Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands.
Department of Medical Psychology, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands.
J Med Internet Res. 2023 Aug 21;25:e42647. doi: 10.2196/42647.
Many women experience at least one type of intimate partner violence and abuse (IPVA), and although various support options are available, we still know relatively little about web-based interventions for IPVA survivors. We conducted a qualitative evaluation of the SAFE eHealth intervention for women experiencing IPVA in the Netherlands, complementing the quantitative evaluation of self-efficacy, depression, anxiety, and multiple feasibility aspects.
This study assessed users' experiences and what, according to them, were useful and helpful aspects of the intervention.
The intervention consisted of modules with information on relationships and IPVA, help options, physical and mental health, and social support. It also contained interactive elements such as exercises, stories from survivors, a chat, and a forum. A randomized controlled trial was conducted with an intervention arm receiving the complete version of the intervention and a control arm receiving only a static version with the modules on relationships and IPVA and help options. We gathered data through open questions from surveys (for both study arms; n=65) and semistructured interviews (for the intervention study arm; n=10), all conducted on the web, during the randomized controlled trial and process evaluation. Interview data were coded following the principles of open thematic coding, and all qualitative data were analyzed using qualitative content analysis.
Overall, most users positively rated the intervention regarding safety, content, and suiting their needs, especially participants from the intervention study arm. The intervention was helpful in the domains of acknowledgment, awareness, and support. However, participants also identified points for improvement: the availability of a simplified version for acute situations; more attention for survivors in the aftermath of ending an abusive relationship; and more information on certain topics, such as technological IPVA, support for children, and legal affairs. Furthermore, although participants expressed a prominent need for interactive contact options such as a chat or forum, the intervention study arm (the only group that had these features at their disposal) mainly used them in a passive way-reading instead of actively joining the conversation. The participants provided various reasons for this passive use.
The positive outcomes of this study are similar to those of other web-based interventions for IPVA survivors, and specific points for improvement were identified. The availability of interactive elements seems to be of added value even when they are used passively. This study provides in-depth insight into the experiences of female IPVA survivors with the SAFE eHealth intervention and makes suggestions for improvements to SAFE and comparable web-based interventions for IPVA as well as inspiring future research. Furthermore, this study shows the importance of a varied assessment of an intervention's effectiveness to understand the real-world impact on its users.
Netherlands Trial Register NTR7313; https://tinyurl.com/3t7vwswz.
许多女性至少经历过一种形式的亲密伴侣暴力和虐待（IPVA），尽管有各种支持选择，但我们对 IPVA 幸存者的基于网络的干预措施仍知之甚少。我们对荷兰经历 IPVA 的女性的 SAFE eHealth 干预措施进行了定性评估，补充了自我效能感、抑郁、焦虑和多个可行性方面的定量评估。
本研究评估了用户的体验以及他们认为干预措施中哪些方面是有用和有帮助的。
该干预措施包括模块，内容涉及人际关系和 IPVA、帮助选项、身心健康以及社会支持。它还包含互动元素，例如练习、幸存者故事、聊天和论坛。一项随机对照试验在干预组中使用了完整版本的干预措施，在对照组中仅使用了关系和 IPVA 模块以及帮助选项的静态版本。我们通过调查中的开放式问题（对两个研究组；n=65）和半结构化访谈（对干预研究组；n=10）收集数据，所有这些都在随机对照试验和过程评估期间在网上进行。访谈数据按照开放式主题编码的原则进行编码，所有定性数据均采用定性内容分析进行分析。
总体而言，大多数用户对干预措施的安全性、内容和满足其需求给予了积极评价，特别是干预研究组的参与者。干预措施在认可、意识和支持方面有帮助。然而，参与者也确定了需要改进的地方：为紧急情况提供简化版本；在结束虐待关系后更多地关注幸存者；以及提供更多关于某些主题的信息，例如技术 IPVA、儿童支持和法律事务。此外，尽管参与者表达了对聊天或论坛等互动联系选项的明显需求，但干预研究组（唯一可以使用这些功能的组）主要以被动的方式使用它们，即阅读而不是积极参与对话。参与者为此被动使用提供了各种原因。
这项研究的积极结果与其他针对 IPVA 幸存者的基于网络的干预措施相似，并确定了需要改进的具体方面。互动元素的可用性似乎具有附加价值，即使它们被被动使用。本研究深入了解了女性 IPVA 幸存者对 SAFE eHealth 干预措施的体验，并为 SAFE 和类似的基于网络的 IPVA 干预措施提出了改进建议，并为未来的研究提供了启示。此外，本研究表明需要对干预措施的有效性进行多样化评估，以了解其对用户的实际影响。
荷兰试验登记处 NTR7313；https://tinyurl.com/3t7vwswz。
