Unmet Need
Intimate partner violence (IPV) is an underrecognized and under-addressed worldwide health and public health problem. IPV is a pattern of behavior used by one person to gain and maintain power and control over a current or former intimate partner and can include physical, verbal, emotional, sexual, digital, stalking, and financial abuse, as well as controlling reproductive choices and access to medical care. The Center for Disease Control estimates that 41% of US women and 26% of men have experienced sexual violence, physical violence or stalking in their lifetime. The most common age for experiencing IPV is 18-24, college age. In addition to injuries, IPV survivors are at elevated risk for a range of negative long-term health and mental health outcomes (including diabetes, hypertension, early heart disease, sexually transmitted infections, asthma, chronic pain, sleep disorders, depression, anxiety, psychiatric disorders, substance use disorder, and more), but the most serious consequence is death. Over 50% of US women killed are murdered by a partner, and female victims of domestic violence have eight times the risk for suicide compared with the general population. The cornerstone of IPV intervention is safety planning, an individualized process of creating an action plan with strategies and resources to increase a victim’s and their family’s physical and emotional safety. Safety planning is typically done with a trained service provider or clinician, however, due to a variety of well documented barriers, most IPV survivors do not access the formal services that could increase their safety and health outcomes. Further, the under-detection of IPV by health providers represents a missed opportunity for intervention. Survivors most often confide in friends, family, or other informal supports who are often not equipped to provide effective intervention. Thus, there exists a need for a digital solution that expands access to resources for people experiencing abuse and their loved ones.
Technology Overview
Johns Hopkins researchers have developed myPlan, a safety decision aid for people experiencing intimate partner violence. It is a cross-platform app available on iOS, Android, and the web that guides users through interactive, evidence-based assessments and delivers personalized strategies and resources for users to make informed decisions to increase their safety, health, and well-being. myPlan provides concerned friends or family members personalized information about how to support a loved one experiencing abuse from a partner, and can be used by service providers and clinicians to guide conversations about IPV or to give as a resource to clients or patients to privately assess their relationship and the risks if they are not yet ready to talk to a provider. As abusive partners often misuse technology to monitor IPV victims, myPlan includes features to mitigate risk to the user, including requiring a PIN to protect access, a quick exit button on every page, the ability to change the app icon on a home screen, obscured content if the app tab is left open, and a “safe mode” feature allowing users to lock the app contents and display a bogus page hiding the true purpose of the app.
Stage of Development
myPlan is the first, to our knowledge, safety decision aid for people experiencing abuse from an intimate partner and their concerned friends and family to clarify their priorities, assess risks, and receive tailored strategies and resources for increasing safety and well-being. myPlan is a functioning end-user product. The app currently has 4 main sections developed based on evidence in violence prevention and response, IPV survivor and service/healthcare provider input in focus groups and human-centered design sessions, and outcomes from 2 randomized controlled trials testing the effectiveness of the intervention: (1) Learning – includes activities to learn about myths about IPV, definitions of abuse, consent frequently asked questions, and for friends/family only, reasons why victims can’t “just leave”; (2) Relationship – includes question about the user and their partner, assessments to determine warning signs and red flags for toxic or abusive relationships, The Danger Assessment risk assessment for severe or lethal violence, a priorities-setting activity, and healthy relationship characteristics assessment; (3) Strategies – a list of suggested strategies to employ for increased safety and well-being personalized to the user based on input in the Relationship section – for friends and family, categories are focused on supporting a loved one; and (4) Resources – national service provider resource list personalized based on user input and and local IPV agencies in the user’s area.
https://myplanapp.org/
Publications
https://doi.org/10.1177/0886260509354508
https://doi.org/10.1016/j.amepre.2014.09.027
https://doi.org/10.1016/j.amepre.2016.12.014
https://doi.org/10.1177/0886260521991880
https://doi.org/10.1080/15228835.2013.861784
https://doi.org/10.1097/NNR.0000000000000036
http://dx.doi.org/10.1080/15228835.2015.1037414
https://doi.org/10.1186/s12889-015-2191-6
http://dx.doi.org/10.1080/00918369.2015.1112597
https://doi.org/10.1186/s12889-023-15918-y
https://doi.org/10.1002/nur.21853
