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Feasibility of an Online Safety Planning Intervention for Rural and Urban Pregnant Abused Women

Bloom, Tina L.; Glass, Nancy E.; Case, James; Wright, Courtney; Nolte, Kimberly; Parsons, Lindsay

doi: 10.1097/NNR.0000000000000036
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Background Intimate partner violence (IPV) in pregnancy is common and harmful to maternal–child health. Safety planning is the gold standard for intervention, but most abused women never access safety planning. Pregnant women may face increased barriers to safety planning and risk of severe IPV, particularly if they are also rural residents. Internet-based safety planning interventions may be useful, but no such interventions specific to the needs of pregnant women have been developed.

Objectives The aim was to evaluate feasibility (usability, safety, and acceptability) of Internet-based safety planning for rural and urban abused pregnant women and practicality of recruitment procedures for future trials.

Methods An existing Internet-based safety decision aid for pregnant and postpartum women was adapted; initial content validity was established with survivors of IPV, advocates, and national IPV experts; and a convenience sample of community-dwelling abused pregnant women was recruited and randomized into two groups to test the decision aid.

Results Fifty-nine participants were enrolled; 46 completed the baseline session, 41% of whom (n = 19) resided in nonmetropolitan counties. Participants' average gestational age was 20.2 weeks, and 28.3% resided with the abusive partner. Participants reported severe IPV at baseline (mean Danger Assessment score of 16.1), but all were able to identify a safe computer, and 73.9% completed the baseline session in less than 1 week, with no adverse events reported.

Discussion These findings provide preliminary evidence for the feasibility, acceptability, and safety of an Internet-based safety decision aid for urban and rural abused pregnant women.

Tina L. Bloom, PhD, MPH, RN, is Assistant Professor, Sinclair School of Nursing, University of Missouri, Columbia.

Nancy E. Glass, PhD, MPH, RN, FAAN, is Professor; and James Case, MBI, is Research Associate, School of Nursing, Johns Hopkins University, Baltimore, Maryland.

Courtney Wright, BA, is Research Assistant; Kimberly Nolte, MPH, is Research Assistant; and Lindsay Parsons, MPH, is Research Assistant, Sinclair School of Nursing, University of Missouri, Columbia.

Accepted for publication March 14, 2014.

The authors acknowledge that this project was funded by the University of Missouri Research Board and the Robert Wood Johnson Foundation Nurse Faculty Scholars program (Grant #69343).

The authors have no conflicts of interest to report.

Corresponding author: Tina L. Bloom, PhD, MPH, RN, Sinclair School of Nursing, University of Missouri, Columbia, MO 65233 (e-mail:

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.