1. University of Pittsburgh School of Nursing
Department of Health and Community Systems
A Journey Toward Preventing Intimate
Partner Violence
Presented to Wellspring
Rose E. Constantino, PhD, JD, RN, FAAN, FACFE

2. The speakers have no conflicts of interest to disclose
Disclosures
The speakers have no Conflict of Interest to disclose
The speakers have no conflicts of interest to disclose

3. Contributors University of Pittsburgh Students and Faculty
Dominique Dela Cruz, BSN, Research Assistant, SON
Juhae Grace Hwang, Research Assistant, SON
Joseph Burroughs, Research Assistant, SON
Amirreza Masoumzadeh, Graduate Student, SIS
James Joshi, Associate Professor, SIS
Lei Jen, Graduate Student, SIS

4. From TMI to HELPP to LEAF

5. I. Text Messaging Intervention (TMI)

6. Intimate Partner Violence Definition
Intimate Partner Violence (IPV) is defined as physical, emotional, sexual, or psychological abuse

7. About 72 percent of eighth and ninth graders report "dating."
Teen dating abuse most often takes place in the home of one of the partners.
1 in 10 teen girls and 1 in 11 teen boys admits to having experienced physical violence in a dating relationship in the past year.
1 in 3 teens stay they know someone who has been physically assaulted or hurt by a dating partner

8. Intimate Partner Violence (IPV)

9. Tension Building
This feels like walking on eggshells. Nothing is right, and the victim has no way to predict what the abuser wants. While there may not be physical violence (or at least physical violence is minimal), there is emotional abuse, intimidation and threats. As the cycle is repeated, the violence usually increases in frequency and severity.
Violent Phase
This is the actual violence that includes physical, emotional and/or sexual abuse. NOTE a crime is committed.
Honeymoon Phase:
Abusers act differently after violent episodes. Some ignore or deny the violence. Others try to apologize and make up for the violence by buying presents, flowers, cards and going on romantic dates. It is important to recognize the abuser by seek pity and is an attempt to draw the victim back into the relationship.
The cycle can happen hundreds of times in an abusive relationship. Each stage lasts a different amount of time in a relationship. The total cycle can take anywhere from a few hours to a year or more to complete.

10. Power and Control Wheel
In 1984, staff at the Domestic Abuse Intervention Project (DAIP)
INTIMIDATION:
Making her afraid by using looks, actions, and gestures. Smashing things. Destroying her property. Abusing pets. Displaying weapons.
EMOTIONAL ABUSE:
Putting her down. Making her feel bad about herself. Calling her names. Making her think she’s crazy. Playing mind games. Humiliating her. Making her feel guilty.
ISOLATION:
Controlling what she does, who she sees and talks to, what she reads, and where she goes. Limiting her outside involvement. Using jealousy to justify actions.
MINIMIZING, DENYING, AND BLAMING:
Making light of the abuse and not taking her concerns about it seriously. Saying the abuse didn’t happen. Shifting responsibility for
abusive behavior. Saying she caused it.
USING CHILDREN:
Making her feel guilty about the children. Using the children to relay messages. Using visitation to harass her. Threatening to take the
children away.
ECONOMIC ABUSE:
Preventing her from getting or keeping a job. Making her ask for money. Giving her an allowance. Taking her money. Not letting her know about or have access to family income.
MALE PRIVILEGE:
Treating her like a servant: making all the big decisions, acting like the “master of the castle,” being the one to define men’s and women’s roles.
COERCION AND THREATS:
Making and/or carrying out threats to do something to hurt her. Threatening to leave her, commit suicide, or report her to welfare. Making her drop charges. Making her do illegal things.

11. Text Messaging Intervention
By 2025, five billion people will be texting
Currently, most common method of communication
Shapes the nature of relationships
As a SHIELD to give attention, safety, comfort, love, and belongingness
As a SWORD to control, abuse, punish, stalk, or coerce
Participants are likely to remember short texts that are timely, relevant, rhymed, funny, and interesting

12. Research Design and Methods
Mixed methods design using qualitative and quantitative method of data collection
Duration: 6 weeks
1 week Pre TMI-Survey; 4 weeks TMI; 1 week Post TMI-Survey
Main outcome variable: to evaluate the readability , usability, and feasibility of TMI in imparting of knowledge of the warning signs of Intimate Partner Violence and on building healthy dating relationships

13. Recruitment/Screening
Participants will be screened for having a device with text messaging and meet with investigators, sign IRB-approved informed consent and complete a pre-and post-TMI survey

14. Text Messaging Intervention (TMI)
20 researcher-developed TMI: Roses are red violets are blue, dating is sweet but should not leave marks on you
Data Collection:
Collected twice: baseline and week 6
One TMI once every day, 5 days/week for 6 weeks
Sent by a student nurse facilitator to each participant

15. Pre and Post TMI Survey Questionnaires
Participants will compete surveys on strategies to develop healthy dating relationships and identifying early signs of RV
12 multiple choice and open-ended questions

16. II. HELPP Zone App

17. HELPP Zone Main App Features: Calling Emergency Numbers
Health, Education on safety, and Legal Participant Preferred
For college students to protect themselves against potential dating violence
Set trusted contacts and schedule, and reach them for help based on the context of potential violence occurs
Main App Features:
Calling Emergency Numbers
Situation-Aware Helpers
Asking for Help
Educational Resources

18. Strategy:
Use mobile tech to build healthy relationships by disrupting the communication tool in building healthy relationships and in preventing IPV
Rationale:
The most common and low cost mode of communication for intervention and prevention
By 2025, five billion people will be texting

19. HELPP App ● List of trusted contacts
● Give emergency contacts Situation-awareness, time and location contexts
● Immediate emergency call numbers
● Educational information and ticker tape tips
● SMS text messaging tools
● Use the Android platform

20. Displaying Events User can define a series of events in her schedule
Determines user’s status
States the time it will be activated
Shows the period it lasts
Can also show location
An event can be either:
one time (e.g., a date)
periodic (e.g., walking or biking)

21. Emergencies User can press the “Call 911” to quickly access 911
Can call essential national hotlines
College students can call campus police for unwanted or reportable events in the campus area or other safety-related offices in a specific university
May call emergency numbers that are available in the application database, such as:
Campus police
Sexual assault services based on choice of a university in the settings page

22. Designating Helpers Can choose contacts stored as helpers
User-trusted contacts who are sure to come and rescue unconditionally without hesitation or being judgmental
Helpers are either active or inactive based on the user’s current status

23. Call Me
User is in a situation where she needs to stop an unwanted or unconsented activity in a non-noticeable way
An incoming call to her phone can give her a chance to disrupt the activity and let her helpers know of any potential threat to her
By pressing the “Call Me” button, a prepared message will be drafted to be sent to the active helpers.

24. Notifying Helpers
When a user needs to let her helpers know about her location, she can use function “Need Help Here”.
A prepared message, which contains the location coordinates of the user and current street address, will be drafted to be sent to the active helpers.
When a user needs to consult her helpers, a prepared message will be drafted to be sent to the helpers

25. Resources 6 HELPP Modules
Provides concise safety instructions for intimate partner violence survivors, including:
protective tips when the user is at/away from home
tips on rights, reporting, legal and law enforcement processes.

26. Quick Safety Messages
1-Tap feature that shows quick safety messages on a message bar at the bottom of the “Action” screen
Educational and informational but short and non-intrusive
Different message (ticker-tape) is displayed each time the user opens the application or goes to the home tab
Option of circling through the messages by tapping on the message bar.

27. III. “Lending Encouragement, Affirming Futures” LEAF

28. Purpose
Created to address the issues that arise from limits in physical, social, community support
Embody the vision for a system that provides support during difficult situations

29. Three Components of LEAF:
Web portal
Social network
Phone app

30. LEAF System Administration
Is an individual responsible for upkeep of the system, including web pages and social network
Have the ability to configure content and allocate resources
Maintenance and troubleshooting
Policy enforcement

31. Accessibility
1) Perceivable
4) Robust
2) Operable
3) Understandable

32. Social Network Limited to professionals and abuse victims
Key distinguishing features = Ability to communicate in a trusted as well as anonymous manner

33. Trusted Anonymous Communication Support
Protecting source privacy
Protecting participant privacy
Protecting recipient privacy
Protecting sender and participant location privacy
User Control
Interaction Functionality
Content Controls
Security