Evaluation of Samvedana Plus: An Intervention With Female Sex Workers (FSWs) and Their Intimate Partners to Reduce Partner Violence and Increase Consistent Condom Use Within Intimate Relationships
Phase: NA
Conditions: Violence, Sexual Behaviour, HIV
Sponsor: Karnataka Health Promotion Trust

STRIVE Evaluation of intervention to address condom use and violence among FSWs in intimate relationships: Protocol 
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Protocol Samvedana Plus: Evaluating 
the impact on vulnerability of FSWs to 
HIV and intimate partner violence  
As part of the STRIVE research consortium, KHPT is implementing an intervention with sex workers 
and intimate partners called Samvedana Plus. The intervention aims to reduce vulnerability among 
Female Sex Workers (FSWs) by reducing partner violence and increasing consistent condom use 
within intimate relationships. 
 
The intervention is composed of innovations aimed at three levels: among individual FSWs and their 
intimate partners (IPs); through community-based organizations of female sex workers; and in the 
wider community where the FSWs and their partners live. At the individual level, the intervention 
will focus on the formation of reflection groups for FSWs and access to individual and couples-based 
counselling. These reflection groups are designed to enhance self-esteem, encourage critical thinking 
on gender, social norms, violence, and HIV risk; and build individual and collective efficacy.  At the 
level of FSW collectives, the intervention will focus on strengthening supportive crisis management 
systems for FSWs experiencing intimate partner violence, improved distribution of male and female 
condoms, and improved referrals to clinical services for FSWs and their partners. At the larger 
community level, the intervention will link the FSW groups to women’s organizations, identify and 
train male champions and folk media troops to build a community environment that encourages 
action against intimate partner violence (IPV).  Further information on the intervention and its 
theory of change are available in Appendix A. 
 
The intervention will cover over 2200 FSWs and their intimate partners living in 91 villages and 7 
towns of 4 Talukas of Bagalkot and Bijapur districts in Northern Karnataka. The intervention is partly 
funded by United Nations Trust Fund (UNTF) to End Violence against Women, and implemented by 
KHPT in partnership with two community based organizations (CBO) of FSWs. The intervention has 
been developed and the curriculum for reflection groups and counselling sessions pre-tested and 
revised over the last two years, mainly in the towns. With villages in Bijapur much smaller, and in 
order to ensure comparability between intervention and control clusters, it was decided to restrict 
the evaluation to villages in Bagalkot only, among an estimated 800 FSWs.  
 
This document details the protocol for evaluating Samvedana Plus intervention conducted in 
partnership with the community-based organization (CBO) Chaitanya Mahila Sangha (CMS) in 
Bagalkot district, Karnataka Health Promotion Trust (KHPT), and the London School of Hygiene and 
Tropical Medicine (LSHTM). A separate document details the qualitative component of this study, 
looking more in-depth at relationship change between the participating FSWs and their intimate 
partners. It uses a longitudinal case study method and in-depth interviews with sex workers, their 
intimate partners and the counsellors who lead the reflection groups and provide individual and 
couple-based counselling.  Ethics approval for this qualitative component has already been 
provisionally approved (Review Reference PR/1447/1447). 
 

STRIVE Evaluation of intervention to address condom use and violence among FSWs in intimate relationships: Protocol 
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Existing literature on intimate partner violence and HIV risks among 
FSW 
 
Gender-based violence stems from the low social status of women and girls, undermining their 
safety and well-being. In the context of India, as in many low and middle-income countries, gender-
based violence includes child marriage, sexual violence and intimate partner violence (IPV). A WHO 
multi-country study1 of domestic violence and women’s health found that partner violence is the 
most common form of violence. Data from the National Family Health Survey (NFHS)-32 indicates the 
extent of gender-based domestic violence in India – 35% ever married women aged 15-49 years 
experienced spousal physical or sexual violence while in Karnataka it is 20%. The prevalence of 
violence is much higher among rural women than urban women; among women belonging to the 
Scheduled Castes and Scheduled Tribes (SC/ST) than women from the general category, thereby 
increasing the risk and vulnerability of rural and SC/ST women. 
  
Northern Karnataka is home to one of the most marginalized SC/ST communities in its rural areas – 
the Devadasi sex workers, through a tradition in which young girls are initiated as Devadasis, which 
provides them cultural sanction to engage in sex work. Their situation makes them vulnerable to 
violence from clients (56%), intimate partners (23%), police (7%), and “rowdies” (7%).3 In a 
participatory assessment workshop (2012) that KHPT conducted, FSWs identified key triggers of 
intimate partner violence as insistence on condom use, influence of alcohol, refusal to give status of 
wife to FSW, to have children with her, or accept her children. However, most of the interventions to 
address violence against sex workers are targeted to clients and the police. Addressing intimate 
partner violence is a challenging programmatic gap since the woman and her partner may be in 
more than one intimate relationship.4 The FSW-intimate partner relationships are complex with 98% 
FSWs reporting economic and non-economic support from their main intimate partners, including 
emotional support, social status, and protection from other men5. 
 
FSWs reported low condom use at last sex with their main intimate partner at 38 percent. As per the 
Polling Booth Survey (PBS), 2009, 27% FSWs in Karnataka reported that they could not use the 
condom because either of the partners was under the influence of alcohol.6 Data from NFHS-3 
indicates that women whose husbands drink alcohol experience significantly higher rates of violence 
than women whose husbands do not drink at all. A paper by Beattie et al (2010)7 shows significant 
linkage between women who reported violence, low condom usage, and reduced likelihood of 
accessing HIV services. Gurnani et al (2011)8 cite findings indicating the possibility of addressing the 
broader structural factors of violence as part of HIV prevention programs. 
 
 
                                                          
1 Heise, Lori L., 2011 What Works to Prevent Partner Violence? An Evidence Overview  
2 http://www.measuredhs.com/pubs/pdf/frind3/15chapter15.pdf  
3 http://www.biomedcentral.com/1471-2458/10/476/  
4 Shaw, S and Pillai, P., 2012, Understanding Risk for HIV/STI Transmission and Acquisition within Non-paying 
Partnerships of Female Sex Workers in Southern India, KHPT. 
5 Shaw, S and Pillai, P., 2012, Understanding Risk for HIV/STI Transmission and Acquisition within Non-paying 
Partnerships of Female Sex Workers in Southern India, KHPT. 
6 KHPT, 2010, HIV/AIDS Situation and Response in Karnataka: Epidemiological Appraisal Using Data 
Triangulation. 
7 Beattie et al, “Violence against female sex workers in Karnataka state, south India: impact on health, and 
reductions in violence following an intervention program”, BMC Public Health 2010, 10: 476 
8 Gurnani et al, “An integrated structural intervention to reduce vulnerability to HIV and sexually transmitted 
infections among female sex workers in Karnataka state, south India”, BMC Public Health 2011, 11:755 

STRIVE Evaluation of intervention to address condom use and violence among FSWs in intimate relationships: Protocol 
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The intervention 
 
The intervention is composed of innovations aimed at three levels: among individual FSWs and their 
intimate partners (IPs); through community-based organizations of female sex workers; and in the 
wider community where the FSWs and their partners live. At the level of FSW collectives, the 
intervention will focus on strengthening supportive crisis management systems for FSWs 
experiencing intimate partner violence, improved distribution of male and female condoms, and 
improved referrals to clinical services for FSWs and their partners. 
 
At the individual level, the intervention will focus on the formation of reflection groups for FSWs and 
access to individual and couples-based counselling. The reflection groups will introduce an 
empowerment curriculum with specific sessions focused on: 
• women’s human rights,  
• gender roles and norms 
• violence against women,  
• building solidarity between sex workers,  
• analysing our relationships,  
• responding to HIV-related risks, 
• improving relationship skills and couples communication, 
• negotiation and use of the female condom.   
 
These groups will provide FSWs the motivation and courage to strengthen their individual resolve 
and introduce new mechanisms for protection such as a safety plan.  The wider sex work community 
has implemented a crisis management system where crisis management teams (CMT) are trained to 
intervene in the case of abuse by clients, the police, or street criminals.  The new project will 
encourage women to make a private arrangement with a family members, friend of neighbour, 
which they can call in in case of violence by a partner (or can stay with should a partner become 
abusive or arrive drunk).  
 
Individual counselling sessions will provide women support for action; they will enable counsellors to 
understand the turning points for women – protecting their children from abuse; increased severity 
and frequency of abuse; increased awareness of and access to support services and resources – and 
use them to motivate women to seek change in their IPV situation.9  
 
The project also proposes reflection with and counselling of intimate partners so as to directly 
engage them in the prevention of intimate partner violence. 
 
FSWs will participate in collective action such as rallies, campaigns against domestic violence to 
express and seek solidarity from mainstream women’s groups, positioning violence against FSWs as 
a significant type of gender-based violence that also puts women at risk of STI/HIV. At the larger 
community level, the intervention will link the FSW groups to women’s organizations, identify and 
train male champions and folk media troops to build a community environment that encourages 
action against intimate partner violence (IPV).   
 
The study will test whether the intervention can increase condom use and reduce violence within 
the sex workers' intimate partnerships.   
                                                          
9 Chang, J. C. et al, “Understanding Turning Points in Intimate Partner Violence: Factors and Circumstances 
Leading Women Victims Toward Change”, Journal of Women’s Health (Larchmt), 2010 February; 19(2): 251–259. 

STRIVE Evaluation of intervention to address condom use and violence among FSWs in intimate relationships: Protocol 
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Assumptions 
 
The interventions have been developed following a set of assumptions, and the research (detailed in 
this and the linked qualitative research proposal) will test whether addressing these factors will lead 
to the desired outcomes.  The assumptions are; 
 
1. Given more immediate support will help protect FSWs from future violence 
1. Reduction in violence will happen only if we work with both the victims and the 
perpetuators of violence and other stake holders 
2. With better skills (negotiation, communication) and greater access to female condoms FSWs 
will be able to negotiate safe sex with IP  
3. Individual and collective action against violence and/or STI/HIV transmission requires a 
supporting enabling environment  
4. Building capacities of CBOs and linking them with women’s organization will strengthen the 
support structure 
 
 
Study questions 
The study aims to assess the impact of the interventions on vulnerability of FSWs to HIV and 
intimate partner violence.   
 
Specifically, the research aims to: 
1. Assess the impact of the intervention on consistent condom use and experience of violence 
in intimate relationships among  female sex workers who have access to the intervention 
2. Assess the impact of the intervention on consistent condom use and use of violence in 
intimate relationships among the partners of female sex workers who have access to the 
intervention 
3. Explore how the intervention has affected the response to partner violence among female 
sex workers and the community writ large. 
4. Investigate the processes and causal pathways through which positive changes occur in the 
following areas: enhanced sense of self-worth and individual and collective efficacy; 
enhanced critical thinking on gender, violence, social norms and HIV risks among sex 
workers and their intimate partners; improved sense of safety and well-being among female 
sex workers, increased appreciation among FSWs and their intimate partners of STI/HIV risks 
in the context of intimate partnerships; increased awareness among FSWs, their partners 
and other stakeholders of violence, rights and the law; and reduced acceptance of violence 
by intimate partners among sex workers. 
 
 
Study components 
 
This is a rigorous evaluation study that will be implemented by the Karnataka Health Promotion 
Trust (KHPT), based in Bangalore, Karnataka, in collaboration with the London School of Hygiene and 
Tropical Medicine (LSHTM.  The KHPT will be the implementing agency, with the specific 
responsibilities of data collection, report writing and dissemination of research findings. LSHTM is 
responsible for quality control, contributing to the development of study tools, and study design and 
assistance in analysing and write-up of evaluation results.  
 
The project uses a cluster randomized delayed intervention design to estimate the effect of the 
intervention and this quantitative component has four main components: 

STRIVE Evaluation of intervention to address condom use and violence among FSWs in intimate relationships: Protocol 
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1. A quantitative survey among a random sample of female sex workers with intimate partners 
who are exposed to the intervention and those who are not, at baseline and following the 
intervention  
2. A quantitative survey among the intimate partners of female sex workers who are exposed to 
the intervention (pre and post intervention comparison) 
3. Detailed monitoring of intervention implementation by measuring exposure of each target group to 
various components of intervention 
4. A polling booth survey to validate the responses on primary and secondary outcomes reported 
in face to face interviews. 
 
 
Evaluation design 
 
Indicators and target groups 
The evaluation will collect the quantitative and qualitative data on the following anticipated 
outcomes of the intervention: 
 
Table 1: List of indicators for each target group  
 
FSWs 
IPs 
FSW CBO 
General community 
Impact-level 
outcomes 
• 
Increased 
reported 
consistent 
condom use in 
intimate 
relationships 
• 
Decreased 
experience of 
reported physical 
and/or sexual 
violence in 
intimate 
relationships 
• 
Increased 
reported 
consistent 
condom use in 
intimate 
relationships 
• 
Decreased 
reported use of 
physical and/or 
sexual violence in 
intimate 
relationships 
 
 
Long-term 
outcomes 
• 
Increased individual processes and action to 
reduce intimate partner violence and STI/HIV 
risk 
• 
Enhanced STI/HIV risk perception and skills 
for self protection 
• 
Increased 
collective 
processes and 
action to reduce 
intimate partner 
violence and 
STI/HIV risk 
• 
Improved 
supportive 
environment for 
dialogue and 
action on intimate 
partner violence 
Medium term 
outcomes 
• 
Enhanced sense of 
self-worth and 
individual efficacy 
• 
Improved sense of 
safety and well 
being 
• 
Reduced 
acceptance of 
violence by 
intimate partners 
 
• 
Increased 
appreciation of 
STI/HIV risks in the 
context of 
intimate 
partnerships 
• 
Increased 
awareness of 
violence, rights 
and laws with 
respect to 
intimate partner 
violence 
• 
Reduced 
acceptance of 
violence by 
intimate partners 
• 
Increased 
awareness of 
violence, rights 
and laws with 
respect to 
intimate partner 
violence 
• 
Reduced 
acceptance of 
violence by 
intimate partners 
• 
Enhanced critical thinking on gender, 
violence, social norms and HIV risk 
• 
Increased appreciation of STI/HIV risks in the 
context of intimate partnerships 
• 
Increased awareness of violence, rights and 
laws with respect to intimate partner 
violence 

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Study design 
 
Since April 2012, the intervention started with sensitization of the CBO on intimate partner violence, 
which has been ongoing in all areas. This entails the FSW collectives focusing on strengthening 
supportive crisis management systems for FSWs experiencing intimate partner violence and referral 
for individual and couple counselling.   
 
The intervention will eventually cover over 2200 FSWs and their intimate partners living in 91 
villages and 7 towns of 4 Talukas of Bagalkot and Bijapur districts in Northern Karnataka. The 
intervention has been developed and the curriculum for reflection groups and counselling sessions 
pre-tested and revised over the last two years, mainly in the towns. With villages in Bijapur much 
smaller, and in order to ensure comparability between intervention and control clusters, it was 
decided to restrict the evaluation to villages in Bagalkot only, among an estimated 800 FSWs.  
 
In each of the intervention and control areas, surveys will be carried out both at baseline and after 1 
year of intervention.  
 
Site selection and cluster definition - The intervention is being implemented in 91 villages and 7 
towns of 4 Talukas of Bagalkot and Bijapur districts in Northern Karnataka. Yet during the first two 
years, the curriculum for reflection groups and counselling sessions were developed and tested in 
the towns. Since the villages in Bijapur are much smaller, and in order to ensure comparability 
between intervention and control clusters, the evaluation was restricted to villages in Bagalkot only.   
The village is the unit of randomization, and is stratified by the number of female sex workers with 
intimate partners in the village (above or below 12), and then by village size (1-33rd percentile; 34-
67th percentile; 68-100the percentile).  This produced 8-10 villages per stratum so that 4-5 villages 
can be allocated to the intervention in each. In total 47 villages will be included in the trial.  The 
randomization was performed using STATA and allocated 24 villages to the intervention arm for year 
1 and the balance 23 villages to the wait-list to receive intervention in year 2. 
Sampling of sex workers - The project indicators for reduced vulnerability will be measured in a base-
line and follow-up survey after a year.   The 47 villages have 800 female sex works with intimate 
partners (average 17 per village).  A ‘line-list’ of female sex workers and their intimate partner 
statuses is maintained regularly by the CBO, and this will be used to identify female sex workers for 
baseline and endline surveys.  All women who engage in commercial sex work, are aged over 18, and 
have an intimate partner or had an intimate partner within the last 6 months will be included in the 
surveys.  The surveys will be face-to-face and will include questions on primary and secondary 
outcomes, as well as programme exposure variables.  
Sampling of intimate partners  - it has been recognized that it may not be feasible to reach a sample 
size large enough to measure statistically significant changes among intimate partners, as pretesting 
showed issues with recruiting. Therefore to increase the response rate among intimate partners, 
men will be recruited from a line-list of intimate partners and initially contacted by peer educators 
from the CBOs rather than directly by the research team. Changes in condom use and violence 
reported by intimate partners will therefore not be considered as primary outcomes, but a pre-post 
intervention design will still provide useful information on what change can/cannot be affected by 
the intervention.   

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The sample-size calculation was performed by analyzing simulated data arising from the 800 women, 
distributed according to empirical data from the line-listing.  The analysis was a t-test of the cluster-
level proportions of women having experienced intimate partner violence in the last year between 
intervention and control arms.  The simulations were performed 1500 times, with a control 
proportion of 47%, for different levels of k (the intracluster coefficient of variation), an alpha of 0.05, 
and a narrow range of feasible effect sizes.  The trial will have over 80% power to detect a risk ratio 
of 0.77  if k is between 0.15 and 0.25. This risk ratio corresponds to a risk difference of 11%, or 44 
women who would have experienced intimate partner violence were it not for the intervention.   
Polling pooth survey 
A sub-sample of 260 FSWs will be invited to take part in a polling booth survey in December 2016, 
coinciding with the end of mid-line data collection and before endline. Participants will be recruited 
randomly from the selected villages (Mudhol and Jamakhandi Talukas in Bagalkot). In total, we will 
conduct  26 PBS sessions involving 10-12 FSWs in each session. These  26 sessions will be distributed 
equally across the two talukas (13 sessions each in two talukas). Out of 47 villages we have selected 
26 villages randomly having 10 or more FSWs with an intimate partner.  So from each of the selected 
villages, we will be doing one PBS session. FSWs will be selected randomly using the most updated 
line list of FSWs. There will not be any selection of respondents in those villages where we have only 
10 FSWs.  Participants will be asked a series of 25 questions by an interviewer who will post their 
answers into a closed box. No identifying information will be recorded.  Answers will be analysed at 
a group level. Informed consent will be obtained from all participants.  
Intervention monitoring 
A robust monitoring system has been developed to monitor the activities at group and 
individual/couple levels. The intervention will facilitate the CBOs to form and support group 
sessions, provide individual/couple counselling, and in addressing IPV. Detailed monitoring tools will 
be developed to track the individual FSWs and IPs through their contact with the intervention. 
Data entry and analysis  
The quantitative survey data will be double entered and cleaned using CSPro. At project completion, 
we will assess whether, at follow up, there are significant differences between the intervention and 
control FSWs/IPs in the key indicators of consistent condom use and violence in intimate 
relationships. The final analysis will also assess whether the intervention and control sites 
significantly differ in terms of the long-term and medium-term outcomes.  
Assessing baseline balance 
While randomization is conducted to ensure that the arms of cluster-randomised trials are not 
systematically imbalanced, it is possible that imbalances will arise due to chance.  We expect that 
the arms of this trial will be suitably balanced for the following reasons.   First, this trial has a 
relatively large number of clusters and individual respondents.  Second, the villages included in the 
design have similar characteristics in terms of sex work and relationships between sex workers and 
their intimate partners, the norms that govern such relationships. Third, we stratified the 
randomization by the number of female sex workers with intimate partners in the village, and then 
by village size.  Therefore, we expect that the trial will be largely balanced.  We will assess the extent 
of imbalance in terms of measurable variables as the first step in the analysis.  Any variables for 
which there is indication of imbalance will be adjusted for in the primary analysis of effect.     

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Analysis of primary outcomes 
At project completion, we will assess whether, at follow up, there are significant differences 
between the intervention and control sex workers in the key indicators of condom use and violence 
within their intimate relationships.  We will perform appropriate analysis for stratified trials on the 
cluster mean-summaries, using the t-statistic, to assess the significance of and differences observed 
between the arms.  Adjustment for baseline measures of the outcomes and variables that appear to 
be imbalanced at baseline will be conducted using the ‘two step method’ that is recommended in 
Hayes and Moulton Cluster Randomised Trials.  While this analysis will give a valid estimate of effect, 
and is robust, it may not be statistically optimal given the variation in the size of the clusters.  
Therefore, we will also perform an individual analysis with random effects to account for clustering.  
Both of these analyses will be reported, and any discrepancies will be explored.   
Stata 11 will be used for all analyses. 
Similar methods will be used to compare key indicators, short- and medium-term outcomes.     
Addressing potential biases 
The cluster randomised design will reduce problems associated with confounding factors and 
selection bias, and there is sufficient geographic dispersion of the villages to minimize spill-over 
effects.  The similarity of the intervention and control samples will be assessed at baseline, and any 
differences controlled for in the final analysis. Impact heterogeneity will be addressed by examining 
the intensity of exposure to the intervention among sex workers. 
Potential biases (selection, interviewer and recall biases) will be assessed and addressed in the trial 
as follows:   
Selection bias will be largely addressed as a result of the careful process of randomization and 
selection of subjects. There are chances of selective loss to follow-up which can lead to a bias. There 
will be triangulation with the results of the qualitative longitudinal case studies looking at reasons 
why sex workers or their partners may drop out of the intervention. The self-selection bias with sex 
workers refusing to participate is planned to be countered by the trust created by a careful informed 
consent process and the longstanding relationship that the implementation teams have established 
with sex workers. 
Interviewer biases will be addressed to a large extent by rigorous training of the research 
investigators.  The training will include both class room sessions and field practices and will help 
ensure uniform understanding among all the interviewers and reduce variation between 
interviewers as far as their understanding of questions, questioning and recording of questions and 
responses are concerned.  It will not be possible to mask the interviewers. 
Ethical Framework 
Conducting a study around intimate partner violence and condom use requires careful consideration 
of the potential benefits and harms that may be caused for those involved in the research. Extensive 
discussions between members of the CBO, KHPT programme implementers and LSHTM were held to 
identify strategies to protect the safety of participants and researchers and thus minimize any social 
harms resulting from the research. 

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Informed consent 
Interviews will be conducted in private settings in a sensitive and non-judgmental manner. The 
purpose of the study will be introduced and the respondent will be administered an informed 
consent form before the interview for collecting written or witnessed consent. The Kannada/English 
version of the consent/assent form will be given out to read to the participants and also read out 
and explained before the beginning of the interviews. Written informed consent will be sought prior 
to conducting the interviews.  For women or men who cannot read or write, we will seek oral 
consent witnessed by a friend or family member of the respondent’s choosing. As part of the 
consenting procedure, participants will be assured that their participation is voluntary, and their 
decision to participate will not affect any benefits they receive from the intervention.  
Strategies to maintain confidentiality 
In the context of partner violence research, confidentiality is both a foundation for respecting 
participant privacy and a strategy for limiting harmful fall out that may occur if others deduce the 
nature of the research. Therefore training and strict guidelines will be used with the field team to 
emphasize the importance of confidentiality as a cornerstone of the research.   
Anonymity will be maintained by using proxy names to distinguish individual participants.  The 
identity of the participants and the information shared by them will not be revealed to anyone who 
does not work in the research study. At no time will any of the information given by individual 
participants be shared with anyone outside the research team.  
All questionnaires will be stored in locked filing cabinets in the KHPT offices in Bangalore after the 
data has been computerised. The computer data will be password protected and only the 
statisticians working as part of the research teams will be authorized to open/use the data. Unique 
identifying numbers will be used to identify the questionnaires; no identifying names will be entered 
with the computer data.  All data used at LSHTM will be kept on the secure server.   
Ensuring participant and researcher safety 
Training of interviewers will include content on gender, violence and HIV, role-play, and value 
clarification exercises to limit the possibility that they will communicate judgemental attitudes 
toward respondents, either consciously or unconsciously.  They will be given extensive training on 
the survey instrument and how to handle potential breaches in privacy.   
To limit stigma and possible retaliation from abusive partners, the study will be referred to in the 
community and with other family members, as a study on women and men’s relationships. 
Respondents will be informed of the true nature of the study as part of the informed consent 
process.  We will assume that women know best how to limit their own risk.  
FSW and their intimate partners will be interviewed separately. Discussions with CBO members 
running the project note that the FSW live independently and have their own source of income, 

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making them less vulnerable to threats of retaliation than other women might be. In addition, many 
of the IPs’ do not belong to the same village as the FSW.  
During consent, access numbers to crisis response teams will be given to the women that they can 
call in case of any problems. The interviews will be one-on-one and there will be a code to stop 
talking if anyone interrupts and a plan to start the interview over at a new time or place will be 
decided prior to the interview if this occurs. The location for the interviews will be determined based 
on the comfort of the respondent.