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

Reisenhofer, Sonia; Taft, Angela

doi:10.1016/j.pec.2013.08.004

Cited by 84 publications

(123 citation statements)

References 47 publications

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“…This important study recognised the limitations of screening and identification strategies to increase referrals, consistent with current high quality evidence [5, 9]. The authors’ hypothesis was that if nurses screened, identified and counselled women, and provided safety plans and referrals to community resources, then their partner’s violence might decrease.…”

Section: Challenges Of Ipv Study Primary Outcome Choicessupporting

confidence: 69%

Healthcare system responses to intimate partner violence in low and middle-income countries: evidence is growing and the challenges become clearer

Taft

Colombini

2017

BMC Med

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The damage to health caused by intimate partner violence demands effective responses from healthcare providers and healthcare systems worldwide. To date, most evidence for the few existing, effective interventions in use comes from high-income countries. Gupta et al. provide rare evidence of a nurse-delivered intimate partner violence screening, supportive care and referral intervention from a large-scale randomised trial in Mexican public health clinics. No difference was found in the primary outcome of reduction in intimate partner violence. There were significant short-term benefits in safety planning and mental health (secondary outcomes) for women in the intervention arm, but these were not sustained.This important study highlights the challenges of primary outcome choices in such studies, and further challenges for the sustainability of healthcare systems and healthcare provider interventions. These challenges include the role of theory for sustainability and the risk that baseline measures of intimate partner violence can wash out intervention effects. We emphasise the importance of studying the processes of adaptation, integration and coordination in the context of the wider healthcare system.Please see related article: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0880-y

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Section: Challenges Of Ipv Study Primary Outcome Choicessupporting

confidence: 69%

Healthcare system responses to intimate partner violence in low and middle-income countries: evidence is growing and the challenges become clearer

Taft

Colombini

2017

BMC Med

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“…To this end, we adapted the Transtheoretical Model (TTM) of behavior change [19] to structure narrative interviews with men, in which we asked them to recount their VMMC-seeking trajectories from time they first became aware of adult circumcision to the point of seeking out the procedure for themselves. Centered on the notion that people change their behavior over time, TTM is a flexible theory that has been used to structure a wide variety of health interventions and research [20]–[24]. In our study, by asking men to describe what actually occurred in their lives over time we begin to understand VMMC demand and uptake as a series of dynamic personal events that together constitute a process of change.…”

Section: Introductionmentioning

confidence: 99%

Behavior Change Pathways to Voluntary Medical Male Circumcision: Narrative Interviews with Circumcision Clients in Zambia

et al. 2014

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As an HIV prevention strategy, the scale-up of voluntary medical male circumcision (VMMC) is underway in 14 countries in Africa. For prevention impact, these countries must perform millions of circumcisions in adolescent and adult men before 2015. Although acceptability of VMMC in the region is well documented and service delivery efforts have proven successful, countries remain behind in meeting circumcision targets. A better understanding of men's VMMC-seeking behaviors and experiences is needed to improve communication and interventions to accelerate uptake. To this end, we conducted semi-structured interviews with 40 clients waiting for surgical circumcision at clinics in Zambia. Based on Stages of Change behavioral theory, men were asked to recount how they learned about adult circumcision, why they decided it was right for them, what they feared most, how they overcame their fears, and the steps they took to make it to the clinic that day. Thematic analysis across all cases allowed us to identify key behavior change triggers while within-case analysis elucidated variants of one predominant behavior change pattern. Major stages included: awareness and critical belief adjustment, norming pressures and personalization of advantages, a period of fear management and finally VMMC-seeking. Qualitative comparative analysis of ever-married and never-married men revealed important similarities and differences between the two groups. Unprompted, 17 of the men described one to four failed prior attempts to become circumcised. Experienced more frequently by older men, failed VMMC attempts were often due to service-side barriers. Findings highlight intervention opportunities to increase VMMC uptake. Reaching uncircumcised men via close male friends and female sex partners and tailoring messages to stage-specific concerns and needs would help accelerate men's movement through the behavior change process. Expanding service access is also needed to meet current demand. Improving clinic efficiencies and introducing time-saving procedures and advance scheduling options should be considered.

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“…This appeared to be the case with the didactic DOVE intervention video, which was a limiting feature of its design. It is well documented that abused women are faced with complex decisions and that safety seeking is a gradual process involving multiple steps or strategies [37]. In our study, home visitors and women identified the need for tailored interventions that reflect women’s changing needs.…”

Section: Discussionmentioning

confidence: 91%

Infusing Technology Into Perinatal Home Visitation in the United States for Women Experiencing Intimate Partner Violence: Exploring the Interpretive Flexibility of an mHealth Intervention

Bacchus¹,

Bullock²,

Sharps³

et al. 2016

J Med Internet Res

115

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BackgroundIntimate partner violence (IPV) is common during pregnancy and the postpartum. Perinatal home visitation provides favorable conditions in which to identify and support women affected by IPV. However, the use of mHealth for delivering IPV interventions in perinatal home visiting has not been explored.ObjectiveOur objective was to conduct a nested qualitative interpretive study to explore perinatal home visitors’ and women’s perceptions and experiences of the Domestic Violence Enhanced Home Visitation Program (DOVE) using mHealth technology (ie, a computer tablet) or a home visitor-administered, paper-based method.MethodsWe used purposive sampling, using maximum variation, to select women enrolled in a US-based randomized controlled trial of the DOVE intervention for semistructured interviews. Selection criteria were discussed with the trial research team and 32 women were invited to participate. We invited 45 home visitors at the 8 study sites to participate in an interview, along with the 2 DOVE program designers. Nonparticipant observations of home visits with trial participants who chose not to participate in semistructured interviews were undertaken.ResultsWe conducted 51 interviews with 26 women, 23 home visiting staff at rural and urban sites, and the 2 DOVE program designers. We conducted 4 nonparticipant observations. Among 18 IPV-positive women, 7 used the computer tablet and 11 used the home visitor method. Among 8 IPV-negative women, 7 used the home visitor method. The computer tablet was viewed as a safe and confidential way for abused women to disclose their experiences without fear of being judged. The meanings that the DOVE technology held for home visitors and women led to its construction as either an impersonal artifact that was an impediment to discussion of IPV or a conduit through which interpersonal connection could be deepened, thereby facilitating discussion about IPV. Women’s and home visitors’ comfort with either method of screening was positively influenced by factors such as having established trust and rapport, as well as good interpersonal communication. The technology helped reduce the anticipated stigma associated with disclosing abuse. The didactic intervention video was a limiting feature, as the content could not be tailored to accommodate the fluidity of women’s circumstances.ConclusionsUsers and developers of technology-based IPV interventions need to consider the context in which they are being embedded and the importance of the patient-provider relationship in promoting behavior change in order to realize the full benefits. An mHealth approach can and should be used as a tool for initiating discussion about IPV, assisting women in enhancing their safety and exploring help-seeking options. However, training for home visitors is required to ensure that a computer tablet is used to complement and enhance the therapeutic relationship.ClinicalTrialClinicaltrials.gov NCT01688427; https://clinicaltrials.gov/ct2/show/NCT01688427 (Archived by WebCite at http://www.webcitatio...

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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

Cited by 84 publications

References 47 publications

Healthcare system responses to intimate partner violence in low and middle-income countries: evidence is growing and the challenges become clearer

Healthcare system responses to intimate partner violence in low and middle-income countries: evidence is growing and the challenges become clearer

Behavior Change Pathways to Voluntary Medical Male Circumcision: Narrative Interviews with Circumcision Clients in Zambia

Infusing Technology Into Perinatal Home Visitation in the United States for Women Experiencing Intimate Partner Violence: Exploring the Interpretive Flexibility of an mHealth Intervention

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