title: Use of online safety decision aid by abused women: effect on decisional conflict in a randomized controlled trial.
abstract: BACKGROUND
  An Internet safety decision aid was developed to help abused women understand their risk for repeat and near-lethal intimate partner violence, clarify priorities related to safety, and develop an action plan customized to these priorities.
  
  
  OBJECTIVE
  To test the effectiveness of a safety decision aid compared with usual safety planning (control) delivered through a secure website, using a multistate RCT design. The paper evaluates the effectiveness of the safety decision aid in reducing decisional conflict after a single use by abused women.
  
  
  METHODS
  RCT referred to as Internet Resource for Intervention and Safety (IRIS).
  
  
  METHODS
  Abused women who spoke English (n=708) were enrolled in a four-state RCT.
  
  
  METHODS
  The intervention was an interactive safety decision aid with personalized safety plan; the control condition was usual safety planning resources. Both were delivered to participants through the secure study website.
  
  
  METHODS
  This paper compares women's decisional conflict about safety: total decisional conflict and the four subscales of this measure (feeling: uninformed, uncertain, unsupported, and unclear about safety priorities) between intervention/control conditions. Data were collected from March 2011 to May 2013 and analyzed from January to March 2014.
  
  
  RESULTS
  Immediately following the first use of the interactive safety decision aid, intervention women had significantly lower total decisional conflict than control women, controlling for baseline value of decisional conflict (p=0.002, effect size=0.12). After controlling for baseline values, the safety decision aid group had significantly greater reduction in feeling uncertain (p=0.006, effect size=0.07) and in feeling unsupported (p=0.008, effect size=0.07) about safety than the usual safety planning group.
  
  
  CONCLUSIONS
  Abused women randomized to the safety decision aid reported less decisional conflict about their safety in the abusive intimate relationship after one use compared to women randomized to the usual safety planning condition.
authors.affiliation: Pacific Northwest Evidence-Based Practice Center, Oregon Health & Science University, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University. Electronic address: edenk@ohsu.edu.
authors.forename: Karen B
authors.initials: KB
authors.lastname: Eden
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Perrin
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.
authors.forename: Ginger C
authors.initials: GC
authors.lastname: Hanson
authors.affiliation: School of Social Work, Arizona State University, Phoenix, Arizona.
authors.forename: Jill T
authors.initials: JT
authors.lastname: Messing
authors.affiliation: Sinclair School of Nursing, University of Missouri-Columbia, Columbia, Missouri.
authors.forename: Tina L
authors.initials: TL
authors.lastname: Bloom
authors.affiliation: School of Nursing, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Jacquelyn C
authors.initials: JC
authors.lastname: Campbell
authors.affiliation: Johns Hopkins Center for Injury Research and Policy, and Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Andrea C
authors.initials: AC
authors.lastname: Gielen
authors.affiliation: School of Nursing, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Amber S
authors.initials: AS
authors.lastname: Clough
authors.affiliation: School of Nursing, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Jamie S
authors.initials: JS
authors.lastname: Barnes-Hoyt
authors.affiliation: School of Nursing, Johns Hopkins University, Baltimore, Maryland; Johns Hopkins Center for Global Health, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Glass
mesh_terms: D000328:Adult; D018585:Battered Women / Q000523:psychology*; D003220:Conflict, Psychological; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D020407:Internet; D018570:Risk Assessment; D012449:Safety; D014481:United States