Online intervention to improve intimate relationships for men in substance use treatment

Feasibility parameters:
The feasibility of adapting the ADVANCE group perpetrator intervention for technology-enabled delivery to men in substance use treatment will be assessed by:
1. Number of men eligible to participate/number of men screened (eligibility rates)
2. Number of men consenting to take part in the study/number of eligible men at screening (recruitment rates men)
3. Number of recruited men completing at least one session of the intervention by the end of the 14-week intervention/number of recruited men (uptake of intervention rates men)
4. Number of current or ex- female partners recruited/number of men recruited (recruitment rates women)
5. Number of women taking up the offer of support from a women’s integrated support service by the end of the 14-week intervention/total number of female partners contacted by integrated support service (uptake of support women)
6. Number of recruited women viewing at least one session of the intervention and safety messages by the end of the 14-week intervention/number of recruited women (uptake of intervention rates women)

Acceptability parameters:
The acceptability of the technology-enabled ADVANCE intervention to end-users and substance use treatment staff will be assessed at the end of the 14-week intervention by:
1. Number of sessions of the technology-enabled intervention attended (out of a possible goal setting session, 12 website sessions, 12 telephone coaching sessions and 7 video group sessions/ total number of sessions offered (intervention attendance/completion rates for male and female participants)
2. Number of sessions with the integrated support service during the 14-week intervention/ total number of sessions offered (attendance with integrated support service worker rates for female participants)
3. Men’s experience of using the website sessions assessed using a rating scale developed for the study at the end of each of the 12 website sessions. Men will also be asked to rate how they are feeling by selecting an emoji at the start and at the end of each of the 12 website sessions
4. Men's experience of using the technology-enabled intervention and any behaviour change, assessed with up to four brief individual qualitative interviews during the 14-week intervention
5. Women's experience of using the technology-enabled intervention and safety messages and any behaviour change, assessed with up to four brief individual qualitative interviews during the 14-week intervention
6. Intervention delivery staff's experience of delivering the intervention, assessed with up to four individual brief qualitative interviews or focus groups during the 14-week intervention
7. Number of men interviewed at the end of the intervention/number of men recruited (follow-up rate men)
8. Number of women interviewed at the end of the intervention/number of women recruited (follow-up rate women)
9. Number of serious adverse events (e.g., hospitalisation and self-harm) during the 14-week study/number of participants recruited (adverse events rate)

Engagement
1. Engagement with each of the 12 websites sessions for men and women (how male and female participants used each of the 12 website sessions including frequency/times/duration of login, number of tasks completed) measured using Google Analytics
2. The number out of a possible 12 telephone coaching sessions attended by men will be recorded
3. The number of telephone support sessions attended during the 14-week intervention by female partners will be recorded
4. Men’s perception of therapeutic alliance assessed using the Working Alliance Inventory – applied to Virtual and Augmented Reality (WAI-VAR) and the California Psychotherapy Alliance Scale- Short Form at 4 months post-baseline

Evaluated for men at 4 post-baseline:
1. Intimate partner abuse (IPA) perpetration assessed in the past 4 months at baseline and 4 months post-baseline using:
1.1. Abusive Behavior Inventory (ABI) - partner form (perpetration) in the previous 4 months
1.2. Controlling Behaviours Scale (partial) in the past 4 months
1.3. Use of social media, stalking, locked in and using children against partner in the past 4 months
2. Substance use measured at baseline and 4 months post men’s baseline using:
2.1. Number of alcohol-free days in past 28 days assessed using the Treatment Outcome Profile
2.2. Number of drug-free days in past 28 days assessed using the Treatment Outcome Profile
3. Mental well-being measured using:
3.1. Depressive symptoms in the past 2 weeks assessed using the PHQ-9 at baseline and 4 months post men’s baseline
3.2. Anxiety symptoms in the past 2 weeks assessed using the GAD-7 at baseline and 4 months post men’s baseline
3.3. PTSD symptoms in the past month assessed using the Primary Care PTSD Screen at baseline and 4 months post men’s baseline
3.4. Propensity for male abusiveness of a female partner in intimate relationships, measured using the Propensity for Abusiveness Scale [anger subscale] at baseline and 4 months post baseline
4. Self-control measured using the Brief Self-Control Scale at baseline and 4 months post baseline
5. Quality of life measured using the EQ-5D-3L at baseline and 4 months post baseline
6. Capability measured using the ICECAP-A at baseline and 4 months post baseline
7. Service use and medication in the past 4 months, measured at baseline and 4 months post baseline

To investigate the impact of the ADVANCE intervention in a follow-up study, the following measures will be collected at follow-up from female current or ex-partners at 4 months post-baseline of male current or ex-partner:
1. IPA assessed in the past 4 months at baseline and 4 months post men’s baseline using:
1.1. IPA victimisation measured using the Revised Abusive Behavior Inventory (ABI-R) in the previous 4 months
1.2. Controlling Behaviours Scale (partial) in the past 4 months
1.3. Use of social media, stalking, locked in, and using children against partner in the past 4 months
2. Substance use measured at baseline and 4 months post men’s baseline using:
2.1. Number of alcohol-free days in past 28 days using the Treatment Outcome Profile
2.2. Number of drug-free days in the past 28 days using the Treatment Outcome Profile
3. Mental well-being measured using:
3.1. Depressive symptoms in the past 2 weeks assessed using the PHQ-9 at baseline and 4 months post men’s baseline
3.2. Anxiety symptoms in the past 2 weeks assessed using the GAD-7 at baseline and 4 months post men’s baseline
3.3. PTSD symptoms in the past month assessed using the Primary Care PTSD Screen at baseline and 4 months post men’s baseline
4. Quality of life measured using the EQ-5D-3L at baseline and 4 months post baseline
5. Capability measured using the ICECAP-A at baseline and 4 months post baseline
6. The self-reported use of healthcare, social and civil services, and legal and justice system contacts in the past 4 months, assessed at baseline and 4 months post men's baseline for men and women. Medications prescribed by a doctor or health professional in the past 4 months recorded at baseline and 4 months post men's baseline for men and women