Safety decision-making and planning mobile app for intimate partner violence prevention and response: randomised controlled trial in Kenya

• Published in: BMJ global health 2020-07, Vol.5 (7), p.e002091
• Main Authors: Decker, Michele R, Wood, Shannon N, Hameeduddin, Zaynab, Kennedy, S Rachel, Perrin, Nancy, Tallam, Catherine, Akumu, Irene, Wanjiru, Irene, Asira, Ben, Frankel, Ariel, Omondi, Benjamin, Case, James, Clough, Amber, Otieno, Richard, Mwiti, Morris, Glass, Nancy
• Format: Article
• Language: English
• Subjects: Behavior; Data collection; Decision making; Domestic violence; Empowerment; Global health; Harm reduction; Health administration; Health care; Intervention; Low income groups; Original Research; Personal identification numbers; Planning; Portable computers; Prevention; Privacy; Public health; randomised control trial; Risk reduction; Safety; Urban areas
• ISSN: 2059-7908; 2059-7908
• DOI: 10.1136/bmjgh-2019-002091

IntroductionIntimate partner violence (IPV) threatens women’s health and safety globally, yet services remain underdeveloped and inaccessible. Technology-based resources exist, however, few have been adapted and tested in low-resource settings. We evaluate the efficacy of a community-partnered technology solution: culturally and linguistically adapted version of the myPlan app, a tailored safety decision-making and planning intervention, administrated by trained lay professionals.MethodsThis randomised, controlled, participant-blinded superiority trial compares safety-related outcomes at baseline, immediate post intervention and 3-month follow-up among women at risk of and experiencing IPV in Nairobi, Kenya. Women were randomised (1:1 ratio) to: (1) myPlan Kenya (intervention); or (2) standard IPV referrals (control). Primary outcomes were safety preparedness, safety behaviour and IPV; secondary outcomes include resilience, mental health, service utilisation and self-blame.ResultsBetween April 2018 and October 2018, 352 participants (n=177 intervention, n=175 control) were enrolled and randomly assigned; 312 (88.6%, n=157 intervention, n=155 control) were retained at 3 months. Intervention participants demonstrated immediate postintervention improvement in safety preparedness relative to control participants (p=0.001). At 3 months, intervention participants reported increased helpfulness of safety strategies used relative to control participants (p=0.004); IPV reduced in both groups. Among women reporting the highest level of IPV severity, intervention participants had significant increase in resilience (p