Determining Safe, Equitable and Accessible Virtually Delivered Interventions to Individuals Affected by Intimate Partner Violence: Perspectives of Survivors and Service Providers
Creators: Ghidei, Winta
Publisher: name: University of Alberta Library
Year: 2022

<p>The COVID-19 pandemic has been linked with increased rates of intimate partner violence (IPV) and associated experiences of compounded trauma. Public health measures introduced to limit the virus’s transmission necessitated the delivery of virtual or remote-based interventions to ensure continued access to care and treatment for those affected by IPV. During this rapid shift to virtual care delivery, understanding the barriers to accessing and virtually delivering IPV interventions to these individuals was missed.  This dissertation employed a case study design guided by feminist intersectionality to examine factors of safe, equitable, accessible, and virtually delivered trauma-focused IPV interventions from the perspectives of service providers and IPV survivors in Alberta, Canada.<br>
First, a rapid evidence assessment (REA) was conducted to examine the effectiveness, feasibility, and acceptability of trauma-focused virtual interventions for individuals affected by IPV. The findings of this review helped to refine the research questions for this dissertation and inform the design of an embedded single case study analysis. Additionally, the findings from the REA were used to provide timely guidance for service providers and organizational leaders with the implementation of virtual IPV interventions.<br>
The embedded single case study analysis involved two units of analysis. The first unit of analysis involved semi-structured interviews with 24 service providers from the anti-violence sector in Alberta, Canada. In Alberta, the anti-violence sector includes a range of community organizations, agencies, networks, advocacy groups, health centres and primary care clinics that provide domestic and sexual violence-focused services. These include sexual assault centres, mental health counselling centres, women’s shelters, transition houses, settlement services, victim and perpetrator services and primary care clinics. The interviews focused on the perspectives and experiences of these providers delivering virtual trauma-focused IPV interventions for a diverse range of individuals during the COVID-19 pandemic. <br>
The second unit of analysis involved a photovoice project among survivors of IPV who exchanged knowledge and experiences on how to strengthen virtual IPV interventions that are safe, accessible, and equitable for a diverse range of individuals. Photovoice draws on the principles of the community-based participatory research (CBPR) method. In this procedure, participants capture their experiences in photographs and written narratives, engage in critical reflections and dialogue around these experiences, and develop policy and practice recommendations. Six female IPV survivors residing in Alberta, Canada, participated in this photovoice project. The interview transcripts and the photovoice narratives were analyzed using inductive thematic analysis. <br>
The findings from the REA demonstrated that virtual IPV interventions incorporating trauma-focused interventions for individuals affected by IPV are scarce. Specifically, online interventions involving trauma-focused treatment for this at-risk group have been limited in scope, and effectiveness data have been only preliminary in nature. There is also limited evidence of the acceptability, feasibility, and effectiveness of virtual IPV interventions for ethnically, culturally, and linguistically diverse populations experiencing IPV. <br>
Moreover, this study revealed that accessibility, equity, and safety in relation to accessing virtual IPV interventions are more complex for individuals affected by IPV, especially those who are socially disadvantaged. Participants in this study acknowledged that pre-existing systemic and institutional barriers faced by underserved individuals impact their access to IPV interventions virtually or in-person. The IPV survivors described how the barriers and challenges they encountered in safely accessing IPV interventions during the pandemic were not specific to virtual settings. Instead, these challenges had resulted from preexisting structural challenges and inequities rooted in systemic oppression. Similarly, service providers in this study highlighted how the pandemic exacerbated structural vulnerabilities already experienced by underserved populations. These structural and systemic issues intensified the barriers individuals affected by IPV faced in seeking help, reducing their virtual access to safe, and equitable interventions. <br>
Ultimately, this qualitative research identified key determining factors for delivering safe, equitable, and accessible virtual trauma-focused intervention across a diverse population. The participants listed empathy, validation, affordability, and cultural safety as the key traits of delivering safe, equitable, and accessible virtual IPV interventions. Furthermore, to ensure virtual interventions are safe and equitable, service providers should address underlying systemic and institutional barriers, including client experiences with discrimination and social exclusion. Moreover, there is a need for greater integration across social, health and political systems. Additionally, service providers, policy and decision-makers should commit to dismantling the systems of oppression causing the inequity of and inaccessibility to culturally safe, and equitable trauma-focused IPV interventions.</p>