“It's not just a workout class. It's a safe space.” Victim-survivor perspectives on the design and delivery of a trauma and violence-informed cardio boxing exercise intervention

Victim-survivors of intimate partner violence are at an increased risk of developing a range of physical and mental health conditions (i.e., post-traumatic stress disorder, depression, cardio-vascular disease, chronic pain, sleep difficulties), all of which have the potential to be supported via physical activity. Whilst a limited number of studies have demonstrated that moderate-vigorous forms of physical activity, such as non-contact cardio-boxing, may be beneficial for victim-survivors’ healing and recovery, few have been co-designed with lived-living experience experts. Therefore, this study aimed to centre women victim-survivor voices to understand their needs in the design and delivery of a trauma and violence-informed, non-contact cardio boxing exercise intervention. Semi-structured one-on-one interviews were conducted online with n =14 self-identified women or biological females with lived-living experience of intimate partner violence across Australia. Interviews explored factors influencing acceptability, feasibility, trauma and violence-informed design, barriers to adoption and sustainable implementation. Data were interpreted using Reflective Thematic Analysis. Four themes were developed: 1) the evolving relationship victim-survivors have with exercise and their bodies; 2) cardio boxing as an empowered exercise choice to move through anger 3) understanding that safety considerations come first for victim-survivors; and 4) real-world trauma and violence-informed solutions. Whilst these findings underscore the importance of collaborative trauma and violence-informed approaches to physical activity intervention development and design for intimate partner violence victim-survivors, these insights are applicable beyond this population, including real-world use within a range of physical activity settings (i.e., community gyms, sporting clubs, exercise physiology clinics). • Safety considerations are key to victim-survivor engagement in exercise interventions • A women-only, ‘closed group’ of victim-survivors provides opportunities for connection • Clear, transparent, invitational communication increases access and engagement • Victim-survivors value programs co-facilitated by a mental-health trained support person • Providing opportunities to choose amount of engagement increases agency