The Economics of Domestic Violence: Evidence From Bangladesh
试验速览
- 阶段
- 不适用
- 状态
- 进行中(未招募)
- 入组人数
- 440
- 试验地点
- 1
- 主要终点
- Health assessments to assess Prevalence and frequency of IPV.
研究概览
简要总结
This project aims to test the scalability and cost-effectiveness of edutainment-soap operas designed to challenge harmful social norms and promote resilience-as a strategy to improve mental health and reduce intimate partner violence (IPV) in rural Bangladesh. Investigators will run a clustered randomized control trial in which villages will be randomized to one of three versions of the same soap opera: (i) Norms: Challenges harmful norms that condone IPV, targeting the belief that violence is an acceptable way to assert control or maintain reputation, (ii) Norms + Skills: builds on the norms campaign by adding CBT-based skills for stress management and non-violent conflict resolution, (iii) Placebo: No violence content. Investigators will evaluate the impact on attitudes towards IPV and IPV incidence.
详细描述
Study design features two layers of commuity-level randomization based on a 3x2 factorial design:
First Treatment Variation: Edutainment Content. Communities are randomized into one of three versions of the same soap opera:
- Norms Campaign (176 communities): Challenges harmful norms that condone IPV, targeting the belief that violence is an acceptable way to assert control or maintain reputation.
- Norms + Skills Campaign (176 communities): Builds on the norms campaign by adding CBT-based skills for stress management and non-violent conflict resolution.
- Placebo Campaign (88 communities): Features unrelated content to serve as a control group, isolating the effects of norms and resiliency messaging.
This variation allows for assessing the impact of addressing harmful norms alone from the additional benefits of equipping men with practical coping skills. By comparing the Norms Campaign to the Norms + Skills Campaign, investigators test whether adding stress-coping skills yields additional reductions in IPV and related outcomes.
Second Treatment Variation: Delivery Modes. Fifty percent of communities in each treatment arm are randomized into one of two delivery modes:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Factorial
- 主要目的
- Prevention
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 18 Years 至 65 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •married men and women over the legal age of majority in Bangladesh
排除标准
- •No exclusion criteria were imposed.
研究组 & 干预措施
Norms with Private Delivery
Soap opera that challenges harmful norms that condone IPV, targeting the belief that violence is an acceptable way to assert control or maintain reputation Private Delivery Mode: Men watch the soap opera privately at home on handheld devices.
干预措施: Edutainment Content: Norms Campaign (Behavioral)
Norms + Skills with Private Delivery
Soap opera that builds on the norms campaign by adding CBT-based skills for stress management and non-violent conflict resolution Private Delivery Mode: Men watch the soap opera privately at home on handheld devices.
干预措施: Edutainment Content: Norms Campaign (Behavioral)
Norms + Skills with Private Delivery
Soap opera that builds on the norms campaign by adding CBT-based skills for stress management and non-violent conflict resolution Private Delivery Mode: Men watch the soap opera privately at home on handheld devices.
干预措施: Cognitive Behavioral Therapy (CBT)-based skills (Behavioral)
Placebo with Private Delivery
Soap opera that features unrelated content to serve as a control group, isolating the effects of norms and resiliency messaging.
Private Delivery Mode: Men watch the soap opera privately at home on handheld devices.
干预措施: Edutainment Content: Placebo Campaign (Behavioral)
Norms with Public Delivery
Soap opera that challenges harmful norms that condone IPV, targeting the belief that violence is an acceptable way to assert control or maintain reputation Public Delivery Mode: Men watch the soap opera publicly through community screenings.
干预措施: Edutainment Content: Norms Campaign (Behavioral)
Norms + Skills with Public Delivery
Soap opera that builds on the norms campaign by adding CBT-based skills for stress management and non-violent conflict resolution Public Delivery Mode: Men watch the soap opera publicly through community screenings.
干预措施: Edutainment Content: Norms Campaign (Behavioral)
Norms + Skills with Public Delivery
Soap opera that builds on the norms campaign by adding CBT-based skills for stress management and non-violent conflict resolution Public Delivery Mode: Men watch the soap opera publicly through community screenings.
干预措施: Cognitive Behavioral Therapy (CBT)-based skills (Behavioral)
Placebo with Public Delivery
Soap opera that features unrelated content to serve as a control group, isolating the effects of norms and resiliency messaging.
Public Delivery Mode: Men watch the soap opera publicly through community screenings.
干预措施: Edutainment Content: Placebo Campaign (Behavioral)
Norms with Private Delivery and Cash-for-Work program
Soap opera that challenges harmful norms that condone IPV, targeting the belief that violence is an acceptable way to assert control or maintain reputation Private Delivery Mode: Men watch the soap opera privately at home on handheld devices.
Cash-for-Work: Small weekly payments for viewing and providing feedback on the media content.
干预措施: Edutainment Content: Norms Campaign (Behavioral)
Norms + Skills with Private Delivery and Cash-for-Work program
Soap opera that builds on the norms campaign by adding CBT-based skills for stress management and non-violent conflict resolution Private Delivery Mode: Men watch the soap opera privately at home on handheld devices.
Cash-for-Work: Small weekly payments for viewing and providing feedback on the media content.
干预措施: Edutainment Content: Norms Campaign (Behavioral)
Norms + Skills with Private Delivery and Cash-for-Work program
Soap opera that builds on the norms campaign by adding CBT-based skills for stress management and non-violent conflict resolution Private Delivery Mode: Men watch the soap opera privately at home on handheld devices.
Cash-for-Work: Small weekly payments for viewing and providing feedback on the media content.
干预措施: Cognitive Behavioral Therapy (CBT)-based skills (Behavioral)
Placebo with Private Delivery and Cash-for-Work program
Soap opera that features unrelated content to serve as a control group, isolating the effects of norms and resiliency messaging.
Private Delivery Mode: Men watch the soap opera privately at home on handheld devices.
Cash-for-Work: Small weekly payments for viewing and providing feedback on the media content.
干预措施: Edutainment Content: Placebo Campaign (Behavioral)
Norms with Public Delivery and Cash-for-Work program
Soap opera that challenges harmful norms that condone IPV, targeting the belief that violence is an acceptable way to assert control or maintain reputation Public Delivery Mode: Men watch the soap opera publicly through community screenings.
Cash-for-Work: Small weekly payments for viewing and providing feedback on the media content.
干预措施: Edutainment Content: Norms Campaign (Behavioral)
Norms + Skills with Public Delivery and Cash-for-Work program
Soap opera that builds on the norms campaign by adding CBT-based skills for stress management and non-violent conflict resolution Public Delivery Mode: Men watch the soap opera publicly through community screenings.
Cash-for-Work: Small weekly payments for viewing and providing feedback on the media content.
干预措施: Edutainment Content: Norms Campaign (Behavioral)
Norms + Skills with Public Delivery and Cash-for-Work program
Soap opera that builds on the norms campaign by adding CBT-based skills for stress management and non-violent conflict resolution Public Delivery Mode: Men watch the soap opera publicly through community screenings.
Cash-for-Work: Small weekly payments for viewing and providing feedback on the media content.
干预措施: Cognitive Behavioral Therapy (CBT)-based skills (Behavioral)
Placebo with Public Delivery and Cash-for-Work program
Soap opera that features unrelated content to serve as a control group, isolating the effects of norms and resiliency messaging.
Public Delivery Mode: Men watch the soap opera publicly through community screenings.
Cash-for-Work: Small weekly payments for viewing and providing feedback on the media content.
干预措施: Edutainment Content: Placebo Campaign (Behavioral)
结局指标
主要结局
Health assessments to assess Prevalence and frequency of IPV.
时间窗: 1 month post intervention
Health assessments by community health workers, who check for IPV-related injuries to measure women's experiences of IPV. Measured by the percentage of female respondents across treatments on whom community health workers identify IPV-related injuries.
Demographic and Health Survey (DHS) to assess Acceptability of IPV
时间窗: 1 month post intervention
Standardized attitudinal questions from the Demographic and Health Survey (DHS), which capture whether violence is considered justified in specific situations to measure changes in husbands' personal attitudes towards IPV. Measured by the average score on a justification index across treatments. This index is a normalized index of how justified men think it is for a husband to use IPV.
Hypothetical vignettes to assess Acceptability of IPV
时间窗: 1 month post intervention
Hypothetical vignettes, where respondents evaluate the likely and socially acceptable behavior of a hypothetical husband whose wife transgressed a gender norm. These vignettes mitigate social desirability bias and improve the accuracy of responses on sensitive topics to measure changes in husbands' personal attitudes towards IPV. Measured by the average level of violence respondents across treatments believe hypothetical husband will and should assign if the hypothetical wife transgresses. The scale will be between 0 and 5.
Hypothetical vignettes to assess Perceptions about others' acceptability of IPV.
时间窗: 1 month post intervention
Husbands' perceptions about others' attitudes towards IPV were measured using the hypothetical vignettes. Respondents estimate the attitudes of the other surveyed men in their community using visual aids and stickers, each representing a different respondent. Hypothetical vignettes, where respondents evaluate the likely and socially acceptable behavior of a hypothetical husband whose wife transgressed a gender norm. These vignettes mitigate social desirability bias and improve the accuracy of responses on sensitive topics to measure changes in husbands' personal attitudes towards IPV. This will be measured by the average level of violence respondents across treatments believe other men in their community will assign if the hypothetical wife transgresses. The scale will be between 0 and 5.
Use of coping strategies to assess Men's resilience and mental health.
时间窗: 1 month post intervention
Men's coping and emotional self-regulation strategies are measured using an index constructed from responses provided by their wives. This index includes selected questions on men's approaches to conflict management from the Revised Conflict Tactics Scale, adapted items from the Bengali version of the Brief Resilient Coping Scale that capture spouses' perceptions of men's behavior, and measures of substance use. IPV-related questions are intentionally excluded, as these behaviors represent a distinct conceptual category measured separately. To simplify interpretation, the index is standardized relative to the control group by subtracting the control group's mean and dividing by its standard deviation. Consequently, the resulting index has a mean of zero and a standard deviation of one within the control group. Higher values of the index indicate more positive coping styles and better emotional regulation.
Patient Health Questionnaire-9 (PHQ-9) to assess Men's resilience and mental health.
时间窗: 1 month post intervention
Husbands' self-reported symptoms of depression measured using the PHQ-9 scale. PHQ-9 is a 9-item validated questionnaire used to screen for depression with a range of scores from 0-45. A cumulative score of ≥10 is considered positive with lower scores indicating no or mild anxiety.
Stressors and experiences to assess Men's resilience and mental health.
时间窗: 1 month post intervention
Husbands' open-ended responses on daily stressors and positive experiences to measure husbands' resilience and emotional well-being. A summary index with two subcomponents is developed. First, a sub-index of daily events using an adapted version of the Daily Hassles and Uplifts Scale that includes items relevant to our target population. Second, a sub-index that aggregates men's appraisal of stressors and is based on the 10-item version of the Perceived Stress Scale validated in Bangladesh. Each subcomponent is standardized to have a mean of zero and a standard deviation of one for the control group. The summary index is defined as the equally weighted average of these standardized sub-indexes, with signs oriented so that higher values consistently indicate more favorable outcomes (fewer stressors and/or lower perceived stress).
Biometric stress indicators to assess Men's resilience and mental health.
时间窗: 1 month post intervention
Biometric stress indicators, captured by Empatica E4 wristbands during sensitive survey modules, measuring physiological markers of emotional regulation and stress to measure husbands' resilience and emotional well-being. Specifically, electrodermal activity (EDA) data, expressed in microsiemens (μS), is used to analyze Skin Conductance Responses (SCRs). SCRs are quantified using a trough-to-peak (TTP) analysis, where the amplitude of each response is measured as the difference between the peak and the preceding trough within a defined time window. To identify event-related SCRs, a response window of 1 to 5 seconds following a stimulus is applied, with a minimum amplitude threshold of 0.01 μS to detect significant responses. The primary outcome variable is the sum of SCR amplitudes for significant responses. The average sum of SCR amplitudes across treatment groups is compared to assess differences in physiological stress responses.
Adapted version of the DHS to assess Prevalence and frequency of IPV.
时间窗: 1 month post intervention
An adapted version of the DHS, covering physical, psychological, financial, and sexual violence. To enhance privacy and reduce misreporting, women use visual response tools to answer these questions privately to measure women's experiences of IPV. Measured by the average of a standardized IPV index. This is a normalized index which captures the frequency (never, very few times, sometimes, or very often) of women's reported experiences of IPV in the past six months. Higher values indicate higher frequency of IPV.
Number of participants with IPV-related injuries to assess Prevalence and frequency of IPV.
时间窗: 1 month post intervention
Enumerators' reports of visible IPV-related injuries, such as bruises, documented using a standardized reporting protocol. Enumerators receive specialized training to identify and record signs of physical violence, with a focus on facial bruises and scratches, which remain visible even for veiled women to measure women's experiences of IPV.
Incidence of IPV to assess Prevalence and frequency of IPV.
时间窗: Baseline and 6-12 months post intervention
Women's self-reports of IPV through rolling phone surveys six to twelve months post-intervention. Measured by the average of a standardized IPV index. This is a normalized index which captures the frequency (never, very few times, sometimes, or very often) of women's reported experiences of IPV in the past six months.
次要结局
- Cost-effectiveness of the edutainment campaigns assessed by benefit-to-cost ratio(1 month post intervention)
- Respectable man scale to assess Men's self-esteem.(1 month post intervention)
- Perceived respectabillity to assess Men's reputation(1 month post intervention)
- Cost-effectiveness of the edutainment campaigns assessed by Reduction to IPV exposure(1 month post intervention)
