The Impact of Digital Hotline on Health and Safety of Intimate Partner and Sexual Violence Survivors

Background: Intimate partner violence, sexual assault, and trafficking are associated with severe physical, mental, economic, and health consequences, yet many survivors face challenges accessing support to help mitigate impacts. Hotline is the first, and often only, service used by violence survivors seeking help. Digital hotlines (e.g. chat and text) are growing in use at community-based organizations focused on violence survivors, however little research has been done to assess its effectiveness. This study addresses this gap by analyzing changes in health and violence revictimization following first-time digital hotline use.

Methods: A sequential mixed methods longitudinal study was conducted with 307 first-time digital hotline users recruited from two violence prevention agencies in the U.S. South. Participants completed surveys immediately after engaging in digital hotline and were followed at three time points over six months. Validated measures assessed mental health symptoms (PTSD and depression), violence victimization (IPV, sexual assault, and sex and labor trafficking), and economic variables such as income and housing stability. A subsample (n=25) participated in qualitative interviews. Staff interviews and programmatic data were analyzed additional understanding of the practice model. Bivariate and multivariate statistical approaches were used, and thematic analysis was applied for qualitative data.

Results: Over the two-year study period, 10.83% of hotline interactions were digital (chat or text). Longitudinal study participants were predominantly female (91%), racially and ethnically diverse, low-income, and housing insecure. At baseline, 40.5% had experienced sexual assault in the past 6 months, 76% had experienced IPV in the past six months, and15.3% had experienced trafficking in the past six months. Nearly 75% met criteria for probable PTSD, while 47% had probable depression. Most commonly, participants contacted digital hotline for help with shelter, counseling, and safety planning. Qualitative interviews indicate that digital hotline advocates helped survivors with emotional support, psychoeducation, and address health and safety needs. Six months post-hotline use, significant declines were observed in PTSD (p=0.001) and depression symptoms (p=0.001). Physical (p=0.001) and psychological violence (p=0.001) also decreased significantly, though no significant changes were observed in sexual violence or stalking. Surprisingly, trafficking significantly increased at six months baseline. No significant changes were found in physical health or hazardous drinking. Participants indicate that digital hotlines are accessible, focused on individual goals, and survivor-centered.

Conclusions: Findings suggest that digital hotlines may serve as an effective intervention for survivors of violence, particularly in reducing mental health symptoms and facilitating resource connection. These results highlight the importance of integrating digital hotlines approaches into sexual violence prevention services to improve health and safety outcomes.