Safety decision-making and planning mobile app for intimate partner violence prevention and response: randomised controlled trial in Kenya.


Journal

BMJ global health
ISSN: 2059-7908
Titre abrégé: BMJ Glob Health
Pays: England
ID NLM: 101685275

Informations de publication

Date de publication:
07 2020
Historique:
received: 16 10 2019
revised: 10 03 2020
accepted: 15 03 2020
entrez: 18 7 2020
pubmed: 18 7 2020
medline: 22 6 2021
Statut: ppublish

Résumé

Intimate partner violence (IPV) threatens women's health and safety globally, yet services remain underdeveloped and inaccessible. Technology-based resources exist, however, few have been adapted and tested in low-resource settings. We evaluate the efficacy of a community-partnered technology solution: culturally and linguistically adapted version of the myPlan app, a tailored safety decision-making and planning intervention, administrated by trained lay professionals. This randomised, controlled, participant-blinded superiority trial compares safety-related outcomes at baseline, immediate post intervention and 3-month follow-up among women at risk of and experiencing IPV in Nairobi, Kenya. Women were randomised (1:1 ratio) to: (1) myPlan Kenya (intervention); or (2) standard IPV referrals (control). Primary outcomes were safety preparedness, safety behaviour and IPV; secondary outcomes include resilience, mental health, service utilisation and self-blame. Between April 2018 and October 2018, 352 participants (n=177 intervention, n=175 control) were enrolled and randomly assigned; 312 (88.6%, n=157 intervention, n=155 control) were retained at 3 months. Intervention participants demonstrated immediate postintervention improvement in safety preparedness relative to control participants (p=0.001). At 3 months, intervention participants reported increased helpfulness of safety strategies used relative to control participants (p=0.004); IPV reduced in both groups. Among women reporting the highest level of IPV severity, intervention participants had significant increase in resilience (p<0.01) compared with controls, and significantly decreased risk for lethal violence (p<0.01). Facilitated delivery of a technology-based safety intervention appropriately adapted to the context demonstrates promise in improving women's IPV-related health and safety in a low-resource, urban setting. Pan African Clinical Trial Registry (PACTR201804003321122).

Identifiants

pubmed: 32675229
pii: bmjgh-2019-002091
doi: 10.1136/bmjgh-2019-002091
pmc: PMC7368487
pii:
doi:

Banques de données

PACTR
['PACTR201804003321122']

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Michele R Decker (MR)

Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA mdecker@jhu.edu.
Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.
Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

Shannon N Wood (SN)

Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.

Zaynab Hameeduddin (Z)

Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.

S Rachel Kennedy (SR)

Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.

Nancy Perrin (N)

Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.

Catherine Tallam (C)

Ujamaa Africa, Nairobi, Kenya.

Irene Akumu (I)

Ujamaa Africa, Nairobi, Kenya.

Irene Wanjiru (I)

Ujamaa Africa, Nairobi, Kenya.

Ben Asira (B)

Ujamaa Africa, Nairobi, Kenya.

Ariel Frankel (A)

International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

Benjamin Omondi (B)

Ujamaa Africa, Nairobi, Kenya.

James Case (J)

Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.

Amber Clough (A)

Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.

Richard Otieno (R)

Ujamaa Africa, Nairobi, Kenya.

Morris Mwiti (M)

Ujamaa Africa, Nairobi, Kenya.

Nancy Glass (N)

Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.
International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Center for Global Health, Johns Hopkins University, Baltimore, Maryland, USA.

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