Elsevier

Women's Health Issues

Volume 26, Issue 2, March–April 2016, Pages 208-216
Women's Health Issues

Gender-Based Violence
I-DECIDE: An Online Intervention Drawing on the Psychosocial Readiness Model for Women Experiencing Domestic Violence

https://doi.org/10.1016/j.whi.2015.07.011Get rights and content

Abstract

Background

Domestic violence (DV) perpetrated by men against women is a pervasive global problem with significant physical and emotional consequences. Although some face-to-face interventions in health care settings have shown promise, there are barriers to disclosure to health care practitioners and women may not be ready to access or accept help, reducing uptake. Similar to the mental health field, interventions from clinical practice can be adapted to be delivered by technology.

Purpose

This article outlines the theoretical and conceptual development of I-DECIDE, an online healthy relationship tool and safety decision aid for women experiencing DV. The article explores the use of the Psychosocial Readiness Model (PRM) as a theoretical framework for the intervention and evaluation.

Methods

This is a theoretical article drawing on current theory and literature around health care and online interventions for DV.

Results

The article argues that the Internet as a method of intervention delivery for DV might overcome many of the barriers present in health care settings. Using the PRM as a framework for an online DV intervention may help women on a pathway to safety and well-being for themselves and their children. This hypothesis will be tested in a randomized, controlled trial in 2015/2016.

Conclusion

This article highlights the importance of using a theoretical model in intervention development and evaluation.

Section snippets

Interventions for DV

I-DECIDE is informed by pilot work on an online DV intervention conducted in the United States (Glass et al., 2010; the IRIS Project). To our knowledge, IRIS is the first such intervention developed to date, with similar interventions being developed in New Zealand (Koziol-McLain et al., 2015) and Canada (NCT02258841). Drawing on the theoretical framework of empowerment (Dutton, 1992), the U.S. intervention focuses on reducing decisional conflict, while also increasing safety behaviors.

Causal Pathway for the I-DECIDE Intervention

It can be difficult to determine what outcomes a DV intervention should target, whatever the mode of delivery (Hegarty et al., 2008, O'Doherty et al., 2014). A goal of reducing exposure to violence may be unrealistic for a brief intervention in the short term. Moreover, Chang et al. (2010) have demonstrated that leaving the abusive partner may also be an unreliable measure of an intervention's success, because women may leave only to return again after a period of time. O'Doherty et al. (2014)

I-DECIDE: An Online Healthy Relationship Tool and Safety Decision Aid for Women Experiencing DV

The I-DECIDE intervention will be evaluated through a randomized, controlled trial in 2015 and 2016, comparing its effectiveness to a comparison website that represents minimum safe practice (basic resources and a generic emergency safety plan). The I-DECIDE trial is described in detail elsewhere, including recruitment and screening protocols (Hegarty et al., 2015). In brief, women aged between 16 and 50 who respond to advertisements on popular websites and social media asking if they feel

Implications for Practice and/or Policy

The theoretical journey described may assist other researchers developing interventions addressing DV, particularly in terms of how theory can be effectively harnessed and applied to develop an intervention. It may also be useful to those working to develop online interventions in other sensitive areas, because it explores the possibility of providing social support without face-to-face contact by using messaging developed in conjunction with the target user group. The I-DECIDE healthy

Conclusion

This article has outlined the theoretical and conceptual background to I-DECIDE, an online intervention for women experiencing DV. It has emphasized how the PRM can provide a useful framework for DV interventions through targeting awareness, self-efficacy, and perceived support. Furthermore, the model's emphasis on the changeable and fluid nature of women's decision making and journey to change mirrors reality for many women (Feder, Hutson, Ramsay, & Taket, 2006); this may make it easier for

Laura Tarzia, PhD, is a sociologist and a research fellow at the Department of General Practice, The University of Melbourne. Her research interests include violence against women and technological interventions. She is currently coordinating the development and evaluation of I-DECIDE.

References (54)

  • S. Reisenhofer et al.

    Women's journey to safety—The Transtheoretical model in clinical practice when working with women experiencing Intimate Partner Violence: A scientific review and clinical guidance

    Patient Education and Counseling

    (2013)
  • D. Richards et al.

    Computer-based psychological treatments for depression: A systematic review and meta-analysis

    Clinical Psychological Review

    (2012)
  • A. Taft et al.

    Are men and women equally violent to intimate partners?

    Australia and New Zealand Journal of Public Health

    (2001)
  • J. Valpied et al.

    'Sometimes cathartic. Sometimes quite raw': Benefit and harm in an intimate partner violence trial

    Aggression and Violent Behavior

    (2014)
  • Australian Bureau of Statistics. (2014). Household Use of Information Technology, Australia, 2012–2013, cat no....
  • G. Bedi et al.

    Intimate partner violence: What are the impacts on children?

    Australian Psychologist

    (2007)
  • L. Biener et al.

    The contemplation ladder: Validation of a measure of readiness to consider smoking cessation

    Health Psychology

    (1991)
  • J.C. Campbell

    Nursing assessment for risk of homicide with battered women

    Advances in Nursing Science

    (1986)
  • J.C. Campbell et al.

    Risk factors for femicide in abusive relationships: Results from a multisite case control study

    American Journal of Public Health

    (2003)
  • J.C. Chang et al.

    Understanding turning points in intimate partner violence: Factors and circumstances leading women victims toward change

    Journal of Women's Health (Larchmont)

    (2010)
  • H. Christensen et al.

    Delivering interventions for depression by using the internet: Randomised controlled trial

    BMJ

    (2004)
  • Council of Europe Convention on preventing and combating violence against women and domestic violence (Vol. CETS no.210)

    (2011)
  • M. Dutton

    Empowering and healing the battered woman

    (1992)
  • K.B. Eden et al.

    Patients were more consistent in randomized trial at prioritizing childbirth preferences using graphic-numeric than verbal formats

    Journal of Clinical Epidemiology

    (2009)
  • M. Ellsberg et al.

    Researching violence against women: A practical guide for researchers and activists

    (2005)
  • M.A. Evans et al.

    Help-seeking amongst women survivors of domestic violence: A qualitative study of pathways towards formal and informal support

    Health Expectations

    (2015)
  • G. Feder et al.

    Women exposed to intimate partner violence: Expectations and experiences when they encounter health care professionals: A meta-analysis of qualitative studies

    Archives of Internal Medicine

    (2006)
  • Cited by (0)

    Laura Tarzia, PhD, is a sociologist and a research fellow at the Department of General Practice, The University of Melbourne. Her research interests include violence against women and technological interventions. She is currently coordinating the development and evaluation of I-DECIDE.

    Elizabeth Murray, PhD, is a general practitioner and academic based within the e-Health Unit, Department of Primary Care & Population Health, at University College London. Her work focuses on use of new technologies (such as the Internet and mobile phones) to improve health and health care.

    Cathy Humphreys, PhD, is based at the Department of Social Work at The University of Melbourne. She specializes in research on domestic and family violence with a particular emphasis on issues involving children living with violence.

    Nancy Glass, PhD, is Associate Director of the Johns Hopkins Centre for Global Health. She conducts community-based interventions with diverse populations. She is PI of studies to test employment, economic empowerment, and safety interventions for survivors of gender-based violence and their families.

    Angela Taft, PhD, is Director of the Judith Lumley Centre, La Trobe University, Australia. She is a public health social scientist whose major focus is women's health. She leads the center’s research program on intimate partner/gender-based violence and sexual and reproductive health.

    Jodie Valpied, BA, MEd, PGDip(Psych), is a researcher in the Department of General Practice, The University of Melbourne, specializing in researching sensitive issues, specifically intimate partner violence. She has a background in psychology and teaching.

    Kelsey Hegarty, PhD, is an academic general practitioner, Department of General Practice, The University of Melbourne. She leads an Abuse and Violence research program. Her current research includes interventions to prevent and respond to violence against women. She is the PI on I-DECIDE.

    Funding: This work was funded by an Australian Research Council Discovery Project Grant, DP 130102799.

    View full text