Examining organization and provider challenges with the adoption of virtual domestic violence and sexual assault interventions in Alberta, Canada, during the COVID-19 pandemic

Abstract

Objectives In Canada, calls to domestic violence and sexual assault hotlines increased during the COVID-19 pandemic as stricter public health restrictions took effect in parts of the country. Moreover, the public health measures introduced to limit the transmission of COVID-19 saw many health providers abruptly pivot to providing services virtually, with little to no opportunity to plan for this switch. We carried out a qualitative research study to understand the resulting challenges experienced by providers of domestic violence and sexual assault support services. Methods Twenty-four semi-structured interviews were conducted to gather in-depth information from service providers and organizational leaders in the Canadian province of Alberta about the challenges they experienced adopting virtual and remote-based domestic violence and sexual assault interventions during the COVID-19 outbreak. Interview transcripts and field notes were analysed using a thematic analysis approach. Results Our findings highlighted multiple challenges organizations, service providers and clients experienced. These included: (1) systemic (macro-level) challenges pertaining to policies, legislation and funding availability, (2) organization and provider (meso-level) challenges related to adapting services and programmes online or for remote delivery and (3) provider perceptions of client (micro-level) challenges related to accessing virtual interventions. Conclusions Equity-focused policy and intersectional and systemic action are needed to enhance delivery and access to virtual interventions and services for domestic violence and sexual assault clients.

Understanding Virtual Primary Healthcare with Indigenous Populations: A Rapid Evidence Review

“…Concerns surrounding the technological and cultural accessibility of virtual care services further highlight the need to explore patient experiences with virtual primary healthcare through key indicators [14] to ensure a focus on incorporating holistic aspects of health and self-management, health promotion and prevention [2,15,16]. Further research is needed to examine how digital exclusion is experienced by diverse population groups, and across intersecting factors of gender, sex, age, geography, disability, race, ethnicity and culture [73]. One could argue that using a telephone for a phone call versus a video call is easier to access and better understood.…”

“…If these factors are not considered when developing Indigenous virtual care interventions, quality of care will be negatively impacted, and digital health equity will therefore not be achieved. Worthy of mention here is a promising endeavour by the World Health Organization in the development of a strategy on digital health which will aim to "develop the infrastructure for information and communication technologies for health… [and] to promote equitable, affordable and universal access to their bene ts" [73,75]. One other positive step towards closing the digital divide was taken recently in Canada with the introduction of the Universal Broadband Fund, introduced by the Canadian Federal government in 2020.…”

“…This was a C$1.75 billion investment to bring high-speed internet to rural and remote communities. As part of this initiative, up to C$50 million has been made available to support mobile internet projects that bene t Indigenous peoples in Canada [73].…”

Perspectives on delivering safe and equitable trauma-focused intimate partner violence interventions via virtual means: A qualitative study during COVID-19 pandemic

“…The semi-structured interviews also explored the providers’ needs and challenges in delivering virtual interventions. The findings pertaining to service providers’ experiences has been published elsewhere [ 46 ]. All interviews were conducted over a two-month period via telephone or videoconference and lasted approximately one hour in duration.…”

General practice wide adaptations to support patients affected by DVA during the COVID-19 pandemic: a rapid qualitative study

“…Digital support can create opportunities for survivors of DVA to access care, and can offer flexibility and autonomy, but there are risks of adverse impacts on rapport and relationship building [ 31 ]. The loss of non-verbal cues and human presence are known to impact adversely on the experience of service delivery for both providers and patients [ 32 ]. These concerns raise important considerations about the potential impacts of digital and remote care on equity of service provision and access to care.…”