{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T17:28:48Z","timestamp":1786382928330,"version":"build-2736575974"},"reference-count":49,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Hum Factors"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Removal platforms for nonconsensual intimate images (NCIIs) are essential, as they have become the recourse for victims of such abuse; yet their interfaces are not designed around the cognitive and emotional realities of trauma. Safety by Design directs platforms to protect vulnerable users but not how; trauma-informed care defines what that protection requires, while usability heuristics keep interfaces usable but are not themselves trauma-sensitive. However, no framework integrates them into design guidance that is both usable and protective for NCII removal platforms.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study develops trauma-informed design, a cohesive framework that integrates trauma-informed care with established usability heuristics under Safety by Design, so that NCII removal platforms protect trauma-affected users while remaining realistically usable; a preliminary, domain-informed evaluation provides initial supporting evidence.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We used a 2-phase sequential exploratory design, drawing on a globally accessible NCII removal platform as an illustrative case. Phase 1 developed trauma-differentiated personas and mapped each persona\u2019s user journey to surface pain points that varied by level of trauma. Phase 2 analyzed a focus group of 8 female Counseling-UX (User Experience) Psychology students who had completed coursework in user psychological safety with consensual qualitative research methodology. Participants assessed the plausibility of the personas and the proposed framework with respect to perceived emotional safety and perceived usability.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Mapping each persona\u2019s journey surfaced pain points that differed by level of trauma, which were synthesized into a 6-guideline trauma-informed design framework: emotional scaffolding, process transparency, self-pacing mechanisms, institutional trust signals, context-aware support, and grounding tools. In phase 2, domain-informed evaluators judged the personas plausible, and the framework directions emotionally safer, and potentially more usable.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Integrating trauma principles into user experience evaluation can help identify and address psychological barriers in NCII removal platforms. The framework provides the preliminary, domain-informed foundation that trauma-sensitive design of such platforms requires. Because the framework was not tested with NCII victim-survivors or users actively seeking image-removal support, findings represent preliminary plausibility and acceptability evidence rather than ecological validation or real-world effectiveness.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/94438","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T16:41:37Z","timestamp":1786380097000},"page":"e94438-e94438","source":"Crossref","is-referenced-by-count":0,"title":["Designing a Trauma-Informed Safety by Design Framework for Nonconsensual Intimate Image Removal Platforms: A 2-Phase Sequential Exploratory Study"],"prefix":"10.2196","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3728-9808","authenticated-orcid":false,"given":"Ji-yeon","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3311-3513","authenticated-orcid":false,"given":"Yejun","family":"Koh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"R1","doi-asserted-by":"crossref","unstructured":"Chen JX McDonald A Zou Y et al. 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[doi: 10.1145\/191666.191729]","DOI":"10.1145\/191666.191729"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1145\/3686914","article-title":"The sociotechnical stack: opportunities for social computing research in non-consensual intimate media","volume":"8","author":"Qiwei","journal-title":"Proc ACM Hum Comput Interact"},{"issue":"6","key":"R11","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1037\/0894-4105.20.6.716","article-title":"Neuropsychological functioning in posttraumatic stress disorder and alcohol abuse","volume":"20","author":"Samuelson","journal-title":"Neuropsychology"},{"key":"R12","unstructured":"Herman JL . Trauma and Recovery. Basic Books; 1992. 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