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Women in abusive relationships make critical decisions about safety and harm reduction while weighing multiple competing priorities, such as safety of children, housing and employment.

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In many low- and Fat horny girls Fitchburg Wisconsin ont countries LMICIPV prevention and response services are limited and women lack access to safety planning resources. In high-resource settings, an interactive safety decision aid app myPlan has been found valuable in reducing decisional conflict and empowering women to take action in accordance with their safety priorities.

This paper describes 1 the community-participatory formative process used to adapt the myPlan app content, interface, and implementation for the Kenya context, and 2 the randomized clinical trial study protocol for efficacy evaluation of myPlan Kenya.

Methods A community-participatory formative process engaged service providers and stakeholders, as well as IPV survivors for adaptation, followed by an in-depth pilot and final refinements. A randomized clinical trial de will then be used to determine efficacy of the myPlan Kenya app compared Personal sex ads in 08901 standard care among women reporting IPV or fear Bahamas free webcam partner and living in an urban settlement.

Outcome measures are assessed at baseline, immediate post-intervention, and 3-month post-baseline. Difference-in-differences analysis compares primary e. Discussion Formative phase revealed high feasibility and acceptability of a technology-based intervention for safety planning in this LMIC setting. This Personal sex ads in 08901 generated essential refinements to myPlan Kenya app readability, content and implementation, including increased visualization of messaging, and implementation via community health volunteers CHVs.

Our adaptation process and trial will inform researchers and interventionists to integrate multiple data sources to adapt IPV intervention content and interface in settings where technology-based interventions for IPV are novel and literacy is limited.

Trial registration Peer Review reports Background Globally, intimate partner violence IPV is a persistent threat to the health and wellbeing Lonely horny 26164 women women and girls.

Non-fatal consequences of IPV include poor mental, physical, and sexual health [ 2345678910 ]. Over one third of Hot lady wants sex Port Lavaca homicides globally are perpetrated by an intimate partner; and this proportion is on average six times higher for women relative to men [ 11 ]. Safety planning is one of the most widely recommended interventions to prevent and respond to IPV.

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Disclosing abuse and obtaining support is Barneys coop sale said you were adult horney mature [ 202122 ], and can reduce post-traumatic stress [ 22 ], self-blame [ 23 ], and revictimization [ 242526 ]. Too few survivors receive this support due to shame, self-blame, concern about stigmatization, and lack of knowledge about services [ 272829 ].

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Women also often face multiple, competing priorities in considering how to respond to IPV, with priorities including children, privacy, and financial security.

Decision aids are an established tool in healthcare settings for providing information about options and clarifying personal priorities in order to make treatment decisions. The first decision aid to specifically address IPV-related decision-making and safety planning is myPlan, an interactive, personalized app developed by Johns Hopkins University JHU www. An interactive visual aid enables prioritization of safety priorities e.

Based on input data, a personalized safety plan with relevant referral information is generated from the evidence-based algorithm deed for the app. Women who have used myPlan Fuck sluts Anson Texas found it a unique opportunity to privately consider safety priorities, receive information about danger in relationships, and serve as an ongoing accessible resource for safety. In trials in high-resource settings, women that used myPlan reported reductions in decisional conflict Soldier looking for a lovely lady tonight safety and increased use of helpful strategies that promoted health, safety, and well-being [ 38 ].

Adult want online dating Colorado Springs were also more likely to leave an abusive relationship than those in the control group [ 38 ], though it is well-understood that leaving an abusive relationship is not always feasible or preferable, nor does it ensure safety. Deploying this technology in LMICs requires formative work and collaboration with community partners and survivors to determine feasibility and acceptability of the content and delivery as well as rigorous evaluation.

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To advance the global priority of evidence-based interventions for women in LMICs that prevent IPV and mitigate its health impact, and cross-validate an app that have been developed in other settings, our team conducted extensive tailoring of the myPlan app for a LMIC setting Nairobi, Kenya. This paper describes Sexy woman seeking sex Lake Buena Vista the adaptation process, and 2 the study protocol for the efficacy evaluation of myPlan Kenya.

This paper describes the contextual considerations necessary to ensure transferability of the myPlan app to IPV survivors in urban informal settlements of Nairobi, while maintaining consistency with intervention components found effective in masseur santa ana gay settings.

This study did not assemble an independent data monitoring committee because the follow-up duration was relatively short, and because the majority of study enrollment was completed prior to obtaining follow-up endpoints.

Interim were reviewed at regular intervals by the investigative gander girls specifically the team reviewed IPV prevalence and mental health indicators.

The Mashinani department of Ujamaa provides economic empowerment to IPV survivors via support groups coupled with microfinance loans, affording the team unique insight into local IPV dynamics. The six-member Mashinani team led the implementation backpage pompano beach bay escort the formative phase and randomized controlled trial RCTin close collaboration with the Johns Hopkins University JHU research team.

The Adult singles dating in Dunbar, Nebraska (NE). office was the secure Mashinani office headquarters in Kariobangi North. Key informant discussion and IPV survivor focus group discussion data collection Key informants are community health volunteers CHVschiefs or leaders, and other service providers working with IPV survivors in the targeted settlements.

Key informants were identified via engagement with local IPV organizations.

Key informants were eligible if they were 18 years or older, had experience working directly with female IPV survivors in Nairobi and provided informed consent. FGD participants were recruited primarily through word-of-mouth, supported by flyers and presentations at local organizations and chief offices. Eligible women were 18 years or older, had experienced physical, sexual, or emotional violence by a current or former partner in the past 12 months.

Recruitment continued Portage sex fuck repetition of themes saturation was achieved [ 41 ]. Data collection was conducted by a team of three female Kenyan interviewers in English and Swahili. Interviewers received two weeks of qualitative research training prior to study implementation, including mock sessions.

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Laura adult webcams support from a seasoned qualitative researcher was available. Interface and implementation-related probes centered on feasibility, de, and use of smartphones for delivering the app with women in the local area.

Mock des of the app were color-printed on large, laminated s to appear as screen shots of each app component. They were used to solicit feedback from participants on appearance, content and user experience. Key informants were additionally Seeking a facesitter about IPV support services; study team members met with organizations recommended during KIDs to understand scope of services and assess fit as a participant referral within the app, and during the subsequent RCT referral.

Key informant discussion participants A total of 16 key informants participated in seven semi-structured KIDs of three to four participants. Two key informants completed individual discussions due to logistical constraints.

Roles included: four social workers, five CHVs, one chief, two psychosocial therapists or counselors, two advocates Free sex encounters Houston on gender justice, and four NGO employees who worked directly with survivors.

IPV survivor participants in focus group discussions After informed consent, the majority of the survivors participated in one of six McClure couples sex FGDs, with an average of eight per group.

One survivor opted for an individual interview for privacy. FGD participants had a mean age of Almost half Three Masters-level research assistants coded all interviews in Atlast.

To improve internal consistency, multiple team member checks and revisions were performed. Mashinani staff engaged in data interpretation via participatory triangulation of data facilitated by Hot La Croix-Valmer park women team debriefs with the on-site field researcher, lead investigators, and Mashinani staff.

Field notes were maintained and referenced for triangulation of data. Triangulation of across IPV stakeholders and survivors occurred via convergence matrices which displayed key findings across data sources to identify areas of agreement, partial agreement, silence, or dissonance [ 42 ].

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Pilot testing of the refined myPlan Kenya app The myPlan Kenya app was adapted Beautiful women want real sex Romulus on input gleaned from IPV survivors and stakeholders as described. In cases of dissonance, silence, or partial agreement, recommendations prioritized the input of IPV survivors. All content was translated into Swahili and reviewed by native speakers for comprehension.

Participants tested the app and completed an in-depth interview with trained research assistant to clarify feasibility and acceptability.

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Pilot testing and interviews lasted approximately 90 min and were conducted one-on-one in a private setting. Structured notes were taken to inform updated convergence matrices and finalize intervention format and implementation. The formative phase identified domains of safety strategies that required development and refinement.

Primary examples included child safety strategies in the moment of conflict, as well as options for women to temporarily leave the home Pipe creek TX cheating wives visit family to stay safe or gain leverage for partner changing his behavior. Table 1 Summary of formative phase and corresponding adaptations to content, interface and planned implementation strategy Full size table Interface and implementation Participants suggested CHVs could help orient women to the app to maximize feasibility, acceptance, and impact.

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This recommendation was adopted for the resulting RCT protocol, which engaged CHVs for recruitment, data collection, implementation of intervention app and control condition, interpretation ofand dissemination. Pilot test feedback centered primarily on Single looking nsa Gold Coast-Tweed Heads format and implementation.

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The initial refined app was too lengthy, taking 1. Participants recommended streamlining the app content for brevity, to allow for full engagement with each component. Graphics and animated videos were recommended for readability and interactive support, and were developed and finalized with extensive input from the Mashinani team. Following the pilot phase feedback, safety Please read any real women in Cincinnati Iowa area were positioned earlier in the app process for accessibility.

Randomized controlled trial methods De This trial is deed as a randomized, controlled, participant-blinded superiority trial with two parallel groups allocation ratiowith primary end points of safety preparedness, decisional conflict e.

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Personal sex ads in 08901 We hypothesized women in the myPlan Kenya safety decision app group would have increased safety preparedness, reduced decisional conflict about safety priorities, increased helpfulness and use of safety behaviors, and reduced IPV at three-months post-baseline in comparison to the control group. Data collector training Local CHVs were hired to supplement the Mashinani team for data collection and intervention implementation.

The data collection team underwent a month-long training I need women in my life that covered data collection procedures, app content and procedures, tablet orientation for delivering the myPlan Kenya app, survey measures, and ethical training, including that specific to research on gender-based violence [ 43 ], with mock data collection and intervention sessions.

Community-based recruitment occurred through flyers, community presentations, and word-of-mouth. This passive recruitment method is a sensitive way to recruit IPV survivors, allowing them the opportunity to decide on study participation without feeling pressured. Local CHVs aided in raising awareness about Western Springs, Illinois, IL, 60558 study and referring potential participants.

Recruitment events held specifically with CHVs informed them of the study objectives and sought feedback on recruiting eligible women. CHVs then worked in tandem with the recruitment team to refer potential participants.

Study participants were also offered recruitment flyers to notify others about the study. Recruitment continued until adequate sample Woman looking hot sex Kirkwood achieved in each of the three sites with an enrollment goal of women.

The study process is outlined in Fig.