A web-based intervention for abused women: the New Zealand isafe randomised controlled trial protocol
Open accessAbstract
BACKGROUND: Intimate partner violence (IPV) and its associated negative mental health consequences are significant for women in New Zealand and internationally. One of the most widely recommended interventions is safety planning. However, few women experiencing violence access specialist services for safety planning. A safety decision aid, weighing the dangers of leaving or staying in an abusive relationship, gives women the opportunity to prioritise, plan and take action to increase safety for themselves and their children. This randomised controlled trial is testing the effectiveness of an innovative, interactive web-based safety decision aid. The trial is an international collaborative concurrent replication of a USA trial (IRIS study NCT01312103), regionalised for the Aotearoa New Zealand culture and offers fully automated online trial recruitment, eligibility screening and consent. METHODS/DESIGN: In a fully automated web-based trial (isafe) 340 abused women will be randomly assigned in equal numbers to a safety decision aid intervention or usual safety planning control website. Intervention components include: (a) safety priority setting, (b) danger assessment and (c) an individually tailored safety action plan. Self-reported outcome measures are collected at baseline and 3, 6, and 12-months post-baseline. Primary outcomes are depression (measured by Center for Epidemiologic Studies Depression Scale, Revised) and IPV exposure (measured by Severity Violence Against Women Scale) at 12 months post-baseline. Secondary outcomes include PTSD, psychological abuse, decisional conflict, safety behaviors and danger in the relationship. DISCUSSION: This trial will provide much-needed information on the potential relationships among safety planning, improved mental health, reduced violence as well as decreased decisional conflict related to safety in the abusive relationship. The novel web-based safety decision aid intervention may provide a cost-effective, easily accessed safety-planning resource that can be translated into clinical and community practice by multiple health disciplines and advocates. The trial will also provide information about how women in abusive relationships safely access safety information and resources through the Internet. Finally, the trial will inform other research teams on the feasibility and acceptability of fully automated recruitment, eligibility screening, consent and retention procedures. TRIAL REGISTRATION: Trial registered on 03 July 2012 on the Australian New Zealand Clinical Trials Registry ACTRN12612000708853 .
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The CESD has good internal consistency reliability and has been used with survivors of domestic violence, with Cronbach's α > 0.90 in community samples.
“The CESD, a 20-item scale to measure symptoms of depression, has been used in depression epidemiology in Community Mental Health Assessment Surveys, has good internal consistency reliability, and has been used to assess levels of depression in cross-cultural studies with survivors of domestic violence (Li & Hicks, 2008) with Cronbach's α > 0.90 in community samples (Koziol-McLain et al., 2015).”
From A survey of mothers' experiences of shared parenting and domestic violence (2023) · cites this paper as Koziol-McLain et al., 2015
The Methods/Design > Outcomes passage reports strong psychometric properties, including Cronbach’s α > 0.90 in community samples, for the CESD-R. It distinguishes the CESD-R from the original CESD, so it does not directly establish that reliability figure for the CESD named in the citing sentence. The cross-cultural use claim is attributed to a different citation. (LLM, conf=0.85)
Experimental — accuracy not yet measured
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“It can thus be seen as a form of therapeutic intervention, which differentiates I-DECIDE from the other similar websites being developed in the USA, Canada and New Zealand, which are primarily decision aids.”
BackgroundSelf-citationCollagen fragments modulate innate immunity.
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“Targeted interventions delivered via the internet have shown promise as an alternative method of support for women experiencing IPV (Eden et al., 2015; Glass, Eden, Bloom, & Perrin, 2010; Koziol-McLain et al., 2018; Koziol-McLain et al., 2015; Lindsay et al., 2013; Tarzia, Iyer, Thrower, & Hegarty, 2017; Tarzia et al.…”
MethodDecker, M., Wood, S. N., Kennedy, S., Hameeduddin, Z., Tallam, C., Akumu, I., Wanjiru, I., Asira, B., Omondi, B., Case, J., et al. (2020) · BMC Public Health · doi:10.1186/s12889-020-08901-4 · Cited by 36 · see citing works
Self-citationInterventions to support recovery after domestic and sexual violence in primary care
Hegarty, K., Tarzia, L., Hooker, L., & Taft, A. J. (2016) · International Review of Psychiatry · doi:10.1080/09540261.2016.1210103 · Cited by 43 · see citing works
“There are also a few trials testing the effectiveness of internet-based safety decision aids (Eden et al., 2015; Koziol-McLain et al., 2015) which provide an action plan for safety and well-being which could also be suggested by practitioners if they are shown to be effective.”
BackgroundTarzia, L., Valpied, J., Koziol‐McLain, J., Glass, N. E., & Hegarty, K. L. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.7039 · Cited by 40 · see citing works
“[46] asked women to input their full name and residential address upon signing up to their study.”
Self-citationHegarty, K. L., Tarzia, L., Murray, E., Valpied, J., Humphreys, C., Taft, A., Gold, L. H., & Glass, N. E. (2015) · BMC Public Health · doi:10.1186/s12889-015-2072-z · Cited by 39 · see citing works
“Subsequent related international work conducted in New Zealand (ACTRN12612000708853) [21] and in Canada (NCT02258841) is evaluating similar safety decision online interventions to promote safety and improved mental health.”
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Spangaro, J. (2017) · Australian Health Review · doi:10.1071/ah16155 · Cited by 39 · see citing works
An Evidence Synthesis of Covert Online Strategies Regarding Intimate Partner Violence
Grimani, A., Gavine, A. J., & Moncur, W. (2020) · Trauma Violence & Abuse · doi:10.1177/1524838020957985 · Cited by 25 · see citing works
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“Many interventions in domestic violence rely on changes in perpetrator behaviours , although more recently there has been a focus on providing support and access to safety planning for women who identify as experiencing domestic violence (Campo, 2015; Koziol-McLain et al., 2015).”
van Gelder, N. E., van Rosmalen-Nooijens, K. A. W. L., Ligthart, S. A., Prins, J. B., Oertelt‐Prigione, S., & Lagro-Janssen, A. L. M. (2020) · BMC Public Health · doi:10.1186/s12889-020-08743-0 · Cited by 23 · see citing works
Sabri, B., Glass, N. E., Murray, S. M., Perrin, N., Case, J., & Campbell, J. C. (2021) · BMC Public Health · doi:10.1186/s12889-021-11930-2 · Cited by 21 · see citing works
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Koziol-Mclain, J., McLean, C., Rohan, M., Sisk, R., Dobbs, T., Nada-Raja, S., Wilson, D., & Vandal, A. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.6515 · Cited by 12 · see citing works
“In this study we examined the recruitment experience for the New Zealand isafe trial [15] that tested a Web-based safety decision aid for women who experience abuse.”
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“59– 61 In the realm of HIV care, technology-based interventions primarily employ mobile apps or are SMS-based (text message-based).”
Barriers to Leaving an Abusive Relationship
Saunders, D. G. (2021) · Springer eBooks · doi:10.1007/978-3-319-89999-2_186 · Cited by 15 · see citing works
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Barriers to Leaving an Abusive Relationship
Saunders, D. G. (2020) · Springer eBooks · doi:10.1007/978-3-319-62122-7_186-1 · Cited by 11 · see citing works
A survey of mothers' experiences of shared parenting and domestic violence
Archer‐Kuhn, B., Saini, M., Hughes, J., Tam, D., & Trudgill, D. I. N. (2023) · Family Court Review · doi:10.1111/fcre.12715 · Cited by 5 · see citing works
Signorelli, M. C., da Silva, V. L. C., Evans, D. P., Prado, S. M., & Glass, N. E. (2022) · Journal of Family Violence · doi:10.1007/s10896-022-00409-2 · Cited by 5 · see citing works
Self-citationSafety Planning Interventions for Adults Who Experience Interpersonal Violence: a Systematic Review
Sabuncu, B. C., Signorelli, M. C., Evans, D. P., Millender, E., Murgor, J. C., Lane, B., Okantey, B., & Hall, C. X. (2024) · Journal of Family Violence · doi:10.1007/s10896-024-00770-4 · Cited by 4 · see citing works
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“Women report that technology-based interventions feel more confidential, lead to more efficient and perceived-safer care, and feel more empowering to women with a history of interpersonal violence than nontechnology interventions [94-98].”
Global women's health issues: sex and gender matter
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“The terminology of the child safety consent point has been a point of deliberation in the team, stating that if the research team has concerns about child safety they will discuss these concerns with the participant first (Koziol-McLain et al., 2015).”
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“…are noted to feel more confidential and perceived to provide safer care, while also feeling more empowering than in-person formats for women with histories of violence/trauma (Bacchus et al., 2016; Glass et al., 2010; Klevens et al., 2012; Koziol-McLain et al., 2015; Tarzia et al., 2016).”
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- Authors
- Koziol-McLain, J., Vandal, A. C., Nada-Raja, S., Wilson, D., Glass, N. E., Eden, K. B., McLean, C., Dobbs, T., & Case, J.
- Affiliations
- Auckland University of Technology (NZ)
- Johns Hopkins University (US)
- Oregon Health & Science University (US)
- ORCID
- Venue
- BMC Public Health
- Published
- 2015-01-31
- Volume
- 15
- Issue
- 1
- Pages
- 56-56
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC4314812
- OpenAlex
- W2025623274
- Cited by
- 48
- References
- 62
- Citations by year
- 2026: 1 · 2024: 3 · 2023: 4 · 2022: 4 · 2021: 4 · 2020: 9 · 2019: 2 · 2018: 5 · 2017: 5 · 2016: 7 · 2015: 3
- FWCI
- 8.28
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Tuwhera (Auckland University of Technology) (submittedVersion, cc-by)
- Funders
- Auckland University of Technology, New Zealand
- Health Research Council of New Zealand
- Topics
- Social Sciences › Health › Intimate Partner and Family Violence
- Social Sciences › Sociology and Political Science › Stalking, Cyberstalking, and Harassment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- intimate partner violence, safety planning, online intervention, battered women, decisional conflict, depression, post-traumatic stress disorder, psychological violence, violence against women, New Zealand
- MeSH terms
- Adolescent, Adult, Australia, Cost-Benefit Analysis, Decision Making, Depression, Female, Humans, Interpersonal Relations, Mental Health, Middle Aged, New Zealand, Research Design, Safety, Spouse Abuse, Risk Assessment, Battered Women, Internet, Young Adult
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