BSAFER: A Web-Based Intervention for Drug use and Intimate Partner Violence Demonstrates Feasibility and Acceptability among Women in the Emergency Department

Abstract

Background Addressing violence along with drug use change goals is critical for women with coexisting intimate partner violence (IPV) and substance use disorders (SUD). Methods This was an acceptability and feasibility study of BSAFER, a brief Web-based program and booster phone call addressing violence and drug use. A screening survey identified women with recent drug use and IPV in the emergency department (ED). Participants were randomized to BSAFER or a Web-based control program and booster call providing education about home fire safety. Program completion, usability, satisfaction and MI adherence were primary outcomes. Drug use and IPV outcomes were measured at baseline, one and three months. Results Forty women were enrolled (21 BSAFER, 19 control); 50% were non-white and mean age was 30 years. Most commonly used drugs were marijuana (88%) and cocaine (30%); 45% reported physical abuse and 33% severe combined physical and sexual abuse. Thirty-nine (98%) completed the Web program, 30 (75%) completed the booster, and 29 (73%) completed 3-month follow up. Mean System Usability Scale (SUS) for the BSAFER Web program was 84 (95% CI 78–89) of 100; mean Client Satisfaction Questionnaire (CSQ-8) was 28 (95% CI 26–29) of 32. MI adherence scores were high and similar for both the Web program and the booster. Both intervention and control groups had small mean decreases in weekly drug use days (0.7 days vs. 1.5 days); participants using drugs other than marijuana demonstrated greater average reductions in drug use than those using marijuana only. Conclusions An ED Web-based intervention for SUD and IPV in women demonstrated feasibility and acceptability. Future studies will examine efficacy of the BSAFER program and investigate whether specific subgroups of drug using women may be most responsive to ED-based Web interventions.

Double jeopardy: Predictors of elevated lethality risk among intimate partner violence victims seen in emergency departments

“…Future research may explore potential benefits to using LAP in DVRR and other eHealth interventions to further reduce provider burden and improve patient IPV care in EDs. Some interventions, including DVRR, can be administered by mid-level practitioners, nurses, or social workers (Choo et al, 2015;Feder et al, 2011). DVRR is one of few interventions that provide victims with a warm handoff to professional advocacy services.…”

“…Several enhanced IPV interventions use eHealth technology to accomplish these goals (Choo et al, 2015;Eden et al, 2015;Feder et al, 2011). eHealth screening and referral systems simplify .…”

“…These interventions frequently enable digital screening for all patients, often prior to their appointments. As appropriate, these screening data are used to give alerts or actionable steps to providers (Choo et al, 2015;Feder et al, 2011;Humphreys et al, 2011;Miller et al, 2015;Rhodes et al, 2006). eHealth screenings typically result in higher rates of disclosure, more conversations about IPV, and increased referrals to supportive services (Ambuel et al, 2013;Feder et al, 2011;Haegerich et al, 2014;Humphreys et al, 2011;Miller et al, 2015;Rhodes et al, 2006;Trautman et al, 2007).…”

“…eHealth screenings typically result in higher rates of disclosure, more conversations about IPV, and increased referrals to supportive services (Ambuel et al, 2013;Feder et al, 2011;Haegerich et al, 2014;Humphreys et al, 2011;Miller et al, 2015;Rhodes et al, 2006;Trautman et al, 2007). eHealth screenings alone, when accompanied by educational video clips about IPV, serve as a systemic treatment for chronic IPV and increase victim contact with supportive services (Choo et al, 2015;Haegerich et al, 2014), or reduced rates of IPV at one-month follow-up (Humphreys et al, 2011). Several studies indicate facilitated referrals to domestic violence advocates also increase contact with supportive services and reduce rates of subsequent IPV (Ambuel et al, 2013;Feder et al, 2011;Miller et al, 2015;Trautman et al, 2007).…”

Technology-Based Substance Use Interventions: Opportunities for Gender-Transformative Health Promotion

“…Other brief web-based interventions designed to reach and engage women often combined interventions on substance use with other gender-based health concerns such as sexual or relational violence [28,29]. For example, Gilmore et al examined the impact of a combined brief web-based substance use intervention and sexual assault risk reduction intervention for college women [29,30].…”