Abstract
BackgroundAdolescents and young adults (AYAs) are of special interest in a group of children exposed to family violence (FV). Past-year prevalence of exposure to FV is known to be highest in AYAs and has severe consequences. Peer support is an effective approach to behavior change and the Internet is considered suitable as a mode of delivery.ObjectiveThe study aimed to evaluate both effectiveness and feasibility of a randomized controlled trial (RCT) and feasibility study of the Internet-based self-support method “Feel the ViBe” (FtV) using mixed-methods approach to fully understand the strengths and weaknesses of a new intervention.MethodsAYAs aged 12-25 years and exposed to FV were randomized in an intervention group (access to FtV + usual care) and a control group (minimally enhanced usual care) after they self-registered themselves. From June 2012 to July 2014, participants completed the Impact of Event Scale (IES) and Depression (DEP) and Anxiety (ANX) subscales of the Symptom CheckList-90-R (SCL-90) every 6 weeks. The Web Evaluation Questionnaire was completed after 12 weeks. Quantitative usage data were collected using Google analytics and content management system (CMS) logs and data files. A univariate analysis of variance (UNIANOVA) and mixed model analysis (intention-to-treat [ITT], complete case) were used to compare groups. Pre-post t tests were used to find within-group effects. Feasibility measures structurally address the findings. The CONsolidated Standards Of Reporting Trials of Electronic and Mobile HEalth Applications and onLine TeleHealth (CONSORT-EHEALTH) checklist was closely followed.ResultsIn total, 31 out of 46 participants in the intervention group and 26 out of 47 participants in the control group started FtV. Seventeen participants (intervention: n=8, control: n=9) completed all questionnaires. Mixed model analysis showed significant differences between groups on the SCL-90 DEP (P=.04) and ANX (P=.049) subscales between 6 and 12 weeks after participation started. UNIANOVA showed no significant differences. Pre-post paired sample t tests showed significant improvements after 12 weeks for the SCL-90 DEP (P=.03) and ANX (P=.046) subscales. Reported mean Web-based time per week was 2.83 with a session time of 36 min. FtV was rated a mean 7.47 (1-10 Likert scale) with a helpfulness score of 3.16 (1-5 Likert scale). All participants felt safe. Two-thirds of the intervention participants started regular health care.ConclusionsNo changes on the IES were found. SCL-90 DEP and ANX showed promising results; however, the calculated sample size was not reached (n=18). FtV functions best as a first step for adolescents and young adults in an early stage of change. FtV can be easily implemented without extensive resources and fits best in the field of public health care or national governmental care.Trial RegistrationNetherlands National Trial Register (NTR): NTR3692; http://www.trialregister.nl/trialreg/admin/ rctview.asp?TC=3692 (Archived by WebCite at http://www.webcitation.org/6qIeKyjA4)
Highlights
Violence (FV) mostly affects women and children—about 30% of all women in a relationship reported to have experienced some form of violence in their relationship [1,2]; and in approximately 60% of the cases, children are living in these violent households [3,4]
Feel the ViBe (FtV) is a freely-available, Internet-based self-support method for AYAs exposed to family violence (FV) [59,60] with three main goals: (1) providing information, (2) offering support, and (3) lowering the threshold to regular health care services by supporting participants to move to a higher level of change and to find health care fitting their needs
J Med Internet Res 2017 | vol 19 | iss. 6 | e204 | p. 11 van Rosmalen-Nooijens et al Results from the baseline General Questionnaire (GQ) and Web Evaluation Questionnaire (WEQ) show that first impressions of Feel the ViBe” (FtV) were positive—participants were enthusiastic (47%, 9/19) or felt that FtV was made especially for people in their own situation (32%, 6/19)
Summary
Violence (FV) mostly affects women and children—about 30% of all women in a relationship reported to have experienced some form of violence in their relationship [1,2]; and in approximately 60% of the cases, children are living in these violent households [3,4]. Exposure to violence is associated with emotional, behavioral, and adjustment problems as internalizing and externalizing behavior, educational dropout, and mental health disorders such as post-traumatic stress disorder (PTSD), affective and depressive disorders, and suicidal attempts. It is associated with adolescent dating violence, high-risk sexual behavior, teenage pregnancy, and intergenerational transmission—becoming a victim or perpetrator of FV in adult life [8,9,10,11,12,13,14,15,16,17,18,19,20]. Peer support is an effective approach to behavior change and the Internet is considered suitable as a mode of delivery
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