Assessment of the STOP intervention – a MAST analysis

Deliverables


This document presents an analysis of the STOP project according to the Model for Assessment of Telemedicine (MAST). It provides a multidisciplinary assessment that summarizes and evaluates the result of the STOP project. A total of 16,068 women underwent IPV screening and 1195/14013 (8.5%) and 350/2055 (17%) screened positive in Denmark and Spain, respectively. Women who were identified as being exposed to IPV were offered the STOP intervention which comprised a safety planning app and video consultations. Out of 485 eligible women, 104 accepted the offer and 56 completed the scheduled counselling sessions. The STOP intervention significantly increased the women’s empowerment as well as decreased both physical violence, non-physical violence, and post-partum depression. Qualitative interviews were conducted among 29 who had received the STOP intervention. In general, the women found the video counselling both highly acceptable and feasible, whilst the safety app was acceptable but not feasible. The video counselling was considered helpful, and supportive. Further, the women found the digital solution offered flexibility in regards of scheduling the counselling sessions as well providing comfortable surroundings compared to face-to-face counselling. Also, the women found that the set-up of the safety planning app and the monthly meetings where appropriate in guaranteeing the women’s safety. The economic and organizational assessment revealed that the STOP intervention can be implemented in routine antenatal care at a modest cost. Considering the results obtained from the STOP project, we recommend that pregnant women are routinely screened for IPV as part of antenatal care, and those who screen positive for IPV are offered video counselling with trained counsellors.

 

Find the deliverable here: STOP D4.6 Assessment of the STOP intervention – a MAST analysis


Final conference

Deliverables


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.

 

Find the deliverable here: STOP D1.6


Progress report

Deliverables


STOP project progress report on

  • – Deliverables, milestones & critical risks
  • – Overview of the progress & activities
  • – Budget consumption

Find the deliverable here: STOP D1.4


Communication platforms

Deliverables


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.

 

Find the deliverable here: STOP D1.3


Dissemination Plan

Deliverables


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.

 

 

Find the deliverable here: STOP D1.2


Strenghts and limitations of the pilot RCT

Deliverables


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.

 

Find the deliverable here: STOP D5.2 vs 2


Ethical Approval

Deliverables


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

Deliverables


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.


Participatory Workshop

Deliverables


The purpose of the participatory workshops was to gather information and input from relevant stakeholders in both Spain and Denmark to develop the STOP intervention covering both the Video Counselling and Safety Planning app.

The workshops are considered a very important source for information guiding the development of the intervention.

  • The Spanish workshop was completed on September 30, 2020, with six participants from different Spanish NGO’s.
  • The Danish workshop was completed on September 17, 2020, with six participants from different Danish NGO’s.

The focus of both workshops was to discuss and receive input about the needs of woman exposed to IPV, the content of the video counselling service, and desired features of the safety planning app. The participants were presented with the app, “MyPlan”, that has been identified as the safety planning app to be used in STOP.

To conduct the interviews a few changes has been implemented to meet the requirements of COVID-19 guidelines. Despite these changes, the workshop participants provided valuable input in line with input that would have been delivered in the originally planned setting. Thus, the input gathered has guided the development of the intervention as it was set out in the project description.

The workshops were to be conducted by the WP3 leader and in a physical format. However, COVID-19 restrictions required some changes. The Spanish workshop was carried out by project partners from UGR due to travel restrictions between Denmark and Spain. The UGR team had received a workshop guideline and thorough instructions prior to the workshops to ensure alignment between the Danish and Spanish workshops. The WP3 leader participated via video to support the workshop if necessary. In the Danish workshop, one participant was not able to join in person and therefore, a video connection was established.

Despite these changes implemented to meet the requirements of COVID-19 guidelines, the workshop participants provided valuable input in line with input that would have been delivered in the originally planned setting. Thus, the input gathered has guided the development of the intervention as it was set out in the project description.

As this deliverable is confidential, it is not available here.


Focus Group Interviews

Deliverables


To inform the development of the STOP intervention, focus group interviews were carried out in both Spain and Denmark with NGOs and women exposed to intimate partner violence (IPV). The purpose of the focus group interviews was to gather information and input from relevant stakeholders (NGO’s) in both Spain and Denmark to develop the STOP intervention covering both the Video Counselling and Safety Planning app.

The focus group interview with the Spanish NGO’s was completed on September 30, 2020, with six participants. The focus group interview with the Spanish women exposed to IPV was completed on October 6, 2020, with five participants.

The focus group interview with the Danish NGO’s took place on September 8, 2020, with three participants. This was followed by three additional interviews with NGO’s on the October 2, 2020, October 5, 2020 and November 2, 2020. The interview with the Danish woman exposed to IPV was completed on November 24, 2020.

The focus of the interviews was to discuss and receive input about the needs of women exposed to IPV, their existing ways of handling IPV and their concerns for a video counselling service, and the use of a safety planning app.

Based on the interviews, the following needs in terms of support have been identified:

  • Acknowledgement: The pregnant woman does not see herself as a victim of violence and finds it hard to accept.
  • Ambivalent emotions towards the partner: They have a lot of dreams and hopes regarding their relationship, and this makes it hard to accept that their “life project” to create a family is broken.
  • Fear of the system: Fear of losing custody of their child if they communicate their situation.
  • Resources: Worries about being on their own, having to do everything on their own and without financial support from the partner.
  • Low self-esteem: Finding it difficult to make decisions and taking actions to change their situation.
  • Isolation: Rebuilding their connections and relations in the world, helping them identify their network and learn about the resources available for help.
  • In order to help the woman acknowledge her situation it is very important that the counsellors listen to her, hear her story and gain her trust. Some of the participants were concerned that having the counselling via video might create distance and make it hard to gain the women’s’ trust. Others believed it might make it easier to talk about the difficult subjects because of the distance. They were also concerned about if and where the woman would be able to conduct the video counselling, due to a controlling partner or lack of access to Wi-Fi.

The participants found that the features in the safety planning app could be useful for the women. All the participants agreed that it was very important that the app would be camouflaged so the partner would not get suspicious.

All the participants agreed that a full recovery is often a long process that can take years and often the violence continues after the woman leaves the violent partner. If the STOP-intervention is a limited service, it is important that the women receive support and are encouraged to seek treatment elsewhere.

As this deliverable is confidential, it is not made available here.