Exploring the feasibility of email-mediated interaction in survivors of abuse

Use of technology in evidence-based programs for child maltreatment and its impact on parent and child outcomes

Introduction

Technology has been used in evidence-based child maltreatment (CM) programs for over a decade. Although advancements have been made, the extent of the application of technology in these programs, and its influence on parental and child outcomes, remains unclear within the context of changes that emerged because of the COVID-19 pandemic. This scoping review provides a contextualized overview and summary of the use of technology in evidence-based parenting and child programs serving families impacted by child maltreatment and the effects of technology-enhanced programs on target outcomes.

Materials and methods

Using Arksey and O'Malley's methodological framework, we searched seven databases to identify peer-reviewed and grey literature published in English from 2000 to 2023 on evidence-based programs, according to the California Evidence-Based Clearinghouse (CEBC), that included technological supports for two populations: at-risk parents for child maltreatment prevention, and children and youth 0-18 years exposed to child maltreatment. All study designs were included.

Results

Eight evidence-based parenting programs and one evidence-based child trauma program were identified as using technology across a total of 25 peer-reviewed articles and 2 peer-reviewed abstracts meeting inclusion criteria (n = 19 on parent-level programs; n = 8 on child-level programs). Four studies were published in the context of COVID-19. Two main uses of technology emerged: (1) remote programmatic delivery (i.e., delivering all or part of the program virtually using technology) and (2) programmatic enhancement (i.e., augmenting program content with technology). Improvements across parenting and child mental health and behavioral outcomes were generally observed.

Discussion

Technology use in evidence-based child maltreatment programs is not new; however, the small sample since the start of the COVID-19 pandemic in this review that met inclusion criteria highlight the dearth of research published on the topic. Findings also suggest the need for the inclusion of implementation outcomes related to adoption and engagement, which could inform equitable dissemination and implementation of these programs. Additional considerations for research and practice are discussed.

Technology-based and digital interventions for intimate partner violence: A systematic review and meta-analysis

BACKGROUND

A growing body of research shows the promise and efficacy of technology-based or digital interventions in improving the health and well-being of survivors of intimate partner violence (IPV). In addition, mental health comorbidities such as anxiety, post-traumatic stress disorder (PTSD), and depression occur three to five times more frequently in survivors of IPV than non-survivors, making these comorbidities prominent targets of technology-based interventions. Still, research on the long-term effectiveness of these interventions in reducing IPV victimization and adverse mental health effects is emergent. The significant increase in the number of trials studying technology-based therapies on IPV-related outcomes has allowed us to quantify the effectiveness of such interventions for mental health and victimization outcomes in survivors. This meta-analysis and systematic review provide critical insight from several randomized controlled trials (RCTs) on the overall short and long-term impact of technology-based interventions on the health and well-being of female IPV survivors.

OBJECTIVES

To synthesize current evidence on the effects of technology-based or digital interventions on mental health outcomes (depression, anxiety, and PTSD) and victimization outcomes (physical, psychological, and sexual abuse) among IPV survivors.

SEARCH METHODS

We examined multiple traditional and grey databases for studies published from 2007 to 2021. Traditional databases (such as PubMed Central, Web of Science, CINAHL Plus, and PsychINFO) and grey databases were searched between April 2019 and February 2021. In addition, we searched clinical trial registries, government repositories, and reference lists. Authors were contacted where additional data was needed. We identified 3210 studies in traditional databases and 1257 from grey literature. Over 2198 studies were determined to be duplicates and eliminated, leaving 64 studies after screening titles and abstracts. Finally, 17 RCTs were retained for meta-analysis. A pre-registered protocol was developed and published before conducting this meta-analysis.

SELECTION CRITERIA

We included RCTs targeting depression, anxiety, PTSD outcomes, and victimization outcomes (physical, sexual, and psychological violence) among IPV survivors using a technology-based intervention. Eligible RCTs featured a well-defined control group. There were no study restrictions based on participant gender, study setting, or follow-up duration. Included studies additionally supplied outcome data for calculating effect sizes for our desired outcome. Studies were available in full text and published between 2007 and 2021 in English.

DATA COLLECTION AND ANALYSIS

We extracted relevant data and coded eligible studies. Using Cochrane's RevMan software, summary effect sizes (Outcome by Time) were assessed using an independent fixed-effects model. Standardized mean difference (SMD) effect sizes (or Cohen's d) were evaluated using a Type I error rate and an alpha of 0.05. The overall intervention effects were analyzed using the Z-statistic with a p-value of 0.05. Cochran's Q test and Higgins' I ² statistics were utilized to evaluate and confirm the heterogeneity of each cumulative effect size. The Cochrane risk of bias assessment for randomized trials (RoB 2) was used to assess the quality of the studies. Campbell Systematic Reviews registered and published this study's protocol in January 2021. No exploratory moderator analysis was conducted; however, we report our findings with and without outlier studies in each meta-analysis.

MAIN RESULTS

Pooled results from 17 RCTs yielded 18 individual effect size comparisons among 4590 survivors (all females). Survivors included college students, married couples, substance-using women in community prisons, pregnant women, and non-English speakers, and sample sizes ranged from 15 to 672. Survivors' ages ranged from 19 to 41.5 years. Twelve RCTs were conducted in the United States and one in Canada, New Zealand, China (People's Republic of), Kenya, and Australia. The results of this meta-analysis found that technology-based interventions significantly reduced depression among female IPV survivors at 0-3 months only (SMD = -0.08, 95% confidence interval [CI] = -0.17 to -0.00), anxiety among IPV survivors at 0-3 months (SMD = -0.27, 95% CI = -0.42 to -0.13, p = 0.00, I ² = 25%), and physical violence victimization among IPV survivors at 0-6 months (SMD = -0.22, 95% CI = -0.38 to -0.05). We found significant reductions in psychological violence victimization at 0-6 months (SMD = -0.34, 95% CI = -0.47 to -0.20) and at >6 months (SMD = -0.29, 95% CI = -0.39 to -0.18); however, at both time points, there were outlier studies. At no time point did digital interventions significantly reduce PTSD (SMD = -0.04, 95% CI = -0.14 to 0.06, p = .46, I ² = 0%), or sexual violence victimization (SMD = -0.02, 95% CI = -0.14 to 0.11, I ² = 21%) among female IPV survivors for all. With outlier studies removed from our analysis, all summary effect sizes were small, and this small number of comparisons prevented moderator analyses.

AUTHORS' CONCLUSIONS

The results of this meta-analysis are promising. Our findings highlight the effectiveness of IPV-mitigating digital intervention as an add-on (not a replacement) to traditional modalities using a coordinated response strategy. Our findings contribute to the current understanding of "what works" to promote survivors' mental health, safety, and well-being. Future research could advance the science by identifying active intervention ingredients, mapping out intervention principles/mechanisms of action, best modes of delivery, adequate dosage levels using the treatment intensity matching process, and guidelines to increase feasibility and acceptability.

An Evidence Synthesis of Covert Online Strategies Regarding Intimate Partner Violence

This systematic review synthesizes evidence of how people use the internet to deploy covert strategies around escaping from, or perpetrating, intimate partner violence (IPV). Online tools and services can facilitate individuals leaving abusive relationships, yet they can also act as a barrier to departure. They may also enable abusive behaviors. A comprehensive literature search of published and unpublished studies in electronic databases was conducted. Two researchers independently screened abstracts and full texts for study eligibility and evaluated the quality of included studies. The systematic review includes 22 studies (9 qualitative and 11 cross-sectional studies, a randomized control trial [RCT] and a nonrandomized study [NRS]) published between 2004 and 2017. Four covert behaviors linked to covert online strategies around IPV were identified: presence online, granular control, use of digital support tools and services, and stalking and surveillance. The same technology that provides individuals with easy access to information and supportive services related to IPV, such as digital devices, tools, and services, also enables perpetrators to monitor or harass their partners. This review takes a rigorous interdisciplinary approach to synthesizing knowledge on the covert strategies adopted by people in relation to IPV. It has particular relevance to practitioners who support survivors in increasing awareness of the role of digital technologies in IPV, to law enforcement agencies in identifying new forms of evidence of abuse, and in enabling designers of online/social media applications to take the needs and vulnerabilities of IPV survivors into account.

Reaching Out To Women Who Are Victims of Intimate Partner Violence

PURPOSE

To evaluate if disclosure of abuse among female university students and among women at an emergency department varied based on three different types of data collection method used; and to explore women's development of symptoms of post-traumatic stress disorder (PTSD) and the outcome on health.

DESIGN AND METHOD

Cross-sectional research design was used (N = 306 women).

FINDINGS

The women who experienced intimate partner violence (IPV) in their current relationship, and had symptoms of PTSD, reported significantly lower physical and mental health. In addition, the women who experienced three types of abuse (physical, mental, and sexual) reported significantly more symptoms of PTSD.

PRACTICE IMPLICATIONS

Detecting IPV and screening for PTSD in clinical settings might benefit women who suffer from violence in their intimate relationships.

Comparing Online with Face-to-Face HELPP Intervention in Women Experiencing Intimate Partner Violence

Intimate partner violence (IPV) is a public health problem. The purpose of this study was to compare the effectiveness of the HELPP (Health, Education on Safety, and Legal Support and Resources in IPV Participant Preferred) intervention among IPV survivors. A sequential, transformative mixed-methods design was used. Participants were randomly assigned to one of three study groups: Online (ONL), Face-to-Face (FTF), and Waitlist Control (WLC). The HELPP intervention was offered to 32 adult female participants who were 45.2% Asian, 32.3% White, and 22.5% Black. Outcome measures were anxiety, depression, anger, personal, and social support. In total, 64% (n  =  20) of the participants reported having experienced IPV before the age of 18. The anger mean score pre-test to post-test difference was significant for ONL (p < 0.001) and WLC (p  =  0.01). The personal and social support pre-test to post-test mean score differences were significant for ONL (p < 0.001; p < 0.001) and WLC (p  =  0.01; p  =  0.006), respectively. The HELPP intervention (1) decreased anxiety, depression, anger, and (2) increased personal and social support in the ONL group. The HELPP information and intervention was shown to be feasible, acceptable, and effective among IPV survivors compared with participants in the WLC group. The WLC participants displayed (1) increased levels of anxiety, depression, and anger and (2) decreased levels of personal and social support, post-intervention. Further research could be conducted to determine if e-mail alone or e-mail plus mobile devices are more useful modes of delivering interventions.

Is e-mail communication a feasible method to interview young people with mental health problems?

TOPIC

E-mail interviewing-not to be confused with "online surveying"-shows promise for researchers working with adolescent mental health populations as a data collection method.

PURPOSE

To explore potential advantages, constraints, and applications of e-mail interviewing as a research method for staff working with adolescent mental health populations.

CONCLUSIONS

At face value, there appear to be several advantages to e-mail interviewing with young populations and further exploration of this method is warranted.

Disclosure: a concept analysis

AIM

This article is a report of a concept analysis of disclosure.

BACKGROUND

Disclosure of health concerns is often delayed or incomplete, resulting in a lack of appropriate care or inability to avoid complications. Disclosure is a poorly understood phenomenon in nursing, however, an understanding of the concept is critical to providing effective nursing care.

DATA SOURCES

Literature from the humanities, social sciences, business, law, nursing and allied health fields in five search engines was reviewed for insight into a patient's decision to disclose health information to a healthcare provider.

REVIEW METHODS

Wilson's method of concept analysis guided this study into the meaning of disclosure from the point of view of a patient seeking healthcare. Inclusive years of search ranged from 1991 to 2010.

RESULTS

Disclosure is defined as the act of seeking care by revealing personally significant information that exposes the bearer to the risk of rejection or negative judgment. Attributes of disclosure are identified as: holding significant health-related information, assistance needed to cope, tolerance for unpredictable result, divulgence and expectation of serious response. Consequences of disclosure include resolution, reassurance or assistance gained, but may also include suffering rejection or negative repercussions.

CONCLUSION

Implications for nursing practice are explored and include focused questioning, providing for safety concerns, acknowledging significance and sensitivity of disclosed information and acting on the disclosure.

Habilidades maternas de mulheres vítimas de violência doméstica: uma revisão da literatura

O presente estudo objetivou revisar a literatura nacional e internacional de 2007 a 2010 sobre violência doméstica e habilidades maternas nas seguintes bases de dados: Bireme, Web of Science, Lilacs e Medline. A busca resultou em 85 artigos, sendo analisados 28 que se relacionavam com a proposta deste estudo, todos internacionais, divididos em quatro categorias: (1) prevalência, (2) intervenção, (3) relação entre violência conjugal e habilidades maternas e (4) impacto da violência conjugal nos filhos. A análise dos artigos permitiu verificar que uma parcela expressiva de crianças presencia desentendimentos violentos entre os pais e são afetadas direta ou indiretamente por eles. Nos artigos em que se buscou avaliar a relação entre a violência conjugal e as habilidades maternas, os resultados demonstraram os impactos negativos da exposição à violência conjugal e a importância de um relacionamento mãe-filho positivo para a diminuição dos problemas de comportamento dos filhos, sendo esse um fator importante quando se pensa em intervir nessa população. Destaca-se que todos os dados foram obtidos por meio de autorrelato das mulheres, sendo sugeridas pesquisas futuras que utilizem outras formas de coleta de dados, como fontes de informação diversas ou estudos observacionais sistematizados.

E-mail Use Among a Sample of Intimate Partner Violence Shelter Residents

Although it is estimated that approximately 75% of U.S. adults have e-mail access, the proportion of battered women's shelter residents who use e-mail is currently unknown. Remaining in contact with residents following shelter stays is challenging. E-mail might hold promise for follow-up contact if a sufficient number of survivors use e-mail and safety concerns can be addressed. Among a convenience sample of residents of 11 Massachusetts shelters ( N = 57), the authors find that 47% had a current e-mail account. Among those with e-mail accounts, 89% used e-mail in locations other than their own homes; 81% reported that, to their knowledge, their e-mail accounts had never been accessed by unauthorized dating partners; and 88% reported that they thought it would be safe for the shelter to e-mail them following their departure. Additional research assessing the feasibility (i.e., safety, acceptability, and cost benefit) of remaining in contact with shelter residents via the Internet would be beneficial.

Peer support telephone calls for improving health

BACKGROUND

Peer support telephone calls have been used for a wide range of health-related concerns. However, little is known about their effects.

OBJECTIVES

To assess the effects of peer support telephone calls in terms of physical (e.g. blood pressure), psychological (e.g. depressive symptoms), and behavioural health outcomes (e.g. uptake of mammography) and other outcomes.

SEARCH STRATEGY

We searched: The Cochrane Library databases (CENTRAL, DARE, CDSR) (issue 4 2007); MEDLINE (OVID) (January 1966 to December 2007); EMBASE (OVID) (January 1985 to December 2007); CINAHL (Athens) (January 1966 to December 2007), trials registers and reference lists of articles, with no language restrictions.

SELECTION CRITERIA

Randomised controlled trials of peer support interventions delivered by telephone call.

DATA COLLECTION AND ANALYSIS

Two review authors independently extracted data. We present results narratively and in tabular format. Meta-analysis was not possible due to heterogeneity between studies.

MAIN RESULTS

We included seven studies involving 2492 participants.Peer support telephone calls were associated with an increase in mammography screening, with 49% of women in the intervention group and 34% of women in the control group receiving a mammogram since the start of the intervention (P </ = 0.001). In another study, peer telephone support calls were found to maintain mammography screening uptake for baseline adherent women (P = 0.029).Peer support telephone calls for post myocardial infarction patients were associated at six months with a change in diet in the intervention and usual care groups of 54% and 44% respectively (P = 0.03). In another study for post myocardial infarction patients there were no significant differences between groups for self-efficacy, health status and mental health outcomes.Peer support telephone calls were associated with greater continuation of breastfeeding in mothers at 3 months post partum (P = 0.01).Peer support telephone calls were associated with reduced depressive symptoms in mothers with postnatal depression (Edinburgh Postnatal Depression Scale (EPDS) > 12). The peer support intervention significantly decreased depressive symptomatology at the 4-week assessment (odds ratio (OR) 6.23 (95% confidence interval (CI) 1.15 to 33.77; P = 0.02)) and 8-week assessment (OR 6.23 (95% CI 1.40 to 27.84; P = 0.01). One study investigated the use of peer support for patients with poorly controlled diabetes. There were no significant differences between groups for self-efficacy, HbA1C, cholesterol level and body mass index.

AUTHORS' CONCLUSIONS

Whilst this review provides some evidence that peer support telephone calls can be effective for certain health-related concerns, few of the studies were of high quality and so results should be interpreted cautiously. There were many methodological limitations thus limiting the generalisability of findings. Overall, there is a need for further well designed randomised controlled studies to clarify the cost and clinical effectiveness of peer support telephone calls for improvement in health and health-related behaviour.