Assessing the feasibility of a web-based domestic violence intervention using chronic disease frameworks: reducing the burden of ‘treatment’ and promoting capacity for action in women abused by a partner

Abstract

BackgroundDomestic violence shares many features with chronic disease, including ongoing physical and mental health problems and eroded self-efficacy. Given the challenges around help-seeking for women experiencing domestic violence, it is essential that they be given support to ‘self-manage’ their condition. The growing popularity of web-based applications for chronic disease self-management suggests that there may be opportunities to use them as an intervention strategy for women experiencing domestic violence, however, as yet, little is known about whether this might work in practice.DiscussionIt is critical that interventions for domestic violence—whether web-based or otherwise—promote agency and capacity for action rather than adding to the ‘workload’ of already stressed and vulnerable women. Although randomised controlled trials are vital to determine the effectiveness of interventions, robust theoretical frameworks can complement them as a way of examining the feasibility of implementing an intervention in practice. To date, no such frameworks have been developed for the domestic violence context. Consequently, in this paper we propose that it may be useful to appraise interventions for domestic violence using frameworks developed to help understand the barriers and facilitators around self-management of chronic conditions. Using a case study of an online healthy relationship tool and safety decision aid developed in Australia (I-DECIDE), this paper adapts and applies two theories: Burden of Treatment Theory and Normalisation Process Theory, to assess whether the intervention might increase women’s agency and capacity for action. In doing this, it proposes a new theoretical model with which the practical application of domestic violence interventions could be appraised in conjunction with other evaluation frameworks.SummaryThis paper argues that theoretical frameworks for chronic disease are appropriate to assess the feasibility of implementing interventions for domestic violence in practice. The use of the modified Burden of Treatment/Normalisation Process Theory framework developed in this paper strengthens the case for I-DECIDE and other web-based applications as a way of supporting women experiencing domestic violence.

An online healthy relationship tool and safety decision aid for women experiencing intimate partner violence (I-DECIDE): a randomised controlled trial

“…30 Whether our intervention could have done more to promote this sense of control in women is unclear. 31 Limitations of this study include the online recruitment, resulting in a need to validate participants as actually being women in Australia, and the unavailablity of the website in languages other than English, which restricted the generalisability of the findings. Our study assessed a self-selected population who engage with social media and had safe access to a computer or smartphone.…”

Women’s Experiences Receiving Support Online for Intimate Partner Violence: How Does it Compare to Face-to-Face Support from a Health Professional?

“…These include: fear of being judged or misunderstood (Chang et al, 2005); financial pressures; concern about the partner finding out (Hegarty & Taft, 2001;Rose et al, 2011); and a belief that IPV is a private matter (Hegarty & Taft, 2001;Othman et al, 2014). Qualitative studies show that similar barriers are faced by women trying to disclose to informal supports such as family and friends Trotter & Allen, 2009) Targeted interventions delivered via the internet have shown promise as an alternative method of support for women experiencing IPV (Eden et al, 2015;Glass, Eden, Bloom, & Perrin, 2010;Koziol-McLain et al, 2018;Koziol-McLain et al, 2015;Lindsay et al, 2013;Tarzia, Iyer, Thrower, & Hegarty, 2017;Tarzia et al, 2015), with the potential to overcome some of the barriers associated with accessing face-to-face services (Tarzia, May, & Hegarty, 2016). Although there has been increasing attention paid to the negative effects of technology on IPV victims including stalking, harassment and technology-facilitated abuse (Dimond, Fiesler, & Bruckman, 2011;Woodlock, 2017), there are also many positive aspects.…”

Advocate and Survivor Perspectives on the Role of Technology in Help Seeking and Services with Emerging Adults in Higher Education

“…Institutions of Higher Education often have secure digital communication methods already in place; with the right amount of institutional backing advocates could build their services to incorporate already licensed tool without needing a large infusion of cash. Comparatively, some communitybased advocates are already focused on service provision via tech (remote work, mobile advocacy, and using tech to facilitate engagement) and could provide a model for campus services (Gray et al, 2015;Tarzia et al, 2018Tarzia et al, , 2016. With the onset of technology into everyday social life, these adaptations should consider the ways in which technologies are relational and changing (Baym, 2015).…”