Development and testing of a smartphone-delivered climate adaptation and IPV and related stress intervention for residents of informal settlements in Kenya using ecological momentary approaches

项目摘要 气候变化（CC）和相关的天气事件预计将影响亲密伴侣暴力（IPV）。妇女 中低收入国家（LMIC）的非正规住区更有可能经历IPV， 获得服务的可能性更小，更容易受到气候变化和相关极端天气的影响 事件（EWE）。尽管CC对IPV有潜在影响，但在这些定居点适应CC的战略，即， 减少日益严重的气候挑战的后果，忽视了与暴力有关的后果。在 特别是，缺乏干预措施来帮助经历IPV的非正规住区居民适应 或尽量减少CC对其安全和福祉的影响。本次探索性/发展性 R21/R33研究旨在开发和测试智能手机提供的气候适应安全的初步功效 在肯尼亚非正规住区使用生态系统为遭受IPV的妇女进行干预和减少伤害 瞬时干预（EMI）和生态瞬时评估（EMA）。我们将通过以下方式实现这一目标： R21：目标1是开发和试验一种基于智能手机的应用程序，以收集实时EMA 有关IPV体验、情绪压力、IPV自我效能、接受IPV相关社会支持的信息， 服务、安全、气候相关舒适度、社会和环境背景以及320 IPV的当前行为 非正式定居点的幸存者。参与者将在两周的基线期内每天完成三次EMA 以及三种常见的EWE（热浪，寒流，暴雨）后的两周。R21：目标2：是 使用AIM 1数据探索重要的，但未充分研究的气候和IPV之间的关联。R33：目标1是 调整基于证据的希望之翼干预（WINGS），以整合到EMA应用程序中 在R21研究中发现。R33：目的2是测试事件触发的可行性和初步疗效 通过随机对照试验（RCT）在R33：Aim 1中采用基于WINGS的EMI。保留的参与人 R21阶段（n=272）将随机接受单次会话、移动的版本WINGS（n=136） 或R33：Aim 1中采用的事件触发、基于WINGS的EMI（n=136）。九个月来，参与者 将提示分配到事件触发EMI的患者在EWE后两周内参与每日EMI。 他们还将被提示在这两周内完成每日EMA。所有参与者，无论 分配后，将被要求在基线时完成数字评估， 单次WINGS，以及3个月、6个月和12个月。这项研究的目的是：为妇女提供一个 低成本，可访问，基于智能手机的工具，使他们能够开发，利用和修改个人安全 和减少危害的战略，专门应对与气候相关的IPV，并为幸存者提供 进行实时干预。研究结果可以支持低成本，可持续和易于适应的气候 非正规住区或其他非正规住区的适应和IPV响应应用和实施模式 全球范围内的资源配置。

PROJECT SUMMARY Climate change (CC) and related weather events are expected to impact intimate partner violence (IPV). Women in informal settlements in lower- and middle-income countries (LMICs) are more likely to be experiencing IPV, less likely to have access to services, and more vulnerable to the effects of CC and related extreme weather events (EWEs). Despite the potential impacts of CC on IPV, strategies to adapt to CC in these settlements, i.e., reducing the consequences of mounting climate challenges, have overlooked violence-related outcomes. In particular, there is a paucity of interventions to help residents of informal settlements experiencing IPV to adapt to or minimize the impact of CC on their safety and well-being. The purpose of this exploratory/developmental R21/R33 study is to develop and test the preliminary efficacy of a smartphone-delivered climate adaptation safety and harm reduction intervention for women experiencing IPV in informal settlements in Kenya using ecological momentary intervention (EMI) and ecological momentary assessment (EMA). We will achieve this goal through the following aims: R21: Aim 1 is to develop and pilot a smartphone-based application to collect real-time EMA information about IPV experiences, emotional stress, IPV self-efficacy, receipt of IPV-related social support and services, safety, climate-related comfort, social and environmental context, and current behaviors from 320 IPV survivors in informal settlements. Participants will complete EMAs thrice daily for a two-week baseline period and for two-weeks following three common types of EWEs (heatwave, cold spell, heavy rainfall). R21: Aim 2: is to use AIM 1 data to explore important, but understudied associations between climate and IPV. R33: Aim 1 is to adapt an evidence-based Wings of hope intervention (WINGS) for integration into the EMA application developed in the R21 study. R33: Aim 2 is to test the feasibility and preliminary efficacy of the event-triggered WINGS-based EMI adapted in R33: Aim 1 through a randomized control trial (RCT). Participants retained from the R21 phase (n=272), will be randomized to receive either a single-session, mobile version of WINGS (n=136) or the event-triggered, WINGS-based EMI adapted in R33: Aim 1 (n=136). For nine months, participants assigned to the event-triggered EMI will be prompted to participate in daily EMIs for two-weeks following EWEs. They will also be prompted to complete daily EMAs during these two-week periods. All participants, regardless of assignment, will be asked to complete digital assessments at baseline, immediately following receipt of the single-session of WINGS, and at 3-, 6-, and 12-months. The goals of this study are: to provide women with a low-cost, accessible, smartphone-based tool that empowers them to develop, utilize, and revise personal safety and harm reduction strategies that are specifically responsive to climate-related IPV and to provide survivors with interventions in real-time. Findings could support a low-cost, sustainable, and easily adaptable climate adaptation and IPV response application and implementation model for informal settlements or other under- resourced settings, globally.