Pregnant Women's Attitudes Toward and Experiences With a Tablet Intervention to Promote Safety Behaviors in a Randomized Controlled Trial: Qualitative Study

Bente Walter, Hege Indreboe, Mirjam Lukasse, Lena Henriksen, Lisa Garnweidner-Holme, Bente Walter, Hege Indreboe, Mirjam Lukasse, Lena Henriksen, Lisa Garnweidner-Holme

Abstract

Background: Intimate partner violence (IPV) is recognized as a global health problem. Women with low education and limited resources are more vulnerable, as are immigrant women. There is a lack of evidence on how health care professionals should communicate about and intervene against IPV during pregnancy. Earlier research has shown that when women manage digital questionnaires, they are more likely to disclose IPV. However, little is known about how women experience eHealth interventions with safety behaviors to prevent IPV.

Objective: The aim of this study was to explore pregnant women's attitudes toward and experiences with a tablet intervention to promote safety behaviors in a randomized controlled trial (RCT) in antenatal care.

Methods: Individual semistructured interviews were conducted with 10 women who participated in the Safe Pregnancy Study. The Safe Pregnancy Study was a randomized controlled trial (RCT) using a tablet intervention containing IPV questions and a film to promote safety behaviors. Six women from the intervention group and four women from the control group were recruited. The content was available in Norwegian, Somali, and Urdu. Five of the women participating in the interviews spoke Norwegian at home and five spoke another language. The majority of the women who did not speak Norwegian at home perceived themselves as relatively well integrated. The interviews were conducted at different maternal and child health centers (MCHCs) in Norway between March 2020 and June 2020. The analysis was guided by thematic analysis.

Results: Women who participated in the tablet intervention appreciated being asked questions about IPV on a tablet. However, it was important to supplement the tablet intervention with face-to-face communication with a midwife. The MCHC was regarded as a suitable place to answer questions and watch a film about safety behaviors. Women suggested making the tablet intervention available in other settings where women meet health care professionals. Some women expressed uncertainty about their anonymity regarding their answers in the questionnaire. We found no real differences between ethnic Norwegian and immigrant women's attitudes toward and experiences with the tablet intervention.

Conclusions: Questions about IPV and a film about safety behaviors on a tablet, as a supplement to face-to-face communication, might initiate and facilitate communication about IPV in antenatal care. Uncertainty regarding anonymity has to be addressed when questions about IPV are being asked on a tablet.

Trial registration: ClinicalTrials.gov NCT03397277; https://ichgcp.net/clinical-trials-registry/NCT03397277.

Keywords: antenatal care, safety behaviors; eHealth; intimate partner violence; pregnancy; tablet intervention.

Conflict of interest statement

Conflicts of Interest: None declared.

©Bente Walter, Hege Indreboe, Mirjam Lukasse, Lena Henriksen, Lisa Garnweidner-Holme. Originally published in JMIR Formative Research (https://formative.jmir.org), 20.07.2021.

References

    1. Responding to intimate partner violence and sexual violence against women. World Health Organisation. 2013. [2021-06-08].
    1. Global regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence. World Health Organization. 2013. [2021-07-10]. .
    1. James L, Brody D, Hamilton Z. Risk factors for domestic violence during pregnancy: a meta-analytic review. Violence Vict. 2013;28(3):359–80. doi: 10.1891/0886-6708.vv-d-12-00034.
    1. Henriksen L, Flaathen EM, Angelshaug J, Garnweidner-Holme L, Småstuen MC, Noll J, Taft A, Schei B, Lukasse M. The Safe Pregnancy study - promoting safety behaviours in antenatal care among Norwegian, Pakistani and Somali pregnant women: a study protocol for a randomized controlled trial. BMC Public Health. 2019 Jun 10;19(1):724–9. doi: 10.1186/s12889-019-6922-y.
    1. Lukasse M, Schroll A, Ryding EL, Campbell J, Karro H, Kristjansdottir H, Laanpere M, Steingrimsdottir T, Tabor A, Temmerman M, Van Parys A, Wangel A, Schei B. Prevalence of emotional, physical and sexual abuse among pregnant women in six European countries. Acta Obstet Gynecol Scand. 2014 Jul 20;93(7):669–77. doi: 10.1111/aogs.12392. doi: 10.1111/aogs.12392.
    1. Stockman JK, Hayashi H, Campbell JC. Intimate Partner Violence and its Health Impact on Ethnic Minority Women [corrected] J Womens Health (Larchmt) 2015 Jan;24(1):62–79. doi: 10.1089/jwh.2014.4879.
    1. Edin KE, Dahlgren L, Lalos A, Högberg U. "Keeping up a front": narratives about intimate partner violence, pregnancy, and antenatal care. Violence Against Women. 2010 Feb 06;16(2):189–206. doi: 10.1177/1077801209355703.
    1. Van Parys A, Verhamme A, Temmerman M, Verstraelen H. Intimate partner violence and pregnancy: a systematic review of interventions. PLoS One. 2014 Jan 17;9(1):e85084–e85084. doi: 10.1371/journal.pone.0085084.
    1. Hill A, Pallitto C, McCleary-Sills J, Garcia-Moreno C. A systematic review and meta-analysis of intimate partner violence during pregnancy and selected birth outcomes. Int J Gynaecol Obstet. 2016 Jun 11;133(3):269–76. doi: 10.1016/j.ijgo.2015.10.023.
    1. Pastor-Moreno G, Ruiz-Pérez I, Henares-Montiel J, Petrova D. Intimate partner violence during pregnancy and risk of fetal and neonatal death: a meta-analysis with socioeconomic context indicators. Am J Obstet Gynecol. 2020 Feb;222(2):123–133.e5. doi: 10.1016/j.ajog.2019.07.045.
    1. Alhusen JL, Ray E, Sharps P, Bullock L. Intimate partner violence during pregnancy: maternal and neonatal outcomes. J Womens Health (Larchmt) 2015 Jan;24(1):100–6. doi: 10.1089/jwh.2014.4872.
    1. Jewkes R. Intimate partner violence: causes and prevention. The Lancet. 2002 Apr;359(9315):1423–1429. doi: 10.1016/s0140-6736(02)08357-5.
    1. Svangerskapsomsorgen. Helsedirektoratet. 2018. [2021-07-10]. .
    1. Linde DS, Bakiewicz A, Normann AK, Hansen NB, Lundh A, Rasch V. Intimate Partner Violence and Electronic Health Interventions: Systematic Review and Meta-Analysis of Randomized Trials. J Med Internet Res. 2020 Dec 11;22(12):e22361. doi: 10.2196/22361.
    1. Fair F, Raben L, Watson H, Vivilaki V, van den Muijsenbergh M, Soltani H, ORAMMA team Migrant women's experiences of pregnancy, childbirth and maternity care in European countries: A systematic review. PLoS One. 2020 Feb 11;15(2):e0228378. doi: 10.1371/journal.pone.0228378.
    1. Garnweidner-Holme LM, Lukasse M, Solheim M, Henriksen L. Talking about intimate partner violence in multi-cultural antenatal care: a qualitative study of pregnant women's advice for better communication in South-East Norway. BMC Pregnancy Childbirth. 2017 Apr 19;17(1):123. doi: 10.1186/s12884-017-1308-6.
    1. Weil A. Intimate partner violence: Diagnosis and screening. Up To Date. 2019. [2021-07-10].
    1. Flaathen EME, Lukasse M, Garnweidner-Holme L, Angelshaug J, Henriksen L. User-Involvement in the Development of a Culturally Sensitive Intervention in the Safe Pregnancy Study to Prevent Intimate Partner Violence. Violence Against Women. 2020 Sep 28;:1077801220954274. doi: 10.1177/1077801220954274.
    1. Taft AJ, Hooker L, Humphreys C, Hegarty K, Walter R, Adams C, Agius P, Small R. Maternal and child health nurse screening and care for mothers experiencing domestic violence (MOVE): a cluster randomised trial. BMC Med. 2015 Jun 25;13(1):150–9. doi: 10.1186/s12916-015-0375-7.
    1. Garnweidner-Holme L, Hoel Andersen T, Sando MW, Noll J, Lukasse M. Health Care Professionals' Attitudes Toward, and Experiences of Using, a Culture-Sensitive Smartphone App for Women with Gestational Diabetes Mellitus: Qualitative Study. JMIR Mhealth Uhealth. 2018 May 14;6(5):e123. doi: 10.2196/mhealth.9686.
    1. Hussain N, Sprague S, Madden K, Hussain FN, Pindiprolu B, Bhandari M. A comparison of the types of screening tool administration methods used for the detection of intimate partner violence: a systematic review and meta-analysis. Trauma Violence Abuse. 2015 Jan 15;16(1):60–9. doi: 10.1177/1524838013515759.
    1. Lewin S, Glenton C, Oxman AD. Use of qualitative methods alongside randomised controlled trials of complex healthcare interventions: methodological study. BMJ. 2009 Sep 10;339(sep10 1):b3496–b3496. doi: 10.1136/bmj.b3496.
    1. Chang JC, Dado D, Schussler S, Hawker L, Holland CL, Burke JG, Cluss PA. In person versus computer screening for intimate partner violence among pregnant patients. Patient Educ Couns. 2012 Sep;88(3):443–8. doi: 10.1016/j.pec.2012.06.021.
    1. Tarzia L, Cornelio R, Forsdike K, Hegarty K. Women’s Experiences Receiving Support Online for Intimate Partner Violence: How Does it Compare to Face-to-Face Support from a Health Professional? Interacting with Computers. 2018;30(5):433–443. doi: 10.1093/iwc/iwy019.
    1. Bacchus LJ, Bullock L, Sharps P, Burnett C, Schminkey DL, Buller AM, Campbell J. Infusing Technology Into Perinatal Home Visitation in the United States for Women Experiencing Intimate Partner Violence: Exploring the Interpretive Flexibility of an mHealth Intervention. J Med Internet Res. 2016 Nov 17;18(11):e302. doi: 10.2196/jmir.6251.
    1. O'Doherty L, Taket A, Valpied J, Hegarty K. Receiving care for intimate partner violence in primary care: Barriers and enablers for women participating in the weave randomised controlled trial. Soc Sci Med. 2016 Jul;160:35–42. doi: 10.1016/j.socscimed.2016.05.017.
    1. Moonesinghe L, Rajapaksa L, Samarasinghe G. Development of a screening instrument to detect physical abuse and its use in a cohort of pregnant women in Sri Lanka. Asia Pac J Public Health. 2004 Jun 30;16(2):138–44. doi: 10.1177/101053950401600211.
    1. Rabin RF, Jennings JM, Campbell JC, Bair-Merritt MH. Intimate partner violence screening tools: a systematic review. Am J Prev Med. 2009 May;36(5):439–445.e4. doi: 10.1016/j.amepre.2009.01.024.
    1. Ford-Gilboe M, Wathen CN, Varcoe C, MacMillan HL, Scott-Storey K, Mantler T, Hegarty K, Perrin N. Development of a brief measure of intimate partner violence experiences: the Composite Abuse Scale (Revised)-Short Form (CASR-SF) BMJ Open. 2016 Dec 07;6(12):e012824. doi: 10.1136/bmjopen-2016-012824.
    1. Hegarty K, Sheehan M, Schonfeld C. A Multidimensional Definition of Partner Abuse: Development and Preliminary Validation of the Composite Abuse Scale. Journal of Family Violence. 1999;14(4):399–415. doi: 10.1023/A:1022834215681.
    1. McFarlane J, Malecha A, Gist J, Watson K, Batten E, Hall I, Smith S. An intervention to increase safety behaviors of abused women: results of a randomized clinical trial. Nurs Res. 2002;51(6):347–54. doi: 10.1097/00006199-200211000-00002.
    1. McFarlane J, Malecha A, Gist J, Watson K, Batten E, Hall I, Smith S. Increasing the safety-promoting behaviors of abused women. Am J Nurs. 2004 Mar;104(3):40–50; quiz 50. doi: 10.1097/00000446-200403000-00019.
    1. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006 Jan;3(2):77–101. doi: 10.1191/1478088706qp063oa.
    1. Byrskog U, Essén B, Olsson P, Klingberg-Allvin M. 'Moving on' Violence, wellbeing and questions about violence in antenatal care encounters. A qualitative study with Somali-born refugees in Sweden. Midwifery. 2016 Sep;40:10–7. doi: 10.1016/j.midw.2016.05.009.
    1. Ellsberg M. Violence against women and the Millennium Development Goals: facilitating women's access to support. Int J Gynaecol Obstet. 2006 Sep 12;94(3):325–32. doi: 10.1016/j.ijgo.2006.04.021.
    1. Devries KM, Kishor S, Johnson H, Stöckl H, Bacchus LJ, Garcia-Moreno C, Watts C. Intimate partner violence during pregnancy: analysis of prevalence data from 19 countries. Reproductive Health Matters. 2010 Nov 24;18(36):158–170. doi: 10.1016/s0968-8080(10)36533-5.
    1. Dehling T, Gao F, Schneider S, Sunyaev A. Exploring the Far Side of Mobile Health: Information Security and Privacy of Mobile Health Apps on iOS and Android. JMIR Mhealth Uhealth. 2015 Jan 19;3(1):e8. doi: 10.2196/mhealth.3672.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren