Abstract
BackgroundIntimate partner violence (IPV) and its associated negative mental health consequences are significant for women in New Zealand and internationally. One of the most widely recommended interventions is safety planning. However, few women experiencing violence access specialist services for safety planning. A safety decision aid, weighing the dangers of leaving or staying in an abusive relationship, gives women the opportunity to prioritise, plan and take action to increase safety for themselves and their children. This randomised controlled trial is testing the effectiveness of an innovative, interactive web-based safety decision aid. The trial is an international collaborative concurrent replication of a USA trial (IRIS study NCT01312103), regionalised for the Aotearoa New Zealand culture and offers fully automated online trial recruitment, eligibility screening and consent.Methods/DesignIn a fully automated web-based trial (isafe) 340 abused women will be randomly assigned in equal numbers to a safety decision aid intervention or usual safety planning control website. Intervention components include: (a) safety priority setting, (b) danger assessment and (c) an individually tailored safety action plan. Self-reported outcome measures are collected at baseline and 3, 6, and 12-months post-baseline.Primary outcomes are depression (measured by Center for Epidemiologic Studies Depression Scale, Revised) and IPV exposure (measured by Severity Violence Against Women Scale) at 12 months post-baseline. Secondary outcomes include PTSD, psychological abuse, decisional conflict, safety behaviors and danger in the relationship.DiscussionThis trial will provide much-needed information on the potential relationships among safety planning, improved mental health, reduced violence as well as decreased decisional conflict related to safety in the abusive relationship. The novel web-based safety decision aid intervention may provide a cost-effective, easily accessed safety-planning resource that can be translated into clinical and community practice by multiple health disciplines and advocates. The trial will also provide information about how women in abusive relationships safely access safety information and resources through the Internet. Finally, the trial will inform other research teams on the feasibility and acceptability of fully automated recruitment, eligibility screening, consent and retention procedures.Trial registrationTrial registered on 03 July 2012 on the Australian New Zealand Clinical Trials Registry ACTRN12612000708853.
Highlights
Intimate partner violence (IPV) and its associated negative mental health consequences are significant for women in New Zealand and internationally
This trial will provide much-needed information on the potential relationships among safety planning, improved mental health, reduced violence as well as decreased decisional conflict related to safety in the abusive relationship
Beyond the well-known negative physical health impacts, research consistently demonstrates a strong association between IPV and increased rates of depression, post-traumatic stress disorder (PTSD), substance abuse and suicide [4,5,6]
Summary
This trial will provide information on the potential relationships among safety planning, reduction of decisional conflict, exposure to violence and mental health. The novel intervention used in this trial and its automated web-based delivery may set a new standard for safety planning that includes risk assessment, priority setting for decision making and creation of a personalised safety action plan. The web-based safety decision intervention may provide a cost-effective, evidence-based safetyplanning tool that could be translated into practice by multiple health disciplines and advocates. The trial will provide information about women in abusive relationships safely accessing the web and the experience of fully automated recruitment and retention processes. Competing interests The authors declare that they have no competing interests. All authors read and approved the final manuscript
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