Comic Intervention for Sexual Violence Prevention and Post-rape Care

Not Applicable

Completed

• Conditions: Post-exposure Prophylaxis; Knowledge, Attitudes, Practice
• Interventions: Behavioral: Participatory Comic Intervention

• Registration Number: NCT04656522
• Lead Sponsor: University of Toronto

Brief Summary

In humanitarian settings, sexual and gender-based violence disproportionately impacts women and children. However, there continues to be a lack of evidence regarding both sexual violence prevention and post-rape care interventions in low- and middle-income humanitarian contexts, with even less evidence supporting adolescents and youth in these settings. Participatory comics offer a youth-friendly, low-cost, scalable approach for preventing sexual violence and training clinicians in post-rape care in humanitarian settings. This study aims to develop, implement, and evaluate the effectiveness of a comic intervention on preventing sexual violence and improving post-rape care with youth aged 16-24 and health care providers in the Bidi Bidi refugee settlement.

Detailed Description

Uganda is Sub-Saharan Africa's largest refugee host community; with over 250,000 residents, Bidi Bidi is the largest refugee settlement in Uganda and the second largest globally. In humanitarian settings, sexual and gender-based violence disproportionately impacts women and children. However, there continues to be a lack of evidence regarding both sexual violence prevention and post-rape care interventions in low- and middle-income humanitarian contexts, with even less evidence supporting adolescents and youth in these settings. Stigma directed toward adolescent sexual practices and engagement in sexual and reproductive health services, such as contraception, HIV testing, and post-exposure prophylaxis (PEP), is also associated with social isolation, violence and mental health challenges. Participatory comics offer a youth-friendly, low-cost, scalable approach for preventing sexual violence and training clinicians in post-rape care in humanitarian settings. This study aims to develop, implement, and evaluate the effectiveness of a comic intervention on preventing sexual violence and improving post-rape care with youth aged 16-24 and health care providers in the Bidi Bidi refugee settlement. Participating youth and health care providers will take part in 4-hour peer-facilitated workshops exploring topics of social, sexual, and psychological needs and pro-social interventions (youth) and post-rape care responses and attending to the needs of youth refugees who have experienced sexual violence (health care providers) using comics developed with qualitative data collected from an earlier study phase. Using a pre-test/post-test design, this study will assess changes in participants' PEP knowledge and acceptance, bystander behaviour, and sexual violence stigma.

Study Timeline

• Study First Submitted: 2020-11-13
• Study Start: 2020-11-30
• Study First Submitted QC: 2020-11-30
• Study First Posted: 2020-12-07
• Primary Completion: 2021-04-30
• Study Completion: 2021-04-30
• Status Verified: 2021-12
• Last Update Submitted: 2021-12-23
• Last Update Posted: 2021-12-28

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 100

Inclusion Criteria

Not provided

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Exclusion Criteria

Not provided

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Participatory Comic Intervention	Participatory Comic Intervention	This is a pre-test/post-test trial, therefore all participants will participate in the participatory comic intervention.

Primary Outcome Measures

Name	Time	Method
Changes in PEP Knowledge & Acceptability	Time 1 (0-baseline), Time 2 ( 6 hours follow-up), Time 3 (4 week follow-up)	PEP knowledge and acceptability assessed through testing participants on their knowledge of correct PEP use and asked to report on their acceptance towards PEP use and adherence. Scores are binary yes/no.
Changes in Bystander Practices	Time 1 (0-baseline), Time 2 ( 6 hours follow-up), Time 3 (4 week follow-up)	Bystander practices assessed through the Bystander Decision Balance Scale and Slaby Bystander Efficacy Scale (Range 16-64). Higher scores indicate increased bystander practices.
Changes in Sexual Violence Stigma	Time 1 (0), Time 2 (5hours), Time 3 (4 weeks post-workshop)	Attitudes and beliefs towards sexual violence will be assessed using the Sexual Violence Stigma scale (Range 17-68). Higher score indicates poorer attitudes and beliefs, and thus greater stigma, towards sexual violence and sexual violence survivors.

Secondary Outcome Measures

Name	Time	Method
Changes in Depression	Time 1 (0-baseline), Time 3 (4 week follow-up)	Depression outcomes will be assessed using the Patient Health Questionnaire 2-item (PHQ-2) (Range 0-6). Scores of 3 or above signal major depressive disorder.
Changes in Gender Equitable Norms	Time 1 (0-baseline), Time 2 ( 6 hours follow-up), Time 3 (4 week follow-up)	Gender Equitable Norms will be assessed using the physical violence subscale (Range 6-18) of the gender equitable men (GEM) scale to measure attitudes towards gender equitable norms considering the prevailing norms in the community concerning physical violence. A higher score indicates positive attitudes towards gender equitable norms.

Trial Locations

Locations (2)

Uganda Refugee and Disaster Management Council; 🇺🇬 Arua, Uganda

Factor-Inwentash Faculty of Social Work, University of Toronto; 🇨🇦 Toronto, Ontario, Canada