Adapting the ADVANCE group program for digitally-supported delivery to reduce intimate partner violence by men in substance use treatment: a feasibility study

Gail Gilchrist^1* Amy Johnson² Sandi Dheensa³ Juliet Henderson¹ Polly Radcliffe¹ Georges Dwyer¹ Richard Turner¹ Kate Thomson² Cat Papastavrou Brooks³ Beverly Love¹ Zohra Zenasni¹ Cassandra Berbary⁴ Ben Carter¹ Steve Parrott⁵ Jinshuo Li⁵ Caroline Easton⁴ Ciara Bergman⁶ Gene Feder³ Elizabeth Gilchrist²

• ¹King's College London, United Kingdom
• ²University of Edinburgh, United Kingdom
• ³University of Bristol, United Kingdom
• ⁴Rochester Institute of Technology (RIT), United States
• ⁵University of York, United Kingdom
• ⁶Other, United Kingdom

Introduction Covid-19 restrictions created barriers to ‘business as usual’ in healthcare but also opened the door to innovation driven by necessity. This manuscript 1) describes how ADVANCE, an in-person group perpetrator program to reduce intimate partner violence (IPV) against female (ex)partners by men in substance use treatment, was adapted for digitally-supported delivery (ADVANCE-D), and 2) explores the feasibility and acceptability of delivering ADVANCE-D to men receiving substance use treatment. Methods Firstly, the person-based approach and mHealth development framework were used to iteratively adapt ADVANCE for digitally-supported delivery including conceptualization, formative research and pre-testing. Then, a non-randomized feasibility study was conducted to assess male participants’s eligibility, recruitment and attendance rates and uptake of support offered to their (ex)partners. Exploratory analyses on reductions in IPV perpetration (assessed using the Abusive Behavior Inventory; ABI) and victimization (using the revised ABI; ABI-R) at the end of the program were performed. Longitudinal qualitative interviews with participants, their (ex)partners and staff provided an understanding of the program’s implementation, acceptability and outcomes. Results The adapted ADVANCE-D Program includes one goal-setting session, seven online groups, 12 self-directed website sessions and 12 coaching calls. ADVANCE-D includes enhanced risk management and support for (ex)partners. Forty-five participants who had perpetrated IPV in the past 12 months were recruited. Forty of whom were offered ADVANCE-D, attending 11.4 (SD 9.1) sessions on average. Twenty-one (ex)partners were recruited, 13 of whom accepted specialist support. Reductions in some IPV perpetration and victimization outcome measures were reported by the 25 participants and 11 (ex)partners interviewed pre and post-program, respectively. Twenty-two participants, 11 (ex)partners, 12 facilitators and 7 integrated support service workers were interviewed at least once about their experiences of participation. Overall, the program content was well-received. Some participants and facilitators believed digital sessions offered increased accessibility. Conclusions The digitally-supported delivery of ADVANCE-D was feasible and acceptable. Remote delivery has applicability post-pandemic, providing greater flexibility and access. Given the small sample size and study design, we do not know if reductions in IPV were due to ADVANCE-D, time, participant factors, or chance. More research is needed before conclusions can be made about the efficacy of ADVANCE-D.