A cluster randomised controlled trial to evaluate the impact of a gender transformative intervention on intimate partner violence against women in newly formed neighbourhood groups in Tanzania.
A cluster randomised controlled trial to evaluate the impact of a gender transformative intervention on intimate partner violence against women in newly formed neighbourhood groups in Tanzania.
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DOI：
10.1136/bmjgh-2020-004555
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发表时间：
2021-07
影响因子：
8.1
通讯作者：
Kapiga S
中科院分区：
文献类型：
--
作者：
Harvey S;Abramsky T;Mshana G;Hansen CH;Mtolela GJ;Madaha F;Hashim R;Kapinga I;Watts C;Lees S;Kapiga S
针对妇女的暴力行为是一个全球性的公共卫生问题；大约四分之一的妇女在一生中会遭受亲密伴侣的身体暴力或性暴力。我们评估了旨在预防亲密伴侣暴力 (IPV) 的性别变革干预措施对女性的影响。我们在坦桑尼亚姆万扎市对新成立的社区妇女进行了一项整群随机对照试验，以评估旨在增强妇女权能、预防 IPV 和促进健康关系的为期 10 次的参与性干预措施。基线访谈后，各组被随机分配（1:1 比例）至干预组或对照组。进行意向治疗分析以评估干预对主要结局的影响，并在干预后 24 个月进行评估。其中包括过去一年的身体 IPV 和性 IPV（主要）；过去一年的情感虐待； IPV 的可接受性和耐受性。 2015 年 9 月至 2017 年 2 月期间，在 66 个社区招募了 1265 名女性，并随机分配到干预组（n = 33 个社区的 627 名妇女）或对照组（n = 33 个社区的 638 名妇女）。对 551 名（88%）干预妇女和 575 名（90%）对照妇女完成了结果评估。在干预妇女中，113 名 (21%) 名干预妇女报告了身体 IPV，而对照妇女为 117 名 (20%)（调整后 OR (aOR) 0.98，95%CI 0.72 至 1.33，p=0.892）；与 121 名 (21%) 对照妇女相比，109 名 (20%) 干预妇女报告了性 IPV (aOR 0.98， 95% CI 0.72 至 1.32，p=0.881）。干预妇女报告的情感虐待较少（aOR 0.74，95%CI 0.56 至 0.98，p=0.035），并且不太可能表达接受 IPV 的态度（aOR 0.49，95%CI 0.36 至 0.66，p<0.001），并且相信 IPV 是私人事务（aOR 0.54， 95%CI 0.38 至 0.78，p=0.001），或应该耐受（aOR 0.48，95%CI 0.34 至 0.66，p<0.001）。这些结果表明，干预措施可以有效减少情感虐待并积极影响纵容 IPV 的态度和信念，但不足以减少身体或性 IPV。 NCT02592252。
Violence against women is a global public health concern; around a quarter of women will experience intimate partner physical or sexual violence during their lifetime. We assessed the impact of a gender transformative intervention for women designed to prevent intimate partner violence (IPV). We conducted a cluster randomised controlled trial in Mwanza city, Tanzania, among women in newly formed neighbourhood groups to evaluate a 10-session participatory intervention that aims to empower women, prevent IPV and promote healthy relationships. Following a baseline interview, groups were randomly assigned (1:1 ratio) to the intervention or control arm. An intention-to-treat analysis was conducted to assess the impact of the intervention on the main outcomes, assessed 24 months postintervention. These included past-year physical IPV and sexual IPV (primary); past-year emotional abuse; and acceptability and tolerance of IPV. Between September 2015 and February 2017, 1265 women were recruited in 66 neighbourhoods and randomly allocated to intervention (n=627 women in 33 neighbourhoods) or control (n=638 women in 33 neighbourhoods). Assessment of outcomes was completed for 551 (88%) intervention and 575 (90%) control women. Among intervention women, 113 (21%) reported physical IPV compared with 117 (20%) control women (adjusted OR (aOR) 0.98, 95% CI 0.72 to 1.33, p=0.892), and 109 (20%) intervention women reported sexual IPV compared with 121 (21%) control women (aOR 0.98, 95% CI 0.72 to 1.32, p=0.881). Intervention women reported less emotional abuse (aOR 0.74, 95% CI 0.56 to 0.98, p=0.035), and were less likely to express attitudes accepting of IPV (aOR 0.49, 95% CI 0.36 to 0.66, p<0.001), and beliefs that IPV is a private matter (aOR 0.54, 95% CI 0.38 to 0.78, p=0.001), or should be tolerated (aOR 0.48, 95% CI 0.34 to 0.66, p<0.001). These results indicate that the intervention was effective in reducing emotional abuse and positively impacting attitudes and beliefs condoning IPV, but was not sufficient to reduce physical or sexual IPV. NCT02592252.
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