Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
4677 participants
INTERVENTIONAL
2016-03-12
2018-08-14
Brief Summary
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Methods and analysis: The study uses a concurrent mixed-methods design. The quantitative aspect of the evaluation is a pair-matched, repeated cross-sectional 2-armed, single-blinded cluster trial (RCT: N=36 clusters, 1440 individuals), comparing a social behavior change communication (SBCC) strategy to radio programming alone for its impact on physical and / or sexual IPV at the end of programming (12 months' post-baseline) and 6-months post the cessation of project activities (24-months post baseline). The qualitative aspects of the design include several longitudinal approaches to understand the impact of the intervention and examine mechanisms of change including in-depth interviews with participants (N=18 couples), and focus group discussions with community leaders (N=3 groups), and family members of participants (N=12 groups). Treatment effects will be estimated with generalized logistic mixed models specified to compare differences in primary outcome from baseline to follow-up, and baseline to 24-months post following intention-to-treat principles.
Detailed Description
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Married couple participants will be asked to interact with a radio program and participate in weekly, sex-separate listening and discussion groups (LDG) that each last for between 75 and 120 minutes over the course of 9 months. The same participants will be invited to participate in workshops and community activities such as theater and town hall meetings. Female LDG members will be asked to take a survey three times over the course of 24 months. Family members of LDG members in the treatment condition will be asked to interact with a radio program, and attend up to two focus group discussions (FGD) to understand the environmental facilitators and constraints to the couple exhibiting more gender equitable attitudes and behaviors and changes in family-based norms. Family members will be invited to attend one LDG meeting every 3 months, street theaters and community meetings. Community leaders will be asked to interact with a radio program, to participate in a workshop, to develop a plan of action to promote gender equity and the reduction of violence, to jointly run a community event with an LDG in their area and to attend up to two FGDs. At three separate time points, a randomly selected sample of female community members meeting inclusion criteria will be invited to take a survey.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
PREVENTION
NONE
Study Groups
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Radio Program
Married couple participants will be asked to interact with a radio program and participate in weekly, sex-separate listening and discussion groups (LDG) that each last for between 75 and 120 minutes over the course of 9 months.
Behavior Change Communication
9-month weekly episode behavior change radio drama with interactive voice response (IVR)/short message service (SMS) listener engagement
Community Mobilization
Listening and discussions groups, 2 male and 2 female groups per study site meet weekly for 39 weeks and will receive training on gender equity, intimate partner violence (IPV), life skills, community mobilization, non-violent conflict resolution for listening and discussion group (LDG) facilitators to support knowledge and skill set acquisition of LDG members. There will be a joint couple's session every month to foster mutual learning and understanding in addition to community mobilization incentives led by LDGs and encouragement of family members of LGD members to listen to the radio and attend LDG sessions once every 3 months. Participants will also receive awareness raising and street theater to engage families and community members.
Advocacy
Training and 6-month follow up of religious/community leaders and religious leaders support community mobilization activity of local listening and discussion group (LGD).
Control
The control group participants will be exposed to the radio program only, and will not participate in the LDGs, nor will they or their family members participate in the workshops and community activities.
Behavior Change Communication
9-month weekly episode behavior change radio drama with interactive voice response (IVR)/short message service (SMS) listener engagement
Interventions
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Behavior Change Communication
9-month weekly episode behavior change radio drama with interactive voice response (IVR)/short message service (SMS) listener engagement
Community Mobilization
Listening and discussions groups, 2 male and 2 female groups per study site meet weekly for 39 weeks and will receive training on gender equity, intimate partner violence (IPV), life skills, community mobilization, non-violent conflict resolution for listening and discussion group (LDG) facilitators to support knowledge and skill set acquisition of LDG members. There will be a joint couple's session every month to foster mutual learning and understanding in addition to community mobilization incentives led by LDGs and encouragement of family members of LGD members to listen to the radio and attend LDG sessions once every 3 months. Participants will also receive awareness raising and street theater to engage families and community members.
Advocacy
Training and 6-month follow up of religious/community leaders and religious leaders support community mobilization activity of local listening and discussion group (LGD).
Eligibility Criteria
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Inclusion Criteria
* Of reproductive age (between 18-49 years)
* Husband is at least 18 years of age
* Both the wife and husband reside regularly in the study area
* The wife and husband live together
Family Members
* At least 18 years of age
* A family member of a Listening and Discussion Group member
Community Leaders
* At least 18 years of age
* Considered to be in a position of authority or influence within the study communities per the recommendation of other community stakeholders
Listening and Discussion Group facilitators
* Have a 12th grade standard academic qualification or better
* Be living with his/her spouse
* Have good communication skills
* Have a good reputation in the community based on feedback from local social mobilizers
* Able to commit to 9 months of programming and weekly reporting
Exclusion Criteria
* Must not be have plans to relocate in the coming 2 years
* A physical or cognitive impairment that precludes participation for the duration requested by activity
18 Years
ALL
No
Sponsors
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Emory University
OTHER
Responsible Party
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Cari Clark
Associate Professor
Principal Investigators
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Cari Clark, Sc.D., M.P.H.
Role: PRINCIPAL_INVESTIGATOR
Emory University
References
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Clark CJ, Batayeh B, Shrestha PN, Morrow G, Shrestha B, Ferguson G. Diffusion in social norms change about violence against women: A longitudinal analysis of intervention data from a cluster randomised trial. Glob Public Health. 2021 Oct;16(10):1618-1630. doi: 10.1080/17441692.2020.1828984. Epub 2020 Oct 6.
Clark CJ, Shrestha B, Ferguson G, Shrestha PN, Calvert C, Gupta J, Batayeh B, Bergenfeld I, Oakes JM. Impact of the Change Starts at Home Trial on Women's experience of intimate partner violence in Nepal. SSM Popul Health. 2019 Dec 13;10:100530. doi: 10.1016/j.ssmph.2019.100530. eCollection 2020 Apr.
Cardoso LF, Clark CJ, Rivers K, Ferguson G, Shrestha B, Gupta J. Menstrual restriction prevalence and association with intimate partner violence among Nepali women. BMJ Sex Reprod Health. 2018 Sep 28;45(1):38-43. doi: 10.1136/bmjsrh-2017-101908. Online ahead of print.
Clark CJ, Spencer RA, Shrestha B, Ferguson G, Oakes JM, Gupta J. Evaluating a multicomponent social behaviour change communication strategy to reduce intimate partner violence among married couples: study protocol for a cluster randomized trial in Nepal. BMC Public Health. 2017 Jan 13;17(1):75. doi: 10.1186/s12889-016-3909-9.
Other Identifiers
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IRB00091115
Identifier Type: -
Identifier Source: org_study_id