Technology “Feels Less Threatening”: The processes by which digital technologies facilitate youths’ access to services at intimate partner violence organizations

Storer, Heather L.; Nyerges, Eva X.; Hamby, Sherry

doi:10.1016/j.childyouth.2022.106573

Cited by 8 publications

(2 citation statements)

References 43 publications

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“…Overall, both behaviourally-informed chatbots were significantly better at encouraging user retention and engagement, compared to information-focused chatbots. Technological solutions may improve youth’s access to care and could complement existing in-person services if young people feel more engaged or less threatened with this medium of communication [ 34 ]. Only 24% of Attention Treatment participants were retained (compared to 56% and 60% for T1 and T0, respectively).…”

Section: Discussionmentioning

confidence: 99%

Effects of digital chatbot on gender attitudes and exposure to intimate partner violence among young women in South Africa

De Filippo,

Bellatin,

Tietz

et al. 2023

PLOS Digit Health

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Background South Africa has among the highest rates of intimate partner violence (IPV) globally, with young women at heightened risk due to inequitable gender roles, limited relationship skills, and inadequate social support. Despite an urgent need for violence prevention in low- and middle-income settings, most efficacious approaches are time-intensive and costly to deliver. Digital, interactive chatbots may help young women navigate safer relationships and develop healthier gender beliefs and skills Methods Young women (18–24 years old) across South Africa were recruited via Facebook for participation in an individually randomised controlled trial (n = 19,643) during the period of June 2021-September 2021. Users were randomly allocated, using a pipeline algorithm, to one of four trial arms: Pure Control (PC) had no user engagement outside of study measures; Attention Treatment (T0) provided didactic information about sexual health through a text-based chatbot; Gamified Treatment (T1) was a behaviourally-informed gamified text-based chatbot; Narrative Treatment (T2) was a behaviourally-informed drama delivered through pre-recorded voice notes. All chatbots were delivered in WhatsApp, through which users were invited to complete brief “quizzes” comprising adapted versions of validated scales. Primary outcomes were short-form adaptations of scales for gender attitudes (Gender Relations Scale) and past-month IPV (WHO Multi-country Study Instrument). Secondary outcomes were identification of unhealthy relationship behaviours (Intimate Partner Violence Attitudes Scale) and brief screener for depressive symptoms (Patient Health Questionnaire). A direct chat link to a trained counsellor was a safety measure (accessed by 4.5% of the sample). We estimated treatment effects using ordinary least squares and heteroskedasticity robust standard errors Findings The trial retained 11,630 (59.2%) to the primary endpoint of gender attitudes. Compared to control, all treatments led to moderate and significant changes in attitudes towards greater gender equity (Cohen’s D = 0.10, 0.29, 0.20 for T0, T1, and T2, respectively). The gamified chatbot (T1) had modest but significant effects on IPV: 56% of young women reported past-month IPV, compared to 62% among those without treatment (marginal effects = -0.07, 95%CI = -0.09to-0.05). The narrative treatment (T2) had no effect on IPV exposure. T1 increased identification of unhealthy relationship behaviours at a moderate and significant level (Cohen’s D = 0.25). Neither T1 nor T2 had a measurable effect on depressive symptoms as measured by the brief screener. Interpretation: A behaviourally-informed, gamified chatbot increased gender equitable attitudes and was protective for IPV exposure among young women in South Africa. These effects, while modest in magnitude, could represent a meaningful impact given potential to scale the low-cost intervention.

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Section: Discussionmentioning

confidence: 99%

Effects of digital chatbot on gender attitudes and exposure to intimate partner violence among young women in South Africa

De Filippo,

Bellatin,

Tietz

et al. 2023

PLOS Digit Health

View full text Add to dashboard Cite

show abstract

“…Technological solutions may improve youth's access to care and could complement existing in-person services if young people feel more engaged or less threatened with this medium of communication. 26 Only 24% of Attention Treatment participants were retained (compared to 56% and 60% for T1 and T0, respectively). This could indicate that the behaviourally-informed chatbots are more engaging than typical information-only digital approaches.…”

Section: Discussionmentioning

confidence: 99%

Effects of digital chatbot on gender beliefs and exposure to intimate partner violence among young women in South Africa

Filippo¹,

Bellatin²,

Tietz³

et al. 2022

Preprint

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Background: South Africa has among the highest rates of intimate partner violence (IPV) globally, with young women at heightened risk due to inequitable gender roles, limited relationship skills, and inadequate social support. Despite an urgent need for low-cost, scaleable IPV solutions, most efficacious approaches are time-intensive and costly to deliver. Digital, interactive chatbots could deliver behaviourally-informed strategies to help young women navigate their relationships in the context of high IPV prevalence. Methods: Young women (18-24 years old) across South Africa were recruited via Facebook for participation in an individually randomised controlled trial (n=19,643). Users were randomly allocated, using a pipeline algorithm, to one of four trial arms: Pure Control (PC) had no user engagement outside of study measures; Attention Treatment (T0) provided didactic information about sexual health through a text-based chatbot; Gamified Treatment (T1) was a behaviourally-informed gamified text-based chatbot; Narrative Treatment (T2) was a behaviourally-informed drama delivered through pre-recorded voice notes. All chatbots were delivered in WhatsApp, through which users were invited to complete brief “quizzes” comprising adapted versions of validated scales. A direct chat link to a trained counsellor was a safety measure (and was accessed by 4·5% of the sample). Primary outcomes were adapted validated scales of gender beliefs and past-month IPV. Secondary outcomes were identification of unhealthy relationship behaviours and depressive symptoms. We estimated treatment effects using ordinary least squares and heteroskedasticity robust standard errors.Findings: Compared to control, all treatments were effective in improving gender beliefs (Cohen’s D=0·10, 0·29, 0·20 for T0, T1, and T2, respectively). The gamified chatbot (T1) had small but significant effects on IPV: 56% of young women reported past-month IPV, compared to 62% among those without treatment (marginal effects=-0·07, 95%CI=-0·09to-0·05). The narrative treatment (T2) had no effect on IPV exposure. T1 significantly increased identification of unhealthy relationship behaviours (Cohen’s D=0·25). Neither T1 nor T2 had a measurable effect on mental health, nor did either treatment arm cause mental distress.Interpretation: A behaviourally-informed, gamified chatbot increased gender equitable beliefs and skills and was protective for IPV exposure among young women in South Africa. These effects, while modest in magnitude, could represent a meaningful impact were the gamified chatbot to be scaled.

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Initial Examination of DAHLIA: A Fully-automated Internet Intervention for Women Survivors of Sexual Assault

Goodmann,

Brown,

Bunge

et al. 2023

J. technol. behav. sci.

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Sexual assault is a common human rights violation that globally affects approximately 1 in 3 women (30%). Making interventions available via the internet can enhance the security, privacy, and accessibility of mental health resources. This pilot study evaluates utilization, perceived helpfulness, and initial efficacy of Digital Aid to Help Life Improve after Assault (DAHLIA), a fully automated internet-based microintervention website developed to help women improve mood and functioning. Sixty-eight individuals consented to take part in this study. Although most participants visited the website only once, the eight DAHLIA microinterventions were used 117 times. Participants rated the microinterventions as moderately useful; depression and anxiety were inversely related to the perception of usefulness (p < .05). Microinterventions that were designed to offer immediate relief improved mood from before to after use more than the microinterventions requiring activities outside of the intervention (p < .05). Both types of microinterventions were similarly effective for reducing distress from before to after using microinterventions. Our initial test of DAHLIA indicated an interest in such interventions along with their potential to improve mental well-being in the moment. This study also suggested areas for improvement and further development.

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Technology “Feels Less Threatening”: The processes by which digital technologies facilitate youths’ access to services at intimate partner violence organizations

Cited by 8 publications

References 43 publications

Effects of digital chatbot on gender attitudes and exposure to intimate partner violence among young women in South Africa

Effects of digital chatbot on gender attitudes and exposure to intimate partner violence among young women in South Africa

Effects of digital chatbot on gender beliefs and exposure to intimate partner violence among young women in South Africa

Initial Examination of DAHLIA: A Fully-automated Internet Intervention for Women Survivors of Sexual Assault

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