Violence, Violence, Domestic, Violence, Gender-Based, Violence, Physical, Violence-Related Symptom, Violence, Sexual
Conditions
Keywords
Intimate partner violence, safety planning, immigrant, risk for future violence, risk for intimate partner homicide, empowerment, mental health, safety
Brief summary
This study evaluates the impact of adaptive technology-based intervention (online, text and phone) weWomenPlus on safety, mental health and empowerment of abused immigrant women.
Detailed description
Intimate partner violence (IPV) disproportionately affects immigrant women. However, immigrant women remain an understudied and underserved population in need for evidence-based rigorously evaluated culturally competent interventions that address the health and safety needs of immigrant women. This study used a sequential, multiple assignment, randomized trial (SMART) design to rigorously evaluate an adaptive culturally informed intervention tailored to needs of immigrant women with IPV experiences. For the first stage randomization, participants were randomly assigned to a personalized online intervention or the standard online safety information/usual care control arm and safety, mental health and empowerment outcomes were assessed at 3, 6 and 12 months follow up. For the second stage randomization, women who did not report significant improvement in safety (i.e., reduction in IPV) and in empowerment from baseline to follow up points (i.e., non-responders) were re- randomized to the augmented intervention components (text only or a combination of text and phone) developed in the formative phase. Data on outcomes (safety, mental health and empowerment) were assessed at 6 and 12 months of re- randomization. By re-randomizing participants, the study assessed the relative effectiveness of two strategies for augmentation (text only or a combination of text and phone) on safety, mental health and empowerment outcomes among the non-responders of the online interventions. In addition, the study compared the non-responder group of women to the responder group of the online interventions to determine if the strategies of augmentation brought the non-responders to the level of responders on safety, mental health and empowerment.
Interventions
BEHAVIORALWeWomen Plus technology based intervention
The WeWomen Plus intervention is a technology based (online, text and phone)culturally tailored intervention designed to reduce the risk of future intimate partner violence or a homicide, improve mental health and increase empowerment of abused immigrant women.
Sponsors
National Institute on Minority Health and Health Disparities (NIMHD)
Johns Hopkins University
Study design
Allocation
RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Intervention model description
The study used a sequential, multiple assignment, randomized (SMART) design
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 64 Years
Healthy volunteers
Yes
Inclusion criteria
* Experiences of intimate partner violence within the past one year * Foreign born immigrant woman * 18-64 years of age * Can access and use internet and phone
Exclusion criteria
* No experience of intimate partner violence within the past one year * US born * Younger than 18 or older than 64 * Cannot access or use internet or phone
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale | Baseline (1st month), 3 months, 6 months, 12 months | The adapted version of the Revised Conflict Tactics Scale (CTS2; Straus, 1996) was used to measure the severity and frequency of abusive or violent acts in intimate partner relationships. The CTS2 subscales included physical aggression, injury, psychological aggression, and sexual coercion. Response categories ranged from 0=never to 4=very frequently. Total scores ranged from 0-164, with higher scores indicating greater frequency and severity of intimate partner violence experiences. Items were scored using the severity-times-frequency weighted score method as recommended by Straus (1996). Change scores were calculated as the differences between baseline CTS-2 total scores and follow-up scores at each time point (3, 6, and 12 months). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9) | Baseline, 3 months, 6 months, 12 months | The Patient Health Questionnaire (PHQ-9) was used to assess depression symptoms over the past two weeks based on DSM-IV diagnostic criteria for major depressive disorder. Each of the 9 items was scored from 0 (not at all) to 3 (nearly every day). Total scores were computed by summing all items, ranging from 0-27. Higher scores indicated more severe depression symptoms (1-4=minimal, 5-9=mild, 10-14=moderate, 15-19=moderately severe, 20-27=severe depression). Change scores were calculated as the differences between baseline PHQ-9 total scores and follow-up scores at each time point (3, 6, and 12 months). |
| Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire | Baseline, 3 months, 6 months, 12 months | Past week PTSD symptoms were measured using the Harvard Trauma Questionnaire, a 16-item scale with response options that ranged from 1 (not at all) to 5 (extremely). Mean scores across all 16 items were calculated for each participant. Higher scores indicated more severe PTSD symptoms, with scores greater than 2.5 indicating clinically significant PTSD symptoms. Change scores were calculated as the differences between baseline mean scores and the follow-up mean scores at each time point (3, 6, and 12 months). |
| Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised | Baseline, 3 months, 6 months, 12 months | The Personal Progress Scale-Revised was used to measure empowerment across multiple domains including positive self-evaluation, self-esteem, emotional regulation, gender-role and cultural identity awareness, self-efficacy, self-care, problem-solving, and assertiveness skills. Participants rated 28 items on a 7-point scale from 1 (almost never) to 7 (almost always). Total scores were calculated by summing all items, ranging from 28-196, with higher scores indicating greater empowerment. Change scores were calculated as the differences between baseline total scores and follow-up scores at each time point (3, 6, and 12 months). |
| Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale | Baseline, 3 months, 6 months, 12 months | The MOVERS scale was used to measure empowerment within the safety domain, including safety-related goal development, self-efficacy beliefs, and knowledge of support resources. Participants rated 13 items on a 5-point scale from 1 (never true) to 5 (always true). Mean scores across all 13 items were calculated for each participant. Higher scores indicated greater safety-related empowerment. Change scores were calculated as the differences between baseline mean scores and follow-up mean scores at each time point (3, 6, and 12 months). |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Personalized Online Intervention Women received the culturally adapted myPlan intervention, a web-based safety decision-making tool based on Dutton's empowerment model with danger assessment and tailored safety planning. | 660 |
| Standard Online Safety Information Women received usual safety planning resources modeled on national and state domestic violence online resources without danger assessment-informed safety planning. | 605 |
| Total | 1,265 |
Baseline characteristics
| Characteristic | Personalized Online Intervention | Standard Online Safety Information | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 8 Participants | 6 Participants | 14 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 652 Participants | 599 Participants | 1251 Participants |
| Age, Continuous | 36.70 years STANDARD_DEVIATION 9.88 | 37.39 years STANDARD_DEVIATION 9.67 | 37.00 years STANDARD_DEVIATION 9.8 |
| Depression | 9.98 units on a scale STANDARD_DEVIATION 6.39 | 10.39 units on a scale STANDARD_DEVIATION 6.61 | 10.18 units on a scale STANDARD_DEVIATION 6.5 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 255 Participants | 269 Participants | 524 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 396 Participants | 330 Participants | 726 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 9 Participants | 6 Participants | 15 Participants |
| Overall Empowerment | 119.60 units on a scale STANDARD_DEVIATION 21.19 | 118.85 units on a scale STANDARD_DEVIATION 21.67 | 119.24 units on a scale STANDARD_DEVIATION 21.41 |
| Physical and Sexual IPV | 18.03 units on a scale STANDARD_DEVIATION 25.52 | 17.83 units on a scale STANDARD_DEVIATION 25.07 | 17.94 units on a scale STANDARD_DEVIATION 25.29 |
| Post-traumatic Stress Disorder (PTSD) | 2.42 units on a scale STANDARD_DEVIATION 0.93 | 2.50 units on a scale STANDARD_DEVIATION 1 | 2.46 units on a scale STANDARD_DEVIATION 0.96 |
| Race (NIH/OMB) American Indian or Alaska Native | 3 Participants | 5 Participants | 8 Participants |
| Race (NIH/OMB) Asian | 222 Participants | 164 Participants | 386 Participants |
| Race (NIH/OMB) Black or African American | 85 Participants | 87 Participants | 172 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 2 Participants | 1 Participants | 3 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 181 Participants | 159 Participants | 340 Participants |
| Race (NIH/OMB) White | 167 Participants | 189 Participants | 356 Participants |
| Safety-Related Empowerment | 3.36 units on a scale STANDARD_DEVIATION 0.72 | 3.38 units on a scale STANDARD_DEVIATION 0.75 | 3.37 units on a scale STANDARD_DEVIATION 0.73 |
| Sex: Female, Male Female | 660 Participants | 605 Participants | 1265 Participants |
| Sex: Female, Male Male | 0 Participants | 0 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 660 | 0 / 605 | 0 / 183 | 0 / 183 |
| other Total, other adverse events | 0 / 660 | 0 / 605 | 0 / 183 | 0 / 183 |
| serious Total, serious adverse events | 0 / 660 | 0 / 605 | 0 / 183 | 0 / 183 |
Outcome results
Primary
Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale
The adapted version of the Revised Conflict Tactics Scale (CTS2; Straus, 1996) was used to measure the severity and frequency of abusive or violent acts in intimate partner relationships. The CTS2 subscales included physical aggression, injury, psychological aggression, and sexual coercion. Response categories ranged from 0=never to 4=very frequently. Total scores ranged from 0-164, with higher scores indicating greater frequency and severity of intimate partner violence experiences. Items were scored using the severity-times-frequency weighted score method as recommended by Straus (1996). Change scores were calculated as the differences between baseline CTS-2 total scores and follow-up scores at each time point (3, 6, and 12 months).
Time frame: Baseline (1st month), 3 months, 6 months, 12 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Personalized Online Intervention | Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale | 3- 6 months | -0.81 score on a scale | Standard Deviation 16.07 |
| Personalized Online Intervention | Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale | 1-3 months | -6.29 score on a scale | Standard Deviation 22.56 |
| Personalized Online Intervention | Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale | 1-6 months | -7.65 score on a scale | Standard Deviation 22.35 |
| Personalized Online Intervention | Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale | 1-12 months | -6.46 score on a scale | Standard Deviation 22.15 |
| Personalized Online Intervention | Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale | 3 -12 months | -0.24 score on a scale | Standard Deviation 20.81 |
| Online Usual Care or Standard Online Safety Information | Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale | 1-3 months | -5.16 score on a scale | Standard Deviation 21.07 |
| Online Usual Care or Standard Online Safety Information | Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale | 3- 6 months | -0.30 score on a scale | Standard Deviation 18.96 |
| Online Usual Care or Standard Online Safety Information | Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale | 1-12 months | -5.22 score on a scale | Standard Deviation 22.5 |
| Online Usual Care or Standard Online Safety Information | Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale | 1-6 months | -5.62 score on a scale | Standard Deviation 21.61 |
| Online Usual Care or Standard Online Safety Information | Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale | 3 -12 months | 0.03 score on a scale | Standard Deviation 19.47 |
| WeWomen Plus Text Messaging Only | Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale | 1-6 months | -4.61 score on a scale | Standard Deviation 20.63 |
| WeWomen Plus Text Messaging Only | Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale | 1-12 months | -3.50 score on a scale | Standard Deviation 23.34 |
| WeWomen Plus Text Messaging Only | Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale | 1-3 months | -2.20 score on a scale | Standard Deviation 20.01 |
| WeWomen Plus Text Messaging Only | Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale | 3 -12 months | -0.43 score on a scale | Standard Deviation 19.73 |
| WeWomen Plus Text Messaging Only | Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale | 3- 6 months | -1.74 score on a scale | Standard Deviation 20.99 |
| WeWomen Plus Text Messaging and Phone | Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale | 3 -12 months | -4.94 score on a scale | Standard Deviation 24.5 |
| WeWomen Plus Text Messaging and Phone | Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale | 3- 6 months | -6.10 score on a scale | Standard Deviation 19.33 |
| WeWomen Plus Text Messaging and Phone | Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale | 1-12 months | -7.27 score on a scale | Standard Deviation 22.32 |
| WeWomen Plus Text Messaging and Phone | Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale | 1-3 months | -1.82 score on a scale | Standard Deviation 21.3 |
| WeWomen Plus Text Messaging and Phone | Change in Severity of Physical and Sexual Intimate Partner Violence as Assessed by the Revised Conflict Tactics Scale | 1-6 months | -8.27 score on a scale | Standard Deviation 20.87 |
Secondary
Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9)
The Patient Health Questionnaire (PHQ-9) was used to assess depression symptoms over the past two weeks based on DSM-IV diagnostic criteria for major depressive disorder. Each of the 9 items was scored from 0 (not at all) to 3 (nearly every day). Total scores were computed by summing all items, ranging from 0-27. Higher scores indicated more severe depression symptoms (1-4=minimal, 5-9=mild, 10-14=moderate, 15-19=moderately severe, 20-27=severe depression). Change scores were calculated as the differences between baseline PHQ-9 total scores and follow-up scores at each time point (3, 6, and 12 months).
Time frame: Baseline, 3 months, 6 months, 12 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Personalized Online Intervention | Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9) | 3-12 months | -0.87 score on a scale | Standard Deviation 5.97 |
| Personalized Online Intervention | Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9) | 1-12 months | -1.20 score on a scale | Standard Deviation 6.18 |
| Personalized Online Intervention | Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9) | 1-6 months | -1.04 score on a scale | Standard Deviation 5.61 |
| Personalized Online Intervention | Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9) | 3-6 months | -0.66 score on a scale | Standard Deviation 5.36 |
| Personalized Online Intervention | Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9) | 1-3 months | -0.41 score on a scale | Standard Deviation 5.32 |
| Online Usual Care or Standard Online Safety Information | Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9) | 3-6 months | -1.07 score on a scale | Standard Deviation 5.43 |
| Online Usual Care or Standard Online Safety Information | Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9) | 3-12 months | -0.87 score on a scale | Standard Deviation 5.66 |
| Online Usual Care or Standard Online Safety Information | Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9) | 1-6 months | -1.45 score on a scale | Standard Deviation 5.79 |
| Online Usual Care or Standard Online Safety Information | Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9) | 1-3 months | -0.35 score on a scale | Standard Deviation 5.23 |
| Online Usual Care or Standard Online Safety Information | Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9) | 1-12 months | -1.25 score on a scale | Standard Deviation 6.02 |
| WeWomen Plus Text Messaging Only | Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9) | 3-6 months | -2.02 score on a scale | Standard Deviation 5.47 |
| WeWomen Plus Text Messaging Only | Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9) | 1-3 months | 0.83 score on a scale | Standard Deviation 5.35 |
| WeWomen Plus Text Messaging Only | Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9) | 1-6 months | -1.20 score on a scale | Standard Deviation 5.9 |
| WeWomen Plus Text Messaging Only | Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9) | 3-12 months | -1.79 score on a scale | Standard Deviation 5.88 |
| WeWomen Plus Text Messaging Only | Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9) | 1-12 months | -0.95 score on a scale | Standard Deviation 5.82 |
| WeWomen Plus Text Messaging and Phone | Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9) | 1-3 months | 0.03 score on a scale | Standard Deviation 4.71 |
| WeWomen Plus Text Messaging and Phone | Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9) | 1-12 months | -1.73 score on a scale | Standard Deviation 5.31 |
| WeWomen Plus Text Messaging and Phone | Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9) | 3-12 months | -1.78 score on a scale | Standard Deviation 5.7 |
| WeWomen Plus Text Messaging and Phone | Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9) | 3-6 months | -1.51 score on a scale | Standard Deviation 5.41 |
| WeWomen Plus Text Messaging and Phone | Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire (PHQ-9) | 1-6 months | -1.41 score on a scale | Standard Deviation 5.58 |
Secondary
Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale
The MOVERS scale was used to measure empowerment within the safety domain, including safety-related goal development, self-efficacy beliefs, and knowledge of support resources. Participants rated 13 items on a 5-point scale from 1 (never true) to 5 (always true). Mean scores across all 13 items were calculated for each participant. Higher scores indicated greater safety-related empowerment. Change scores were calculated as the differences between baseline mean scores and follow-up mean scores at each time point (3, 6, and 12 months).
Time frame: Baseline, 3 months, 6 months, 12 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Personalized Online Intervention | Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale | 3-12 months | -0.09 score on a scale | Standard Deviation 0.7 |
| Personalized Online Intervention | Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale | 1-6 months | 0.08 score on a scale | Standard Deviation 0.63 |
| Personalized Online Intervention | Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale | 1-12 months | 0.07 score on a scale | Standard Deviation 0.68 |
| Personalized Online Intervention | Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale | 1-3 months | 0.16 score on a scale | Standard Deviation 0.71 |
| Personalized Online Intervention | Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale | 3-6 months | -0.10 score on a scale | Standard Deviation 0.7 |
| Online Usual Care or Standard Online Safety Information | Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale | 1-12 months | 0.02 score on a scale | Standard Deviation 0.71 |
| Online Usual Care or Standard Online Safety Information | Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale | 3-12 months | -0.09 score on a scale | Standard Deviation 0.72 |
| Online Usual Care or Standard Online Safety Information | Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale | 1-6 months | 0.04 score on a scale | Standard Deviation 0.65 |
| Online Usual Care or Standard Online Safety Information | Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale | 3-6 months | -0.06 score on a scale | Standard Deviation 0.72 |
| Online Usual Care or Standard Online Safety Information | Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale | 1-3 months | 0.10 score on a scale | Standard Deviation 0.69 |
| WeWomen Plus Text Messaging Only | Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale | 1-12 months | -0.07 score on a scale | Standard Deviation 0.54 |
| WeWomen Plus Text Messaging Only | Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale | 1-3 months | -0.40 score on a scale | Standard Deviation 0.45 |
| WeWomen Plus Text Messaging Only | Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale | 3-6 months | 0.35 score on a scale | Standard Deviation 0.64 |
| WeWomen Plus Text Messaging Only | Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale | 1-6 months | -0.04 score on a scale | Standard Deviation 0.61 |
| WeWomen Plus Text Messaging Only | Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale | 3-12 months | 0.34 score on a scale | Standard Deviation 0.63 |
| WeWomen Plus Text Messaging and Phone | Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale | 3-6 months | 0.29 score on a scale | Standard Deviation 0.64 |
| WeWomen Plus Text Messaging and Phone | Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale | 1-3 months | -0.39 score on a scale | Standard Deviation 0.45 |
| WeWomen Plus Text Messaging and Phone | Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale | 1-12 months | -0.16 score on a scale | Standard Deviation 0.66 |
| WeWomen Plus Text Messaging and Phone | Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale | 3-12 months | 0.24 score on a scale | Standard Deviation 0.58 |
| WeWomen Plus Text Messaging and Phone | Change in Empowerment Related to Safety as Assessed by the Measure of Victim Empowerment Related to Safety (MOVERS) Scale | 1-6 months | -0.10 score on a scale | Standard Deviation 0.63 |
Secondary
Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised
The Personal Progress Scale-Revised was used to measure empowerment across multiple domains including positive self-evaluation, self-esteem, emotional regulation, gender-role and cultural identity awareness, self-efficacy, self-care, problem-solving, and assertiveness skills. Participants rated 28 items on a 7-point scale from 1 (almost never) to 7 (almost always). Total scores were calculated by summing all items, ranging from 28-196, with higher scores indicating greater empowerment. Change scores were calculated as the differences between baseline total scores and follow-up scores at each time point (3, 6, and 12 months).
Time frame: Baseline, 3 months, 6 months, 12 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Personalized Online Intervention | Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised | 1-6 months | 1.20 score on a scale | Standard Deviation 17.81 |
| Personalized Online Intervention | Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised | 1-12 months | 1.25 score on a scale | Standard Deviation 20.52 |
| Personalized Online Intervention | Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised | 3-6 months | 1.20 score on a scale | Standard Deviation 16.01 |
| Personalized Online Intervention | Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised | 1-3 months | 0.42 score on a scale | Standard Deviation 16.3 |
| Personalized Online Intervention | Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised | 3-12 months | 1.46 score on a scale | Standard Deviation 17.8 |
| Online Usual Care or Standard Online Safety Information | Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised | 3-12 months | -0.53 score on a scale | Standard Deviation 16.62 |
| Online Usual Care or Standard Online Safety Information | Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised | 1-6 months | 1.81 score on a scale | Standard Deviation 17.41 |
| Online Usual Care or Standard Online Safety Information | Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised | 3-6 months | 1.20 score on a scale | Standard Deviation 15.73 |
| Online Usual Care or Standard Online Safety Information | Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised | 1-3 months | 0.66 score on a scale | Standard Deviation 16.76 |
| Online Usual Care or Standard Online Safety Information | Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised | 1-12 months | 0.33 score on a scale | Standard Deviation 18.25 |
| WeWomen Plus Text Messaging Only | Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised | 1-12 months | -0.84 score on a scale | Standard Deviation 17.09 |
| WeWomen Plus Text Messaging Only | Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised | 3-6 months | 2.74 score on a scale | Standard Deviation 16.2 |
| WeWomen Plus Text Messaging Only | Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised | 3-12 months | 2.59 score on a scale | Standard Deviation 15.47 |
| WeWomen Plus Text Messaging Only | Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised | 1-3 months | -3.16 score on a scale | Standard Deviation 15.89 |
| WeWomen Plus Text Messaging Only | Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised | 1-6 months | -0.39 score on a scale | Standard Deviation 16.23 |
| WeWomen Plus Text Messaging and Phone | Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised | 3-12 months | 3.75 score on a scale | Standard Deviation 16.85 |
| WeWomen Plus Text Messaging and Phone | Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised | 1-6 months | -0.05 score on a scale | Standard Deviation 16.63 |
| WeWomen Plus Text Messaging and Phone | Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised | 1-3 months | -5.10 score on a scale | Standard Deviation 15.92 |
| WeWomen Plus Text Messaging and Phone | Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised | 1-12 months | -1.35 score on a scale | Standard Deviation 17.66 |
| WeWomen Plus Text Messaging and Phone | Change in Overall Empowerment as Assessed by the Personal Progress Scale-Revised | 3-6 months | 5.35 score on a scale | Standard Deviation 16.71 |
Secondary
Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire
Past week PTSD symptoms were measured using the Harvard Trauma Questionnaire, a 16-item scale with response options that ranged from 1 (not at all) to 5 (extremely). Mean scores across all 16 items were calculated for each participant. Higher scores indicated more severe PTSD symptoms, with scores greater than 2.5 indicating clinically significant PTSD symptoms. Change scores were calculated as the differences between baseline mean scores and the follow-up mean scores at each time point (3, 6, and 12 months).
Time frame: Baseline, 3 months, 6 months, 12 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Personalized Online Intervention | Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire | 1-3 months | -0.10 score on a scale | Standard Deviation 0.75 |
| Personalized Online Intervention | Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire | 3-12 months | -0.08 score on a scale | Standard Deviation 0.81 |
| Personalized Online Intervention | Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire | 1-12 months | -0.18 score on a scale | Standard Deviation 0.82 |
| Personalized Online Intervention | Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire | 1-6 months | -0.18 score on a scale | Standard Deviation 0.78 |
| Personalized Online Intervention | Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire | 3-6 months | -0.08 score on a scale | Standard Deviation 0.71 |
| Online Usual Care or Standard Online Safety Information | Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire | 1-6 months | -0.18 score on a scale | Standard Deviation 0.78 |
| Online Usual Care or Standard Online Safety Information | Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire | 3-12 months | -0.04 score on a scale | Standard Deviation 0.76 |
| Online Usual Care or Standard Online Safety Information | Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire | 3-6 months | -0.06 score on a scale | Standard Deviation 0.72 |
| Online Usual Care or Standard Online Safety Information | Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire | 1-12 months | -0.17 score on a scale | Standard Deviation 0.88 |
| Online Usual Care or Standard Online Safety Information | Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire | 1-3 months | -0.11 score on a scale | Standard Deviation 0.76 |
| WeWomen Plus Text Messaging Only | Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire | 3-12 months | -0.18 score on a scale | Standard Deviation 0.83 |
| WeWomen Plus Text Messaging Only | Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire | 1-6 months | -0.24 score on a scale | Standard Deviation 0.87 |
| WeWomen Plus Text Messaging Only | Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire | 1-3 months | 0.01 score on a scale | Standard Deviation 0.76 |
| WeWomen Plus Text Messaging Only | Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire | 3-6 months | -0.22 score on a scale | Standard Deviation 0.79 |
| WeWomen Plus Text Messaging Only | Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire | 1-12 months | -0.16 score on a scale | Standard Deviation 0.82 |
| WeWomen Plus Text Messaging and Phone | Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire | 1-12 months | -0.27 score on a scale | Standard Deviation 0.87 |
| WeWomen Plus Text Messaging and Phone | Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire | 3-6 months | -0.09 score on a scale | Standard Deviation 0.79 |
| WeWomen Plus Text Messaging and Phone | Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire | 3-12 months | -0.14 score on a scale | Standard Deviation 0.81 |
| WeWomen Plus Text Messaging and Phone | Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire | 1-6 months | -0.19 score on a scale | Standard Deviation 0.74 |
| WeWomen Plus Text Messaging and Phone | Change in Symptoms of Post-traumatic Stress Disorder (PTSD) as Assessed by the Harvard Trauma Questionnaire | 1-3 months | -0.09 score on a scale | Standard Deviation 0.73 |