JMIR Publications

ABSTRACT

Background:

Many women experience at least one type of intimate partner violence and abuse (IPVA) and while various support options are available, we still know relatively little about online interventions for IPVA survivors. We conducted a qualitative evaluation of the SAFE eHealth intervention for women experiencing IPVA in the Netherlands, complementing the quantitative evaluation on self-efficacy, depression, anxiety, and multiple feasibility aspects.

Objective:

This study assessed the users’ experiences and what, according to them, are useful and helpful aspects of the intervention.

Methods:

The intervention consisted of modules with information on relationships and IPVA, help options, (mental) health, and social support. It also contained interactive elements such as exercises, stories from survivors, a chat, and a forum. A randomized controlled trial (RCT) was conducted with an intervention study arm, receiving the complete version of the intervention, and a control study arm, receiving only a static version of the intervention with the modules on relationships and IPVA, and help options. We gathered data through open questions from surveys (for both study arms, N=65) and semi-structured interviews (for the intervention study arm, N=10), all conducted online, during the RCT and process evaluation. The interview data were coded following the principles of open thematic coding and all qualitative data were analyzed with qualitative content analysis.

Results:

Overall, the majority of the users gave a positive rating to the intervention regarding safety, content, and it suiting their needs, especially participants from the intervention study arm. The intervention was helpful in the domains of acknowledgement, awareness, and support. However, participants also identified points for improvement: availability of a simplified version for acute situations, more attention for survivors in the aftermath of ending an abusive relationship, and (more) information on certain topics such as technological IPVA, support for children, and legal affairs. Furthermore, while participants expressed a prominent need for interactive contact options such as a chat or forum, the intervention study arm (the only group who had these features at their disposal) mainly used them in a passive way: reading instead of actively joining the conversation. The participants provided various reasons for the passive use of the chat and forum.

Conclusions:

The positive outcomes of this study are similar to those for other online interventions for IPVA survivors, and specific points for improvement have been identified. The availability of interactive elements seems of added value, even when they are used passively. This study provides in-depth insight about the experiences of women IPVA survivors with the SAFE eHealth interventions and makes suggestions for improvements to SAFE and comparable online interventions for IPVA, as well as inspiring future research. Furthermore, this study shows the importance of a varied assessment of an intervention’s effectiveness in order to understand the real-world impact on its users. Clinical Trial: This trial was registered on 15 August 2017 at the Netherlands Trial Register NL7108 (NTR7313).