“It Could Save Her Life”: Perceptions of a Mobile Safety Decision Aid for Women Experiencing Intimate Partner Violence in Curitiba, Brazil Restricted; Files Only
Carvalho Guimarães, Maria Amália (Spring 2023)
Abstract
Intimate partner violence (IPV) poses a severe threat to the health and safety of women globally, presenting an urgent need for accessible and efficient services to address this issue. Online safety decision aids (SDA) are tools that show promise in supporting women experiencing IPV, however little is known about their potential use in low- and middle-income countries (LMIC) and no prior SDAs have been tested in Brazil, a country with alarmingly high rates of IPV and femicide. This study aimed to assess key stakeholders’ perceptions of the feasibility of Eu-Decido, an app-based SDA developed for use in Brazil. Focus group discussions (FGD) were conducted with staff of a cross-sectoral one-stop center called the House of the Brazilian Woman (HBW), survivors of IPV, and community stakeholders working in the field of IPV (n=20). Qualitative data from FDGs were coded in MAXQDA20 and analyzed thematically using inductive codes. Results from this analysis indicated that most participants considered Eu-Decido feasible, highlighting its potential to sensitize survivors to IPV and the inclusion of safety features and visual aids as primary advantages of the tool. HBW staff raised concerns regarding the appropriateness of app length and language for low-literacy survivors and safety risks associated with independent use, advocating for facilitated use of Eu-Decido alongside a trained IPV service provider to circumvent these challenges. Survivors, however, praised the confidentiality and flexibility associated with independent use, suggesting that further research should investigate the feasibility of both modalities, including potential integration into primary care settings given the limited availability of HBWs nationwide. Findings from this study provide significant insights into the use of internet-based SDAs in Brazil, emphasizing the importance of centering the voices of survivors in all phases of IPV intervention research and contributing to the growing body of knowledge surrounding how SDAs can be implemented in LMIC to support and empower survivors of IPV.
Table of Contents
Table of Contents
Chapter I: Introduction…………………………………………………………………...……..1
Chapter II: Comprehensive Review of the Literature…………. …................……..….4
Violence Against Women……………………………………………………….....……………4
Intimate Partner Violence……………………………………………………………...…....…5
Health Impacts of IPV…………………………………………………………………....…...…7
IPV Risk Factors……………………………………………………………………………….…..8
IPV Interventions ……………………………………………………………..….………………8
Intimate Partner Violence in Brazil ……………………………………..…..……..……….10
Response to VAW in Brazil……………………………………………………….…………….12
MHealth in Brazil ………………………………………………………………………………..15
Online Safety Decision Aids…………………………………………………..……..….…….16
Online SDAs in High-Income Countries…………………………………………….………17
Online SDAs in Low- and Middle-Income Countries………………………….……….…26
Online SDAs in Brazil: Eu-Decido……………………………………………………….……29
Summary..........................................................................................................32
Chapter III: Manuscript…………………………......………..……………..………..….…...34
Abstract.......................................................................................................... 35
Introduction.....................................................................................................36
Methods...........................................................................................................39
Results.............................................................................................................42
Discussion........................................................................................................55
Conclusion........................................................................................................65
Limitations........................................................................................................67
Chapter IV: Public Health Implications for Future Research..................................68
References………………......……………………………………………………….……….....…70
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