requirements for physical distancing and/or remote delivery of services have created challenges in accessing services. We synthesized research evidence from 4 systematic reviews and 20 individual studies to address how IPV interventions can be adapted within the context of the pandemic. As many interventions have been delivered via various technologies, access to technology is of particular importance during the pandemic. Our results can inform the provision of services during the remainder of the COVID-19 pandemic including how to support women who have little access to in-person services.

Adapting the ADVANCE group program for digitally-supported delivery to reduce intimate partner violence by men in substance use treatment: a feasibility study

Introduction

COVID-19 restrictions created barriers to "business as usual" in healthcare but also opened the door to innovation driven by necessity. This manuscript (1) describes how ADVANCE, an in-person group perpetrator program to reduce intimate partner violence (IPV) against female (ex)partners by men in substance use treatment, was adapted for digitally-supported delivery (ADVANCE-D), and (2) explores the feasibility and acceptability of delivering ADVANCE-D to men receiving substance use treatment.

Methods

Firstly, the person-based approach and mHealth development framework were used to iteratively adapt ADVANCE for digitally-supported delivery including conceptualization, formative research, and pre-testing. Then, a non-randomized feasibility study was conducted to assess male participants' eligibility, recruitment, and attendance rates and uptake of support offered to their (ex)partners. Exploratory analyses on reductions in IPV perpetration (assessed using the Abusive Behavior Inventory; ABI) and victimization (using the revised ABI; ABI-R) at the end of the program were performed. Longitudinal qualitative interviews with participants, their (ex)partners, and staff provided an understanding of the program's implementation, acceptability, and outcomes.

Results

The adapted ADVANCE-D program includes one goal-setting session, seven online groups, 12 self-directed website sessions, and 12 coaching calls. ADVANCE-D includes enhanced risk management and support for (ex)partners. Forty-five participants who had perpetrated IPV in the past 12 months were recruited, forty of whom were offered ADVANCE-D, attending 11.4 (SD 9.1) sessions on average. Twenty-one (ex)partners were recruited, 13 of whom accepted specialist support. Reductions in some IPV perpetration and victimization outcome measures were reported by the 25 participants and 11 (ex)partners interviewed pre and post-program, respectively. Twenty-two participants, 11 (ex)partners, 12 facilitators, and 7 integrated support service workers were interviewed at least once about their experiences of participation. Overall, the program content was well-received. Some participants and facilitators believed digital sessions offered increased accessibility.

Conclusion

The digitally-supported delivery of ADVANCE-D was feasible and acceptable. Remote delivery has applicability post-pandemic, providing greater flexibility and access. Given the small sample size and study design, we do not know if reductions in IPV were due to ADVANCE-D, time, participant factors, or chance. More research is needed before conclusions can be made about the efficacy of ADVANCE-D.

Protocol for a randomised controlled trial of a healthy relationship tool for men who use intimate partner violence (BETTER MAN)

BACKGROUND

Intimate partner violence (IPV) is common globally, but there is a lack of research on how to intervene early with men who might be using IPV. Building on evidence supporting the benefits of online interventions for women victim/survivors, this study aims to test whether a healthy relationship website (BETTER MAN) is effective at improving men's help seeking, their recognition of behaviours as IPV and their readiness to change their behaviours.

METHODS/DESIGN

In this two-group, pragmatic randomised controlled trial, men aged 18-50 years residing in Australia who have been in an adult intimate relationship (female, male or non-binary partner) in the past 12 months are eligible. Men who report being worried about their behaviour or have had others express concerns about their behaviour towards a partner in the past 12 months will be randomised with a 1:1 allocation ratio to receive the BETTER MAN website or a comparator website (basic healthy relationships information). The BETTER MAN intervention includes self-directed, interactive reflection activities spread across three modules: Better Relationships, Better Values and Better Communication, with a final "action plan" of strategies and resources. Using an intention to treat approach, the primary analysis will estimate between-group difference in the proportion of men who report undertaking help-seeking behaviours for relationship issues in the last 6 months, at 6 months post-baseline. Analysis of secondary outcomes will estimate between-group differences in: (i) mean score of awareness of behaviours in relationships as abusive immediately post-use of website; (ii) mean score on readiness to change immediately post-use of website and 3 months after baseline; and (iii) cost-effectiveness.

DISCUSSION

This trial will evaluate the effectiveness of an online healthy relationship tool for men who may use IPV. BETTER MAN could be incorporated into practice in community and health settings, providing an evidence-informed website to assist men to seek help to promote healthy relationships and reduce use of IPV.

TRIAL REGISTRATION

ACTRN12622000786796 with the Australian New Zealand Clinical Trials Registry: 2 June 2022. Version: 1 (28 September 2023).

Technology-Facilitated Abuse in Intimate Relationships: A Scoping Review

Technology-facilitated abuse (TFA) is a significant, harmful phenomenon and emerging trend in intimate partner violence. TFA encompasses a range of behaviours and is facilitated in online spaces (on social media and networking platforms) and through the misuse of everyday technology (e.g. mobile phone misuse, surveillance apps, spyware, surveillance via video cameras and so on). The body of work on TFA in intimate relationships is emerging, and so this scoping review set out to establish what types of abuse, impacts and forms of resistance are reported in current studies. The scoping review examined studies between 2000 and 2020 that focused on TFA within intimate partnerships (adults aged 18+) within the setting of any of these countries: the UK and Ireland, USA, Canada, New Zealand and Australia. The databases MEDLINE, CINAHL and Scopus were searched in December 2020. A total of 22 studies were included in the review. The main findings were that TFA is diverse in its presentation and tactics, but can be typed according to the eight domains of the Duluth Power & Control Wheel. Impacts are not routinely reported across studies but broadly fall into the categories of social, mental health and financial impacts and omnipresence. Similarly, modes of resistance are infrequently reported in studies. In the few studies that described victim/survivor resistance, this was in the context of direct action, access to legal or professional support or in the identification of barriers to resistance.

Women in Need-The Nature of Social Support in an Online Community

Some women, especially victims of violence, seek support in online groups. The objective of this research was to investigate the nature of the social support women receive in such online communities. For this purpose, all the posts from a large online support community group for women in Slovenia, Women in Need, from 2002 to the end of 2020 were retrieved and analyzed manually as well as by using a text-mining approach. The results show that women in the investigated community mostly seek informational support, spend little time actively contributing to online discussions, and rarely become engaged members of supportive groups within the focal online space. Some recommendations on how to improve the functionality of online social support sites are provided.

Key Factors in Helpfulness and Use of the SAFE Intervention for Women Experiencing Intimate Partner Violence and Abuse: Qualitative Outcomes From a Randomized Controlled Trial and Process Evaluation

BACKGROUND

Many women experience at least one type of intimate partner violence and abuse (IPVA), and although various support options are available, we still know relatively little about web-based interventions for IPVA survivors. We conducted a qualitative evaluation of the SAFE eHealth intervention for women experiencing IPVA in the Netherlands, complementing the quantitative evaluation of self-efficacy, depression, anxiety, and multiple feasibility aspects.

OBJECTIVE

This study assessed users' experiences and what, according to them, were useful and helpful aspects of the intervention.

METHODS

The intervention consisted of modules with information on relationships and IPVA, help options, physical and mental health, and social support. It also contained interactive elements such as exercises, stories from survivors, a chat, and a forum. A randomized controlled trial was conducted with an intervention arm receiving the complete version of the intervention and a control arm receiving only a static version with the modules on relationships and IPVA and help options. We gathered data through open questions from surveys (for both study arms; n=65) and semistructured interviews (for the intervention study arm; n=10), all conducted on the web, during the randomized controlled trial and process evaluation. Interview data were coded following the principles of open thematic coding, and all qualitative data were analyzed using qualitative content analysis.

RESULTS

Overall, most users positively rated the intervention regarding safety, content, and suiting their needs, especially participants from the intervention study arm. The intervention was helpful in the domains of acknowledgment, awareness, and support. However, participants also identified points for improvement: the availability of a simplified version for acute situations; more attention for survivors in the aftermath of ending an abusive relationship; and more information on certain topics, such as technological IPVA, support for children, and legal affairs. Furthermore, although participants expressed a prominent need for interactive contact options such as a chat or forum, the intervention study arm (the only group that had these features at their disposal) mainly used them in a passive way-reading instead of actively joining the conversation. The participants provided various reasons for this passive use.

CONCLUSIONS

The positive outcomes of this study are similar to those of other web-based interventions for IPVA survivors, and specific points for improvement were identified. The availability of interactive elements seems to be of added value even when they are used passively. This study provides in-depth insight into the experiences of female IPVA survivors with the SAFE eHealth intervention and makes suggestions for improvements to SAFE and comparable web-based interventions for IPVA as well as inspiring future research. Furthermore, this study shows the importance of a varied assessment of an intervention's effectiveness to understand the real-world impact on its users.

TRIAL REGISTRATION

Netherlands Trial Register NTR7313; https://tinyurl.com/3t7vwswz.

Digital self-help for people experiencing intimate partner violence: a qualitative study on user experiences and needs including people with lived experiences and services providers

BACKGROUND

Intimate partner violence (IPV) is a prevalent public health issue associated with multiple physical and mental health consequences for survivors. Digital interventions can provide low-threshold support to those experiencing IPV, but existing digital interventions have limited efficacy in improving the safety and mental health of IPV survivors. Digitally adapting an integrative intervention with advocacy-based and psychological content holds promise for increasing the efficacy of digital interventions in the context of IPV.

METHODS

This study examines the needs, acceptability and usability of an integrative digital intervention for people affected by IPV. We used the think-aloud method and semi-structured interviews with a sample of six people with lived experiences of IPV and six service providers. We analyzed the data using thematic analysis.

RESULTS

We identified the increasing general acceptance of digital support tools and the limited capacity of the current support system as societal context factors influencing the acceptance of and needs regarding digital interventions in the context of IPV. An integrative digital self-help intervention offers several opportunities to complement the current support system and to meet the needs of people affected by IPV, including the reduction of social isolation, a space for self-reflection and coping strategies to alleviate the situation. However, potentially ongoing violence, varying stages of awareness and psychological capacities, and as well as the diversity of IPV survivors make it challenging to develop a digital intervention suitable for the target group. We received feedback on the content of the intervention and identified design features required for intervention usability.

CONCLUSION

An integrative digital self-help approach, with appropriate security measures and trauma-informed design, has the potential to provide well-accepted, comprehensive and continuous psychosocial support to people experiencing IPV. A multi-modular intervention that covers different topics and can be personalized to individual user needs could address the diversity of the target population. Providing guidance for the digital intervention is critical to spontaneously address individual needs. Further research is needed to evaluate the efficacy of an integrative digital self-help intervention and to explore its feasibility it in different settings and populations.

Interventions for intimate partner violence during the perinatal period: a scoping review protocol

INTRODUCTION

Globally, the prevalence and incidence of perinatal intimate partner violence (IPV) are well documented and substantiated; however, there is an urgent need to identify interventions to prevent recurrence or revictimisation, and decrease the harms of perinatal IPV. This scoping review is designed to broadly capture all potential interventions for the secondary prevention of IPV, review them in detail, and assess what can reduce revictimisation and foster improvements in both maternal and neonatal outcomes.

METHODS AND ANALYSIS

With the structure of the Joanna Briggs Institute and Arksey and O'Malley methodology for scoping reviews, the search will be conducted in: MEDLINE(R) ALL (OvidSP), Embase (OvidSP), CINAHL (EBSCOHost), APA PsycInfo (OvidSP), Cochrane Central Register of Controlled Trials (OvidSP), Web of Science, and Applied Social Sciences Index & Abstracts (ProQuest). A manual search of the reference lists of the retrieved articles will be conducted to capture all relevant studies for potential inclusion. A year limit of January 2000-June 2022 will be applied to retrieve most current peer-reviewed articles. No search filters or language limits will be used, but only publications in English and French will be eligible for inclusion. Interventions include but are not limited to: psychotherapy, educational sessions, home visitation, etc. Outcomes include but are not limited to: (1) harms of IPV among survivors (eg, revictimisation) and (2) adverse perinatal outcomes (eg, preterm birth). Interventions will be excluded if they target the perpetrator or child(ren) alone. Titles and abstracts of included studies will be screened in duplicate. Full-text documents will be extracted and reviewed by two independent reviewers. Conflicts between reviewers will be resolved by a third independent reviewer. Findings will be presented with descriptive statistics and narrative synthesis.

ETHICS AND DISSEMINATION

Ethics approval is not required for this scoping review. The results will be disseminated through peer-reviewed publication and conference presentations.

STUDY REGISTRATION

Open Science Framework (OSF) registry (https://osf.io/e294r) in Centre for Open Science (OSF) on 27 May 2022.

Examining the Effectiveness, Acceptability, and Feasibility of Virtually Delivered Trauma-Focused Domestic Violence and Sexual Violence Interventions: A Rapid Evidence Assessment

The COVID-19 pandemic has forced a rapid shift to virtual delivery of treatment and care to individuals affected by domestic violence and sexual violence. A rapid evidence assessment (REA) was undertaken to examine the effectiveness, feasibility and acceptability of trauma-focused virtual interventions for persons affected by domestic violence and sexual violence. The findings from this review will provide guidance for service providers and organizational leaders with the implementation of virtual domestic violence and sexual violence-focused interventions. The REA included comprehensive search strategies and systematic screening of and relevant articles. Papers were included into this review (1) if they included trauma-focused interventions; (2) if the intervention was delivered virtually; and (3) if the article was published in the English-language. Twenty-one papers met inclusion criteria and were included for analysis. Findings from the rapid review demonstrate that virtual interventions that incorporate trauma-focused treatment are scarce. Online interventions that incorporate trauma-focused treatment for this at-risk group are limited in scope, and effectiveness data are preliminary in nature. Additionally, there is limited evidence of acceptability, feasibility and effectiveness of virtual interventions for ethnically, culturally, and linguistically diverse populations experiencing domestic violence and sexual violence. Accessing virtual interventions was also highlighted as a barrier to among participants in studies included in the review. Despite the potential of virtual interventions to respond to the needs of individuals affected by domestic violence and/or sexual violence, the acceptability and effectiveness of virtual trauma-focused care for a diverse range of populations at risk of violence are significantly understudied.

A systematic review of ethical challenges and opportunities of addressing domestic violence with AI-technologies and online tools

Domestic violence remains a pressing complex social problem of people of any gender, age, socio-economic status, and ethno-cultural background, an issue that worsened worldwide during the COVID-19 pandemic. Digital, online, or artificial intelligence-based smart technological services, applications, and tools provide novel approaches in addressing domestic violence, including intimate partner violence. This systematic literature review analyses the ethical challenges and opportunities these (protective) digital and smart technologies provide to the stakeholders involved. Our results highlight that the public health and societal issue are the leading narratives of domestic violence, which is predominantly interpreted as gender-based violence. The review highlights an emerging trend of the role of machine learning- and artificial intelligence-based approaches in identifying and preventing domestic violence. However, we argue that little recommendation is available to professionals about how to use these approaches in a responsible way, and that the smartness of high-tech technologies is often challenged by basic-level technologies from perpetrators, creating an imbalance that also limits an impactful development of a comprehensive socio-technical regime that serves the safety and resilience of families in their communal setting.

Smartphone Apps for Domestic Violence Prevention: A Systematic Review

Smartphone applications or apps are increasingly being produced to help with protection against the risk of domestic violence. There is a need to formally evaluate their features.

OBJECTIVE

This study systematically reviewed app-based interventions for domestic violence prevention, which will be helpful for app developers.

METHODS

We overviewed all apps concerning domestic violence awareness and prevention without language restrictions, collating information about features and limitations. We conducted searches in Google, the Google Play Store, and the App Store (iOS) covering a 10-year time period (2012-2022). We collected data related to the apps from the developers' descriptions, peer reviewed research articles, critical reviews in blogs, news articles, and other online sources.

RESULTS

The search identified 621 potentially relevant apps of which 136 were selected for review. There were five app categories: emergency assistance (n = 61, 44.9%), avoidance (n = 29, 21.3%), informative (n = 29, 21.3%), legal information (n = 10, 7.4%), and self-assessment (n = 7, 5.1%). Over half the apps (n = 97, 71%) were released in 2020-22. Around a half were from north-east America (n = 63, 46.3%). Where emergency alerts existed, they required triggering by the potential victim. There was no automation. Content analysis showed 20 apps with unique features, including geo-fences, accelerometer-based alert, shake-based alert, functionality under low resources, alert auto-cancellation, anonymous communication, and data encryption. None of the apps deployed artificial intelligence to assist the potential victims.

CONCLUSIONS

Apps currently have many limitations. Future apps should focus on automation, making better use of artificial intelligence deploying multimedia (voice, video, image capture, text and sentiment analysis), speech recognition, and pitch detection to aid in live analysis of the situation and for accurately generating emergency alerts.

Prevalence & Correlates of Intimate Partner Violence During COVID-19: A Rapid Review

In response to the COVID-19 pandemic, governments enacted a range of public health measures aimed at preventing the spread of the virus. These measures resulted in school closures, social isolation, and job loss, which all contributed to increased psychosocial stress, particularly among families with pre-existing vulnerability factors. Given the relationship between increased psychosocial stress and intimate partner violence (IPV), this rapid review investigated change in the prevalence and correlates of IPV victimization during the first six months of the pandemic. PsycINFO, MEDLINE, Embase, PubMed, Scopus, and the Cochrane COVID-19 registry were reviewed. This search resulted in 255 unique results, of which 24 studies were included. There were 19 studies that examined changes in the rate of IPV from before the COVID-19 pandemic to during the pandemic. Of the studies examining changes in the rate of IPV, 11 found a significant increase. Key vulnerability factors contributing to the increase include low socioeconomic status, unemployment, a personal or familial COVID-19 diagnosis, family mental illness, or overcrowding. Six studies examined whether the presence of children in the home was associated with IPV, but the direction of this relationship was inconsistent. This review finds preliminary evidence of a relationship between COVID-19 induced stressors, pre-existing vulnerabilities, and increased IPV, which present important implications for policy and practice.

Intimate Partner Violence and Openness to Online Counseling Among College Students

Intimate partner violence (IPV) is prevalent and has devastating consequences for college students. Online counseling (OC) may be a way to decrease barriers to help. This study seeks to determine openness to OC compared to face-to-face counseling (F2F) by examining: (1) How openness to OC varies depending on college students' personal and IPV characteristics and (2) How these characteristics vary compared to college non-IPV survivors. Two linear regressions were conducted using a sample from a cross sectional survey. First with the entire sample of college students (N = 1,518) to examine characteristics of those more open to OC and second with only those that identified as experiencing IPV (n = 1,211). The results demonstrated that IPV survivors are less open to OC than to F2F counseling (b = -.23, p < .01). For the model with all college students, those who were significantly more open to OC were female (b = -.39, p < .001), identified as LGBT (b = .23, p < .05), or Asian/Pacific Islander (API) (b = .26, p < .05), and had a physical health issue (b = -.19, p < .05). For the model that only analyzed IPV survivors, the same characteristics were shown to be significantly related to openness to OC. More research is needed to explore why IPV survivors are less open to OC compared to F2F counseling. Exploring why characteristics of female, LGBT, and physical health issues lead to openness to OC could help understand what barriers need to be addressed for wider use.

Information and communications technology use to prevent and respond to sexual and gender-based violence in low- and middle-income countries: An evidence and gap map

BACKGROUND

The use of information and communications technologies (ICT) in low- and middle-income countries (LMIC) has increased significantly in the last several years, particularly in health, including related areas such as preventing and responding to sexual and gender-based violence (SGBV) against women and children. While the evidence for ICT effectiveness has grown significantly in the past 5 years in other aspects of health, it has not for effectiveness of using ICT for the prevention and response to SGBV against women and children in LMIC.

OBJECTIVES

The primary goal of this evidence and gap map (EGM) is to establish a baseline for the state of the evidence connected with the use of ICT for preventing and responding to SGBV against women and children in LMIC. Objectives that contribute to the achievement of this goal are: (1)identifying evidence of effectiveness for the use of ICT targeting the prevention of, and response to, SGBV against women and children in LMIC;(2)identifying key gaps in the available ICT for SGBV prevention and/or response evidence;(3)identifying research methodology issues reflected in the current evidence;(4)identifying any clusters of evidence in one or more ICT interventions suitable for systematic review;(5)identifying enabling factors associated with effective interventions using ICT for the prevention of, and response to, SGBV against women and children in LMIC; and(6)providing a structured and accessible guide to stakeholders for future investment into interventions and research using ICT for SGBV prevention and response in LMIC.

SEARCH METHODS

The date of the last search from which records were evaluated, and any studies identified were incorporated into the EGM was July 11, 2021. Twenty (20) databases were searched, and identified under "Methods."

SELECTION CRITERIA

We conducted systematic searches of multiple academic databases using search terms and criteria related to the use of ICT for prevention and/or response to SGBV against women and children. Although excluded, we did consider studies conducted in higher-income countries (HIC) only to provide context and contrast for the EGM discussion of the eligible studies from LMIC.

DATA COLLECTION AND ANALYSIS

The EGM search process included five phases: (1) initial search of academic databases conducted by two researchers simultaneously; (2) comparison of search results, and abstract screening by two researchers collaboratively; (3) second screening by reviewing full articles of the studies identified in the first screening by two reviewers independently; (4) comparison of results of second screening; resolution of discrepancies of screening results; and (5) data extraction and analysis.

MAIN RESULTS

The EGM includes 10 studies published in English of which 4 were systematic, literature or scoping reviews directly addressing some aspect of the use of ICT for SGBV prevention and/or response in women and girls. The six individual studies were, or are being, conducted in LMIC (a condition for eligibility). No eligible studies addressed children as a target group, although a number of the ineligible studies reported on the use of ICT for intermediate outcomes connected with violence against children (e.g., digital parenting). Yet, such studies did not explicitly attach those intermediate outcomes to SGBV prevention or response outcomes. Countries represented among the eligible individual studies include Cambodia, Kenya, Nepal Democratic Republic of Congo (DRC), and Lebanon. Of the 10 eligible studies (individual and reviews), most focused on intimate partner violence against women (IPV). Intervention areas among the eligible studies include safety planning using decision algorithms, educational and empowerment messaging regarding norms and attitudes towards gender-based violence (GBV), multi-media radio drama for social behavior change, the collection of survivor experience to inform SGBV/GBV services, and the collection of forensic evidence connected to the perpetration of SGBV. Thirty-one studies which otherwise would have been eligible for the evidence and gap map (EGM) were conducted in HIC (identified under "Excluded Reviews"). None of the eligible studies reported results related to effectiveness of using ICT in a control setting, for the primary prevention of SGBV as an outcome, but rather reported on outcomes such as usability, secondary and tertiary prevention, feasibility, access to services and other outcomes primarily relating to the development of the interventions. Two studies identified IPV prevention as a measurable outcome within their protocols, but one of these had not yet formally published results regarding primary prevention as an outcome. The other study, while reporting on the protocol (and steps to adapt the ICT application, previously reported as effective in HIC contexts to a specific LMIC context), has not yet as of the date of writing this EGM, published outcome results related to the reduction of IPV. Of the four reviews identified as eligible, two are better characterized as either a literature review or case study rather than as traditional systematic reviews reporting on impact outcomes with methodologically rigorous protocols.

AUTHORS' CONCLUSIONS

The evidence baseline for using ICT to prevent and/or respond to SGBV against women and children in LMIC is nascent. Promising areas for future study include: (1) how ICT can contribute changing gender and social norms related to SGBV and primary prevention; (2) mobile phone applications that promote safety and security; (3) mobile technology for the collection and analysis of survivors' experience with SGBV response services; and (4) digital tools that support the collection of forensic evidence for SGBV response and secondary prevention. Most striking is the paucity of eligible studies examining the use of ICT in connection with preventing or responding to SGBV against children. In light of the exponential increase in the use of ICT by children and adolescents, even in LMIC, greater attention should be given to examining how ICT can be used during adolescence to address gender norms that lead to SGBV. While there appears to be interest in using ICT for SGBV prevention and/or response in LMIC, other than several ad hoc studies, there is little evidence of if, and how effective these interventions are. Further inquiry should be made regarding if and how interventions proven effective in HIC can be adapted to LMIC contexts.

Uses of mHealth in Injury Prevention and Control: a Critical Review

Purpose of Reviews

The purpose of this review was to summarize the current state of the literature on the use of "mHealth" (the use of mobile devices for health promotion) for injury prevention and control.

Recent Findings

mHealth is being used to measure, predict, and prevent the full spectrum of injuries. However, most literature remains preliminary or in a pilot stage. Use of best-of-class design principles (e.g., user-centered design, theory-based development) is uncommon, and wide-scale dissemination of effective monitoring or intervention tools is rare.

Summary

mHealth for injury prevention holds promise, but further work is needed across the full spectrum of development and translation.

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.

"If I'd Had Something Like SAFE at the Time, Maybe I Would've Left Him Sooner."-Essential Features of eHealth Interventions for Women Exposed to Intimate Partner Violence: A Qualitative Study

Approximately one in three women worldwide experiences intimate partner violence and abuse (IPVA) in her lifetime. Despite its frequent occurrence and severe consequences, women often refrain from seeking help. eHealth has the potential to remove some of the barriers women face in help seeking and disclosing. To guarantee the client-centeredness of an (online) intervention it is important to involve the target group and people with expertise in the development process. Therefore, we conducted an interview study with survivors and professionals, in order to assess needs, obstacles, and wishes with regard to an eHealth intervention for women experiencing IPVA. Semi-structured interviews were conducted with 16 women (8 survivors and 8 professionals) between 22 and 52 years old, with varied experiences of IPVA and help. Qualitative data was analyzed using a grounded theory approach and open thematic coding. During analysis we identified a third stakeholder group within the study population: survivor-professionals, with both personal experiences of and professional knowledge on IPVA. All stakeholder groups largely agree on the priorities for an eHealth intervention: safety, acknowledgment, contact with fellow survivors, and help. Nevertheless, the groups offer different perspectives, with the survivor-professionals functioning as a bridge group between the survivors and professionals. The groups prioritize different topics. For example, survivors and survivor-professionals highlighted the essential need for safety, while professionals underlined the importance of acknowledgment. Survivor-professionals were the only ones to emphasize the importance of addressing various life domains. The experiences of professionals and survivors highlight a broad range of needs and potential obstacles for eHealth interventions. Consideration of these findings could improve the client-centeredness of existing and future (online) interventions for women experiencing IPVA.

Women's EmotionS, Trauma and EmpowErMent (W-ES.T.EEM) study protocol: a psychoeducational support intervention for victims of domestic violence - a randomised controlled trial

INTRODUCTION

Intimate partner violence (IPV) is a widespread phenomenon that affects the physical and mental well-being of victims. Several barriers prevented sufferers from receiving face-to-face interventions. These obstacles increased with the advent of the COVID-19 pandemic, and online psychological intervention can represent a valid solution to increase the well-being of IPV victims. This manuscript describes the study protocol for a single blind randomised controlled trial that examines the efficacy of a web-based psychoeducational intervention for IPV victims that integrates dialectical behavioural therapy and the empowerment approach.

METHODS AND ANALYSIS

Eighty-six women who were victims of IPV during the COVID-19 outbreak will be recruited by the Interdepartmental Center for Family Research (CIRF) staff from the several antiviolence centres located in Italy. Participants will be randomly allocated to the Women's EmotionS, Trauma and EmpowErMent experimental group or the treatment as usual control condition. Both interventions will be administered individually to each woman.

ETHICS AND DISSEMINATION

The study protocol was approved by the Ethics Committee of the University of Padua (protocol no 4300). Written informed consent will be obtained from all research participants before study entry. Study results will be published as peer-reviewed articles. Any relevant protocol changes will be reported in the published articles. The results will be reported anonymously.

TRIAL REGISTRATION NUMBER

ISRCTN12880309.

On the Front Lines of the COVID-19 Pandemic: Occupational Experiences of the Intimate Partner Violence and Sexual Assault Workforce

In the face of increasing risk for intimate partner violence (IPV) and sexual assault during the COVID-19 pandemic, there is an urgent need to understand the experiences of the workforce providing support to survivors, as well as the evolving service delivery methods, shifting safety planning approaches, and occupational stress of frontline workers. We addressed this gap by conducting an online survey of members of IPV and sexual assault workforce using a broad, web-based recruitment strategy. In total, 352 staff from 24 states participated. We collaborated with practitioner networks and anti-violence coalitions to develop the brief survey, which included questions about work and health, safety planning, and stress. We used chi-square, t-test, and ANOVA analysis techniques to analyze differences within position and demographic variables. For qualitative data, we used thematic analysis to analyze responses from four open-ended questions. The sample was majority female-identified (93.7%) and essential workers in dual IPV and sexual assault programs (80.7%). Findings demonstrated that since the pandemic began, IPV and sexual assault staff are experiencing more personal and professional stressors, perceive a decrease in client safety, and lack resources needed to help survivors and themselves. Common problems included a lack of food or supplies at home and work and housing and financial support for survivors. There was a 51% increase in the use of video conference for work, which contributed to workforce strain. Reductions in overall service capacity and a shift to remote service provision have implications for both survivors and staff. These findings suggest a critical need for additional training, infrastructure, and support for the IPV and sexual assault workforce. There is an urgent need to classify IPV and sexual assault staff as first responders and address the occupational stress associated with the COVID-19 pandemic.

Improving the mental health of women intimate partner violence survivors: Findings from a realist review of psychosocial interventions

BACKGROUND

Intimate partner violence (IPV) is highly prevalent and is associated with a range of mental health problems. A broad range of psychosocial interventions have been developed to support the recovery of women survivors of IPV, but their mechanisms of action remain unclear.

METHODS

Realist review following a prospectively published protocol in PROSPERO (CRD42018114207) and reported using the Realist and Meta-narrative Evidence Synthesis: Evolving Standards (RAMSES) guidelines.

RESULTS

Evidence was extracted from 60 reviews and triangulated in expert consultations. Mechanisms of action were categorised as either associated with intervention design and delivery or with specific intervention components (access to resources and services; safety, control and support; increased knowledge; alterations to affective states and cognitions; improved self-management; improved family and social relations).

CONCLUSIONS

Findings suggest that psychosocial interventions to improve the mental health of women survivors of IPV have the greatest impact when they take a holistic view of the problem and provide individualised and trauma-informed support.

"Don't Know where to Go for Help": Safety and Economic Needs among Violence Survivors during the COVID-19 Pandemic

The COVID-19 pandemic and related quarantine has created additional problems for survivors of interpersonal violence. The purpose of this study is to gain a preliminary understanding of the health, safety, and economic impacts of the COVID-19 pandemic on people that are experiencing or have previously experienced violence, stalking, threats, and/or abuse. An online survey, open from April to June 2020, was taken by people with safety concerns from interpersonal violence. Participants were recruited from IPV and sexual assault-focused agencies, state coalitions, and social media. Quantitative data were summarized using descriptive methods in SPSS and coding methods from thematic and content analysis was used to analyze qualitative data from open-ended questions. A total of 53 participants were recruited for the survey. Individuals with safety concerns have experienced increased challenges with health and work concerns, stress from economic instability, difficulties staying safe, and access resources and support. Over 40% of participants reported safety had decreased. Use of social media and avoidance strategies were the most common safety approaches used. Participants reported mixed experiences with virtual services. The COVID-19 pandemic has exacerbated existing structural concerns for survivors of violence like IPV and sexual assault. Increased support and economic resource access, coupled with modified safety planning and improved virtual approaches, would better help meet survivor needs.

Advocate and Survivor Perspectives on the Role of Technology in Help Seeking and Services with Emerging Adults in Higher Education

Emerging adults, aged 18-25, have come of age in a technology oriented world. The internet has been critical in mediating their personal relationships and their understanding of daily life. Emerging adults are also at unique risk of experiencing intimate partner and sexual violence (IPV & SV) Given the increasing infusion of information communication technology (ICT) into anti-violence advocacy, and the broad use of ICT among college-attending emerging adults, this study aimed to explore how both survivors and advocates are leveraging technology for support. Using a QUAL + qual methodology (Morse and Niehaus, 2009), data were collected as part of an evaluation of campus-based advocacy as implemented in five programs. Interviews took place with 23 campus and community-based advocates, and 25 survivors of interpersonal violence who had accessed campus-based advocacy services. Additionally, 63 survivors who engaged in campus-based advocacy services responded to an online survey. Key domains identified were: 1) technology as a means of informing potential clients about services; 2) the role of technology in help-seeking, including its role in tailoring and extending the reach of services; and 3) the importance of recognizing technology facilitated abuse in the advocacy and education process with emerging adults. As advocacy programs are rapidly shifting to technology facilitated services in the wake of COVID-19, this study provides data on advocate and survivor experiences with technology, which can inform these changes across the spectrum of IPV & SV services.

Opportunities for technologically driven dialogical health communication for participatory interventions: Perspectives from male peer navigators in rural South Africa

There is increasing interest in the potential to deliver participatory dialogical HIV and intimate partner violence (IPV) prevention interventions via digital platforms, though the majority of mHealth interventions have been didactic in approach. We undertook 10 in-depth interviews with male Peer Navigators (PNs) who had been extensively trained and working on a larger intervention promoting young people's sexual and reproductive rights, in rural KwaZulu-Natal. Interviews focused on their, and their peers', use of technology in their everyday lives. Data were transcribed and translated, and subjected to thematic analysis. PNs described structural barriers to the use of technology, including poor connectivity, high data costs, and erratic electricity. They primarily used Facebook and WhatsApp for communication and highlighted how reading messages asynchronously was important to overcome connectivity challenges. PNs shared how groups were primarily for information sharing, they also discussed ‘sensitive’ issues online. Privacy was a concern, especially for conversations, and there was recognition of how confidentiality could be breached. It was also felt that WhatsApp could potentially support greater openness in discussions. We reflect on the potential for online interventions to support dialogical health communication, highlighting how dialogical health communication may be enabled through information provision, the asynchronous communication enhancing the potential for reflection, and greater participation in discussion by those who are shyer. Despite this potential there remain important risks around privacy of discussions and how to implement these approaches online.

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Qualitative research with young men showed high levels of cellphone usage.

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Emphasizes the importance of sharing information and personal discussions online.

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Suggests potential opportunities for discussion and reflection via WhatsApp.

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Recognises limitations of WhatsApp communication for health communication.

Web-Based and mHealth Interventions for Intimate Partner Violence Victimization Prevention: A Systematic Review

Mobile health (mHealth) technologies are increasingly used across health programming including intimate partner violence (IPV) prevention to optimize screening, educational outreach, and linkages to care via telehealth. We systematically evaluated current web-based and mHealth interventions, which include web- or mobile-based delivery methods for primary, secondary, and tertiary IPV victimization prevention. We searched MEDLINE/PubMed, Embase, CINAHL, PsycINFO, Open Grey, and Google Scholar for empirical studies published 1998-2019. Studies were included if they considered empirical data, participants in adult romantic relationships, IPV as a primary or secondary outcome, and an mHealth component. The Mixed Methods Appraisal Tool was used to record critical ratings of quality among studies selected for inclusion. We assessed variation in targeted populations, types of IPV addressed, and mHealth approaches used. Of 133 studies identified for full-text review, 31 were included. Computer-based screening with or without integrated education was the most common mHealth approach (n = 8, 26%), followed by safety decision aids (n = 7, 23%). Feasibility and acceptability were found to be generally high where assessed (23% of studies, n = 7). There was limited evidence around whether mHealth interventions better addressed population needs compared to conventional interventions. mHealth tools for IPV prevention are especially acceptable in health-care settings, on mobile phone platforms, or when connecting victims to health care. Despite enthusiasm in pilot projects, evidence for efficacy compared to conventional IPV prevention approaches is limited. A major strength of mHealth IPV prevention programming is the ability to tailor interventions to individual victim needs without extensive human resource expenditure by providers.

Individually tailored Internet-delivered cognitive-behavioral therapy for survivors of intimate partner violence: A randomized controlled pilot trial

Intimate partner violence (IPV) is a serious public health concern worldwide and defined as behavior performed by spouses or other intimate partners that causes physical, sexual, or psychological harm. Internet-delivered cognitive-behavioral therapy (ICBT) may be particularly useful for survivors of IPV for several reasons, including barriers pertaining to limited community recourses and treatment availability, safety concerns, and issues of stigma, guilt and shame, which may prevent members of this population from seeking help via face-to-face interactions. However, Internet interventions are lacking. The primary aim of the present randomized controlled pilot trial was to explore the feasibility of ICBT as guided self-help individually tailored to the predominant symptomatology of PTSD or depression in survivors of IPV. A second aim was to conduct a preliminary evaluation exploring the short- and long-term effects of the treatment in comparison to a waitlist control condition. Results showed that the treatment was feasible. Attrition rate was low (9.4%), and participants were satisfied with treatment. However, treatment adherence was moderate in terms of completed modules (62.5%). Results of the preliminary evaluation of treatment effects showed large and statistically significant between-group effect sizes (Cohen's d = 0.86-1.08) on some measures of PTSD and depression at post assessment, favoring the treatment condition. However, there were no effects on other measures. At follow-up assessment, when the control condition had received delayed treatment, there were large and statistically significant within-group effect sizes (d = 0.96-1.48) on measures of PTSD, depression and anxiety, and small effects (d = 0.48) on a measure of quality of life. The results of the present pilot study are promising and warrant further research on ICBT for this population.

Domestic Violence and Its Effects on Women, Children, and Families

Men and women experience severe domestic violence (DV) and intimate partner violence (IPV); however, women and children remain especially vulnerable. Violence along the DV/IPV continuum has been recognized as a type of child maltreatment and a child's awareness that a caregiver is being harmed or at risk of harm is sufficient to induce harmful sequelae. Consequences of these abusive behaviors are associated with mental and physical health consequences. Health care professionals can screen, identify, and manage this pathology in affected families while educating communities to these pernicious effects.