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Safar C, Jackson KT, Irwin JD, Mantler T. Exploring Coping Strategies Among Older Women Who Have Experienced Intimate Partner Violence During COVID-19. Violence Against Women 2023; 29:2418-2438. [PMID: 37501603 PMCID: PMC10375232 DOI: 10.1177/10778012231188086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
This interpretive description study explored coping among older women in Ontario experiencing intimate partner violence (IPV) during COVID-19. Twelve in-depth interviews with older women found age-related normative beliefs played a role in how older women viewed their lives and how they looked beyond their experiences of IPV. Their roles as caretakers and homemakers influenced their response to IPV, and COVID-19 exacerbated feelings of lost time and loneliness. Coping strategies consisted of social support, including telephone formal services and physical activities. Women expressed a lack of appropriate services and financial limitations as barriers. They identified the need for age-appropriate services that acknowledge their unique experiences.
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Affiliation(s)
- Christina Safar
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
| | - Kimberley T. Jackson
- Arthur Labatt Family School of Nursing, Faculty of Health Sciences, The University of Western Ontario, London, Canada
| | - Jennifer D. Irwin
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
- School of Health Studies, Faculty of Health Sciences, The University of Western Ontario, London, Canada
| | - Tara Mantler
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
- School of Health Studies, Faculty of Health Sciences, The University of Western Ontario, London, Canada
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Bloom TL, Perrin N, Brown ML, Campbell J, Clough A, Grace KT, Laughon K, Messing J, Eden KB, Turner R, Glass N. Concerned friends of intimate partner violence survivors: results from the myPlan randomized controlled trial on college campuses. BMC Public Health 2023; 23:1033. [PMID: 37259087 DOI: 10.1186/s12889-023-15918-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 05/17/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Nearly half of intimate partner violence (IPV) survivors experience their first abusive relationship at college age (18-24 years). Most often they disclose the violence to friends. Existing college campus "bystander" interventions training peers to safely intervene have been effective in sexual assault prevention; similar interventions have rarely been tested for IPV. Therefore, we evaluated the effectiveness of an interactive, personalized safety decision and planning tool, myPlan app, on decisional conflict, decisional preparedness, confidence in intervening, supportive safety behaviors, and IPV attitudes with concerned friends of abused college women. METHODS We recruited college students (age 18-24, N = 293) of any gender who had a female-identified friend who had recently experienced IPV ("concerned friends") from 41 Oregon and Maryland colleges/universities. Participants were randomized to myPlan (n = 147) or control (usual web-based resources; n = 146). Outcomes included decisional conflict, decisional preparedness, confidence to intervene, safety/support behaviors, and IPV attitudes. RESULTS At baseline, concerned friends described the abused person as a close/best friend (79.1%); 93.7% had tried at least one strategy to help. Most (89.2%) reported concerns their friend would be seriously hurt by the abuser; 22.7% reported extreme concern. Intervention participants had greater improvements in decisional conflict (specifically, understanding of their own values around the decision to intervene and help a friend) and decisional preparedness immediately after their first use of myPlan, and a significantly greater increase in confidence to talk with someone about their own relationship concerns at 12 months. At 12-month follow-up, both intervention and control groups reported increased confidence to intervene, and did not differ significantly in terms of percentage of safety/support strategies used, whether strategies were helpful, or IPV attitudes. CONCLUSIONS A technology-based intervention, myPlan, was effective in reducing one aspect of decisional conflict (improving clarity of values to intervene) and increasing decisional preparedness to support a friend in an unsafe relationship. Information on IPV and related safety strategies delivered through the myPlan app or usual web-based resources both increased confidence to intervene with a friend. College students in the myPlan group were more likely to talk with someone about concerns about their own relationship, demonstrating potential for IPV prevention or early intervention. TRIAL REGISTRATION Clinicaltrials.gov ID: NCT02236663, registration date 10/09/2014.
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Affiliation(s)
- Tina L Bloom
- School of Nursing, Notre Dame of Maryland University, Baltimore, Maryland, US.
| | - Nancy Perrin
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, US
| | | | | | - Amber Clough
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, US
| | | | - Kathryn Laughon
- School of Nursing, University of Virginia, Charlottesville, Virginia, US
| | - Jill Messing
- School of Social Work, Arizona State University, Tempe, Arizona, US
| | - Karen B Eden
- Dept of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, US
| | - Rachael Turner
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, US
| | - Nancy Glass
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, US
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Ndungu J, Ngcobo-Sithole M, Gibbs A. Learners' viewpoints on the possibilities and limitations imposed by social contexts on online group-based participatory interventions to address violence. Glob Public Health 2022; 17:3894-3911. [PMID: 35748787 DOI: 10.1080/17441692.2022.2092182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Intimate partner violence (IPV) is a global public health concern amongst young people. Consequently, prevention efforts in the form of participatory interventions have been implemented, mainly in face-to-face settings. However, in recent years, there has been a growing interest to deliver participatory IPV prevention interventions online, and this has been exacerbated by COVID-19 imposed limitations. There remain concerns, however, about the impact social contexts may have on transformative communication in participatory interventions online. We conducted semi-structured interviews with 18 learners (14-19 years) from Eastern Cape province, South Africa, to understand the possibilities and limitations that social contexts impose on online participatory IPV prevention interventions. Access to devices, reliable internet, and privacy in homes provided opportunities for online IPV prevention interventions, while limited privacy, safety, concentration, and familiarity with some apps online challenged young people's interest in online IPV prevention interventions. We also found that young people's greatest concern was around achieving trust, privacy and safety online. More evidence is needed on how trust, privacy, and safety, supportive of transformative communication, can be achieved online. Further, young people are active and strategic in their engagements online and their potential to generate creative relevant solutions to address these challenges is highlighted.
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Affiliation(s)
- Jane Ndungu
- School of Behavioural Sciences, Nelson Mandela University, Port Elizabeth, South Africa
| | | | - Andrew Gibbs
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa.,Centre for Rural Health, School of Nursing and Public Health, University of Kwa-Zulu Natal, Durban, South Africa.,Institute for Global Health, University College London, London, UK
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Wood MA, Ross S, Johns D. Primary Crime Prevention Apps: A Typology and Scoping Review. TRAUMA, VIOLENCE & ABUSE 2022; 23:1093-1110. [PMID: 33478344 DOI: 10.1177/1524838020985560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In the last decade, an array of smartphone apps have been designed to prevent crime, violence, and abuse. The evidence base of these apps has, however, yet to analyzed systematically. To rectify this, the aims of this review were (1) to establish the extent, range, and nature of research into smartphone apps with a primary crime prevention function; (2) to locate gaps in the primary crime prevention app literature; and (3) to develop a typology of primary crime prevention apps. Employing a scoping review methodology and following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, studies were identified via Web of Science, EBSCOhost, and Google Scholar. We included English-language research published between 2008 and 2020 that examined smartphone applications designed explicitly for primary crime prevention. Sixty-one publications met our criteria for review, out of an initial sample of 151 identified. Our review identified six types of crime prevention app examined in these publications: self-surveillance apps, decision aid apps, child-tracking apps, educational apps, crime-mapping/alert apps, and crime reporting apps. The findings of our review indicate that most of these forms of primary crime prevention apps have yet to be rigorously evaluated and many are not evidence-based in their design. Consequently, our review indicates that recent enthusiasm over primary crime prevention apps is not supported by an adequate evidence base.
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Affiliation(s)
- Mark A Wood
- Deakin University, Melbourne, Victoria, Australia
| | - Stuart Ross
- The University of Melbourne, Victoria, Australia
| | - Diana Johns
- The University of Melbourne, Victoria, Australia
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Emezue C, Chase JD, Udmuangpia T, Bloom TL. Technology-based and digital interventions for intimate partner violence: A systematic review and meta-analysis. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1271. [PMID: 36909881 PMCID: PMC9419475 DOI: 10.1002/cl2.1271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
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.
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Affiliation(s)
- Chuka Emezue
- Department of Women, Children and Family NursingRush University College of NursingChicagoIllinoisUSA
| | - Jo‐Ana D. Chase
- Sinclair School of NursingUniversity of MissouriColumbiaMissouriUSA
| | - Tipparat Udmuangpia
- Department of Maternal‐Child Health and MidwiferyBoromarajonani College of NursingKhon KaenThailand
| | - Tina L. Bloom
- School of NursingNotre Dame of Maryland UniversityBaltimoreMarylandUSA
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Saboury Yazdy N, Talaei A, Ebrahimi M, Ghofrani Ivari A, Pouriran MA, Faridhosseini F, Mohaddes Ardabili H. "Be my Voice" to break social stigma against domestic violence: The underestimated role of smartphone applications in protecting victims in developing countries. Front Psychiatry 2022; 13:954602. [PMID: 35990047 PMCID: PMC9386513 DOI: 10.3389/fpsyt.2022.954602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/14/2022] [Indexed: 12/04/2022] Open
Affiliation(s)
- Niloofar Saboury Yazdy
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Talaei
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Ebrahimi
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Aida Ghofrani Ivari
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Amin Pouriran
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farhad Faridhosseini
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Mohaddes Ardabili
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Shillington KJ, Jackson KT, Davidson CA, Yates J, Irwin JD, Kaschor B, Mantler T. Riding on resilience: impacts of the COVID-19 pandemic on women experiencing intimate partner violence. SN SOCIAL SCIENCES 2022; 2:92. [PMID: 35756910 PMCID: PMC9211786 DOI: 10.1007/s43545-022-00343-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 03/28/2022] [Indexed: 12/02/2022]
Abstract
The COVID-19 pandemic and resultant public health measures, although helpful in reducing the spread of the disease, have disproportionately impacted women experiencing intimate partner violence (IPV). Despite these adverse circumstances, women continue to show resilience. Although difficult to define, resilience can be conceptualized as a dynamic process in which psychosocial and environmental factors interact to enable an individual to survive, grow, and thrive despite exposure to adversity. This research identifies facilitators and gaps in supports to promoting resilience among urban and rural women experiencing intimate partner violence (IPV) during the COVID-19 pandemic, via an online survey (n = 95) and interviews (n = 19). T-tests, Wilcoxon rank sum tests, and interpretive description were utilized for analyses. Almost 41% of participants experienced an increase in abuse during COVID-19, and resilience significantly decreased during COVID-19 (t(44) = 2.91, p = 0.006). Qualitatively, four parent themes (coercive control, social services, resilience, and future) and seven sub-themes emerged. Changes are needed in accessibility and delivery of support services for women experiencing IPV during COVID-19, and future pandemics.
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Affiliation(s)
- Katie J. Shillington
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, The University of Western Ontario, London, ON Canada
| | - Kimberley T. Jackson
- Arthur Labatt Family School of Nursing, Faculty of Health Sciences, The University of Western Ontario, London, ON Canada
| | - Cara A. Davidson
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, The University of Western Ontario, London, ON Canada
| | - Julia Yates
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, The University of Western Ontario, London, ON Canada
| | - Jennifer D. Irwin
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, The University of Western Ontario, London, ON Canada
- School of Health Studies, Faculty of Health Sciences, The University of Western Ontario, HSB Room 332, 1151 Richmond Street, London, ON N6A 5B9 Canada
| | - Brenna Kaschor
- Department of Family Medicine, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON Canada
- Citywide Department of Family Medicine, London Health Sciences Center, London, ON Canada
- PRISMA Health Care Collaborative/G.R.O.W., London, ON Canada
| | - Tara Mantler
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, The University of Western Ontario, London, ON Canada
- School of Health Studies, Faculty of Health Sciences, The University of Western Ontario, HSB Room 332, 1151 Richmond Street, London, ON N6A 5B9 Canada
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Glass NE, Clough A, Messing JT, Bloom T, Brown ML, Eden KB, Campbell JC, Gielen A, Laughon K, Grace KT, Turner RM, Alvarez C, Case J, Barnes-Hoyt J, Alhusen J, Hanson GC, Perrin NA. Longitudinal Impact of the myPlan App on Health and Safety Among College Women Experiencing Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP11436-NP11459. [PMID: 33576291 DOI: 10.1177/0886260521991880] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The objective of this study was to examine differences in change over time in health and safety outcomes among female college students randomized to myPlan, a tailored safety planning app, or usual web-based safety planning resources. Three hundred forty-six women (175 intervention, 171 control) from 41 colleges/universities in Oregon and Maryland completed surveys at baseline, 6- and 12-months from July 2015 to October 2017. Generalized estimating equations were used to test group differences across time. Both groups improved on four measure of intimate partner violence (IPV; Composite Abuse Scale [CAS], TBI-related IPV, digital abuse, reproductive coercion [RC]) and depression. Reduction in RC and improvement in suicide risk were significantly greater in the myPlan group relative to controls (p = .019 and p = .46, respectively). Increases in the percent of safety behaviors tried that were helpful significantly reduced CAS scores, indicating a reduction in IPV over time in the myPlan group compared to controls (p = .006). Findings support the feasibility and importance of technology-based IPV safety planning for college women. myPlan achieved a number of its objectives related to safety planning and decision-making, the use of helpful safety behaviors, mental health, and reductions in some forms of IPV.
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Affiliation(s)
| | | | | | | | | | - Karen B Eden
- Oregon Health & Science University, Portland, OR, USA
| | | | | | | | | | | | | | - James Case
- Johns Hopkins University, Baltimore, MD, USA
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Ndungu J, Ngcobo-Sithole M, Gibbs A. Researchers or practitioners' opinion of the possibilities for creating virtual safe social spaces for violence prevention interventions for young people. HEALTH EDUCATION RESEARCH 2022; 37:155-166. [PMID: 35349674 DOI: 10.1093/her/cyac008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 01/05/2022] [Accepted: 03/09/2022] [Indexed: 06/14/2023]
Abstract
Intimate partner violence (IPV) is a global concern. Interventions designed to prevent IPV are often participatory in nature, implemented in face-to-face settings and seek to create 'safe social spaces'. We however do not fully understand how safe social spaces can be created in online spaces. Our study sought to understand the possibility of creating safe social spaces online, supportive of participatory interventions, from the perspective of those developing and implementing IPV prevention interventions. We conducted in-depth interviews with a global sample of 20 researchers and practitioners. Interviews were transcribed and analysed using thematic network analysis. We found mixed results about the possibility of creating safe social spaces online. Researchers and practitioners raised issues such as sharing of devices, the difficulties in developing trust and a sense of community online, challenges in having privacy and confidentiality online and difficulty in reading non-verbal cues as some of the key considerations when creating online safe social spaces. Younger researchers and practitioners were more optimistic about creating safe social spaces online. Our results show that the creation of safe social spaces online is complex and requires further investigation.
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Affiliation(s)
- Jane Ndungu
- School of behavioral Sciences, Nelson Mandela University, Port Elizabeth, South Africa
| | | | - Andrew Gibbs
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
- Centre for Rural Health, School of Nursing and Public Health, University of Kwa-Zulu Natal, Durban, South Africa
- Institute for Global Health, University College London, London, UK
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Signorelli MC, Costa da Silva VL, Evans DP, Prado SM, Glass N. Feasibility of an Online-Based Safety Decision Aid for Brazilian Women Living with Intimate Partner Violence: Findings from Participatory-Action Research in a One Stop Center. JOURNAL OF FAMILY VIOLENCE 2022; 38:433-446. [PMID: 35601758 PMCID: PMC9113623 DOI: 10.1007/s10896-022-00409-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/02/2022] [Indexed: 06/15/2023]
Abstract
Intimate partner violence (IPV) is a challenge in Brazil; the country is ranked 6th globally for femicide and one in four women experience physical and/or sexual IPV in their lifetimes. Safety decision aids (SDA) are tools for women experiencing IPV. Building upon previously developed and tested online SDA tools, we intend to adapt an SDA tool for use in Brazil. The purpose of this study was to examine the feasibility of a technology-based SDA to support Brazilian women living with IPV, tailored for the Brazilian context. Our participatory-action research approach built upon research between 2018 and 2019 at the House of the Brazilian Woman (HBW) of Curitiba, Brazil, a cross-sectoral one-stop center (OSC) providing comprehensive care for IPV survivors. Field research included observation, field notes, and in-depth interviews with twenty-eight (n = 28) participants (HBW staff and survivors). The results were grouped into four main thematic categories: advantages; uncertainties; barriers; and suggestions. The triangulated results showed that the majority of participants considered the SDA feasible, highlighting flexibility and confidentiality; information about IPV; and access to resources for formal help-seeking as advantages of the tool. Participants also expressed uncertainties about SDA's ability to increase women's safety and its accessibility for the most vulnerable. They made suggestions for improvement to meet the unique needs of Brazilian women. This study provided evidence on the potential of an SDA tailored for use within a comprehensive program of women survivors in Brazil. This step was crucial to inform the future implementation and evaluation.
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Affiliation(s)
- Marcos Claudio Signorelli
- Chamber of Public Health, Federal University of Paraná, Rua Jaguariaíva, 512, Matinhos, PR 83260-000 Brazil
| | - Vera Lucia Costa da Silva
- Post-Graduation in Sustainable Territorial Development, Federal University of Paraná, Rua Jaguariaíva, 512, Matinhos, PR 83260-000 Brazil
| | - Dabney P. Evans
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322 USA
| | - Sandra Marques Prado
- House of the Brazilian Woman of Curitiba, Av. Paraná, 870, Curitiba, PR 80035-130 Brazil
| | - Nancy Glass
- Johns Hopkins Center for Global Health, Johns Hopkins University, 415 N Washington St, Baltimore, MD 21205 USA
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Grace KT, Perrin NA, Clough A, Miller E, Glass NE. Correlates of reproductive coercion among college women in abusive relationships: baseline data from the college safety study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1204-1211. [PMID: 32672505 PMCID: PMC7885792 DOI: 10.1080/07448481.2020.1790570] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 04/21/2020] [Accepted: 06/28/2020] [Indexed: 05/28/2023]
Abstract
ObjectiveThe purpose of this study was to examine correlates of reproductive coercion (RC) among a sample of college women in abusive relationships. Participants: 354 college students reporting a recent history of intimate partner violence (IPV). Methods: This study examines baseline data from a randomized controlled trial testing effectiveness of an interactive safety decision aid (myPlan). Results: Almost a quarter (24.3%) of the sample reported RC. Associated factors included races other than White (p = 0.019), relationship instability (p = 0.022), missing class due to relationship problems (p = 0.001), IPV severity (p < 0.001), technology abuse (p < 0.001), traumatic brain injury-associated events (p < 0.001), and depression (p = 0.024). Conclusions: RC was a significant predictor of depression, with implications for providers working with abused college women regarding the need for mental health services concurrent with IPV/RC services. A larger proportion of women who experienced RC sought help from a healthcare provider for contraception, which suggests intervention opportunities for college health providers.
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Affiliation(s)
| | - Nancy A. Perrin
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Amber Clough
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Elizabeth Miller
- School of Medicine, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Nancy E. Glass
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
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Cheng SY, Wachter K, Kappas A, Brown ML, Messing JT, Bagwell-Gray M, Jiwatram-Negron T. Patterns of Help-seeking Strategies in Response to Intimate Partner Violence: A Latent Class Analysis. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP6604-NP6632. [PMID: 33084471 DOI: 10.1177/0886260520966671] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Women engage in multiple strategies to cope with the impact of intimate partner violence (IPV). Prior research has focused predominantly on women's service utilization and help seeking as individual acts, yet it is likely that women engage in distinct patterns of multiple help-seeking strategies to achieve safety. As such, the current article examines patterns of service-related help-seeking strategies survivors employ. This article also investigates demographic factors, relationship characteristics, and mental and physical health effects of IPV associated with patterns of help seeking. Using a web-based survey, data were collected from service-engaged adult female IPV survivors (n = 369) in the Southwest region of the United States. Latent class analysis (LCA), a person-centered analytical approach, was used to identify survivors' patterns of help seeking. A 3-class LCA model was determined to be the best fit for the data. Among the sample, 50% of women broadly engaged formal and informal networks, 15% primarily engaged informal networks, and 35% broadly engaged networks but avoided legal systems while seeking other formal services. Findings indicated varying and significant associations between class membership and race/ethnicity, foreign-born status, number of children, IPV severity, and mental health symptoms. The findings reinforce the need for practitioners to be aware of the varied ways women choose or avoid seeking help and explore women's preferences. Comprehensive and collaborative service networks are necessary for early detection and holistic care. Addressing structural factors is imperative for expanding the range of viable support options available to IPV survivors, particularly women of color.
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Sabri B, Saha J, Lee J, Murray S. Conducting Digital Intervention Research among Immigrant Survivors of Intimate Partner Violence: Methodological, Safety and Ethnical Considerations. JOURNAL OF FAMILY VIOLENCE 2022; 38:447-462. [PMID: 35531064 PMCID: PMC9054112 DOI: 10.1007/s10896-022-00405-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/20/2022] [Indexed: 06/14/2023]
Abstract
Intimate partner violence, described as a global pandemic by the United Nations, has been found to disproportionately affect immigrant women. Many immigrant survivors of IPV are unable or unwilling to attend in-person services due to barriers related to immigration status, transportation, and social isolation. By providing remote support to women in abusive relationships, digital interventions can help address these barriers and ensure their health and safety. Research on safe and ethical approaches to digital service delivery for immigrant IPV survivors is a necessary first step to meeting these women's needs for remote support. The purpose of this qualitative study was to explore considerations and challenges of conducting digital intervention research (online, phone and text) with diverse groups of immigrant women. Data was collected via 5 focus groups and 46 in-depth interviews with immigrant survivors of IPV from different countries of origin. In addition, data was collected via key informant interviews with 17 service providers. Participants shared safety, ethical and methodological challenges to accessing interventions, such as their abusive partner being at home or lack of safe access to technology. Further, participants shared strategies for safe data collection, such as scheduling a contact time when participants are afforded privacy and deleting evidence of the intervention to retain personal safety. The findings will be informative for researchers conducting digital intervention studies or practitioners engaging in remote intervention approaches with marginalized populations such as immigrant women at high risk of violence.
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Affiliation(s)
- Bushra Sabri
- Johns Hopkins University School of Nursing, 525 North Wolfe Street, Room N530L, Baltimore, MD 21205 USA
| | - Jyoti Saha
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD USA
| | - Jennifer Lee
- Johns Hopkins University School of Nursing, 525 North Wolfe Street, Room N530L, Baltimore, MD 21205 USA
| | - Sarah Murray
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD USA
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14
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Mantler T, Shillington KJ, Davidson CA, Yates J, Irwin JD, Kaschor B, Jackson KT. Impacts of COVID-19 on the Coping Behaviours of Canadian Women Experiencing Intimate Partner Violence. GLOBAL SOCIAL WELFARE : RESEARCH, POLICY & PRACTICE 2022; 9:141-156. [PMID: 35340812 PMCID: PMC8933611 DOI: 10.1007/s40609-022-00224-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/02/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Strict public health measures central to slowing the spread of COVID-19 have, unintentionally, exacerbated risks for women experiencing intimate partner violence (IPV) while impeding their usual coping strategies. The goal of this study was to understand how coping was influenced by COVID-19 for women who have experienced IPV and identify changes in coping strategies and gaps that need to be addressed to support coping. METHODS A qualitatively driven, sequential, cross-sectional design, where quantitative data informed and was embedded within qualitative data collection, was used to explore the experiences of IPV (CAS-R-SF scale) and coping (Brief-COPE scale) specific to IPV of 95 Canadian women. A subset of 19 women was invited to complete an interview exploring coping strategies identified within the survey to contextualize and validate these findings. RESULTS Survey data subjected to quantitative content analysis identified ten themes, all of which were explored in semi-structured interviews. Thematic interview findings included (1) influence of COVID-19 on coping, (2) coping during COVID-19, and (3) needed coping strategies. CONCLUSION COVID-19 had important impacts on the experiences and coping strategies of women who experience IPV. To better support this population in pandemic circumstances, in-person services should be prioritized with an emphasis on accessible and empathetic care. Public health measures in response to COVID-19, and the eventuality of future pandemics, should aim to be gender- and violence-informed.
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Affiliation(s)
- Tara Mantler
- School of Health Studies, Faculty of Health Sciences, The University of Western Ontario, 1151 Richmond Street, ON N6A 5B9 London, Canada
| | - Katie J. Shillington
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, The University of Western Ontario, London, ON Canada
| | - Cara A. Davidson
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, The University of Western Ontario, London, ON Canada
| | - Julia Yates
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, The University of Western Ontario, London, ON Canada
| | - Jennifer D. Irwin
- School of Health Studies, Faculty of Health Sciences, The University of Western Ontario, 1151 Richmond Street, ON N6A 5B9 London, Canada
| | - Brenna Kaschor
- Department of Family Medicine, Schulich School of Medicine and Dentistry, The University of Western Ontario, ON London, Canada
| | - Kimberley T. Jackson
- Arthur Labatt Family School of Nursing, Faculty of Health Sciences, The University of Western Ontario, London, ON Canada
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15
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Draughon Moret J, Todd A, Rose L, Pollitt E, Anderson J. Mobile Phone Apps for Intimate Partner and Sexual Violence Prevention and Response: Systematic Search on App Stores. JMIR Form Res 2022; 6:e28959. [PMID: 35133285 PMCID: PMC8864520 DOI: 10.2196/28959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 10/06/2021] [Accepted: 11/30/2021] [Indexed: 01/17/2023] Open
Abstract
Background Since the 2008 advent of the smartphone, more than 180 billion copies of apps have been downloaded from Apple App Store, with more than 2.6 million apps available for Android and 2.2 million apps available for iOS. Many violence prevention and response apps have been developed as part of this app proliferation. Objective This study aims to evaluate the prevalence and quality of freely available mobile phone apps targeting intimate partner violence (IPV) and sexual violence (SV) prevention and response. Methods We conducted a systematic search of violence prevention and response mobile phone apps freely available in Apple App Store (iOS; March 2016) and Google Play Store (Android; July 2016). Search terms included violence prevention, sexual assault, domestic violence, intimate partner violence, sexual violence, forensic nursing, wife abuse, and rape. Apps were included for review if they were freely available, were available in English, and had a primary purpose of prevention of or response to SV or IPV regardless of app target end users. Results Using the Mobile Application Rating Scale (MARS), we evaluated a total of 132 unique apps. The majority of included apps had a primary purpose of sharing information or resources. Included apps were of low-to-moderate quality, with the overall subjective quality mean for the reviewed apps being 2.65 (95% CI 2.58-2.72). Quality scores for each of the 5 MARS categories ranged from 2.80 (engagement) to 4.75 (functionality). An incidental but important finding of our review was the difficulty in searching for apps and the plethora of nonrelated apps that appear when searching for keywords such as “rape” and “domestic violence” that may be harmful to people seeking help. Conclusions Although there are a variety of mobile apps available designed to provide information or other services related to SV and IPV, they range greatly in quality. They are also challenging to find, given the current infrastructure of app store searches, keyword prioritization, and highlighting based on user rating. It is important for providers to be aware of these resources and be knowledgeable about how to review and recommend mobile phone apps to patients, when appropriate.
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Affiliation(s)
- Jessica Draughon Moret
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, United States
| | - Angela Todd
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, United States
| | - Lauren Rose
- College of Nursing, Pennsylvania State University, University Park, PA, United States
| | - Erin Pollitt
- District of Columbia Forensic Nurse Examiners, Washington, DC, United States
| | - Jocelyn Anderson
- College of Nursing, Pennsylvania State University, University Park, PA, United States
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16
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Grace KT, Decker MR, Alexander KA, Campbell J, Miller E, Perrin N, Glass N. Reproductive Coercion, Intimate Partner Violence, and Unintended Pregnancy Among Latina Women. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:1604-1636. [PMID: 32486886 PMCID: PMC8162928 DOI: 10.1177/0886260520922363] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Reproductive coercion (RC) describes a range of behaviors that restrict reproductive autonomy including pregnancy coercion, birth control sabotage, and controlling the outcome of a pregnancy. RC is associated with pregnancies that are mistimed and unwanted (i.e., unintended). Past research demonstrates that Latina women have higher risk for RC and for unintended pregnancy. This cross-sectional descriptive study with Latina women (n = 482) examined prevalence and risk factors for RC, evaluated the association of RC and unintended pregnancy among women with a past-year pregnancy, and explored use of safety and harm reduction strategies. A tablet survey was administered to women attending a community health center, between the ages of 15 and 45, who self-identified as Latina and who had a dating or sexual partner in the past year. Approximately one in six (16.8%) experienced past-year RC and risk factors included younger age (adjusted odds ratio [AOR] = 0.95, 95% confidence interval [CI] = [0.91, 1.00], p = .038) and concurrent intimate partner violence (IPV; AOR = 4.47, 95% CI = [2.06, 9.70], p < .001). IPV questions were specific to the partner involved with RC behaviors. For the 185 participants who reported a past-year pregnancy, RC was associated with lower pregnancy planning scores (β = -.27, 95% CI = [-0.41, -0.13], p < .001). The combination of experiencing RC and IPV appeared particularly potent in lowering pregnancy planning scores (β = -.15, 95% CI = [-0.29, 0.00], p = .052). Approximately 10.6% of participants engaged in harm reduction strategies, most commonly ending an unhealthy or abusive relationship (6.1%) and using less detectable methods of contraception so that partners would not find out (3.4%). The study articulates the risk of RC and its intersection with IPV and unintended pregnancy for Latina women. Providers working with racially and ethnically marginalized women have an important role in promoting safety and harm reduction strategies that include offering less detectable methods of contraception and support in leaving unhealthy and abusive relationships.
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Affiliation(s)
| | - Michele R Decker
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | - Nancy Perrin
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Nancy Glass
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
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17
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Laughon K, Bloom T, Amar AF, Debnam K. Conceptualizing an approach to secondary prevention of relationship violence among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:798-805. [PMID: 31975651 DOI: 10.1080/07448481.2019.1706535] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 10/20/2019] [Accepted: 12/12/2019] [Indexed: 06/10/2023]
Abstract
College-age women represent the highest-risk age group for intimate partner violence (IPV) victimization. Bystander prevention approaches (primarily developed to address sexual assault risk on college campuses), have quickly become the mainstay of primary prevention education for gender-based violence in these settings and have been applied to all forms of gender violence in this setting, including IPV. The purpose of this paper is to critically examine the application of bystander approaches to prevention of IPV among college students. A brief overview of the current policy environment mandating prevention education will precede a summary of the conceptual framework underpinning bystander approaches to preventing and responding to sexual violence, followed by an analysis of how IPV does (and does not) fit within that same conceptual framework. The paper concludes with recommendations informal social network-informed approaches to dating violence that improve our theoretical understanding of IPV prevention on college campuses.
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Affiliation(s)
- Kathryn Laughon
- School of Nursing, University of Virginia, Charlottesville, VA, USA
| | - Tina Bloom
- Sinclair School of Nursing, University of Missouri, Columbia, MO, USA
| | - Angela F Amar
- School of Nursing, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Katrina Debnam
- School of Nursing, University of Virginia, Charlottesville, VA, USA
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18
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Wood SN, Kennedy SR, Hameeduddin Z, Asira B, Tallam C, Akumu I, Wanjiru I, Glass N, Decker MR. "Being Married Doesn't Mean You Have to Reach the End of the World": Safety Planning With Intimate Partner Violence Survivors and Service Providers in Three Urban Informal Settlements in Nairobi, Kenya. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP10979-NP11005. [PMID: 31587653 DOI: 10.1177/0886260519879237] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Intimate partner violence (IPV) harms women physically, sexually, and psychologically. Safety strategies, or harm reduction techniques implemented by women undergoing recurrent violence, may help mitigate the negative health, economic, and social consequences of IPV. This study aimed to understand recommended and utilized safety strategies among three urban informal settlements in Nairobi, Kenya. Semi-structured key informant discussions (KIDs; n = 18) with community-based service providers and focus group discussions (FGDs; n = 49) with IPV survivors were conducted. All interviews were audio-recorded, transcribed, and translated verbatim from Swahili to English. Inductive thematic analysis was used to structure codes. Convergence matrices were used to analyze emergent strategies by data source (service providers vs. IPV survivors). Women preferred safety strategies that they could implement unassisted as first line of harm reduction. Strategies included removing stressors, proactive communication, avoidance behaviors, sexual and reproductive health (SRH), economic, leaving partner for safety, child safety, and securing personal property. Strategies recommended by service providers and utilized by IPV survivors differed, with clear divergence indicated for leaving the abusive relationship, SRH, and personal property strategies. Innovative strategies emerged from IPV survivors for safeguarding property. Similar to upper-income and other low and middle-income contexts, women experiencing IPV in urban informal settlements of Nairobi actively engage in behaviors to maximize safety and reduce harm to themselves and their families. Integration of strategies known to be helpful to women in these communities into community-based prevention and response is strongly encouraged. Increased synergy between recommended and implemented safety strategies can enhance programming and response efforts.
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Affiliation(s)
- Shannon N Wood
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Zaynab Hameeduddin
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | | | - Nancy Glass
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Center for Global Health, Johns Hopkins University, Baltimore, MD, USA
| | - Michele R Decker
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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19
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Seff I, Vahedi L, McNelly S, Kormawa E, Stark L. Remote evaluations of violence against women and girls interventions: a rapid scoping review of tools, ethics and safety. BMJ Glob Health 2021; 6:e006780. [PMID: 34489330 PMCID: PMC8422319 DOI: 10.1136/bmjgh-2021-006780] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/19/2021] [Indexed: 11/06/2022] Open
Abstract
Although programmes and policies targeting violence against women and girls (VAWG) have increased in the past decade, there is a paucity of evidence on the effectiveness of these interventions. To expand this evidence base, researchers increasingly employ remote data collection (RDC)-including online surveys, mobile applications and telephone interviews-in their evaluations. Although RDC allows for evaluations without in-person interactions-which are restricted during crises such as the COVID-19 pandemic- information about these methods is necessary to understand their potential usefulness and limitations. This scoping review examines remote evaluations of VAWG interventions to describe the landscape of RDC methods, reflect on safety and ethical considerations, and offer best practices for RDC in VAWG research. Fourteen studies met eligibility criteria, with seven, five, and two studies employing telephone interviews, online surveys, and mobile applications, respectively. Studies commonly stated that participants were asked to use a safe email or device, but the method for verifying such safety was rarely specified. Best practices around safety included creating a 'quick escape' button for online data collection to use when another individual was present, explaining to participants how to erase browsing history and application purchases, and asking participants to specify a safe time for researchers to call. Only eight studies established referral pathways for respondents as per best practice. None of the eligible studies took place in low/middle-income countries (LMICs) or humanitarian settings, likely reflecting the additional challenges to using RDC methods in lower resource settings. Findings were used to create a best practice checklist for programme evaluators and Institutional Review Boards using RDC for VAWG interventions. The authors found that opportunities exist for researchers to safely and effectively use RDC methodologies to gather VAWG data, but that further study is needed to gauge the feasibility of these methods in LMICs and humanitarian settings.
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Affiliation(s)
- Ilana Seff
- Brown School of Social Work, Washington University in St Louis, St Louis, Missouri, USA
| | - Luissa Vahedi
- Brown School of Social Work, Washington University in St Louis, St Louis, Missouri, USA
| | - Samantha McNelly
- Brown School of Social Work, Washington University in St Louis, St Louis, Missouri, USA
| | | | - Lindsay Stark
- Brown School of Social Work, Washington University in St Louis, St Louis, Missouri, USA
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20
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Anderson JC, Pollitt E, Crowley J, Holbrook D, Moret JED. A mixed-methods evaluation of college student and provider perspectives on a smartphone application for help-seeking after violence. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:668-674. [PMID: 31944911 PMCID: PMC7363504 DOI: 10.1080/07448481.2019.1705839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 10/19/2019] [Accepted: 12/12/2019] [Indexed: 06/10/2023]
Abstract
To elicit feedback on the acceptability, usability, and dissemination options for the bMOREsafe smartphone application (app). Participants: Forty-nine students and six service-providers provided feedback on the bMOREsafe app between April 2015 and March 2016. Methods: Students responded to an anonymous online survey and providers participated in semi-structured interviews. Descriptive and thematic analyses were completed. Results: Students rated the app as useful, however less applicable to themselves and their peers. Students stated they would be most receptive to recommendations about the app from peers and social media. Qualitative data from service providers fell into three main categories: trauma-informed aspects; inclusivity vs. specificity; and within an app, language matters. Conclusions: Smartphone technology can provide confidential information and resources to help students make decisions related to sexual assault or intimate partner violence care. While students and providers identified apps as a useful strategy for sharing this information, dissemination challenges remain.
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Affiliation(s)
- Jocelyn C. Anderson
- Pennsylvania State University, State College, PA
- Mercy Medical Center, Baltimore, MD
- Johns Hopkins University School of Nursing
| | - Erin Pollitt
- Mercy Medical Center, Baltimore, MD
- District of Columbia Forensic Nurse Examiners, Washington, DC
| | | | | | - Jessica E. Draughon Moret
- Mercy Medical Center, Baltimore, MD
- The Betty Irene Moore School of Nursing at the University of California Davis, Sacramento, CA
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21
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Debnam KJ, Kumodzi T. Adolescent Perceptions of an Interactive Mobile Application to Respond to Teen Dating Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:6821-6837. [PMID: 30600761 DOI: 10.1177/0886260518821455] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Although research and intervention efforts in the United States have aimed to reduce teen dating violence (TDV), 10-year prevalence estimates suggest that TDV persists. Safety planning is an advocated intervention to reduce intimate partner abuse; yet, safety planning services for adolescents have not been systematically developed or tested. Personalized safety planning interventions that reflect teens' immediate risk, priorities, and resources may be a key prevention and empowerment tool. Thus, the current study examined adolescent perceptions of an existing safety planning app, myPlan. A small convenience sample of adolescents participated in focus groups. Focus groups investigated the feasibility of an app for TDV intervention and elicited feedback on how apps can better assist adolescents experiencing dating violence. Qualitative content analysis was used to identify themes and patterns in the data. The following themes emerged: (a) careful and thoughtful inclusion of diverse adolescents, (b) capturing unique safety dilemmas encountered by adolescents, (c) clarifying the signs of an unhealthy and abusive relationship, and (d) resources for immediate help. Adolescents were thoughtful in their consideration of the myPlan app and articulated specific ways in which future applications could be more responsive to their lived experiences and challenges. Mobile app or electronic interventions that are developed with an eye toward empowering adolescents to understand how abusive behaviors may manifest in their relationships, weigh the risk and benefits of intervening, and are informed about local resources available to them for help may be most successful in reducing TDV.
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22
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The Usage of Mobile Apps to Fight Violence against Women: A Survey on a Sample of Female Students Belonging to an Italian University. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136968. [PMID: 34209846 PMCID: PMC8297081 DOI: 10.3390/ijerph18136968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/18/2021] [Accepted: 06/26/2021] [Indexed: 11/19/2022]
Abstract
The prevalence of violence against women continues to grow and this plague has had a huge impact from a clinical, social and judicial point of view. For this reason, alongside the efforts made at the legislative level to prevent the phenomenon and to improve assistance to victims in recent years, efforts to contain and better manage this phenomenon have also grown in the extra-legislative sphere: for example, through the application of new technological solutions and safety planning. In recent years, there has been an increase in the marketing of mobile phone apps dedicated to the prevention of violence against women, with different functions and different objectives. The purpose of this study is to investigate the knowledge and propensity to download this type of app in a group of 1782 Italian female university students. This research was performed using an online questionnaire administered to female students attending four different courses (law, medicine, healthcare professionals and political sciences) at one Italian university. Chi-square or Fisher’s exact test was used to analyze associations between responses to questionnaire and the type and the year of course. The results show that 62.6% of our sample are unaware of the existence of these apps and that 79.5% of the sample would be willing to download one in the future. With regard to whom to turn to after a violent incident, the majority of those interviewed (43.9%) would turn to the police and not to health facilities. According to our findings, law female students (52.7%) think, more than any other category, that the most effective way to improve public safety and reduce the number of victims lies in legislative solutions. Our results suggest that, although this type of technology may be promising, it is necessary to improve the knowledge and dissemination of these apps in order to make them a useful tool for prevention, education and assistance in cases of violence against women.
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23
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Emezue C. Digital or Digitally Delivered Responses to Domestic and Intimate Partner Violence During COVID-19. JMIR Public Health Surveill 2020; 6:e19831. [PMID: 32678797 PMCID: PMC7394520 DOI: 10.2196/19831] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/13/2020] [Accepted: 07/15/2020] [Indexed: 01/26/2023] Open
Abstract
Before the coronavirus disease (COVID-19), 1 in 3 women and girls, globally, were victimized by an abusive partner in intimate relationships. However, the current pandemic has amplified cases of domestic violence (DV) against women and girls, with up to thrice the prevalence in DV cases compared to the same time last year. Evidence of the adverse effects of the pandemic on DV is still emerging, even as violence prevention strategies are iteratively being refined by service providers, advocacy agencies, and survivors to meet stay-at-home mandates. Emotional and material support for survivors is a critical resource increasingly delivered using digital and technology-based modalities, which offer several advantages and challenges. This paper rapidly describes current DV mitigation approaches using digital solutions, signaling emerging best practices to support survivors, their children, and abusers during stay-at-home advisories. Some examples of technology-based strategies and solutions are presented. An immediate priority is mapping out current digital solutions in response to COVID-19-related DV and outlining issues with uptake, coverage, and meaningful use of digital solutions.
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Affiliation(s)
- Chuka Emezue
- Sinclair School of Nursing, University of Missouri-Columbia, Columbia, MO, United States
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24
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Decker MR, Wood SN, Kennedy SR, Hameeduddin Z, Tallam C, Akumu I, Wanjiru I, Asira B, Omondi B, Case J, Clough A, Otieno R, Mwiti M, Perrin N, Glass N. Adapting the myPlan safety app to respond to intimate partner violence for women in low and middle income country settings: app tailoring and randomized controlled trial protocol. BMC Public Health 2020; 20:808. [PMID: 32471469 PMCID: PMC7260790 DOI: 10.1186/s12889-020-08901-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 05/12/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is a leading threat to women's health and safety globally. Women in abusive relationships make critical decisions about safety and harm reduction while weighing multiple competing priorities, such as safety of children, housing and employment. In many low- and middle-income countries (LMIC), IPV prevention and response services are limited and women lack access to safety planning resources. In high-resource settings, an interactive safety decision aid app (myPlan) has been found valuable in reducing decisional conflict and empowering women to take action in accordance with their safety priorities. This paper describes 1) the community-participatory formative process used to adapt the myPlan app content, interface, and implementation for the Kenya context, and 2) the randomized clinical trial study protocol for efficacy evaluation of myPlan Kenya. METHODS A community-participatory formative process engaged service providers and stakeholders, as well as IPV survivors for adaptation, followed by an in-depth pilot and final refinements. A randomized clinical trial design will then be used to determine efficacy of the myPlan Kenya app compared to standard care among women reporting IPV or fear of partner and living in an urban settlement. myPlan Kenya app provides and solicits information on a) relationship health; b) safety priorities; and c) severity of relationship violence. Based on the woman's inputs, the evidence-based algorithm developed for myPlan Kenya generates a tailored safety plan. Outcome measures are assessed at baseline, immediate post-intervention, and 3-month post-baseline. Difference-in-differences analysis compares primary (e.g. safety preparedness, safety behavior, IPV), and secondary outcomes (e.g. resilience, mental health, service utilization, self-blame) across timepoints by group. DISCUSSION Formative phase revealed high feasibility and acceptability of a technology-based intervention for safety planning in this LMIC setting. This phase generated essential refinements to myPlan Kenya app readability, content and implementation, including increased visualization of messaging, and implementation via community health volunteers (CHVs). The resulting trial will be the first to evaluate efficacy of a community-partnered technology-based IPV intervention in a LMIC. Our adaptation process and trial results will inform researchers and interventionists to integrate multiple data sources to adapt IPV intervention content and interface in settings where technology-based interventions for IPV are novel and literacy is limited. TRIAL REGISTRATION Pan African Clinical Trial Registry approval received 25 April 2018 (PACTR201804003321122); retrospectively registered.
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Affiliation(s)
- Michele R Decker
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA. .,Center for Public Health & Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Shannon N Wood
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | | | - Zaynab Hameeduddin
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | | | - Irene Akumu
- Ujamaa-Africa, Mashinani Department, Nairobi, Kenya
| | | | - Ben Asira
- Ujamaa-Africa, Mashinani Department, Nairobi, Kenya
| | | | - James Case
- Johns Hopkins School of Nursing, Baltimore, USA
| | | | | | - Morris Mwiti
- Ujamaa-Africa, Mashinani Department, Nairobi, Kenya
| | | | - Nancy Glass
- Johns Hopkins School of Nursing, Baltimore, USA.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.,Center for Global Health, Johns Hopkins University, Baltimore, USA
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Anderson EJ, McClelland J, Meyer Krause C, Krause KC, Garcia DO, Koss MP. Web-based and mHealth interventions for intimate partner violence prevention: a systematic review protocol. BMJ Open 2019; 9:e029880. [PMID: 31401604 PMCID: PMC6701589 DOI: 10.1136/bmjopen-2019-029880] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Victims of intimate partner violence (IPV), or those individuals susceptible to IPV victimisation or perpetration, may benefit from participation in primary, secondary or tertiary interventions to address or mitigate exposure to violence despite mixed evidence of IPV intervention effectiveness. However, participation in such programmes is limited by poor access, sociocultural barriers and programme cost. As the world fast approaches universal access to the internet, web-based technologies and low-cost smartphones, new avenues to provide preventive health services including mobile health (mHealth) tools, platforms and services have emerged. The objective of this systematic review is to assess current web-based and mHealth interventions, which include web-based or mobile-based delivery methods for IPV prevention. Interpersonal violence is defined as perpetration or victimisation of a physical, psychological or sexual nature among adults. Interventions may be at the primary, secondary or tertiary level of the public health model. METHODS AND ANALYSIS This systematic review will incorporate studies focused on any empirical prevention intervention intended for IPV victims or perpetrators of any gender where one or more components is web based or mobile based. Articles will be retrieved from the following academic databases: MEDLINE/PubMed, Embase, CINAHL, PsycInfo and Open Grey, as well Google Scholar. Results will be limited to articles reporting primary data, published since 1998, and in English, Spanish, Portuguese or French. Data extraction procedures will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. The Mixed Methods Appraisal Tool, a critical appraisal tool, will be used to record ratings of quality and risk of bias among studies selected for inclusion. Content analysis and between-study comparisons will be used to answer the objectives of this review. ETHICS AND DISSEMINATION Results from this review will be published in an open access format for the benefit of both academic and non-academic audiences, including community organisations and individuals seeking mHealth strategies to reduce and prevent IPV. TRIAL REGISTRATION NUMBER CRD42019123006.
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Affiliation(s)
| | - Jean McClelland
- Arizona Health Sciences Center, University of Arizona, Tucson, Arizona, USA
| | | | - Keegan C Krause
- College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - David O Garcia
- College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Mary P Koss
- College of Public Health, University of Arizona, Tucson, Arizona, USA
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Sabri B, Njie-Carr VPS, Messing JT, Glass N, Brockie T, Hanson G, Case J, Campbell JC. The weWomen and ourCircle randomized controlled trial protocol: A web-based intervention for immigrant, refugee and indigenous women with intimate partner violence experiences. Contemp Clin Trials 2019; 76:79-84. [PMID: 30517888 PMCID: PMC6449099 DOI: 10.1016/j.cct.2018.11.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 11/08/2018] [Accepted: 11/30/2018] [Indexed: 11/21/2022]
Abstract
Intimate partner violence (IPV), including homicides is a widespread and significant public health problem, disproportionately affecting immigrant, refugee and indigenous women in the United States (US). This paper describes the protocol of a randomized control trial testing the utility of administering culturally tailored versions of the danger assessment (DA, measure to assess risk of homicide, near lethality and potentially lethal injury by an intimate partner) along with culturally adapted versions of the safety planning (myPlan) intervention: a) weWomen (designed for immigrant and refugee women) and b) ourCircle (designed for indigenous women). Safety planning is tailored to women's priorities, culture and levels of danger. Many abused women from immigrant, refugee and indigenous groups never access services [WHY?] and research is needed to support interventions that are most effective and suited to the needs of abused women from these populations in the US. In this two-arm trial, 1250 women are being recruited and randomized to either the web-based weWomen or ourCircle intervention or a usual safety planning control website. Data on outcomes (i.e., safety, mental health and empowerment) are collected at baseline and at 3, 6, and 12 months post- baseline. It is anticipated that the findings will result in an evidence-based culturally tailored intervention for use by healthcare and domestic violence providers serving immigrant, refugee and indigenous survivors of IPV. The intervention may not only reduce risk for violence victimization, but also empower abused women and improve their mental health outcomes.
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Affiliation(s)
- Bushra Sabri
- Johns Hopkins University School of Nursing, 525 N Wolfe Street, Baltimore MD-21205, USA.
| | - Veronica P S Njie-Carr
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, 665 W Lombard Street, Baltimore MD-21201, USA.
| | - Jill T Messing
- School of Social Work, Arizona State University, 411 N Central Avenue, Suite 800, Phoenix, AZ 85004, USA.
| | - Nancy Glass
- Johns Hopkins University School of Nursing, 525 N Wolfe Street, Baltimore MD-21205, USA.
| | - Teresa Brockie
- Johns Hopkins University School of Nursing, 525 N Wolfe Street, Baltimore MD-21205, USA.
| | - Ginger Hanson
- Johns Hopkins University School of Nursing, 525 N Wolfe Street, Baltimore MD-21205, USA.
| | - James Case
- Johns Hopkins University School of Nursing, 525 N Wolfe Street, Baltimore MD-21205, USA
| | - Jacquelyn C Campbell
- Johns Hopkins University School of Nursing, 525 N Wolfe Street, Baltimore MD-21205, USA.
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Ferrari G, Feder G, Agnew-Davies R, Bailey JE, Hollinghurst S, Howard L, Howarth E, Sardinha L, Sharp D, Peters TJ. Psychological advocacy towards healing (PATH): A randomized controlled trial of a psychological intervention in a domestic violence service setting. PLoS One 2018; 13:e0205485. [PMID: 30481183 PMCID: PMC6258512 DOI: 10.1371/journal.pone.0205485] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 08/28/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Experience of domestic violence and abuse (DVA) is associated with mental illness. Advocacy has little effect on mental health outcomes of female DVA survivors and there is uncertainty about the effectiveness of psychological interventions for this population. OBJECTIVE To test effectiveness of a psychological intervention delivered by advocates to DVA survivors. DESIGN, MASKING, SETTING, PARTICIPANTS Pragmatic parallel group individually randomized controlled trial of normal DVA advocacy vs. advocacy + psychological intervention. Statistician and researchers blinded to group assignment. Setting: specialist DVA agencies; two UK cities. Participants: Women aged 16 years and older accessing DVA services. INTERVENTION Eight specialist psychological advocacy (SPA) sessions with two follow up sessions. MEASUREMENTS Primary outcomes at 12 months: depression symptoms (PHQ-9) and psychological distress (CORE-OM). Primary analysis: intention to treat linear (logistic) regression model for continuous (binary) outcomes. RESULTS 263 women recruited (78 in shelter/refuge, 185 in community), 2 withdrew (1 community, control group; 1 intervention, refuge group), 1 was excluded from the study for protocol violation (community, control group), 130 in intervention and 130 in control groups. Recruitment ended June 2013. 12-month follow up: 64%. At 12-month follow up greater improvement in mental health of women in the intervention group. Difference in average CORE-OM score between intervention and control groups: -3.3 points (95% CI -5.5 to -1.2). Difference in average PHQ-9 score between intervention and control group: -2.2 (95% CI -4.1 to -0.3). At 12 months, 35% of the intervention group and 55% of the control group were above the CORE-OM -2clinical threshold (OR 0.32, 95% CI 0.16 to 0.64); 29% of the intervention group and 46% of the control group were above the PHQ-9 clinical threshold (OR 0.41, 95% CI 0.21 to 0.81). LIMITATIONS 64% retention at 12 months. CONCLUSIONS An eight-session psychological intervention delivered by DVA advocates produced clinically relevant improvement in mental health outcomes compared with normal advocacy care. TRIAL REGISTRATION ISRCTN registry ISRCTN58561170 Original Research 3675/3750.
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Affiliation(s)
- Giulia Ferrari
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London United Kingdom
| | - Gene Feder
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | | | - Jayne E. Bailey
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Sandra Hollinghurst
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Louise Howard
- Section of Women’s Mental Health, PO31 King’s College London, London, United Kingdom
| | - Emma Howarth
- NIHR CLAHRC East of England, Douglas House, Cambridge, United Kingdom
| | - Lynnmarie Sardinha
- School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Debbie Sharp
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Tim J. Peters
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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Ferranti D, Lorenzo D, Munoz-Rojas D, Gonzalez-Guarda RM. Health education needs of intimate partner violence survivors: Perspectives from female survivors and social service providers. Public Health Nurs 2017; 35:118-125. [PMID: 29178174 PMCID: PMC10061540 DOI: 10.1111/phn.12374] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To explore the health education needs and learning preferences of female intimate partner violence (IPV) survivors in a social service agency located in South Florida, United States. DESIGN AND SAMPLE An exploratory two-phase sequential mixed-methods study was completed through semistructured interviews with social service providers (n = 10), followed by a survey with predominately female IPV survivors (n = 122, 98.4%). MEASURES Data obtained from interviews with social service providers were analyzed through conventional thematic content analysis. Data from interviews were used in developing a health survey completed by IPV survivors and analyzed utilizing descriptive statistics, chi-square tests and t tests. RESULTS Three themes emerged from interviews including multidimensional health needs, navigating barriers to health care, and self-improvement specific to survivors of intimate partner violence. Survey results indicated that depression and self-esteem were the health education needs of highest priority. Demographic characteristics, including age and language use, were significantly associated to preferred methods of learning, p < .05. CONCLUSIONS IPV survivors present with various health education needs. Current study findings can inform public health nurses in developing interventions or health-based programs for female IPV survivors in social service agency settings.
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Affiliation(s)
| | - Dalia Lorenzo
- School of Business Administration; University of Miami; Coral Gables FL USA
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Conducting Clinically Based Intimate Partner Violence Research: Safety Protocol Recommendations. Nurs Res 2017; 66:405-409. [PMID: 28858149 DOI: 10.1097/nnr.0000000000000235] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Maintaining safety is of utmost importance during research involving participants who have experienced intimate partner violence (IPV). Limited guidance on safety protocols to protect participants is available, particularly information related to technology-based approaches to informed consent, data collection, and contacting participants during the course of a study. PURPOSE The purpose of the article is to provide details on the safety protocol developed and utilized with women receiving care at an urban HIV clinic and who were taking part in an observational study of IPV, mental health symptoms, and substance abuse and their relationship to HIV treatment adherence. The protocol presents the technological strategies to promote safety and allow autonomy in participant decision-making throughout the research process, including Voice over Internet Protocol telephone numbers, and tablet-based eligibility screening and data collection. Protocols for management of participants at risk for suicide and/or intimate partner homicide that included automated high-risk messaging to participants and research staff and facilitated disclosure of risk to clinical staff based on participant preferences are discussed. DISCUSSION Use of technology and partnership with clinic staff helped to provide an environment where research regarding IPV could be conducted without undue burden or risk to participants. Utilizing tablet-based survey administration provided multiple practical and safety benefits for participants. Most women who screened into high-risk categories for suicide or intimate partner homicide did not choose to have their results shared with their healthcare providers, indicating the importance of allowing participants control over information sharing whenever possible.
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Mortier P, Demyttenaere K, Auerbach RP, Cuijpers P, Green JG, Kiekens G, Kessler RC, Nock MK, Zaslavsky AM, Bruffaerts R. First onset of suicidal thoughts and behaviours in college. J Affect Disord 2017; 207:291-299. [PMID: 27741465 PMCID: PMC5460371 DOI: 10.1016/j.jad.2016.09.033] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 09/25/2016] [Indexed: 01/27/2023]
Abstract
BACKGROUND College students are a worldwide increasing group of young people at risk for suicidal thoughts and behaviours (STB). However, no previous studies have prospectively investigated the first onset of STB during the college period. METHODS Using longitudinal data from the Leuven College Surveys, 2337 (response rate [RR]=66.6%) incoming freshmen provided baseline data on STB, parental psychopathology, childhood-adolescent traumatic experiences, 12-month risk for mental disorders, and 12-month stressful experiences. A total of 1253 baseline respondents provided data on 12-month STB in a two-year annual follow-up survey (conditional RR=53.6%; college dropout adjusted conditional RR=70.2%). RESULTS One-year incidence of first-onset STB was 4.8-6.4%. Effect sizes of the included risk factors varied considerably whether viewed from individual-level (ORs=1.91-17.58) or population-level perspective (PARPs=3.4-34.3%). Dating violence prior to the age of 17, physical abuse prior to the age of 17, and 12-month betrayal by someone else than the partner were most strong predictors for first-onset suicidal ideation (ORs=4.23-12.25; PARPs=8.7-27.1%) and plans (ORs=6.57-17.58; PARPs=15.2-34.3%). Multivariate prediction (AUC=0.84-0.91) revealed that 50.7-65.7% of first-onset STB cases were concentrated in the 10% at highest predicted risk. LIMITATIONS As this is a first investigation of STB onset in college, future studies should use validation samples to test the accuracy of our multivariate prediction model. CONCLUSIONS The first onset of STB in college appears to be higher than in the general population. Screening at college entrance is a promising strategy to identify those students at highest prospective risk, enabling the cost-efficient clinical assessment of young adults in college.
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Affiliation(s)
- P Mortier
- Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Leuven, Belgium.
| | - K Demyttenaere
- Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Leuven, Belgium
| | - R P Auerbach
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
| | - P Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
| | - J G Green
- School of Education, Boston University, Boston, MA, USA
| | - G Kiekens
- Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Leuven, Belgium
| | - R C Kessler
- Harvard Medical School, Department of Health Care Policy, Harvard University, Boston, MA, USA
| | - M K Nock
- Department of Psychology, Harvard University, Boston, MA, USA
| | - A M Zaslavsky
- Harvard Medical School, Department of Health Care Policy, Harvard University, Boston, MA, USA
| | - R Bruffaerts
- Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Leuven, Belgium
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