Impact of the SBCC Change Starts at Home Trial on Women's Experience of Intimate Partner Violence in Nepal
Summary:
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. This research presentation will describe the impact of a social and behavior change communication intervention designed to reduce married women's experience of IPV in Nepal. The intervention was a 9-month SBCC strategy involving a radio drama, radio listening and discussion groups, and community-mobilization using interactive street theater, film, town halls and other grass roots activities. We will describe findings to midline, which coincides with the end of the intervention period and endline which occurred over a year after the cessation of program activities. Key findings highlight impact of the intervention among those attending radio listening and discussion groups. No impact was found at the community level. Study findings highlight a difference between the community-level measurement, which relied on a random selection of community residents at each time point, and self-reports of study participants about the persons with whom they discussed programmatic content with, which tended to be confined to socially and geospatially close relationships. The implications of this study suggest that measurement better targeted to respondents' social networks might better capture early signs of behavior change as well as extending the duration of the intervention for greater and more intensive exposure at the community-level.
Background/Objectives:
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 program plus community engagement versus radio programming alone on the 12-month prevalence of IPV.
Description of Intervention and/or Methods/Design:
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 behavior 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 (NCT02942433).
Results/Lessons Learned:
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 and the influence of other interventions which were underway during the study period. 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. Measures of interpersonal engagement around study messaging reflect socially and geospatially close relationships, namely spouses, family, friends and neighbors. These engagements do not align with the community-wide random selection of survey respondents to measure the study's primary outcome.
Discussion/Implications for the Field:
These findings suggest that the intervention was effective among those most frequently engaged. The spread of this learning and behavior change to the wider community was not evident quantitatively, although companion qualitative data suggested more widespread impact, especially among social networks.1,2 Findings suggest that intensive community engagement over longer timespans or social network measurement may be necessary to detect significant changes at the community level. 1.McGhee S et al. Change Really Does Need to Start From Home. J. of Interpersonal Violence, in press. 2.Francis S et al. The Influence of Organized Diffusion on Social Norms Change. under review.
Abstract submitted by:
Cari Jo Clark - Emory University
Binita Shrestha - Equal Access
Gemma Ferguson - Equal Access
Prabin Nanicha Shrestha - Equal Access
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. This research presentation will describe the impact of a social and behavior change communication intervention designed to reduce married women's experience of IPV in Nepal. The intervention was a 9-month SBCC strategy involving a radio drama, radio listening and discussion groups, and community-mobilization using interactive street theater, film, town halls and other grass roots activities. We will describe findings to midline, which coincides with the end of the intervention period and endline which occurred over a year after the cessation of program activities. Key findings highlight impact of the intervention among those attending radio listening and discussion groups. No impact was found at the community level. Study findings highlight a difference between the community-level measurement, which relied on a random selection of community residents at each time point, and self-reports of study participants about the persons with whom they discussed programmatic content with, which tended to be confined to socially and geospatially close relationships. The implications of this study suggest that measurement better targeted to respondents' social networks might better capture early signs of behavior change as well as extending the duration of the intervention for greater and more intensive exposure at the community-level.
Background/Objectives:
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 program plus community engagement versus radio programming alone on the 12-month prevalence of IPV.
Description of Intervention and/or Methods/Design:
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 behavior 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 (NCT02942433).
Results/Lessons Learned:
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 and the influence of other interventions which were underway during the study period. 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. Measures of interpersonal engagement around study messaging reflect socially and geospatially close relationships, namely spouses, family, friends and neighbors. These engagements do not align with the community-wide random selection of survey respondents to measure the study's primary outcome.
Discussion/Implications for the Field:
These findings suggest that the intervention was effective among those most frequently engaged. The spread of this learning and behavior change to the wider community was not evident quantitatively, although companion qualitative data suggested more widespread impact, especially among social networks.1,2 Findings suggest that intensive community engagement over longer timespans or social network measurement may be necessary to detect significant changes at the community level. 1.McGhee S et al. Change Really Does Need to Start From Home. J. of Interpersonal Violence, in press. 2.Francis S et al. The Influence of Organized Diffusion on Social Norms Change. under review.
Abstract submitted by:
Cari Jo Clark - Emory University
Binita Shrestha - Equal Access
Gemma Ferguson - Equal Access
Prabin Nanicha Shrestha - Equal Access
Source
Approved abstract for the postponed 2020 SBCC Summit in Marrakech, Morocco. Provided by the International Steering Committee for the Summit. Image credit: What Works to Prevent Violence Against Women and Girls