Innovation in prevention of and responses to violence against women
Authors: Nancy Glass, Kelsey Hegarty
Journal: The Lancet Public Health (2019)

We agree with the Comment by Rachel Jewkes and Elizabeth Dartnall,1Jewkes R Dartnall E More research is needed on digital technologies in violence against women.Lancet Public Health. 2019; 4: e270-e271Summary Full Text Full Text PDF PubMed Scopus (16) Google Scholar which states that digital technologies must be adapted to the context, acceptable to survivors, and adhere to established ethical guidelines. However, interventions supported through the What Works to Prevent Violence Against Women and Girls global programme are not the only way to engage meaningfully with survivors and achieve behaviour change. As researchers and clinicians working directly with survivors, we know that women have agency and express the wish to self-assess what is happening in their relationships so that they can reflect anonymously and privately, without the fear of judgment often experienced when disclosing violence to health-care providers. Women safely use technology to make informed decisions about the risk of danger in their relationships and priorities for safety, and benefit from a safety action plan tailored to their situation, rather than encouragment to stay or leave a relationship.2Eden KB Perrin NA Hanson GC et al.The immediate impact of an internet safety decision aid on abused women's decisional conflict about staying safe: findings from the IRIS randomized controlled trial.Am J Prev Med. 2015; 48: 372-383Summary Full Text Full Text PDF PubMed Scopus (74) Google Scholar, 3Glass NE Perrin NA Hanson GC et al.The longitudinal impact of an internet safety decision aid for abused women.Am J Prev Med. 2017; 52: 606-615Summary Full Text Full Text PDF PubMed Scopus (66) Google Scholar, 4Koziol-McLain J Vandal AC Wilson D et al.Efficacy of a web-based safety decision aid for women experiencing intimate partner violence: randomized controlled trial.J Med Internet Res. 2018; 19: e426Crossref PubMed Scopus (46) Google Scholar, 5Hegarty K Tarzia L Valpied J et al.An online healthy relationship tool and safety decision aid for women experiencing intimate partner violence (I-DECIDE): a randomised controlled trial.Lancet Public Health. 2019; 4: e301-e310Summary Full Text Full Text PDF PubMed Scopus (42) Google Scholar, 6Bloom T Gielen A Glass N Developing an app for college women in abusive same-sex relationships and their friends.J Homosex. 2016; 63: 855-874Crossref PubMed Scopus (24) Google Scholar, 7Wood SN Glass N Decker MR An integrative review of safety strategies for women experiencing intimate partner violence in low- and middle-income countries.Trauma Violence Abuse. 2019; 221524838018823270Crossref Scopus (32) Google Scholar Traditional interventions often require survivors to attend group sessions over multiple weeks with skilled facilitators, thus limiting the access and reach of such programmes. Violence prevention interventions, even those in the What Works portfolio, have not consistently shown behaviour changes or reductions in violence against women.4Koziol-McLain J Vandal AC Wilson D et al.Efficacy of a web-based safety decision aid for women experiencing intimate partner violence: randomized controlled trial.J Med Internet Res. 2018; 19: e426Crossref PubMed Scopus (46) Google Scholar Traditional interventions have all the challenges associated with digital technologies—adaptation to context, acceptability to survivors, and adherence to ethical guidelines. Digital technologies should not be feared; they are not replacements for traditional interventions, but rather a tool or resource that can be integrated with other effective programmes and that women can use anonymously, 24/7, without feeling judged. We are not simply developing webpages or mobile device applications, but evidence-based interventions codesigned with survivors in local languages, with extensive safety features that are delivered through appropriate technology.5Hegarty K Tarzia L Valpied J et al.An online healthy relationship tool and safety decision aid for women experiencing intimate partner violence (I-DECIDE): a randomised controlled trial.Lancet Public Health. 2019; 4: e301-e310Summary Full Text Full Text PDF PubMed Scopus (42) Google Scholar We might have been trying to do too much in the I-DECIDE trial,5Hegarty K Tarzia L Valpied J et al.An online healthy relationship tool and safety decision aid for women experiencing intimate partner violence (I-DECIDE): a randomised controlled trial.Lancet Public Health. 2019; 4: e301-e310Summary Full Text Full Text PDF PubMed Scopus (42) Google Scholar as evidenced by the null finding. However, engaging with innovation to expand our reach and potential to serve diverse women globally is crucial. We declare no competing interests. More research is needed on digital technologies in violence against womenDigital technologies have proliferated in the health sector in recent years, driven by the hope that they could offer solutions to many of the complex challenges faced in our daily lives.1 In the field of violence against women, there has been a parallel burgeoning of web-based interventions for prevention and responses. This diverse range of web-based interventions for violence against women has included open source mapping of sexual violence exposure, mobile device applications (apps) and websites providing information on services for survivors of violence, safety assessment and planning tools, relationship support interventions, and interventions promoting perpetration-related behaviour changes for men. Full-Text PDF Open Access