Improving family functioning and reducing violence in the home in North Kivu, Democratic Republic of Congo: a pilot cluster-randomised controlled trial of Safe at Home.
Improving family functioning and reducing violence in the home in North Kivu, Democratic Republic of Congo: a pilot cluster-randomised controlled trial of Safe at Home.
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DOI：
10.1136/bmjopen-2022-065759
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发表时间：
2023-03-06
期刊：
影响因子：
2.9
通讯作者：
中科院分区：
文献类型：
--
作者：
测试家庭安全方案的有效性，该方案是为改善家庭福祉和防止家庭中的多种形式的暴力而制定的。等待名单的试点整群随机对照试验。刚果民主共和国，北基伍。202对异性恋情侣。居家保险箱计划。主要结果是家庭功能，次要结果是过去3个 月同时发生的暴力、亲密伴侣暴力和严厉的纪律。评估的途径机制包括与接受严厉纪律有关的态度、性别平等态度、积极的育儿技能和夫妇内部的权力分享。女性(β=1.49；95% CI：−2.75至5.74；p=0.49)和男性(β=1.09；95% CI：−3.13至4.74；p=0.69)的家庭功能没有显著改善。然而，与等待名单中的女性相比，居家安全的女性报告的共生IPV和严厉管教的OR=0.15(p=0.000)、OR=0.23(p=0.001)和OR=0.29(p=0.013)；她们的伴侣的身体/性/情感IPV以及对孩子使用身体和/或情感的严厉管教的改变。参加家庭安全的男性报告说，与等待名单的手臂相比，实施共生暴力的OR=0.23(p=0.005)，任何形式的IPV实施的OR=0.26(p=0.003)，以及对孩子使用严厉管教的OR=0.56(p=0.19)。夫妻之间的态度、技能和行为的路径变量也出现了积极的变化。这一试点试验表明，家庭安全方案在防止家庭中的多种形式的暴力和改善夫妻之间的平等态度和技能方面非常有效。未来的研究应评估纵向影响和大规模实施。NCT04163549。
To test the effectiveness of the Safe at Home programme which was developed to improve family well-being and prevent multiple forms of violence in the home. Waitlisted pilot cluster randomised controlled trial. North Kivu, Democratic Republic of Congo. 202 heterosexual couples. The Safe at Home programme. The primary outcome was family functioning, with secondary outcomes of past-3 month co-occurring violence, intimate partner violence (IPV) and harsh discipline. Pathway mechanisms assessed included attitudes related to acceptance of harsh discipline, gender equitable attitudes, positive parenting skills and power sharing within the couple. No significant improvements in family functioning were documented for women (β=1.49; 95% CI: −2.75 to 5.74; p=0.49) and men (β=1.09; 95% CI: −3.13 to 4.74; p=0.69). However, women in Safe at Home reported a OR=0.15 (p=0.000), OR=0.23 (p=0.001) and OR=0.29 (p=0.013) change in co-occurring IPV and harsh discipline; physical/sexual/emotional IPV by their partner and use of physical and/or emotional harsh discipline against their child, respectively, as compared with women in the waitlisted group. Men participating in Safe at Home reported a OR=0.23 (p=0.005) change in perpetration of co-occurring violence, OR=0.26 (p=0.003) change in any form of IPV perpetration and OR=0.56 (p=0.19) change in use of harsh discipline against their child as compared with the waitlist arm. Positive changes were also noted in pathway variables around attitudes, skills and behaviours within couples. This pilot trial demonstrated the Safe at Home programme to be highly effective in preventing multiple forms of violence in the home and improving equitable attitudes and skills in couples. Future research should assess longitudinal impact and implementation at scale. NCT04163549.
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