Final conference
Anna Wang
To maximize the outreach of STOP’s final conference, it is decided to hold the conference adjacent
to the International Day for the Elimination of Violence Against Women. The conference is held at
University of Granada with participation of numerous public and NGO stakeholders. The
conference receives widespread media coverage, including newspapers and television. The STOP
team presents outcomes from the project; this is followed by discussions with the audience about
the feasibility of interventions against intimate partner violence centered around pregnancy,
interventions targeted migrant women, and the potential of centering the intervention around
pediatric care. The program for the event, a signed attendance list, and the presentation is attached
as appendices.
Progress report
Anna Wang
STOP project progress report on
- – Deliverables, milestones & critical risks
- – Overview of the progress & activities
- – Budget consumption
Communication platforms
Anna Wang
This document describes the communication platforms and channels of the STOP project.
The target group and focus area of STOP requires careful considerations in relation to the
communication and dissemination efforts of the project and project partners in order not to put
pregnant women exposed to IPV at any further risk. Therefore, the initial efforts are focused
around the project website to reach a wide audience and raise awareness of the activities the
project undertakes in relation to combatting intimate partner violence. During the project
lifetime, the communication and dissemination efforts will be adapted.
The visual identity of the project has been developed in order to both represent professionalism
and a softer feel related to the target group. This is reflected in the blue and coral red colours and
in the project logo showcasing a pregnant woman.
The STOP project website contains different pages in order to present both introductory
information about the project and the outputs that are developed during the project including
news items. The pages on the website are divided in:
– Home/Landing page
– About the project
– Partners
– Publications and Outcomes
– News
– Contact.
The communication activities will be updated on an ongoing basis and several means of
communication have already been considered. The project expects to utilise and will take into
account the social media channel Twitter, development of a project leaflet, and the development
of project merchandise.
Dissemination Plan
Anna Wang
Communication and dissemination in STOP are generally, but not exclusively, targeted to health
care professionals and other stakeholders. External communication efforts are centered around
the project’s website, which has serves as a repository of public deliverables and news titbits from
STOP. A logo for STOP is designed and used on project-related communications to provide a sense
of unity. Posters and an information flyer are developed specifically for use in the Danish antenatal
care settings to boost the screening effort and create awareness of the nature of IPV among
pregnant women. Internal communication is centered around near-monthly virtual status
meetings; six consortium meetings (three virtual and three in-person) are held. Dissemination
efforts are focused on professional events, with project members presenting the (preliminary)
results of STOP at conferences and project days in both Denmark and Spain. A final conference is
arranged as a dissemination seminar in November 2022 with participation from several
stakeholder organisations. Scientific dissemination of project results is ensured through scholarly
papers in relevant peer-reviewed journals.
Strenghts and limitations of the pilot RCT
Anna Wang
This document describes a summary of the results of a pilot randomised controlled trial (RCT)
conducted in Denmark and Spain and its strengths and limitations (deliverable D5.3. describes in
more detail the results of the pilot RCT). It also contains propositions for future study designs
based on a review of the relevant literature as the pilot RCT demonstrated that a future full-scale
randomised study was unfeasible. In our pilot study, a subset of women from the STOP cohort
study who screened positive for IPV during their first antenatal visit were invited to participate in
pilot randomised controlled trial of psychological counselling by video conference. The objective
was to randomise a total number of 20 participants to either the intervention or the control
group. The intervention group received the e-health package (six video counselling sessions
combined with the use of a safety planning app), while the control group would receive the same
intervention yet with a delay of 8 weeks permitting collection of control outcome data. This
document will interpret the pilot findings and the existing literature to come up with possible
solutions to address the difficulties in the feasibility of a future full-scale randomised study
observed in the pilot study.
Video Consultations and Safety App Targeting Pregnant Women Exposed to Intimate Partner Violence in Denmark and Spain: Nested Cohort Intervention Study (STOP Study)
Abstract
Background
Intimate partner violence (IPV) during pregnancy is a public health issue with wide-ranging consequences for both the mother and fetus, and interventions are needed. Therefore, the Stop Intimate Partner Violence in Pregnancy (STOP) cohort was established with the overall aim to identify pregnant women exposed to IPV through digital screening and offer women screening positive for IPV a digital supportive intervention.
Objective
The aim of this study was to (1) introduce the design and profile of the STOP cohort study, (2) assess the feasibility of implementing digital IPV screening among pregnant women, and (3) assess the feasibility of implementing a digital supportive intervention targeting pregnant women exposed to IPV.
Methods
Pregnant women attending antenatal care in the Region of Southern Denmark and in Andalucía, Spain were offered digital screening for IPV using validated scales (Abuse Assessment Screen and Women Abuse Screening Tool). Women who screened positive were eligible to receive a digital supportive intervention. The intervention consisted of 3-6 video consultations with an IPV counselor and a safety planning app. In Denmark, IPV counselors were antenatal care midwives trained by a psychologist specialized in IPV, whereas in Spain, the counselor was a psychologist.
Results
Data collection started in February 2021 and was completed in October 2022. Across Denmark and Spain, a total of 19,442 pregnant women were invited for IPV screening and 16,068 women (82.65%) completed the screening. More women in Spain screened positive for exposure to IPV (350/2055, 17.03%) than in Denmark (1195/14,013, 8.53%). Among the women who screened positive, only 31.39% (485/1545) were eligible to receive the intervention with only 104 (21.4%) of these women ultimately receiving it.
Conclusions
Digital screening for IPV among pregnant women is feasible in an antenatal care context in Denmark and Spain; however, a digital supportive intervention during pregnancy appears to have limited feasibility as only a minor subgroup of women who screened positive for eligibility received the intervention. More research is needed on how to best support pregnant women exposed to IPV if universal IPV screening is to be implemented in antenatal care.
E-health psychological intervention in pregnant women exposed to intimate partner violence (eIPV): A protocol for a pilot randomised controlled trial
Abstract
Intimate partner violence (IPV) during pregnancy, a condition as common as obstetrics conditions like gestational diabetes, is associated with maternal and neonatal complications. Systematic detection of IPV is not well established in antenatal screening probably because the effectiveness of protective interventions has not been evaluated. E-health interventions may be beneficial among mothers exposed to IPV. Prior to performing a full-scale effectiveness trial for such an intervention, a pilot study is required to assess the feasibility of randomising a sufficiently large number of women exposed to IPV during pregnancy. The eIPV trial is a randomised pilot study nested within a cohort of consenting mothers who screen positive for IPV in the first antenatal visit at <12 weeks’ gestation and accept an e-health package (psychological counselling by videoconference) in Spain and Denmark. Twenty eligible mothers from the above cohort will be randomised to either intervention or control. The intervention group will receive the e-health package as part of the cohort. The control group will be invited to accept a delay in the intervention (e-health package eight weeks later). After consenting to delay, the control group will provide comparative data without losing the opportunity of obtaining the intervention. We will determine estimates of rates of informed consent to randomization, and the rates of adherence and dropout following randomization. Qualitative interviews will be conducted to examine the women’s perception about the benefit of the intervention, reasons for acceptability and non-adherence, and obstacles to recruitment, randomisation and consent. The results will inform the trial feasibility and variance of key clinical outcome measures for estimation of sample size of the full-scale effectiveness trial.
Women survivors of intimate partner violence talk about using e-health during pregnancy: a focus group study
Abstract
Background
Pregnancy is a period of particular vulnerability to experience intimate partner violence against women (IPVAW). eHealth strategies have been implemented to identify women exposed to IPVAW and to combat the abuse and empower them, but there is a lack of evidence on the use of these strategies among pregnant women. This work aims to identify the needs, concerns and preferences of survivors about the use of eHealth strategies to counsel and empower pregnant victims of IPVAW in antenatal care.
Methods
A focus group of six IPVAW survivors who had been pregnant was conducted and open questions about the use of eHealth strategies were asked. The session was recorded, transcribed and thematically analyzed. We identified three main themes: needs and worries of pregnant women experiencing IPVAW, key aspects of video counseling sessions and usefulness of safety planning apps.
Results
Women highlighted the relevant role of healthcare professionals—especially midwives—in the identification of IPVAW and the wellbeing of their children as one of the main concerns. They perceived video counseling and safety planning apps as valuable resources. The preferred contents for a video counseling intervention were awareness-raising of the situation, self-esteem and legal advice. They also proposed safety and pregnant-related aspects that should be taken into account in the design of the video counseling sessions and the safety planning app.
Conclusions
Video counseling sessions and safety planning apps are potentially useful tools to counsel and empower women who experience IPVAW during pregnancy. Midwives play a key role in this endeavor.
Ethical Approval
Anna Wang
The ethical approval applications have been submitted to the local Ethics Committees at the Danish and Spanish sites, respectively. The descriptions provide information on the background of the project, its aims, methodology with sub-studies, needs assessment, anticipated risks, access to patient information, informed consent, impact, funding, the ethics, safety and security of the project, the members of the research team, and relevant references. At the Spanish site, ethical approval has been received for the screening solution while approval for the video counseling solution is still pending. At the Danish site, the screening solution has been implemented throughout the region and thus no ethical approval is needed, and the ethics committee determined that approval was unnecessary for the video counseling intervention.
As the deliverable is confidential, it has not been made available here.
Joint Training Workshop
Anna Wang
A joint training workshop was conducted on February 1, 2021, as part of the counsellors’ training and the preparation for launching the STOP intervention. The purpose of the workshop was to provide training as well as an inspirational session to the counsellors (the Danish midwives and Spanish psychologist) who are responsible for carrying out the counselling sessions with women exposed to intimate partner violence (IPV).
The keynote speakers invited to the workshop were professors from Johns Hopkins University School of Nursing who are experts in the field of implementing online interventions for women exposed to IPV. They spoke about:
- The target group for the STOP-project, and on how to work with the women in their own homes and about the content and implementation of a safety planning app.
- Routine assessment/inquiry (screening), and how this creates a good opportunity for disclosure, seeking help early and a place for those who are not ready for drastic actions and the shelter. At the same time, the challenge with routine assessment is often the implementation. They underlined the importance of how the counsellors introduce the screening, (e.g., by introducing the theme as part of standard procedure: “Because domestic violence happens to so many women, we are asking ALL the women…”.)
They also offered practical advice on how a safety planning app can be implemented (e.g., if the woman cannot use her own phone because of a controlling partner she might be able to borrow a phone from a friend or a family member.)
The workshop provided an excellent opportunity to learn from researchers and scientists who have implemented similar interventions. The keynote presentations confirmed that what we have developed so far in the STOP-project makes sense, and the challenges we have anticipated seem reasonable. The speakers also offered insight into how they have measured the effect of their interventions, which gave us input regarding how to best measure the effect of the STOP-intervention. Finally, the joint training workshop was an opportunity to create a network within the field of IPV, and the foundation for possible future collaboration, in case we are to have a STOP-project 2.0.
As the deliverable is confidential, it is not made available here.