mHealth (mobile technologies for health) represents a growing array of tools being applied in diverse health care settings. mHealth interventions for improving HIV/AIDS care is a promising strategy, but its evidence-base is limited. We conducted a formative research evaluation to inform the development of novel, mHealth HIV/AIDS care interventions to be used by community health workers (CHWs) in Kampala, Uganda. A mixed methods formative research approach was utilized. Qualitative methods included 20 in-depth interviews and 6 focus groups with CHWs, clinic staff, and patients. Thematic analysis was performed and selected quotations used to illustrate themes. Quantitative methods consisted of a survey administered to CHWs and clinic staff using categorical and Likert scale questions regarding current mobile phone and internet access and perceptions on the potential use of smartphones by CHWs. Qualitative results included themes on significant current care challenges, multiple perceived mHealth benefits, and general intervention acceptability. Key mHealth features desired included tools to verify CHW task completions, clinical decision support tools, and simple access to voice calling. Inhibiting factors identified included concerns about CHW job security and unrealistic expectations of mHealth capabilities. Quantitative results from 27 staff participants found that 26 (96%) did not have internet access at home; yet, only 2 (7.4%) did not own a mobile phone. Likert scale survey responses (1–5, 1=Strongly Disagree, 5=Strongly Agree) indicated general agreement that smartphones would improve efficiency (Mean=4.35) and patient care (4.31) but might be harmful to patient confidentiality (3.88) and training was needed (4.63). Qualitative and quantitative results were generally consistent, and, overall, there was enthusiasm for mHealth technology. However, a number of potential inhibiting factors were also discovered. Findings from this study may help guide future design and implementation of mHealth interventions in this setting, optimizing their chances for success.

Immigrant and refugee women are at high risk for intimate partner violence (IPV) and intimate partner homicide (IPH). Given the growing number of immigrants and refugees in the US and the concerns about IPV and IPH among immigrant and refugee groups, this paper aims to identify survivors and practitioners’ perceptions of a) common and culturally specific risk and protective factors for IPV and IPH for immigrant and refugee women and b) areas of safety planning interventions for survivors who are at risk for severe or lethal violence by an intimate partner. Qualitative data for this multi-site study were collected from women and practitioners residing in seven geographically diverse US locations. Eighty-three in-depth interviews were conducted with adult immigrant and refugee survivors of IPV, who identified as Asian (n=30), Latina (n=30), and African (n=23). Additionally, nine focus groups and five key informant interviews were conducted with practitioners (n=62) who serve immigrant and refugee survivors of IPV. Results revealed multilevel risk and protective factors for IPV/IPH found at the societal-level (e.g., patriarchal cultural norms), relationship-level (e.g., partner abusive behaviors), and individual-level (e.g., acculturation in the US). These findings can inform the development of culturally responsive risk assessment and safety planning interventions across legal, social service, and healthcare settings.

Research indicates that the need for safe housing and the economic resources to maintain safe housing are two of the most pressing concerns among abused women who are planning to or have recently left abusers. Intimate partner violence (IPV) is frequently an immediate cause or precursor to homelessness and housing instability. The aim of the study is to explore abused women’s experiences accessing affordable, safe, and stable housing. To achieve the aim, adult female IPV survivors answered questions about: 1) steps that were taken to secure housing; 2) safety issues after leaving the abuser; 3) barriers to obtaining housing; and 4) responses from housing and domestic violence advocacy systems related to survivors’ housing needs. Four major themes emerged from the in-depth interviews: 1) stable, affordable housing is critical in increasing safety; 2) survivors face multiple systemic or individual barriers; 3) survivors develop and utilize an array of creative and resourceful strategies; and 4) survivors identified a variety of supportive services tailored to address their needs. The findings inform practice, policy and research for both the housing and domestic violence service systems with an emphasis on collaboration to meet the complex safety and stable housing needs of survivors and their families, particularly following the impact on housing of the 2008 U.S. economic crisis and subsequent recession.

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Intimate partner violence (IPV), including homicides is a widespread and significant public health problem, disproportionately affecting immigrant, refugee and indigenous women in the United States (US). This paper describes the protocol of a randomized control trial testing the utility of administering culturally tailored versions of the danger assessment (DA, measure to assess risk of homicide, near lethality and potentially lethal injury by an intimate partner) along with culturally adapted versions of the safety planning (myPlan) intervention: a) weWomen (designed for immigrant and refugee women) and b) ourCircle (designed for indigenous women). Safety planning is tailored to women’s priorities, culture and levels of danger. Many abused women from immigrant, refugee and indigenous groups never access services because of factors such as stigma, and lack of knowledge of resources. Research is, therefore, needed to support interventions that are most effective and suited to the needs of abused women from these populations in the US. In this two-arm trial, 1250 women are being recruited and randomized to either the web-based weWomen or ourCircle intervention or a usual safety planning control website. Data on outcomes (i.e., safety, mental health and empowerment) are collected at baseline and at 3, 6, and 12 months post- baseline. It is anticipated that the findings will result in an evidence-based culturally tailored intervention for use by healthcare and domestic violence providers serving immigrant, refugee and indigenous survivors of IPV. The intervention may not only reduce risk for violence victimization, but also empower abused women and improve their mental health outcomes.