Indashyikirwa IPV Prevention Trial in Rwanda
- Conditions
- Intimate Partner Violence
- Interventions
- Behavioral: Village Savings and Loan Association (VSLA)Behavioral: Indashyikirwa Couples TrainingBehavioral: Indashyikirwa Activist TrainingBehavioral: Indashyikirwa Opinion Leader TrainingOther: Indashyikirwa Women's Spaces
- Registration Number
- NCT03477877
- Lead Sponsor
- Medical Research Council, South Africa
- Brief Summary
The purpose of this study is to test whether the Indashyikirwa ("Agents of Change") program is effective at preventing intimate partner violence (IPV) in communities in Rwanda.
Because IPV has many causes, including factors that operate at the individual, couple, and community levels, the Indashyikirwa program is designed with multiple elements targeting multiple levels. A training program for couples covers gender, power, and relationship skills. Individual graduates this program who are interested and eligible go on to an activist training program to help support sustained change in their communities. Parallel activities operate at the Sector level to create and support change at the community level. Sector level activities include (1) training in gender and IPV prevention for local opinion leaders. (2) Establishment of "Women's Spaces," which are drop in centers that provide support and referrals for women experiencing IPV as well as a wide range of community outreach services to educate communities about, gender, power, women's rights, and violence prevention.
Because the intervention is comprised of multiple components and includes elements designed to be delivered at the Sector level, Sectors were chosen as the unit of randomization. 28 sectors spread across 7 districts are participating; randomization as intervention or control was stratified across Districts to ensure adequate geographical spread of program delivery (Rwandan geographic administrative units are: Province \> District \> Sector \> Cell \> Village). Within each randomized sector are two separate assessments of program impact: (1) A "Couple Cohort" comprised of heterosexual couples who enrol together in the couples training program (some of whom continue into the activist training) compared to similarly situated couples in control communities who participate only in a standard, ongoing VSLA (village savings and loan association) program. Couples cohort members (both intervention and control) are surveyed at enrolment, 12 months post-baseline, and 24 months post-baseline. (2) A "Community Survey" designed to measure community diffusion of the intervention through the activities of the Women's Spaces, Opinion Leader Trainings, and activities of graduates of the activist training. The community survey comprises a repeat cross-sectional population-based household survey of married/cohabiting adults in intervention communities who are NOT direct participants in any of the formal trainings delivered by intervention implementation partners, conducted at baseline and 24 months only. This survey is designed to look at community level shifts in the occurrence of IPV, as well as changes in support for survivors and changes in attitudes among the general population.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 8909
For the Couples Cohort Study:
- Member of an active village savings and loan association (VSLA) group or the partner of a VSLA member
- Between 18 and 49 years old
- Living with or married to current partner for at least 6 months at baseline
- Willing and able to give informed consent for participation in research
- Willing to give contact information of 3 friends, neighbours, or family members who can be used to contact participant over the next 2.5 years
- Has no current plans to move out of the study area in the next 2.5 years
For the Community Surveys:
- Resident in the target community for at least 6 months prior to data collection
- Between 18 and 49 years old
- Living with or be married to current partner for at least 6 months
- NOT enrolled in the couples cohort, opinion leader training, or serving as a women's space facilitator (i.e. not otherwise involved in the study)
d. Willing and able to give informed consent for participation in research
Exclusion Criteria (both Couples Cohort and Community Survey):
- Does not speak Kinyarwanda
- Unable to provide meaningful informed consent
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Indashyikirwa Indashyikirwa Activist Training Sectors which receive the full Indashyikirwa programme, including (1) couples training and activist training and support by RWAMREC, and (2) opinion leader training and establishment of women's spaces by the Rwanda Women's Network. Indashyikirwa Indashyikirwa Opinion Leader Training Sectors which receive the full Indashyikirwa programme, including (1) couples training and activist training and support by RWAMREC, and (2) opinion leader training and establishment of women's spaces by the Rwanda Women's Network. VSLA Only Village Savings and Loan Association (VSLA) Sectors that continue to receive only the village savings and loan association (VSLA) programmes offered by CARE Rwanda Indashyikirwa Indashyikirwa Couples Training Sectors which receive the full Indashyikirwa programme, including (1) couples training and activist training and support by RWAMREC, and (2) opinion leader training and establishment of women's spaces by the Rwanda Women's Network. Indashyikirwa Indashyikirwa Women's Spaces Sectors which receive the full Indashyikirwa programme, including (1) couples training and activist training and support by RWAMREC, and (2) opinion leader training and establishment of women's spaces by the Rwanda Women's Network.
- Primary Outcome Measures
Name Time Method Intimate partner violence with main partner (Community Survey) 24 months Experience (for women) or perpetration (for men) of physical or sexual intimate partner violence as assessed by the WHO Violence Against Women questions as standardized for the What Works to Prevent Violence Against Women and Girls Programme
Intimate partner violence with main partner (Couples Cohort) 24 months Experience (for women) or perpetration (for men) of physical or sexual intimate partner violence as assessed by the WHO (World Health Organization) Violence Against Women questions as standardized for the What Works to Prevent Violence Against Women and Girls Programme
Acceptability of wife beating (Community Survey) 24 months Number of justifications for wife beating endorsed on survey assessment, analyzed separately for male and female participants
Actions to support victims of gender-based violence or combat gender-based violence (Community Survey) 24 months Scores on a checklist of items assessing actions taken to support women who have experienced gender-based violence and/or combat gender-based violence in the community
- Secondary Outcome Measures
Name Time Method Problematic alcohol use (Couples Cohort, Men Only) 24 months Measured using AUDIT (Alcohol Use Disorder Identification Test) short form
Newly occuring intimate partner violence with main partner (Couples Cohort) 24 months Experience (for women) or perpetration (for men) of any physical and/or sexual in main intimate partnership during the 12 months before the assessment among participants who DID NOT report physical and/or sexual IPV at baseline
Recurrent physical and/or sexual intimate partner violence (Couples Cohort) 24 months Experience (for women) or perpetration (for men) of any physical and/or sexual in main intimate partnership during the 12 months before the assessment among participants who DID report physical and/or sexual IPV at baseline
Physical intimate partner violence, main partnership (Couples Cohort) 24 months Experience (for women) or perpetration (for men) of any physical violence in main intimate partnership during the 12 months before the assessment
Economic abuse with main partner (Couples Cohort) 24 months Experience (for women) or perpetration (for men) of economic abuse in main intimate partnership during the 12 months before the assessment
Quality of conflict management strategies (Couples Cohort) 24 months Quality of conflict management strategies used in the past 12 months in main intimate partnership (reduced use of negative strategies and increased use of positive strategies)
Couple communication (Couples Cohort) 24 months Frequency of discussing important relationship topics with main partner (her day, his day, her worries or feelings, his worries or feelings, the sexual relationship) in last 4 weeks
Help seeking among survivors of IPV (Couples Cohort, Women Only) 24 months Help seeking in past 12 months among women in couples cohort who report experience of physical and/or sexual IPV in the past 12 months
Self-efficacy for community engagement (Couples Cohort, Women only ) 24 months Confidence to speak at community meetings / to speak at community meetings if people disagree among comparing women who received both couples training and activist training, couples training only, and control participants
Forced or coerced sex with main partner (Couples Cohort) 24 months Experience (for women) or perpetration (for men) of any forced or coerced sex in main intimate partnership during the 12 months before the assessment
Sources of information on IPV and number of times heard (Community Survey) 24 months Frequency of encountering IPV prevention messages in the community
Help seeking among survivors of IPV (Community Survey, women only) 24 months Help seeking in past 12 months among women in community survey who report experience of physical and/or sexual IPV in the past 12 months
Emotional aggression with main partner (Couples Cohort) 24 months Experience (for women) or perpetration (for men) of emotional aggression in main intimate partnership during the 12 months before the assessment
Depressive symptoms (Couples Cohort) 24 months Level of depressive symptoms in past week using Center for Epidemiologic Studies Depression Scale (CES-D) short form
Children in household witnessing IPV (Couples Cohort) 24 months Frequency of children witnessing mother being beaten in the past 12 months, per parental report
Acceptability of wife beating (Couples cohort) 24 months Number of justifications for wife beating endorsed on survey assessment, analyzed separately for male and female participants
Level of conflict in intimate partnership (Couples Cohort) 24 months Reported sources and frequencies of quarrels with main partner in the past 12 months
Perception of trust, care, and respect in relationship with main partner (Couples Cohort) 24 months Self-reported experience of trust, care, and respect with main partner
Advising neighbors on relationships (Couples Cohort) 24 months Offering direct support or advice to neighbors regarding IPV or relationship conflict comparing participants who received both couples training and activist training, couples training only, and control participants
Participating in action to prevent IPV (Participants in couples cohort who have received activist training, only) 24 months In past 12 months, participated in a meeting, march, rally or gathering aiming to raise awareness and mobilize people around the issue of family violence comparing participants who received both couples training and activist training, couples training only, and control participants