BSAFER: A Web-based intervention for drug use and intimate partner violence demonstrates feasibility and acceptability among women in the emergency department

ABSTRACT

Background: Addressing violence along with drug use change goals is critical for women with coexisting intimate partner violence (IPV) and substance use disorders (SUDs). Methods: This was an acceptability and feasibility study of BSAFER, a brief Web-based program and booster phone call addressing violence and drug use. A screening survey identified women with recent drug use and IPV in the emergency department (ED). Participants were randomized to BSAFER or a Web-based control program and booster call providing education about home fire safety. Program completion, usability, satisfaction, and motivational interviewing (MI) adherence were primary outcomes. Drug use and IPV outcomes were measured at baseline, 1 month, and 3 months. Results: Forty women were enrolled (21 BSAFER, 19 control); 50% were nonwhite and mean age was 30 years. The most commonly used drugs were marijuana (88%) and cocaine (30%); 45% reported physical abuse, and 33% reported severe combined physical and sexual abuse. Thirty-nine (98%) completed the Web program, 30 (75%) completed the booster, and 29 (73%) completed the 3-month follow-up. Mean System Usability Scale (SUS) for the BSAFER Web program was 84 (95% confidence interval [CI]: 78–89) of 100; mean Client Satisfaction Questionnaire (CSQ-8) was 28 (95% CI: 26–29) of 32. MI adherence scores were high and similar for both the Web program and the booster. Both intervention and control groups had small mean decreases in weekly drug use days (0.7 vs. 1.5 days); participants using drugs other than marijuana demonstrated greater average reductions in drug use than those using marijuana only. Conclusions: An ED Web-based intervention for SUDs and IPV in women demonstrated feasibility and acceptability. Future studies will examine efficacy of the BSAFER program and investigate whether specific subgroups of drug using women may be most responsive to ED-based Web interventions.

KEYWORDS:

• Computers
• domestic violence
• drug use disorders
• emergency medicine
• intervention studies
• women's health

Acknowledgments

The authors wish to acknowledge the contributions of Susie Ahn, Madeline Benz, Emily Chang, Lauren Colwell, Marie DeLuca, Jessica Faraj, Kimberly Glerum, Emily Gudbranson, Andrea Haynes, Alexander Krotow, Sumitha Raman, Hyun Ju Ryoo, and Sarah Stern.

Author contributions

Esther K. Choo, MD, MPH, was responsible for research conception and design, collection of data, data analysis, interpretation of the results, and drafting and finalizing the manuscript. Caron Zlotnick, PhD, participated in conceiving and designing the research study, planning the data analysis, interpreting the results, and editing the manuscript. David R. Strong, PhD, participated in designing the research study, planning the data analysis, interpreting the results, and editing the manuscript. Daniel D. Squires, PhD, MPH, participated in designing the research study, planning the data analysis, interpreting the results of the data analysis, and editing the manuscript. Chantal Tapé participated in study planning, data collection, and editing the manuscript. Michael J. Mello, MD, MPH, participated in conceiving and designing the research study, planning the data analysis, interpreting the results, and editing the manuscript.

Funding

This work was supported by NIH/NIDA grant K23DA031881. NIDA provided support for conducting the study but did not play any role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.