Development and testing of a smartphone-delivered climate adaptation and IPV and related stress intervention for residents of informal settlements in Kenya using ecological momentary approaches

使用生态瞬时方法为肯尼亚非正规住区居民开发和测试智能手机提供的气候适应和 IPV 及相关压力干预措施

• 批准号: 10740006
• 负责人: Christine Wayua Musyimi
• 金额: $ 14.35万
• 依托单位: AFRICA MENTAL HEALTH FOUNDATION
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-18 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10740006
• 关键词: Anxiety; Area; Behavior; Behavior Therapy; Cause of Death; Cellular Phone; Climate; Collection; Communities; Data; Development; Ecological momentary assessment; Emotional Stress; Environment; Event; Evidence based intervention; Exclusion; Face; Female; Floods; Foundations; Frequencies; Geography; Goals; Harm Reduction; Health Services Accessibility; Health behavior; Heat Waves; Household; Housing; Industrialization; Infrastructure; Interpersonal Violence; Intervention; Kenya; Land Tenure; Legal; Mental Depression; Mental Health; Modeling; Morbidity - disease rate; Outcome; Participant; Personal Satisfaction; Persons; Phase; Politics; Population; Post-Traumatic Stress Disorders; Poverty; Precipitation; Probability Samples; Rain; Randomized; Randomized, Controlled Trials; Reporting; Research; Resources; Risk; Risk Reduction; Safety; Sanitation; Seasons; Secure; Self Efficacy; Services; Site; Social Work; Social support; Stress; Structure; Surveys; Survivors; Temperature; Testing; Time; Violence; Water; Weather; Well in self; Wing; Woman; Women' s Health; Work; anxiety reduction; assessment application; behavior change; behavioral response; climate adaptation; climate change; climate impact; computerized; cost; design; digital assessment; empowerment; evidence base; experience; extreme weather; feasibility testing; food insecurity; interpersonal conflict; intimate partner violence; low and middle-income countries; low income country; marginalization; mobile application; mortality; participant retention; physical conditioning; pilot test; response; smartphone application; social; spelling; tool; wasting

PROJECT SUMMARY Climate change (CC) and related weather events are expected to impact intimate partner violence (IPV). Women in informal settlements in lower- and middle-income countries (LMICs) are more likely to be experiencing IPV, less likely to have access to services, and more vulnerable to the effects of CC and related extreme weather events (EWEs). Despite the potential impacts of CC on IPV, strategies to adapt to CC in these settlements, i.e., reducing the consequences of mounting climate challenges, have overlooked violence-related outcomes. In particular, there is a paucity of interventions to help residents of informal settlements experiencing IPV to adapt to or minimize the impact of CC on their safety and well-being. The purpose of this exploratory/developmental R21/R33 study is to develop and test the preliminary efficacy of a smartphone-delivered climate adaptation safety and harm reduction intervention for women experiencing IPV in informal settlements in Kenya using ecological momentary intervention (EMI) and ecological momentary assessment (EMA). We will achieve this goal through the following aims: R21: Aim 1 is to develop and pilot a smartphone-based application to collect real-time EMA information about IPV experiences, emotional stress, IPV self-efficacy, receipt of IPV-related social support and services, safety, climate-related comfort, social and environmental context, and current behaviors from 320 IPV survivors in informal settlements. Participants will complete EMAs thrice daily for a two-week baseline period and for two-weeks following three common types of EWEs (heatwave, cold spell, heavy rainfall). R21: Aim 2: is to use AIM 1 data to explore important, but understudied associations between climate and IPV. R33: Aim 1 is to adapt an evidence-based Wings of hope intervention (WINGS) for integration into the EMA application developed in the R21 study. R33: Aim 2 is to test the feasibility and preliminary efficacy of the event-triggered WINGS-based EMI adapted in R33: Aim 1 through a randomized control trial (RCT). Participants retained from the R21 phase (n=272), will be randomized to receive either a single-session, mobile version of WINGS (n=136) or the event-triggered, WINGS-based EMI adapted in R33: Aim 1 (n=136). For nine months, participants assigned to the event-triggered EMI will be prompted to participate in daily EMIs for two-weeks following EWEs. They will also be prompted to complete daily EMAs during these two-week periods. All participants, regardless of assignment, will be asked to complete digital assessments at baseline, immediately following receipt of the single-session of WINGS, and at 3-, 6-, and 12-months. The goals of this study are: to provide women with a low-cost, accessible, smartphone-based tool that empowers them to develop, utilize, and revise personal safety and harm reduction strategies that are specifically responsive to climate-related IPV and to provide survivors with interventions in real-time. Findings could support a low-cost, sustainable, and easily adaptable climate adaptation and IPV response application and implementation model for informal settlements or other under- resourced settings, globally.

项目概要 气候变化 (CC) 和相关天气事件预计会影响亲密伴侣暴力 (IPV)。女性 低收入和中等收入国家 (LMIC) 的非正规住区更有可能经历 IPV， 获得服务的可能性较小，并且更容易受到 CC 和相关极端天气的影响 事件（EWE）。尽管 CC 对 IPV 具有潜在影响，但在这些定居点中适应 CC 的策略，即： 减少日益严峻的气候挑战的后果，却忽视了与暴力相关的后果。在 特别是，缺乏干预措施来帮助经历 IPV 的非正规住区居民适应 尽量减少 CC 对他们的安全和福祉的影响。这一探索性/发展性的目的 R21/R33研究旨在开发和测试智能手机提供的气候适应安全的初步功效 利用生态系统对肯尼亚非正规住区中遭受 IPV 的妇女进行减害干预 瞬时干预（EMI）和生态瞬时评估（EMA）。我们将通过以下方式实现这一目标 R21：目标 1 是开发和试点基于智能手机的应用程序来收集实时 EMA 有关 IPV 经历、情绪压力、IPV 自我效能、接受 IPV 相关社会支持的信息以及 320 个 IPV 的服务、安全、与气候相关的舒适度、社会和环境背景以及当前行为 非正规住区的幸存者。参与者将在两周的基线期内每天完成三次 EMA 以及三种常见类型的 EWE（热浪、寒流、强降雨）后的两周。 R21：目标 2：是 使用 AIM 1 数据探索气候与 IPV 之间重要但尚未充分研究的关联。 R33：目标 1 是 调整基于证据的希望之翼干预措施 (WINGS) 以集成到 EMA 应用程序中 R21 研究中开发的。 R33：目标2是测试事件触发的可行性和初步效果 基于 WINGS 的 EMI 通过随机对照试验 (RCT) 应用于 R33：目标 1。保留的参与者 R21 阶段 (n=272)，将随机接受单次、移动版本的 WINGS (n=136) 或 R33 中采用的事件触发、基于 WINGS 的 EMI：目标 1 (n=136)。九个月来，参与者 分配给事件触发的 EMI 的人员将被提示参加 EWE 后两周的每日 EMI。 他们还将被提示在这两周期间完成每日 EMA。所有参与者，无论 任务分配后，将被要求在收到任务后立即完成基线数字评估 单次 WINGS、3 个月、6 个月和 12 个月。本研究的目标是：为女性提供 低成本、易于使用、基于智能手机的工具，使他们能够开发、利用和修改个人安全 专门针对与气候相关的 IPV 并为幸存者提供帮助的减少伤害战略 实时干预。研究结果可以支持低成本、可持续且易于适应的气候 非正规住区或其他非正规住区的适应和 IPV 响应应用和实施模型 全局资源设置。