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

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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.