Communications and Technology for Violence Prevention Workshop Summary (2012) / Chapter Skim
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6 Foundations of mPreventViolence: Integrating Violence Prevention and Information and Communications Technologies
6 Foundations of mPreventViolence: Integrating Violence Prevention and Information and Communications Technologies
Pages 43-86
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From page 43... ...
This paper also addresses current obstacles and needs in violence prevention, and potential avenues for the inclusion of ICT. In the third paper, Jody Ranck explores the current state of ICT and how ICT might meet the needs of public health and violence prevention now and in the future.
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From page 44... ...
Countless violent acts happen out of public view in offices, homes, or even public institutions. Violence can be prevented, and this assertion has been proven true within the field of public health.
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From page 45... ...
Distinctions are emerging between "old" and "new" forms of media and technology -- that is, between the use of television, radio, and other forms of traditional media that have been employed for decades and newer forms of media, including social media and the mobile phone. Particularly in the case of the developing world, the adoption of the mobile phone has created a new avenue for combating longstanding problems.
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From page 46... ...
One of the most popular types of programs using mobile phones is based on short message service (SMS) messaging, better known as text messages.
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From page 47... ...
This category includes sexual violence, intimate partner violence, elder abuse, youth violence, and child abuse. Sexual violence Sexual violence is defined as "any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, or acts to traffic, or otherwise directed, against a person's sexuality using coercion" (WHO, 2002)
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From page 48... ...
. Often it is an intimate partner that commits sexual violence, making sexual violence dovetail closely with intimate partner violence.
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From page 49... ...
Parents receive real-time communication that mimics the abusive and controlling behaviors teens might face in their relationships.2 This program illuminates the negative role technology can play. On the other hand, texting can be a cheap and effective way to prevent intimate partner violence, as demonstrated by a case in Ohio in which a texting service allowed victims to report incidents silently via a simple SMS message and to make contact with a crisis intervention worker or the police without making an actual phone call.
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From page 50... ...
In the developing world, however, mobile phones can play a unique role in garnering this type of support. In Senegal, the organizations Tostan and UNICEF launched the Jokko Initiative.
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Furthermore, with the ability to train remotely, technology can be used to keep those in the health care industry abreast of the proper diagnosis of elder abuse and what to do about it. The role of social media should also be mentioned.
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From page 52... ...
The National Dating Abuse Helpline recently made its services available via text message by providing teens who text "loveis" to 77054 with help from trained peer advocates.4 In another effort to reach out to teens, particularly in cases of intimate partner violence or dating violence, Futures Without Violence developed the online campaign That's Not Cool. The campaign encourages teenagers to decide for themselves what is okay and what is not okay in their relationships through the use of videos, interactive games, and an online forum for teens to share their stories and receive advice.
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From page 53... ...
. The mobile phone can act as a reporting tool for cases of child abuse.
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The traditional hotlines available to children, such as the National Child Abuse Hotline that is run via Childhelp, offer another approach to assistance and prevention. Childhelp also has information on its website to help children determine if they are being abused and what actions to take.6 Also, because health professionals play a key role in identifying any signs of child abuse in their patients, incorporating such identification as part of their training -- or including information and prompts in the tools they use, such as checklists or reminders -- could help prevent additional cases of abuse.
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From page 55... ...
using the Internet and 19 million teens sharing their lives through text messages, this is definitely a cause for concern. As much as mobile phones, chat rooms, and other forms of communication can help teens work through their issues, they can also push teens in the opposite direction.
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From page 56... ...
EpiSurveyor allows anyone to create an account, design forms, and download the forms to a mobile phone in order to collect data for free. Commcare is free and open-source software that provides community healthcare workers with aid in case management through their mobile phones.
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From page 57... ...
A final issue related to sharing data across silos is the problem of privacy and security. Concern about the ability of users to retain anonymity, especially given the nature of collective violence or intimate partner violence, is understandable, and such concerns should remain at the forefront of any project implementation.
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From page 58... ...
Multiple programs now use e-cards and online petitions or request advocates to share program information with their social networks. Text campaigns have 6-2 Figure become particularly popular over R02165 the past few years, allowing individuals to donate to certain causes via their mobile phones.
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ICTs can be pivotal in addressing these issues, as with the use of mFinance to address poverty or with community health workers using computers or mobile phones to help expand access to health care and education.
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In some very important ways, however, it remains "stuck," facing a number of serious obstacles, some that are generic for global health and others that are unique to the field of violence prevention. This paper sets the stage by describing some of these advances and then presenting the obstacles in order to explore whether ICT -- including the new social media -- can inspire ways to surmount these obstacles.
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. The agencies have also helped to identify specific categories of violence: child maltreatment, intimate partner violence, youth violence, collective violence, sexual violence, elder abuse,
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Risk Factors Define the Problem Delivery Discovery FIGURE 6-3 CDC Public Health Model.
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A cycle of violence can begin, for example, with child neglect at birth, leading to hypervigilant children who are less likely to be calmed and more likely to participate in youth violence, and then intimate partner violence, elder abuse, and suicide when they get older. We have a much better understanding of how to implement violence prevention programs and interventions.
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From page 64... ...
But if we let this guide our efforts, then we fail to account for the costs to the people who suffer in the developing world from interpersonal and self-directed violence because this is not seen as contagious and importable into our own countries. Using "I and It" surveillance will mislead our efforts in formulating policy and setting our priorities if we fail to see that interpersonal violence is intimately connected to group violence and in the end it will pose a threat to our own security.
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From page 65... ...
Additionally, there is a particular risk that faces all of us: becoming disconnected while believing that we are becoming more connected. There is a risk that increased reliance on indirect communication methods such as cell phones and e-mail may diminish direct personal communications and thereby make it more likely that violence will be employed against someone whose face and persona are not known.
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From page 66... ...
An executive from AT&T predicted that the global market for cell phones would peak at approximately 100,000. But by the end of 2011, according to the International Telecommunications Union, almost 6 billion people had access to mobile phones (ITU, 2011)
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Global health experts can no longer afford to view social media as trivial playthings of adolescents. These are major platforms with which to engage the public and to innovate in areas such as civic engagement, public policy, and technology development, and they are transforming the way we think about education, technology development, the media, politics, social movements, and science.
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From page 68... ...
. In January 2008 one of the most powerful examples of the use of social media and mobile devices and of the new forms of cooperation that they entail occurred.
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From page 69... ...
An example of such work that has taken place in developing countries is the group of Trinidadian and Brazilian students who developed a micro-tasking tool for performing medical diagnostics of digitized X-rays on mobile phones that users would scan for eye conditions; this was the winner of InfoDev's microwork challenge, "m2work" (InfoDev, 2012)
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. Beyond mobile devices, the broader social media system is increasingly playing a public health role in the areas of epidemiology, participatory planning, and biosurveillance.
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. Gamification A final area where social media and ICTs can play a role in the future of global health is gaming.
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. The public health community has begun to leverage these mobile devices in order to perform real-time assessments and to intervene at the times when these interventions would be most useful (e.g., in the context of the behavior)
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. Given the reliance on RCTs as the accepted standard for biomedical and behavioral evidence, mHealth interventions, including violence prevention programs delivered via mobile devices, need to be subjected to this same standard if they are to be accepted as a valid and effective method.
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From page 74... ...
For many mobile health applications, the hypothesis should not be that the mobile intervention will produce better outcomes than its low-tech equivalent, but rather that it will produce comparable outcomes at a lower cost. As a result, a cost-per-unit change is often a better indicator of mHealth intervention outcomes.
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Mobile technologies can be used to recruit participants rapidly and to conduct the trial remotely. In one of the first uses of mobile phones for smoking cessation, Rodgers et al.
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, a number of research methodologies are available to evaluate efficacy prior to any full-scale RCT. These preliminary evaluations are particularly important for newly developed mHealth interventions in order to insure that the interventions have been optimized before subjecting them to an RCT.
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Mobile health interventions, however, are uniquely suited to generate the frequent longitudinal assessments needed to conduct these various N-of-1 designs. For example, an mHealth intervention is likely to have some specified baseline period (e.g., 7 days)
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From page 78... ...
This stable baseline can come from routinely collected public health data, but it can also be generated via the mHealth intervention itself by incorporating a baseline assessment prior to intervention initiation. Once the baseline is established, the intervention can be implemented with continued assessment to determine if the intervention is associated with a significant change in the outcome variable.
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. Given that an for community, hospital, or school-based interventions, the interrupted time series design provides a quasi-experimental alternative that requires only one (or slightly more than one)
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. editable vectors To see how the stepped-wedge design might be applied to mobile ap plications to prevent violence, consider a mobile intervention developed to reduce youth violence in schools.
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. The frequent longitudinal assessments often integrated into mHealth interventions can be leveraged to perform automated evaluations of the intervention while it is being disseminated and implemented using these designs.
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Although RCTs are the standard by which most of these interventions are judged, numerous other research designs can be used throughout the development and dissemination of mHealth interventions. REFERENCES Barry, A
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From page 83... ...
2011. Social media join toolkit for hunters of disease.
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2010. Unmasking child abuse with mobile phones.
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2007. Human trafficking hotline: Mobile phones in the fight against slavery.
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2011. Mobilizing communities and building capacity for youth violence prevention: The National Academic Centers of Excellence for Youth Violence Prevention.
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