Dissemination, Implementation, and Effectiveness of an Intervention to Prevent Intimate Partner Violence

预防亲密伴侣暴力干预措施的传播、实施和有效性

• 批准号: 10646157
• 负责人: Michele R. Decker
• 金额: $ 51.79万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10646157
• 关键词: Adoption; Advocate; Affect; Area; Attitude; Cellular Phone; Characteristics; Code; Communities; Community Health; Conflict (Psychology); Consolidated Framework for Implementation Research; Dangerousness; Data; Decision Aid; Disclosure; Dissemination and Implementation; Education; Effectiveness; Effectiveness of Interventions; Faith; Female; Fostering; Frequencies; Government; Health; Homicide; Individual; Informal Sectors; Injury; Institution; International; Internet; Intervention; Interview; Justice; Kenya; Knowledge; Leadership; Link; Longevity; Maintenance; Mental Health; Methods; National Institute of Child Health and Human Development; Nature; Nongovernmental Organizations; Outcome; Pathway interactions; Process; Protocols documentation; Public Health; Quality of life; Randomized, Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Readiness; Recommendation; Reproductive Health; Research; Research Priority; Resource-limited setting; Resources; Risk; Safety; Schools; Science; Secure; Self Efficacy; Services; Severities; Sexual Health; Shame; Social Impacts; Source; Support System; Surveys; Survivors; System; Technology; Training; Translating; Trauma; Universities; Violence; Woman; Women' s Health; acceptability and feasibility; arm; cohort; college; community engagement; community organizations; dissemination research; effectiveness evaluation; effectiveness/implementation hybrid; efficacy evaluation; experience; follow-up; functional status; implementation determinants; implementation research; implementation strategy; improved; informal support; innovation; intervention effect; intimate partner violence; low and middle-income countries; mHealth; meetings; mobile computing; mortality; organizational readiness; outreach; physical conditioning; post-traumatic stress; prevent; promote resilience; public health relevance; resilience; response; revictimization; secondary outcome; structural determinants; technology validation; trend; underserved area; violence prevention; volunteer; web app; web site

Intimate partner violence (IPV) is a widespread and serious public health problem. Globally, 30% of ever-partnered women experience physical or sexual intimate partner violence (IPV), and over one third of female homicides are perpetrated by intimate partners. IPV confers negative health and social impacts across the lifespan, making it critical to understand how to best deploy effective, technology-based interventions to advance resilience, health and safety for women survivors. Glaring gaps exist in meeting the health and safety needs of survivors through the formal and informal support system in low-resource settings. Shame, self-blame and lack of a proactive community response discourage women from disclosing IPV and obtaining the safety planning and support that can improve resilience, safety, and health. In high-resource settings, an interactive, personalized safety decision application ("App"), called myPlan has been found effective in increasing use of helpful safety strategies, perceived support, and safety. Users enter information on: a) relationship health; b) safety priorities; and c) severity of violence/danger in relationship, and the app generates a personalized safety plan based on these inputs with links to local resources. Our team recently adapted the myPlan app for its first LMIC implementation in urban settlements in Nairobi, Kenya where mobile phone access exceeds 94%. The resulting myPlanKenya recently underwent efficacy evaluation via randomized controlled trial with positive preliminary intervention effects on survivor’s safety preparedness and resilience. Our stakeholders have identified two distinct organizational types for app dissemination and implementation: the formal sectors often tasked with IPV response, and the community-based, informal networks where women often turn first for support. Therefore, the objective of the 5-year study is to: 1) disseminate the myPlanKenya app through formal systems (i.e., health, education, justice) and informal, community-based networks in Nairobi, Kenya, and document and compare reach and adoption, 2) compare the nature and intensity of myPlanKenya implementation at 6-month follow-up and maintenance at 12-month follow-up by organizational characteristics (formal vs. informal, organizational readiness for IPV response and IPV-related attitudes), and 3) evaluate the effectiveness of myPlanKenya referral on resilience, health and safety among a cohort of women referred to the myPlanKenya app based on disclosure of IPV or assessed to have IPV related risks. Our study will address the paucity of evidence that exists on dissemination pathways for effective health and safety interventions to prevent and respond to IPV. Our study is comprehensive in informing both processes and impacts of app dissemination, and spanning the full pathway from dissemination to effectiveness. Findings will inform optimization of dissemination and implementation strategies for IPV prevention and response in areas of greatest need.

亲密伴侣暴力（IPV）是一个广泛而严重的公共卫生问题。在全球范围内，有 30% 的人曾经有过伴侣 女性遭受亲密伴侣身体或性暴力（IPV），超过三分之一的女性 凶杀案是由亲密伴侣实施的。 IPV 对整个人类健康和社会产生负面影响 生命周期，因此了解如何最好地部署有效的、基于技术的干预措施以推动进步至关重要 女性幸存者的复原力、健康和安全。在满足健康和安全需求方面存在明显差距 通过资源匮乏地区的正式和非正式支持系统为幸存者提供帮助。羞耻、自责和缺乏 积极的社区反应阻止妇女披露 IPV 并获得安全规划 以及可以提高复原力、安全性和健康的支持。在资源丰富的环境中，交互式、 名为 myPlan 的个性化安全决策应用程序（“应用程序”）已被发现可有效增加使用 有用的安全策略、感知支持和安全。用户输入以下信息： a) 关系健康； b) 安全优先事项； c) 关系中的暴力/危险的严重程度，并且应用程序会生成个性化的安全信息 根据这些投入并链接到当地资源进行规划。我们的团队最近首次对 myPlan 应用程序进行了改造 LMIC 在肯尼亚内罗毕城市住区的实施，该地区的移动电话接入率超过 94%。这 myPlanKenya 最近通过随机对照试验进行了疗效评估，结果呈阳性 初步干预对幸存者的安全准备和复原力的影响。我们的利益相关者有 确定了应用程序传播和实施的两种不同的组织类型：正规部门通常 其任务是应对 IPV，以及基于社区的非正式网络，妇女通常首先向这些网络寻求支持。 因此，为期 5 年的研究目标是： 1）通过正式系统传播 myPlanKenya 应用程序 （即健康、教育、司法）和肯尼亚内罗毕的非正式社区网络，并记录和 比较覆盖范围和采用率，2) 比较 myPlanKenya 实施 6 个月的性质和强度 根据组织特征（正式与非正式、 组织对 IPV 响应的准备情况和 IPV 相关态度），以及 3) 评估以下措施的有效性 myPlanKenya 对接受 myPlanKenya 的一组女性的复原力、健康和安全进行转介 基于 IPV 披露或评估为具有 IPV 相关风险的应用程序。我们的研究将解决缺乏 关于有效健康和安全干预措施的传播途径的现有证据，以预防和 响应 IPV。我们的研究全面了解应用程序传播的过程和影响，并且 实现从传播到实效的全过程。研究结果将为传播优化提供信息 以及在最需要的地区预防和应对 IPV 的实施战略。