Digital chatbot effective at reducing young women’s exposure to intimate partner violence
In partnership with WITS University and the Behavioural Insights Team (BIT), Reach Digital Health has published results from a trial showing a low-cost digital intervention significantly reduced young women’s exposure to past-month intimate partner violence. The study, published by PLOS Digital Health, can be accessed here.
Intimate partner violence (IPV) is experienced by one in three women worldwide and harms their health and well-being. South Africa has among the highest prevalence rates of IPV — defined as any relationship behaviour that causes physical, sexual, or psychological harm. Like youth in many places, young women in South Africa often feel that violence is a normal part of relationships, and they sometimes have trouble recognizing signs of unsafe or unhealthy partners. Despite the great need for interventions for young women, few low-cost digital options have been studied.
Against this backdrop, Reach Digital Health, Wits, and BIT piloted an interactive digital platform to help South African young women navigate their relationships safely and confidentially using Whatsapp, a popular messaging platform. #SafeSigns uses evidence-based behavioural strategies — delivered as a two-way interactive conversation — to help young women reflect on their relationship power, build skills, safety plan, and learn coping and communication techniques.
The intervention was designed to be approachable for young women, using relatable characters and audience-appropriate messaging like emojis and a gamified user journey. An advisory committee of young women helped frame the user experience, local language choices and the chatbot persona. To enhance safety, every young woman taking part in the trial was offered a direct link to the text on Whatsapp with a live counsellor, and 4.5% opted into this additional service.
The trial randomly assigned 19,638 women to receive the gamified chatbot, a normal chatbot without information on violence or no chatbot. Young women aged 18–24 were recruited from across South Africa. In a first for the violence prevention field, the low-cost digital intervention significantly reduced exposure to IPV three months after completing the program (an 11% reduction, p<0.001).
Beyond making women safer, access to the chatbot improved attitudes about gender equity in relationships (a 10% increase, p<0.001). Those in the gamified chatbot arm were also significantly better at identifying harmful relationship behaviours (a 5% increase, p<0.001). The intervention neither harmed nor improved mental health compared to controls — suggesting this work may need to be augmented or complemented with other services to reduce depressive symptoms. Importantly, the gamified chatbot did not seem to increase mental distress. Combined with high retention rates, this suggests a digital intervention may be safe and acceptable for this younger age group.
While this intervention alone cannot solve the complex issue of IPV, it’s an important addition to the prevention toolkit, particularly in low-resource settings. It may potentially reach young audiences at scale and help identify users who may benefit from more intensive, personalized psychosocial support.
In 2022, the chatbot was packaged into an open-source toolkit called #SafeSigns to allow implementation partners to create and launch their own versions of the chatbot. The toolkit is currently being used to launch an adapted version of the chatbot to younger audiences in schools in Colombia — a country with similarly high rates of IPV. A study will be conducted in 2024 to determine the effectiveness of the intervention in this new Latin American setting.
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About Reach Digital Health: Reach builds on 16 years of experience scaling digital health programs to allow faster and more cost-effective implementations in various health domains. Reach has connected the health system with people and communities in over 200 countries and territories through highly available mobile technology.
For media opportunities, contact: Gugulethu Makhubo — Communications Manager — gugulethu@reachdigitalhealth.org
For partnership opportunities, contact: Carlos Yerena — Director of Partnership and Growth — carlos@reachdigitalhealth.org
About our partners:
- Wits School of Public Health researches intimate partner violence interventions in rural, peri-urban, and inner-city areas in South Africa.
- Behavioural Insights Team uses evidence around human behaviour to guide and rigorously test interventions.
