Development and testing of a smartphone-delivered IPV and related stress intervention for residents experiencing extreme weather in informal settlements in Kenya using ecological momentary approaches - PROJECT SUMMARY Extreme weather (EW) is expected to impact intimate partner violence (IPV). Women in informal settlements in lower- and middle-income countries (LMICs) are more likely to experience IPV, less likely to have access to responsive services, and more vulnerable to the effects of EW. Despite the potential impacts of EW on IPV, strategies to respond to and plan for EW in these settlements have overlooked violence-related outcomes. In particular, there is a paucity of interventions to help residents of informal settlements experiencing IPV to minimize the negative impact of EW 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 safety and harm reduction intervention for women experiencing IPV and EW 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, comfort with EW and ambient conditions, 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 EW—a heatwave, a cold spell, and heavy rainfall. R21: Aim 2 is to use AIM 1 data to explore important, but understudied associations between EW 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 IPV and EW and to provide survivors with interventions in real-time. Findings could support a low-cost, sustainable, and easily adaptable IPV and EW response application and implementation model for informal settlements or other under-resourced settings globally.
