Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Department of Gynaecology & Obstetrics, Odense University Hospital, Odense, Denmark.
J Med Internet Res. 2020 Dec 11;22(12):e22361. doi: 10.2196/22361.
Intimate partner violence (IPV) is a major public health concern. 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.
The goal of the review is to examine the effect of eHealth interventions compared with standard care on reducing IPV, depression, and posttraumatic stress disorder (PTSD) among women exposed to IPV.
We searched EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials, PsycInfo, Scopus, Global Health Library, ClinicalTrials.gov, and International Clinical Trials Registry Platform for published and unpublished trials from inception until April 2019. Trials with an eHealth intervention targeting 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 IPV; physical, sexual, and psychological violence; depression; or posttraumatic stress disorder were included in meta-analyses.
A total of 14 trials were included in the review; 8 published trials, 3 unpublished trials and 3 ongoing trials. Of the 8 published trials, 2 were judged as overall low risk of bias trials. The trials reported 23 types of outcomes, and 7 of the trials had outcomes that were eligible for meta-analyses. Our pooled analyses found no effect of eHealth interventions on any of our prespecified outcomes: overall IPV (SMD -0.01; 95% CI -0.11 to 0.08; I=0%; 5 trials, 1668 women); physical violence (SMD 0.01; 95% CI -0.22 to 0.24; I=58%; 4 trials, 1128 women); psychological violence (SMD 0.07; 95% CI -0.12 to 0.25; I=40%; 4 trials, 1129 women); sexual violence (MD 0.36; 95% CI -0.18 to 0.91; I=0%; 2 trials, 1029 women); depression (SMD -0.13; 95% CI -0.37 to 0.11; I=78%; 5 trials, 1600 women); and PTSD (MD -0.11; 95% CI -1.04 to 0.82; I=0%; 5 trials, 1267 women).
There is no evidence from randomized trials of a beneficial effect of eHealth interventions on IPV. More high-quality trials are needed, and we recommend harmonizing outcome reporting in IPV trials by establishing core outcome sets.
PROSPERO International Prospective Register of Systematic Reviews CRD42019130124; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=130124.
亲密伴侣暴力（IPV）是一个主要的公共卫生问题。电子健康干预措施可能会减少暴力暴露和与健康相关的后果，因为该技术为目标人群提供了一个安全和灵活的空间。然而，证据并不清楚。
本研究的目的是评估电子健康干预措施与标准护理相比，在减少 IPV、抑郁和创伤后应激障碍（PTSD）方面对暴露于 IPV 的女性的效果。
我们在 EMBASE、MEDLINE、Cochrane 对照试验中心注册库、PsycInfo、Scopus、全球卫生图书馆、ClinicalTrials.gov 和国际临床试验注册平台上搜索了从成立到 2019 年 4 月发表和未发表的试验。纳入了针对暴力暴露妇女的电子健康干预试验。我们使用 Cochrane 偏倚风险工具评估了偏倚风险。报告了总体 IPV、身体暴力、性暴力和心理暴力、抑郁或 PTSD 总体影响估计的试验被纳入荟萃分析。
共纳入 14 项试验；8 项已发表试验、3 项未发表试验和 3 项正在进行的试验。在 8 项已发表的试验中，有 2 项被评为总体低偏倚风险试验。这些试验报告了 23 种结果，有 7 项试验的结果符合荟萃分析的条件。我们的汇总分析发现，电子健康干预措施对我们预先指定的任何结果均没有影响：总体 IPV（SMD-0.01；95%CI-0.11 至 0.08；I=0%；5 项试验，1668 名女性）；身体暴力（SMD 0.01；95%CI-0.22 至 0.24；I=58%；4 项试验，1128 名女性）；心理暴力（SMD 0.07；95%CI-0.12 至 0.25；I=40%；4 项试验，1129 名女性）；性暴力（MD 0.36；95%CI-0.18 至 0.91；I=0%；2 项试验，1029 名女性）；抑郁（SMD-0.13；95%CI-0.37 至 0.11；I=78%；5 项试验，1600 名女性）和 PTSD（MD-0.11；95%CI-1.04 至 0.82；I=0%；5 项试验，1267 名女性）。
随机试验没有证据表明电子健康干预措施对 IPV 有有益的影响。需要更多高质量的试验，我们建议通过建立核心结局集来协调 IPV 试验的结局报告。
PROSPERO 国际前瞻性系统评价注册中心 CRD42019130124；https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=130124。
