Adapting an evidenced-based intervention to reduce IPV for use among young heterosexual couples in South Africa

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Violence against women is common globally, with an estimate one-third of women experiencing this in their lifetime. In our previous work we have found that young (ages 18-30 years) women living in urban informal settlements experience even higher rates, with around two-thirds experiencing physical and/or sexual IPV in the past year. While there are a growing number of interventions that seek to reduce violence against women, very few of them are successful for young women in urban informal settlements. In this project we seek to take one effective intervention - Stepping Stones and Creating Futures - and strengthen it to make it more effective, through delivering it to heterosexual couples. In a prior study we showed that Stepping Stones and Creating Futures could reduce men's perpetration of IPV. Other studies have shown that working with couples, rather than 'individual' people can strengthen intervention outcomes. Our prior qualitative work supports this, with some men describing how in Stepping Stones and Creating Futures they worked with their female partner (not in the intervention) to improve outcomes. Another project we have just completed, which focused on young women in similar contexts, found that they thought a couples focused intervention would be beneficial for them.In this project we will adapt Stepping Stones and Creating Futures for use with young (18-30) heterosexual couples living in urban informal settlements in Durban, South Africa. We will first undertake qualitative research with young people and local stakeholders to understand relationship dynamics, among young people. We will then adapt the Stepping Stones and Creating Futures theory of change, curriculum and implementation manuals for use with young couples, engaging extensively with young people in this process. Throughout this work a central focus will be on ensuring women's safety in the project and in the revised intervention curriculum and implementation manuals. And we will undertake additional interviews and workshops to ensure this.We will finally pilot the adapted intervention with 100 couples recruited through communities. We will focus on the acceptability, feasibility and safety of the intervention, with follow-up at 6 months. A secondary outcome will be to assess potential effects sizes of the intervention. If the intervention is promising we will write a protocol for a follow up trial to compare the couples intervention with the original intervention. To ensure young people's meaningful engagement we will establish from the beginning of the project a Young People's Advisory Group, comprising of 10 young people (5 women, 5 men) from similar backgrounds to the communities we are targeting. This group will meet regularly and we will discuss the project with them, test sessions and receive feedback, shaping the project as we go through their engagement.