Computerized Service Tool to Address IPV Among Drug- and Criminal Justice-Involved Women: Results from the Wings Randomized Controlled Trial

Purpose:  Research suggests that drug-involved women in the criminal justice system experience disproportionately high rates of intimate partner violence (IPV), which increases their risk of recidivism and a wide range of physical and mental health consequences. This NIDA-funded randomized controlled trial aims to test the feasibility, acceptability, and effectiveness of a one-hour self-paced computerized service session that includes a psycho-educational component on IPV, IPV screening tool using CTS2, safety planning, social support enhancement, goal setting and referral service to address IPV (Computerized WINGS), compared to the same intervention content delivered in non-computerized format by study staff (Traditional WINGS) among drug-involved women on probation or under community supervision. The primary outcomes are identification of different types of IPV and improving linkage to IPV-related services.

Methods:  We screened 427 women from probation and community court sites in NYC of whom 191 met eligibility criteria and enrolled in the study. Participants completed a computer assisted survey interview at baseline and were randomized to receive either a one-hour session of Computerized WINGS (N=94) or Traditional WINGS) (N=97). Both conditions were delivered at criminal justice sites.  171 participants (89.5%) completed the 3-month post-intervention assessment. We used generalized estimating equations models (GEE) to estimate the relative effects of Computerized versus Traditional WINGS on linkage to IPV services at the 3-month follow-up.

Results:  The majority of participants were African American (N=128, 67%) or Latina (N=57, 29.8%). Both Computerized and Traditional WINGS conditions identified identical high rates of experiencing physical and/or sexual IPV in the past year (47% for both conditions) after completing the IPV psycho-educational component. These past year prevalence rates were significantly higher than the rates reported at baseline for both conditions using the same CTS2 measures. Participants in both conditions who reported IPV were more likely to report accessing IPV-related services at 3-months. At baseline, 32.6% of Traditional WINGS participants reported receiving IPV-related services in the prior 3 months, compared to 47% at the 3-month follow up. Similarly, the rates of using IPV services for Computerized WINGS participants increased from 33.3% at baseline to 48.8% at the 3-month follow-up.  The majority of Computerized WINGS participants (88.0%) and Traditional WINGS participants (83%,) reported they were very satisfied with the WINGS session. There were no significant differences found in rates of identifying IPV or linkage to IPV services between study conditions.

Implications:  Both Computerized and Traditional versions of WINGS were equally effective at identifying high rates of physical and sexual IPV and linking women experiencing IPV to IPV-related services. The high participation, retention and client satisfaction rates and absence of reported adverse events suggest the feasibility and acceptability of WINGS for both conditions. Because of fear of disclosing IPV, the lack of privacy and overburdened staff in court or probation settings, Computerized WINGS may have significant advantages over Traditional WINGS. Moreover, the potential cost savings of the self-paced Computerized WINGS suggest the greater feasibility of scaling this service tool up in criminal justice settings to address the high rates of IPV among drug-involved women.