Exploring the ethical and social aspects of an mHealth intervention in urban and rural home visitation programmes for women affected by domestic violence

Background

Pregnancy and the postpartum is a time of increased risk for intimate partner violence (IPV). Pre and postnatal home visitation provide an opportunity for preventive and early intervention. Little is known about the best methods for identifying and supporting abused women in home settings that maintains privacy, is sensitive, and accurately identifies those affected by IPV.

Methods

A nested qualitative study was undertaken within the DOVE2 trial which tests the effectiveness of (i) standard DOVE intervention administered by nurse home visitors using paper assessment and brochures for assessing risk and developing safety plans (ii) eMOCHA DOVE delivered by mHealth technology. Qualitative interviews are being conducted with home visitors and women and data collection and analysis are ongoing.

Results

Early findings suggest that the computer tablet is a helpful way for abused women to disclose their experiences without feeling judged and a safe and confidential method. Some women preferred the paper assessment because they felt relief from talking to their home visitor. Occasionally women and home visitors found the technology challenging which increased the time needed for screening and impacted on other necessary assessments. Screening for IPV by either method helped to develop trust in the relationship between women and their home visitor. Many women had not disclosed IPV to a professional prior to the DOVE intervention and were not aware of support services.

Conclusions

Home visits are an opportune time to raise the issue of IPV and offer interventions to women. IPV training for home visitors is necessary. Mobile health technology offers an alternative approach to screening for IPV and delivering interventions.