Adolescent Perceptions of an Interactive Mobile Application to Respond to Teen Dating Violence

Abstract

Although research and intervention efforts in the United States have aimed to reduce teen dating violence (TDV), 10-year prevalence estimates suggest that TDV persists. Safety planning is an advocated intervention to reduce intimate partner abuse; yet, safety planning services for adolescents have not been systematically developed or tested. Personalized safety planning interventions that reflect teens’ immediate risk, priorities, and resources may be a key prevention and empowerment tool. Thus, the current study examined adolescent perceptions of an existing safety planning app, myPlan. A small convenience sample of adolescents participated in focus groups. Focus groups investigated the feasibility of an app for TDV intervention and elicited feedback on how apps can better assist adolescents experiencing dating violence. Qualitative content analysis was used to identify themes and patterns in the data. The following themes emerged: (a) careful and thoughtful inclusion of diverse adolescents, (b) capturing unique safety dilemmas encountered by adolescents, (c) clarifying the signs of an unhealthy and abusive relationship, and (d) resources for immediate help. Adolescents were thoughtful in their consideration of the myPlan app and articulated specific ways in which future applications could be more responsive to their lived experiences and challenges. Mobile app or electronic interventions that are developed with an eye toward empowering adolescents to understand how abusive behaviors may manifest in their relationships, weigh the risk and benefits of intervening, and are informed about local resources available to them for help may be most successful in reducing TDV.

Keywords

teen dating violence mobile applications adolescent empowerment prevention

Teen dating violence (TDV) is a public health concern with both immediate and long-term health implications for the involved adolescents. Approximately 20% of adolescents either perpetrate or are victims of physical violence, whereas 10% to 20% perpetrate or are victims of sexual TDV (Shorey et al., 2017). When psychological (inclusive of verbal and emotional) violence is included, up to 35% of adolescents report TDV victimization and 31% report TDV perpetration (Haynie et al., 2013). Female adolescents have higher rates of psychological and physical TDV perpetration (Cutter-Wilson & Richmond, 2011; W. L. Johnson, Giordano, Manning, & Longmore, 2015; Shorey et al., 2017; Wincentak, Connolly, & Card, 2017). However, male adolescents commit more severe acts of physical and sexual violence (Debnam, Howard, Garza, & Green, 2014; Haynie et al., 2013; Wincentak et al., 2017). Lesbian, gay, bisexual, and “unsure” adolescents had the highest rates of all TDV types when compared with their heterosexual counterparts (Cutter-Wilson & Richmond, 2011; Dank, Lachman, Zweig, & Yahner, 2014; Olsen, Vivolo-Kantor, & Kann, 2020).

Interventions such as Safe Dates, Green Dot, Coaching Boys Into Men, and the Fourth R have been successful in reducing TDV by lowering the incidences of one or more components (i.e., harassment, stalking, and physical and sexual violence perpetration and/or victimization; Coker et al., 2015; Crooks et al., 2015; Foshee et al., 2005; S. Miller et al., 2015). These programs constitute primary prevention efforts to thwart TDV from ever occurring (Lundgren & Amin, 2015; Wincentak et al., 2017). Primary prevention TDV programs focus on creating positive social norms and strong conflict-management skills, whereas secondary prevention programs focus on developing skills to recognize early signs of TDV for both victims and perpetrators (Foshee et al., 2005). In addition, bystander focused programs (e.g., Bringing in the Bystander, Coaching Boys Into Men, and Green Dot; Banyard, Moynihan, & Plante, 2007; Coker et al., 2016; Coker et al., 2015; E. Miller et al., 2013) generally focus on equipping adolescents with the necessary skills and self-efficacy to safely intervene when they witness dating violence and sexual violence. Although such programs are important to primary and secondary prevention of TDV, several studies show that curriculum-based programs often do not account for variations in gender, dating history, experiences with TDV, and readiness to use skills to remain violence free or extricate themselves from present violent relationships (Fellmeth, Heffernan, Nurse, Habibula, & Sethi, 2013; Levesque, Johnson, & Prochaska, 2017). Ultimately, TDV interventions are most effective when adolescents find the interventions relevant and their implementation is sustainable (Alvarez, Debnam, Clough, Alexander, & Glass, 2018; Levesque et al., 2017).

Another method of preventing partner violence can be found in mobile applications (apps). There are currently apps available addressing adult intimate partner violence (Alvarez et al., 2018; Glass et al., 2015; Google Play, 2018). Although numerous apps target women or health care providers seeking resources for their clients, it is not clear that the apps target teens or the unique issues this population experiences in TDV. Many intimate partner violence–related mobile applications center on safety planning, a pivotal issue when children are involved or when partners cohabitate (Bermea, Khaw, Hardesty, Rosenbloom, & Salerno, 2020; Koziol-McLain et al., 2018; Lacey, Saunders, & Zhang, 2011). Safety planning is more aligned with tertiary violence prevention, which focuses on long-term responses that address the consequences of violence after it has occurred to reduce the chances it will reoccur (Harvey, Garcia-Moreno, & Butchart, 2007; Prothrow-Stith & Davis, 2010). Although safety planning for physical safety may be of utmost importance in adult relationships, adolescents may have different needs and priorities in safely leaving a harmful relationship. For example, adolescent safety planning will likely not require extrication from mutually inhabited living spaces or consideration of shared finances. Consequently, teens may opt out of using an adult-focused app when they need information and support (Bundock, Chan, & Hewitt, 2020).

Moreover, the help-seeking behaviors of adolescents may increase the likelihood of them using a mobile app. Research suggests that the majority of adolescents do not seek help when experiencing dating violence (Ashley & Foshee, 2005). However, when they do seek help, it is typically from peers (Ashley & Foshee, 2005; Banyard, Moynihan, Walsh, Cohn, & Ward, 2010; Martin, Houston, Mmari, & Decker, 2012). In addition, Van Camp, Hébert, Guidi, Lavoie, and Blais (2014) found that many adolescents already feel confident in their ability to help someone else deal with dating violence. Thus, adolescent peers are uniquely poised to benefit from the availability of a safety planning app for use to help their friends.

A tertiary prevention app that addresses TDV and the challenges unique to adolescent relationships may also be viewed as an empowerment tool as the adolescents make difficult decisions that affect their safety. The strengths-based theoretical framework of empowerment developed by Worrell and Remer (2003) supports the need for a safety planning app for adolescents. For example, two of the instruments (i.e., Women’s Experience With Battering Scale and the Modified Post-Traumatic Stress Disorder Symptom Scale) used to measure empowerment in the Worrell and Remer study quantify violence-related issues and outcomes (Johnson, Worrell, & Chandler, 2005). This model has also been effective in designing interventions for partner violence–related posttraumatic stress disorder symptoms and adverse psychological outcomes from sexual trauma (Perez, Johnson, & Wright, 2012; Salina, Ram, & Jason, 2016). The empowerment model has 10 outcomes for its interventions, with four specifically applicable to adolescent safety planning apps: (a) a sense of personal control/self-efficacy, (b) self-nurturance and self-care, (c) effective problem-solving skills, and (d) effective access to multiple economic, social, and community resources (Johnson et al., 2005). Personalized safety planning interventions that reflect an individual’s immediate risk, priorities, and resources align with these four specific outcomes (Glass et al., 2017). For example, an app would be ideal for adolescents to affirm that their experiences in their relationship are violent, that they are capable of stopping the violence with a plan suited to their situation, and that there are resources available online and within their community to support their priorities.

Current Study

Within this context, the current study examined adolescent perceptions of an existing safety planning app, myPlan. The myPlan app (www.myplanapp.org) was developed to provide easy access to safety planning services for college-aged women. The app allows the user to enter information on (a) relationship health, (b) safety priorities, and (c) severity of violence/danger in relationship. The app then provides a personalized safety plan with links to U.S.-based resources. The app has shown some effectiveness in increasing safety behaviors and decreasing decisional conflict among college students after 12 months (Glass et al., 2017). Women in the study who used the app were also more likely to leave their abuser (Glass et al., 2017). To the authors’ knowledge, no other evidence-based app exists that directly addresses safety planning for partner violence. Although several applications can be found on digital distribution services (i.e., Google play, iTunes), currently myPlan is the only one being empirically evaluated. As a result, the myPlan app was used for the current study to guide feedback on an app designed to combat partner violence. The study’s aims were to (a) investigate adolescents’ views on feasibility of an app for TDV intervention and (b) elicit their opinions about how apps, in general, can better assist adolescents experiencing dating violence.

Method

Participants and Eligibility

A qualitative descriptive research design was chosen as it is well suited to describing the experiences and perspectives of participants. In qualitative descriptive research, the investigator remains close to the data and the surface of words and events, seeking an accurate portrayal of the participants’ experiences and their perceptions of the phenomenon under investigation.

Participants constituted a convenience sample recruited through local community-serving agencies in a small mid-Atlantic city. Sampling, recruitment, and focus group protocols received approval from the authors’ institutional review board (IRB). Eligibility criteria included students between the ages of 14 and 18 years and agreement to have the focus group audio recorded. Participants were asked to complete a short sociodemographic survey immediately before the focus group.

A total of 23 adolescents participated in the study, including 15 females, four males, and four youth identifying as non–gender binary or gender fluid. Youth-reported sexual orientation included 13 heterosexual, three gay or lesbian, five bisexual, and two other (e.g., pansexual). The age range of participants was 14 to 18 years with a mean age of 16.43 years (SD = 1.34 years). More than half (61%) of the youth were White, whereas 30% were Black or African American and 9% were of mixed race. In addition, the majority (i.e., 83%) of youth reported that they were not currently in a romantic or dating relationship. Six focus groups were held; there was a mean of 3.96 participants per group with a range of two to eight adolescents across groups. One individual interview was held as a result of low attendance to the scheduled focus group. The adolescents in each group were somewhat acquainted with one another through enrollment at some of the same local public schools, but were not necessarily friends with each other.

Study Procedures

A member of the research team and members of local community agencies described the project to adolescents visiting the agencies using IRB-approved recruitment materials to gauge interest. If the adolescent expressed interest, he or she was asked to provide his or her phone number and email address to the research team member. He or she was also provided a consent form for a parent/legal guardian to review and sign. A member of the research team followed up with the adolescent via phone and email to schedule the focus group. Parents/legal guardians were given the option to mail the signed consent form to the study’s principal investigator’s (PI) office, to fax it directly to the PI, or give it to their child to bring to the focus group. In addition, the study team was granted permission to post recruitment flyers in a local teen health clinic, allowing potential participants to self-identify and contact the study team directly to determine eligibility and obtain consent forms. When youth arrived for the scheduled focus group, the youth’s informed consent materials were reviewed for the required signatures.

Prior to beginning each focus group, consent forms were again reviewed with participants. All participants were also given a resource listing of local and national hotlines and websites specifically geared toward adolescent relationship abuse along with a US$20 gift card. The groups were scheduled at a designated time, taking into consideration convenience for participants (e.g., afterschool or weekend), and held at a centrally located community location that had a private space available for use (e.g., library, community center). All focus groups lasted approximately 60 to 75 min.

Participants were asked to complete a one-time electronic application session on their phone or tablet during the focus group. As a group, the participants and the facilitator read through and filled out all questions in the app, pausing after each section to discuss its content and structure. The focus group guide included detailed questions about (a) developmentally appropriate language, format, and platform; (b) warning signs and red flags of dating abuse; and (c) risks and benefits to using an application on behalf of a friend. Participants were not asked about their personal experiences with intimate partner/dating violence but rather to review the content of the popular app and provide their feedback and suggestions for revisions appropriate to the experience of adolescents and their friends. For example, participants were asked “How do you think an app could benefit the friend of a girl in an abusive relationship,” “What do you feel is missed,” and “Was there any content that you didn’t think was appropriate for friends your age?” Follow-up probing questions were used to elicit a full and detailed description of their impressions of the app and its usability among adolescents.

Reflexivity

The first author and PI (K.D.; female, African American) facilitated all focus groups, while a graduate research assistant (female, Caucasian) took notes. The focus group facilitator has more than 10 years of experience conducting interviews and focus groups with diverse populations. Coding of the transcripts was conducted by the second author (T.K.; female, African American). Data analysis was conducted by both authors separately and then discussed jointly.

Data Analysis

Qualitative content analysis was used to identify themes and patterns in the data. Focus group transcripts were first read to get a sense of the whole, and then coded line-by-line, using a list of codes inductively and deductively developed from the focus group protocol and the data. One member of the research team conducted the coding of all transcripts in the Dedoose software. To strengthen reliability and consistency of coding across all transcripts, a second member of the research team extracted a random sample of data from Dedoose to evaluate the coding at regular intervals during the coding process. Related codes were grouped together into categories. As the analysis proceeded, patterns and relationships, both within and across codes, were sought. Themes, or expressions describing some aspect of the participants’ experience, were derived for this analysis.

Criteria to demonstrate validity or trustworthiness, specified by Lincoln and Guba (1985) and Maxwell (2012), were also addressed. The current study made use of convenience sampling to guide data collection and for the careful documentation (i.e., audit trail) of the entire research process, and later invited participants to provide feedback on themes derived from the data (member checking). Three of the original focus group participants reviewed the themes generated from the research team analysis. The participants agreed with the description of the themes provided below. These strategies were used to maximize the trustworthiness of the study findings.

Results

Careful and Thoughtful Inclusion of Diverse Adolescents

Across focus groups, adolescents discussed the need for the app to be inclusive of all adolescents. They were particularly intolerant of gender-conforming language, lack of sexual orientation options, and language that implied females were always victims. The youth noted that they would not “ever use an app that’s only targeted towards one gender” and insensitivity to this “insulted their identity.” In reference to same-sex relationships and sexual orientation, youth were sensitive to questions that assumed a heterosexual relationship; “there’s so many questions that could be asked if you are talking about a same [sex] partner.”

Youth were also thoughtful in their discussion of males as victims and strongly believed that “women can be perpetrators too.” Participants were quick to remind each other of examples of how females could be abusive to their partners. They also noted that they personally “know some males that have been in some domestic violence relationships.” In describing a male friend who had been in an abusive relationship, the participant stated “he don’t talk about it because he doesn’t have anyone to talk about it with.” This quote exemplifies a sentiment across focus groups that adolescents felt more resources and attention was needed for males as victims in abusive relationships.

Capture Safety Dilemmas Encountered by Adolescents

Adolescents expressed some concern that existing programs were not fully capturing the safety dilemmas that they are encountering in their relationships. In moving through the app, they noted the lack of a focus on emotional or psychological abuse. Adolescents believe this type of abuse has a strong presence in their relationships and needs to be more specifically addressed in programming. “ . . . a lot of teens I have encountered are experiencing much more mental and emotional violence than they are any type of physical violence.” Also, labeled “gaslighting” by the participants, they described situations in which the partner would be coerced into thinking or doing things they would have previously objected to or “teaching somebody to close themselves off.” One youth stated that it is “manipulative to where they’ll make you think that you’re not [being abused].” They described gaslighting as an emotionally abusive and manipulative technique where the partner systematically bends the truth little by little to get his or her way in the relationship. Youth expressed concern that this type of coercion often goes unchecked in relationships; “sometimes people don’t realize what is happening actually is this and it is unhealthy.”

Age differences within school-aged students was another safety dilemma that adolescents mentioned as occurring in their relationships that often is not acknowledged in prevention programming. The youth explained that they see many relationships in which the age difference is the cause of a power imbalance in the relationship. One adolescent described it this way: “Especially in school if the kid is a lot older, more popular . . . I think power imbalances happen, if it’s extreme enough I think it’s hard for that relationship to ever be healthy.” The participants discussed how one partner can use his or her older age to influence the other’s behavior. Participants provided an example where the school unknowingly contributed to the unhealthy relationship. “A situation that a friend was in recently where their boyfriend was older. The person was in high school and their boyfriend was older and he would come and take her out of school.” The partner used his age to gain access to the partner during school hours to engage in the relationship.

Clarifying the Signs of an Unhealthy and Abusive Relationship

Although adolescents displayed some knowledge about the signs of an abusive relationship, they also noted that this was information they learned during high school and are still learning more.

When I came into high school I didn’t really know, I wasn’t very educated on healthy relationships, I wouldn’t know if my friend’s partner was constantly saying like, “Oh, you’re so dumb, I’m so smart,” things like that. [I thought] maybe they’ve got a complex.

In contrast, the participant reflected that now she believes this kind of statement is a sign of an unhealthy relationship. During the conversations, adolescents were able to identify some warning signs of an unhealthy relationship to look out for among their friends. These red flags included things such as changes in routines, “missing class,” “not wanting to talk about their relationship among friends,” “missing school,” and being “weirdly distant.”

Despite their identification of red flags, adolescents expressed some distress about characterizing friends’ relationships as abusive. Participants noted unhealthy relationship behaviors in their friend’s relationships, but often were unwilling to call the relationship abusive. One participant described wanting to be able to have an alternative label to abuse. She “liked the idea of having a mid-ground” between unhealthy and abusive. Another participant shared about the cognitive dissonance that could happen when confronted with information (e.g., quiz in app) that characterizes their relationship as abusive, “they thought their relationship was healthy . . . I don’t think that they would understand and that they would probably just feel like, this [the quiz] is wrong.”

In addition, some adolescents wanted to downplay the unhealthy behaviors or even blame their friends for their unhealthy relationship. When describing a conversation she had with her friend, one participant stated, “my first instinct would be like ‘oh you’re being dramatic’ like it’s not actually that bad.” Another participant said, “she must be doing something wrong . . . or not providing what he needs so it was making him mad.” Although other members of the focus groups often interrupted and discouraged this line of conversation, it was notable that some participants were using this type of victim blaming language.

Where Can They Go for Help?

Participants spent extensive time in each focus group in a discussion of who they would go to for help with dating violence. The most important factors for help seeking were trust and confidentiality. They were open to speaking with their peers, “a peer group where it still is like another anonymous type thing” or adults, but were concerned that “you gotta choose one that’s not gonna blow up on you while you’re trying to describe the situation.” Adolescents provided examples of persons in their schools, churches, and community who they trusted and would go to for help. Participants expressed that sometimes it is challenging to find this trusted person to talk to about their relationships, “some people feel like it’s all their fault that this happened to them. You just gotta make that person feel comfortable and just describe to them how it’s not their fault. So it’s kind of hard finding that person” to whom they can confide. Interestingly, in one of the focus groups, adolescents voiced concern about engaging police when they are having problems, “talk to somebody that you trust before you go to the police and talk to them about it.”

In addition, participants desired reporting options for immediate safety and relationship concerns. They did not feel like they knew what to do when a friend was in immediate danger, “like it’s an emergency, I need to know what to do right now.” In discussing existing websites or an electronic app for reporting, one youth remarked that “it would also be helpful to have a button that could potentially just click, you know, like ‘I need assistance.’” Another desire was for if “there’s an emergency where you can just click and it will take you to what you need, or like an option to put in your location and it can give you more localized results.”

Finally, adolescents were thoughtful about their own role in helping friends out of an abusive relationship. They described some moral distress over protecting self over their friend’s safety. One youth described it this way

it’s very important to keep yourself safe throughout all of this and making sure that you are in a safe place . . . You’re trying to help your friend but you can’t do that if you’re not in a safe place and if you are putting yourself in danger, that’s not good.

Adolescents were able to reflect on how they would continue to help their friend, but needed to be aware of how this could be affecting their relationship with their friend and their own safety.

Discussion

Using focus groups, this study explored adolescent perceptions of mobile apps’ ability to assist in dating violence safety planning with peers. Adolescents provided a thoughtful critique of the ways in which applications can better meet their needs. Although the current study was originated because of a specific existing safety planning app designed for college-aged populations, study findings have implications for service providers and researchers attempting to develop interventions and digital tools for youth. Adolescents articulately described the virtues and shortcomings of existing programming to provide guidance and support when they suspect a friend is involved in an unhealthy dating relationship.

Youth reflected on the need for early comprehensive education about unhealthy relationships. Youth recommended that early learning about healthy relationships is important, particularly in the face of seeing how age of their partner could result in an unhealthy power dynamic in the relationship. A recent meta-analysis of school-based interventions aimed to prevent or reduce violence in teen dating relationships found 13 out of 23 school-based interventions had positive effects on TDV knowledge and attitudes, but had no significant effect on dating violence behaviors (De La Rue, Polanin, Espelage, & Pigott, 2017). With approximately 11% of teens reporting on the national Youth Risk Behavior Survey that they have been a victim of sexual dating violence in ninth grade, comprehensive interventions that can also affect behaviors related to dating violence is warranted (Kann et al., 2016).

Further evidence of the need for earlier interventions targeting attitudes about dating violence are participant statements suggesting victim blaming. Although the majority of the participants did not openly endorse a victim blaming schema, it is concerning that this belief was not denounced by all. Consistent with recommendations put forth by the Centers for Disease Control and Prevention (Niolon et al., 2017) and recent events such as the MeToo movement (https://metoomvmt.org/), it is important to create a culture in which adolescents feel safe sharing violent experiences with trusted peers and adults. If peers are endorsing a belief that the victim is to blame, adolescents may be less willing to disclose TDV experiences (Davies, Rogers, & Whiteleg, 2009).

The particular app that guided the focus group also catered specifically to cisgender heterosexual relationships. Likely as a result of the diversity of gender and sexual orientation represented in the sample, participants were particularly critical of statements and programming that was not inclusive and sensitive to the ways in which adolescents are engaging in romantic relationships. They indicated a preference for programming that endorsed a pansexual view of romantic relationships in which they are not limited in sexual choice regarding biological sex, gender, or gender identity. This finding may be particularly interesting to researchers and service providers in their development of dating violence programming specifically for non–gender-conforming and lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth. Recent studies suggest elevated rates of TDV in this community as compared with heterosexual youth. Dank and colleagues (2014) found that lesbian, gay, and bisexual youth are at higher risk of all types of dating violence victimization compared with heterosexual youth. In addition, when examining gender identity, transgender and female youth were at highest risk of most types of victimization (Dank et al., 2014). Moreover, for sexual minority youth, adolescence is a time when the development of a positive sexual identity is challenging and can lead to teasing, ostracism, and violence (Gillum & Difulvio, 2012; Morrow, 2004). These studies and others (Freedner, Freed, Yang, & Austin, 2002) emphasize the need for future adaptations to the app and programming that is either inclusive of or specifically targets LGBTQ youth. Indeed, since the conduct of the current study, myPlan has released another version of the app that is inclusive of LGBTQ identifying adults.

Finally, it was somewhat surprising to hear the youth request more “quick access” to help when they believe their friend is in danger. Given the numerous online websites (i.e., https://www.futureswithoutviolence.org/; https://www.breakthecycle.org/), school personnel (e.g., counselors, psychologists), and organizations available in many communities, one could assume that youth would be well equipped with ways to respond after a friend discloses TDV. However, as they noted, finding someone they can trust to confide in may be one of the greatest challenges to seeking help among adolescents. National advocacy groups (e.g., Futures Without Violence, Love Is Respect) are using online anonymous chat groups to encourage disclosure. It is possible that a similar strategy could be successful if used within an app structure. Other studies suggest that brief interventions with adolescents experiencing dating violence using motivational interviewing principles can reduce episodes of violent events by increasing youth’s ability to navigate conflict with their partner (Cunningham et al., 2013; Walton et al., 2010).

As previously mentioned, bystander focused interventions are currently a popular method for aiding in partner violence (Storer, Casey, & Herrenkohl, 2016). Bystander focused programs attempt to overcome challenges in adolescents’ willingness to seek help by training all youth and adults in strategies to intervene during a violent situation (Banyard, Plante, & Moynihan, 2004). Dating violence programming that can build on evidence-based bystander interventions by enlisting the support of trusted persons in youths’ lives will be most successful in intervening in the cycle of violence.

Limitations

There are a few limitations of the current study which should be noted. A small convenience sample of youth volunteered to participate in the focus groups, thus findings cannot be generalized to all adolescents 14-18 in the United States. Though it was a small convenience sample, it is important to note that the youth’s racial/ethnic, gender, and sexual orientation identities were relatively diverse (i.e., 30% Black, 17% non-gender binary or gender fluid, and 43% LGBTQ). We were also not able to collect data about participants’ exposure to TDV or violence in their home or community. It is possible that youth’s perceptions were bias by their own experiences with this issue. Finally, a mobile app that was originally developed for a female traditional college-aged population was used as a reference point for the focus group discussion. Given only four males participated in the current study, we are unable to draw conclusions about how this may have biased their perceptions of the app. In addition, there is no evidence to suggest that safety planning is an effective violence prevention strategy for men. Finally, though none were noted directly during the focus group, there may have been readability or comprehension challenges with the app content.

Conclusions

Though national research and intervention efforts have aimed to reduce TDV, 10-year prevalence estimates suggest that TDV remains a persistent public health problem. Safety planning is the most widely advocated intervention to reduce intimate partner abuse, yet safety planning services specific to adolescents have not been systematically developed or tested. The current study sought to understand adolescents’ perceptions of an existing interactive app currently used by adults to respond to partner violence. The youth were thoughtful in their consideration of the existing app and articulated specific ways in which future applications could be more responsive to their lived experiences and challenges. As described in Worrell and Remer’s (2003) empowerment model, it is important that youth understand how abusive behaviors may manifest in their relationships, can weigh the risk and benefits of intervening, and are informed about resources available to them for help.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author Biographies

Katrina J. Debnam, PhD, MPH, is an assistant professor of Nursing and Education at the University of Virginia. She has expertise in mixed-methods research, including hierarchical linear modeling and the conduct and analysis of data from focus groups and interviews. Her research interests include youth violence prevention, teen dating violence (TDV), and school culture.

Trina Kumodzi, BSN, RN, CCRN, is a PhD student at the University of Virginia School of Nursing. Her clinical expertise is in trauma and critical care. Her research interests include firearm violence, TDV, intimate partner violence, and injury prevention.

References

Alvarez

Debnam

Clough

Alexander

Glass

(2018). Responding to intimate partner violence: Healthcare providers’ current practices and views on integrating a safety decision aid into primary care settings. Research in Nursing & Health, 41, 145-155. doi:10.1002/nur.21853

Ashley

O. S.

Foshee

V. A.

(2005). Adolescent help-seeking for dating violence: Prevalence, sociodemographic correlates, and sources of help. Journal of Adolescent Health, 36, 25-31.

Banyard

V. L.

Moynihan

M. M.

Plante

E. G.

(2007). Sexual violence prevention through bystander education: An experimental evaluation. Journal of Community Psychology, 35, 463-481.

Banyard

V. L.

Moynihan

M. M.

Walsh

W. A.

Cohn

E. S.

Ward

(2010). Friends of survivors: The community impact of unwanted sexual experiences. Journal of Interpersonal Violence, 25, 242-256.

Banyard

V. L.

Plante

E. G.

Moynihan

M. M.

(2004). Bystander education: Bringing a broader community perspective to sexual violence prevention. Journal of Community Psychology, 32, 61-79. doi:10.1002/jcop.10078

Bermea

A. M.

Khaw

Hardesty

J. L.

Rosenbloom

Salerno

(2020). Mental and active preparation: Examining variations in women’s processes of preparing to leave abusive relationships. Journal of Interpersonal Violence, 35(3-4), 988-1011.

Bundock

Chan

Hewitt

(2020). Adolescents’ help-seeking behavior and intentions following adolescent dating violence: A systematic review. Trauma, Violence, & Abuse, 21(2), 350-366.

Coker

A. L.

Bush

H. M.

Fisher

B. S.

Swan

S. C.

Williams

C. M.

Clear

E. R.

DeGue

(2016). Multi-college bystander intervention evaluation for violence prevention. American Journal of Preventive Medicine, 50, 295-302.

Coker

A. L.

Fisher

B. S.

Bush

H. M.

Swan

S. C.

Williams

C. M.

Clear

E. R.

DeGue

(2015). Evaluation of the green dot bystander intervention to reduce interpersonal violence among college students across three campuses. Violence Against Women, 21, 1507-1527. doi:10.1177/1077801214545284

10.

Crooks

C. V.

Scott

K. L.

Broll

Zwarych

Hughes

Wolfe

D. A.

(2015). Does an evidence-based healthy relationships program for 9th graders show similar effects for 7th and 8th graders? Results from 57 schools randomized to intervention. Health Education Research, 30, 513-519. doi:10.1093/her/cyv014

11.

Cunningham

R. M.

Whiteside

L. K.

Chermack

S. T.

Zimmerman

M. A.

Shope

J. T.

Raymond Bingham

. . . Walton

M. A.

(2013). Dating violence: Outcomes following a brief motivational interviewing intervention among at-risk adolescents in an urban emergency department. Academic Emergency Medicine, 20, 562-569. doi:10.1111/acem.12151

12.

Cutter-Wilson

Richmond

(2011). Understanding teen dating violence: Practical screening and intervention strategies for pediatric and adolescent healthcare providers. Current Opinion in Pediatrics, 23, 379-383. doi:10.1097/MOP.0b013e32834875d5

13.

Dank

Lachman

Zweig

J. M.

Yahner

(2014). Dating violence experiences of lesbian, gay, bisexual, and transgender youth. Journal of Youth and Adolescence, 43, 846-857. doi:10.1007/s10964-013-9975-8

14.

Davies

Rogers

Whiteleg

(2009). Effects of victim gender, victim sexual orientation, victim response and respondent gender on judgements of blame in a hypothetical adolescent rape. Legal and Criminological Psychology, 14, 331-338. doi:10.1348/978185408X386030

15.

Debnam

K. J.

Howard

D. E.

Garza

M. A.

Green

K. M.

(2014). African American girls’ ideal dating relationship now and in the future. Youth & Society, 49, 271-294. doi:10.1177/0044118X14535417

16.

De La Rue

Polanin

J. R.

Espelage

D. L.

Pigott

T. D.

(2017). A meta-analysis of school-based interventions aimed to prevent or reduce violence in teen dating relationships. Review of Educational Research, 87, 7-34. doi:10.3102/0034654316632061

17.

Fellmeth

G. L. T.

Heffernan

Nurse

Habibula

Sethi

(2013). Educational and skills-based interventions for preventing relationship and dating violence in adolescents and young adults. Cochrane Database of Systematic Reviews, 2013, Article CD004534. doi:10.1002/14651858.CD004534.pub3

18.

Foshee

V. A.

Bauman

K. E.

Ennett

S. T.

Suchindran

Benefield

Linder

G. F.

(2005). Assessing the effects of the dating violence prevention program “safe dates” using random coefficient regression modeling. Prevention Science, 6, 245-258. doi:10.1007/s11121-005-0007-0

19.

Freedner

Freed

L. H.

Yang

Y. W.

Austin

S. B.

(2002). Dating violence among gay, lesbian, and bisexual adolescents: Results from a community survey. Journal of Adolescent Health, 31, 469-474. doi:10.1016/S1054-139X(02)00407-X

20.

Gillum

T. L.

DiFulvio

(2012). “There’s so much at stake”: Sexual minority youth discuss dating violence. Violence Against Women, 18, 725-745. doi:10.1177/1077801212455164

21.

Glass

Clough

Case

Hanson

Barnes-Hoyt

Waterbury

. . . Perrin

(2015). A safety app to respond to dating violence for college women and their friends: The myPlan study randomized controlled trial protocol. BMC Public Health, 15, Article 871. doi:10.1186/s12889-015-2191-6

22.

Glass

Perrin

N. A.

Hanson

G. C.

Bloom

T. L.

Messing

J. T.

Clough

A. S.

. . . Eden

K. B.

(2017). The longitudinal impact of an internet safety decision aid for abused women. American Journal of Preventive Medicine, 52, 606-615. doi:10.1016/j.amepre.2016.12.014

23.

Google Play. (2018). Intimate partner violence search. Retrieved from https://play.google.com/store/search?q=intimate%20partner%20violence&c=apps

24.

Harvey

Garcia-Moreno

Butchart

(2007, May 2-3). Primary prevention of intimate-partner violence and sexual violence: Background paper for WHO expert meeting. Retrieved from http://www.who.int/violence_injury_prevention/publications/violence/IPV-SV.pdf

25.

Haynie

D. L.

Farhat

Brooks-Russell

Wang

Barbieri

Iannotti

R. J.

(2013). Dating violence perpetration and victimization among U.S. adolescents: Prevalence, patterns, and associations with health complaints and substance use. Journal of Adolescent Health, 53, 194-201. doi:10.1016/j.jadohealth.2013.02.008

26.

Johnson

D. M.

Worrell

Chandler

R. K.

(2005). Assessing psychological health and empowerment in women: The personal progress scale revised. Women & Health, 41, 109-129. doi:10.1300/J013v41n01_07

27.

Johnson

W. L.

Giordano

P. C.

Manning

W. D.

Longmore

M. A.

(2015). The age-IPV curve: Changes in the perpetration of intimate partner violence during adolescence and young adulthood. Journal of Youth and Adolescence, 44, 708-726. doi:10.1007/s10964-014-0158-z

28.

Kann

McManus

Harris

W. A.

Shanklin

S. L.

Flint

K. H.

Hawkins

. . . Zaza

(2016). Youth risk behavior surveillance—United States, 2015. MMWR Surveillance Summaries, 65(6), 1-174.

29.

Koziol-McLain

Vandal

A. C.

Wilson

Nada-Raja

Dobbs

McLean

. . . Glass

N. E.

(2018). Efficacy of a web-based safety decision aid for women experiencing intimate partner violence: Randomized controlled trial. Journal of Medical Internet Research, 19(1), e426. doi:10.2196/jmir.8617

30.

Lacey

K. K.

Saunders

D. G.

Zhang

(2011). A comparison of women of color and non-Hispanic White women on factors related to leaving a violent relationship. Journal of Interpersonal Violence, 26, 1036-1055. doi:10.1177/0886260510376496

31.

Levesque

D. A.

Johnson

J. L.

Prochaska

J. M.

(2017). Teen choices, an online stage-based program for healthy, nonviolent relationships: Development and feasibility trial. Journal of School Violence, 16, 376-385. doi:10.1080/15388220.2016.1147964

32.

Lincoln

Y. S.

Guba

E. G.

(1985). Naturalistic inquiry. Newbury Park, CA: Sage.

33.

Lundgren

Amin

(2015). Addressing intimate partner violence and sexual violence among adolescents: Emerging evidence of effectiveness. Journal of Adolescent Health, 56(Suppl. 1), S42-S50. doi:10.1016/j.jadohealth.2014.08.012

34.

Martin

C. E.

Houston

A. M.

Mmari

K. N.

Decker

M. R.

(2012). Urban teens and young adults describe drama, disrespect, dating violence and help-seeking preferences. Maternal and Child Health Journal, 16, 957-966.

35.

Maxwell

J. A.

(2012). Qualitative research design: An interactive approach. Thousand Oaks, CA: Sage.

36.

Miller

Tancredi

D. J.

McCauley

H. L.

Decker

M. R.

Virata

M. C. D.

Anderson

H. A.

. . . Silverman

J. G.

(2013). One-year follow-up of a coach-delivered dating violence prevention program: A cluster randomized controlled trial. American Journal of Preventive Medicine, 45, 108-112.

37.

Miller

Williams

Cutbush

Gibbs

Clinton-Sherrod

Jones

(2015). Evaluation of the start strong initiative: Preventing teen dating violence and promoting healthy relationships among middle school students. Journal of Adolescent Health, 56, S14-S19. doi:10.1016/j.jadohealth.2014.11.003

38.

Morrow

(2004). Social work practice with gay, lesbian, bisexual, and transgender adolescents. Families in Society: The Journal of Contemporary Social Services, 85, 91-99. doi:10.1606/1044-3894.246

39.

Niolon

P. H.

Kearns

Dills

Rambo

Irving

Armstead

Gilbert

(2017). Preventing intimate partner violence across the lifespan: A technical package of programs, policies, and practices. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.

40.

Olsen

E. O.

Vivolo-Kantor

Kann

(2020). Physical and sexual teen dating violence victimization and sexual identity among U.S. high school students, 2015. Journal of Interpersonal Violence, 35(17-18), 3581-3600.

41.

Perez

Johnson

D. M.

Wright

C. V.

(2012). The attenuating effect of empowerment on IPV-related PTSD symptoms in battered women living in domestic violence shelters. Violence Against Women, 18, 102-117. doi:10.1177/1077801212437348

42.

Prothrow-Stith

Davis

R. A.

(2010). A public health approach to preventing violence. In Cohen

Chavez

Chehimi

(Eds.), Prevention is primary: Strategies for community well-being (2nd ed., pp. 323-350). San Francisco, CA: Jossey-Bass.

43.

Salina

D. D.

Ram

Jason

L. A.

(2016). Sexual coercion, trauma, and sex work in justice-involved women with substance use disorders. Journal of Aggression, Maltreatment & Trauma, 25, 254-268. doi:10.1080/10926771.2015.1121189

44.

Shorey

R. C.

Cohen

J. R.

Fite

P. J.

Stuart

G. L.

Temple

J. R.

(2017). Age of onset for physical and sexual teen dating violence perpetration: A longitudinal investigation. Preventive Medicine, 105, 275-279. doi:10.1016/j.ypmed.2017.10.008

45.

Storer

H.L.

Casey

Herrenkohl

(2016). Efficacy of bystander programs to prevent dating abuse among youth and young adults: A review of the literature. Trauma, Violence, & Abuse, 17(3), 256-269. doi:10.1177/1524838015584361

46.

Van Camp

Hébert

Guidi

Lavoie

Blais

. (2014). Teens’ self-efficacy to deal with dating violence as victim, perpetrator or bystander. International Review of Victimology, 20, 289-303.

47.

Walton

M. A.

Chermack

S. T.

Shope

J. T.

Bingham

C. R.

Zimmerman

M. A.

Blow

F. C.

Cunningham

R. M.

(2010). Effects of a brief intervention for reducing violence and alcohol misuse among adolescents: A randomized controlled trial. Journal of the American Medical Association, 304, 527-535. doi:10.1001/jama.2010.1066

48.

Wincentak

Connolly

Card

(2017). Teen dating violence: A meta-analytic review of prevalence rates. Psychology of Violence, 7, 224-241. doi:10.1037/a0040194

49.

Worrell

Remer

(2003). Feminist perspectives in therapy: Empowering diverse women (2nd ed.). New York, NY: John Wiley.