Impact of the Change Starts at Home Trial on Women's experience of intimate partner violence in Nepal

Cari Jo Clark, Binita Shrestha, Gemma Ferguson, Prabin Nanicha Shrestha, Collin Calvert, Jhumka Gupta, Brian Batayeh, Irina Bergenfeld, J. Michael Oakes

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Intimate partner violence (IPV) affects 1 in 3 women worldwide. Research in low- and middle-income countries suggests that multicomponent interventions incorporating media, group work, and community mobilization may be effective at changing social norms that enable such violence. Our study aimed to evaluate the impact of a radio programme plus community engagement versus radio programming alone on the 12-month prevalence of IPV. Using a cluster randomized, repeat cross-sectional, single-blinded approach, thirty-six village communities were pair-matched within three districts in Nepal and randomly assigned to either control or intervention. Both groups were exposed to social behaviour change communication through radio programming. In addition, weekly listening and discussion groups (LDGs) were formed in intervention communities to meet and discuss radio programming over the 40-week intervention period. Participants were also exposed to other community mobilization activities such as street theatre and messaging from local leaders who were engaged in intervention programming. IPV was measured at baseline, 12 months post-baseline at program conclusion, and 28 months post-baseline using a simple random sample of 40 married women per cluster (n = approximately 1440 at each time point) along with 382 women who participated in the LDGs. Although control and intervention groups were demographically similar, baseline rates of IPV were higher in control areas. The trend in IPV for both groups was nonlinear, largely declining at midline (control condition) and rising again at endline (control and intervention conditions), possibly reflecting greater reporting due to awareness-raising activities. Significant differences between the two groups were largely absent at endline. Higher LDG attendance was associated with decreases in several forms of IPV, some of which persisted to endline. These findings suggest that intensive community engagement over longer timespans or social network measurement may be necessary to detect significant changes at the community level (NCT02942433).

Original languageEnglish (US)
Article number100530
JournalSSM - Population Health
Volume10
DOIs
StatePublished - Apr 2020

Bibliographical note

Funding Information:
This manuscript has been funded by a grant ( #P06254 ) from UK aid from the UK government, via the What Works to Prevent Violence Against Women and Girls? Global Programme ( www.whatworks.co.za ). The funds were managed by the South African Medical Research Council . The views expressed do not necessarily reflect the UK government's official policies. Collin Calvert's effort on the research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number T32CA163184 (Michele Allen, MD, MS, PI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Funding Information:
This manuscript has been funded by a grant (#P06254) from UK aid from the UK government, via the What Works to Prevent Violence Against Women and Girls? Global Programme (www.whatworks.co.za). The funds were managed by the South African Medical Research Council. The views expressed do not necessarily reflect the UK government's official policies. Collin Calvert's effort on the research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number T32CA163184 (Michele Allen, MD, MS, PI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Keywords

  • Domestic violence
  • Intimate partner violence
  • Prevention
  • Randomized trial

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