Intimate Partner Violence and Electronic Health Interventions: Systematic Review and Meta-Analysis of Randomized Trials (Preprint)

Abstract

BACKGROUND Intimate partner violence (IPV) is a major public health concern. Electronic health (eHealth) interventions may reduce exposure to violence and health-related consequences as the technology provides a safe and flexible space for the target population. However, the evidence is unclear. OBJECTIVE To examine the effect of eHealth interventions compared to standard care on reducing intimate partner violence, depression and post-traumatic stress disorder (PTSD) among women exposed to intimate partner violence. METHODS We searched EMBASE, MEDLINE, CENTRAL, PsycInfo, Scopus, the Global Health Library, ClinicalTrials.gov, the International Clinical Trial Registry Platform for published and unpublished trials from inception up to April 2019. Trials with an eHealth intervention targeted women exposed to violence were included. We assessed risk of bias using the Cochrane Risk of Bias Tool. Trials that reported effect estimates on overall intimate partner violence, physical violence, sexual violence, psychological violence, depression and/or post-traumatic stress disorder were included in meta-analyses. RESULTS A total of fourteen trials were included in the review; eight published trials, three unpublished trials and three ongoing trials. Two out of the eight published trials were judged as overall low risk of bias trials. The trials reported a total of 23 different types of outcomes and seven of the trials had outcomes that were eligible for meta-analyses. Our pooled analyses found no effect of eHealth interventions on any of our pre-specified outcomes: overall IPV (SMD: -0.01; 95% CI: -0.11 to 0.08; I2=0%; five trials, 1668 women); physical violence (SMD: 0.01; 95% CI: -0.22 to 0.24; I2=58%; four trials, 1128 women); psychological violence (SMD: 0.07; 95% CI: -0.12 to 0.25; I2=40%; four trials, 1129 women); sexual violence (MD: 0.36; 95% CI: -0.18 to 0.91; I2=0%; two trials, 1029 women); depression (SMD: -0.13; 95% CI: -0.37 to 0.11; I2=78%; five trials, 1600 women); and PTSD (MD: -0.11; 95% CI: -1.04-0.82; I2=0%; five trials, 1267 women). CONCLUSIONS There is no evidence from randomised trials of a beneficial effect of eHealth interventions on IPV. More high-quality trials are needed and we recommend harmonising outcome reporting in IPV trials by establishing core outcome sets. CLINICALTRIAL PROSPERO: CRD42019130124.

Information and communications technology use to prevent and respond to sexual and gender‐based violence in low‐ and middle‐income countries: An evidence and gap map

“…Clear consensus for standardized indicators and measurement tools does not yet exist. The research we observed during our review reflected this, and at least one of the reviews explicitly noted the lack of harmonized outcome indicators(Linde et al, 2020). Ironically, the observation about the lack of a lack of homogeneity among the outcome measurements, an obstacle to making analytical comparisons, was also noted in a review of ICT used for SGBV in HIC as well(El Morr, 2020, p. 1)…”

“…Linde summarized the impact of all the included studies (which included studies conducted in HIC) as finding "no evidence from randomized trials of a beneficial effect of eHealth interventions on overall IPV; physical, sexual, or psychological violence; or depression and PTSD. However, the types of outcomes and how they were measured were very heterogenous across trials, which limited the possibility of pooling results and identifying patterns across studies" (Linde et al, 2020).…”

“…Of the studies included, two of the primary studies and two of the reviews focused on IPV contexts (Anderson, Krause, et al, 2019;Clark et al, 2020;Decker, Wood, Kennedy, et al, 2020;Linde et al, 2020;(b). Two primary studies focused on the female entertainment industry, that is, female sex workers (Ampt et al, 2020b;Brody et al, 2021).…”

“…The four reviews included were analyzed for risk of bias and quality of evidence using AMSTAR-2 tool for systematic reviews (Shea et al, 2017). Two reviews (Anderson, Krause, et al, 2019;Linde et al, 2020) scored high on the AMSTAR-2 tool presenting low risk of bias. The third review (Eisenhut et al, 2020) demonstrated some risk of bias, as the review did not include information related to study design selection criteria, nor information as to whether or not analysis and extraction were performed in duplicate.…”

Setting the stage: structures from Gaussian random fields

“…If, as inflation predicts (e.g. Linde 2005), and observations indicate (e.g. Bouchet et al 1993;Nusser, Dekel & Yahil 1995;Planck Collaboration XVII 2016;Planck Collaboration IX 2020), the primordial density field is Gaussian, and statistically homogeneous and isotropic, its latetime power spectrum and the distribution of haloes that form in a sufficiently large volume are fully determined by the laws of physics, and the universal cosmological parameters (e.g.…”