Pregnant Women’s Attitudes Toward and Experiences With a Tablet Intervention to Promote Safety Behaviors in a Randomized Controlled Trial: Qualitative Study

Abstract

Background Intimate partner violence (IPV) is recognized as a global health problem. Women with low education and limited resources are more vulnerable, as are immigrant women. There is a lack of evidence on how health care professionals should communicate about and intervene against IPV during pregnancy. Earlier research has shown that when women manage digital questionnaires, they are more likely to disclose IPV. However, little is known about how women experience eHealth interventions with safety behaviors to prevent IPV. Objective The aim of this study was to explore pregnant women’s attitudes toward and experiences with a tablet intervention to promote safety behaviors in a randomized controlled trial (RCT) in antenatal care. Methods Individual semistructured interviews were conducted with 10 women who participated in the Safe Pregnancy Study. The Safe Pregnancy Study was a randomized controlled trial (RCT) using a tablet intervention containing IPV questions and a film to promote safety behaviors. Six women from the intervention group and four women from the control group were recruited. The content was available in Norwegian, Somali, and Urdu. Five of the women participating in the interviews spoke Norwegian at home and five spoke another language. The majority of the women who did not speak Norwegian at home perceived themselves as relatively well integrated. The interviews were conducted at different maternal and child health centers (MCHCs) in Norway between March 2020 and June 2020. The analysis was guided by thematic analysis. Results Women who participated in the tablet intervention appreciated being asked questions about IPV on a tablet. However, it was important to supplement the tablet intervention with face-to-face communication with a midwife. The MCHC was regarded as a suitable place to answer questions and watch a film about safety behaviors. Women suggested making the tablet intervention available in other settings where women meet health care professionals. Some women expressed uncertainty about their anonymity regarding their answers in the questionnaire. We found no real differences between ethnic Norwegian and immigrant women’s attitudes toward and experiences with the tablet intervention. Conclusions Questions about IPV and a film about safety behaviors on a tablet, as a supplement to face-to-face communication, might initiate and facilitate communication about IPV in antenatal care. Uncertainty regarding anonymity has to be addressed when questions about IPV are being asked on a tablet. Trial Registration ClinicalTrials.gov NCT03397277; https://clinicaltrials.gov/ct2/show/NCT03397277

Antenatal depression and the association of intimate partner violence among a culturally diverse population in southeastern Norway: A cross-sectional study

“…Few women with Pakistani and Somali background participated in our study. Studies have showed that migrant women may be sceptic to participate in research due to cultural differences, language barriers and lack of trust regarding anonymity and confidentiality [30][31][32] . Migrants from Pakistan, Somalia and Central and Eastern Europe constitute the vast majority of childbearing women in Norway 23 .…”

Safe Pregnancy intervention for intimate partner violence: a randomised controlled trial in Norway among culturally diverse pregnant women

“…Although we did not detect any effect at the three-month follow-up, our tablet-based instrument can still be used in antenatal care. In qualitative interviews with women and midwives participating in the Safe Pregnancy trial, both groups viewed it as a supplement to face-to-face communication [ 66 , 67 ]. Further, the women suggested making the tablet intervention available in other settings where women meet health care professionals [ 66 ].…”

“…In qualitative interviews with women and midwives participating in the Safe Pregnancy trial, both groups viewed it as a supplement to face-to-face communication [ 66 , 67 ]. Further, the women suggested making the tablet intervention available in other settings where women meet health care professionals [ 66 ]. The midwives reported that the short intervention video made it easier to address IPV, and as a help in a time-limited setting with many tasks and demands [ 67 ].…”

Video Consultations and Safety App Targeting Pregnant Women Exposed to Intimate Partner Violence in Denmark and Spain: Nested Cohort Intervention Study (STOP Study)

“…Nevertheless, studies have shown that women may not disclose IPV during face-to-face antenatal consultations due to self-blame or presence of their violent partner [15,17]. One way to address this issue would be to offer a digital self-administered screening tool for pregnant women [17][18][19][20], and if screening positive, to subsequently offer an intervention [21,22].…”

“…Further, a recent study from Norway investigating the effect of a digital intervention for the prevention of IPV indicated that women found the antenatal care setting a safe place both to respond to the IPV questions and to watch a video with safety behaviors. Yet, the participating women recommended that the digital intervention should be supplemented with a supporting dialogue with a midwife [ 19 ]. Hence, a trusting relationship with a supportive health care provider may be of importance for the ongoing dialogue about IPV when delivering digital screening and interventions.…”