Clinical trial NCT02349321: Skhokho Supporting Success: A Cluster RCT of a Multi-faceted, School-based IPV Prevention Intervention in South Africa
Official title: Skhokho Supporting Success: A Cluster Randomised Controlled Trial of a Multi-faceted, School-based Intimate Partner Violence Primary Prevention Intervention in Gauteng, South Africa
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Partner of Victim of Physical Abuse
Keywords: physical or sexual intimate partner violence
adolescents
primary prevention
randomised controlled trial
school
South Africa
parenting
Lead sponsor: Medical Research Council, South Africa
Sponsor class: OTHER
First posted: 2015-01-28
Enrollment: 3192
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: Development and evaluation of a multi-faceted school-based intervention to prevent intimate partner violence among Grade 8 high school students in South Africa

Detailed description: Primary prevention of intimate partner violence among young men and women requires an intervention which addresses the underlying driving factors of such violence operating at different ecological levels.That is, interventions need to address factors impacting directly on youth and their family relationships, school as an institutional setting. In the school, holistic interventions strengthen the curriculum and teaching, but also the broader environment of learning, including addressing positive discipline and the culture of the school. In order to prevent violence, interventions need to build gender equality, challenge the normative use of violence in schools and homes (e.g., corporal punishment), strengthen teen-adult relationships and communication, and build negotiation and conflict resolution skills, as well as addressing stress and coping.

A three-arm, cluster randomised controlled trial based in high schools in Gauteng, South Africa is evaluating such a multi-faceted primary prevention intervention. This intervention includes school strengthening components for learners and educators, which includes providing a teaching materials for the grade 8 life orientation (LO) curriculum (which covers gender and violence), training teachers in LO teaching, training staff on positive discipline and establishing learner clubs. A second intervention seeks to strengthen families and is a workshop based intervention delivered over 4 day long sessions for a parent or caregiver and their grade 8 adolescent.

The intervention is being evaluated in a three arm randomised controlled trial, with school-level randomisation involving 24 schools. One is a delayed intervention control arm, two arms have the school strengthening intervention and one arm additionally have the family strengthening intervention.

The outcomes will be addressed using qualitative and quantitative methods with data collected from Grade 8 learners (the primary outcome group), school educators and administrators, and parents/caregivers of Grade 8s. These measures will be conducted pre-intervention and at 6, 12, and 18 month follow up periods. In addition, an economic costing evaluation will be conducted.

Eligibility criteria: Inclusion Criteria:

* LEARNER/TEEN PARTICIPANTS: enrolled in Grade 8 in one of the study schools; informed consent from parent/guardian to participate in study
* EDUCATOR PARTICIPANTS: currently employed/working as an educator (of any group of learners) at one of the study schools
* PARENT/CAREGIVER PARTICIPANTS: the male or female parent/caregiver/guardian of a Grade 8 learner in Arm 2 schools

Exclusion Criteria:

NONE

Primary outcomes:
measure: The incidence of IPV (perpetration of physical or sexual IPV for boys and victimisation for girls)
timeFrame: Over 18 months of the study
measure: The incidence of severe physical and sexual IPV
timeFrame: Over the last 12 months of the study
Secondary outcomes:
measure: Child-caregiver communication scores
timeFrame: 18 month follow up
measure: Childhood trauma scale scores
timeFrame: 18 month follow up
measure: The incidence of non-partner rape victimisation and perpetration
timeFrame: Over 18 months of the study
measure: Childhood trauma exposure incidence
timeFrame: 18 month follow up
measure: Bullying at school score
timeFrame: 18 month follow up
measure: Score for communication with girlfriend/boyfriend
timeFrame: 18 month follow up
measure: The incidence of emotional Intimate Partner Violence perpetration (for boys) and victimisation (for girls)
timeFrame: 18 months follow up
measure: the incidence of delinquency
timeFrame: 18-month follow up
measure: Depression and anxiety score measured on the Child Depression Inventory
timeFrame: 18-month follow up
measure: Gender attitudes score measured across 5 items
timeFrame: 18-month follow up
Other outcomes:
Locations:
Study officials:
affiliation: SA Medical Research Council
name: Rachel Jewkes, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: SA Medical Research Council
name: Anik Gevers, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Jewkes R, Gevers A, Chirwa E, Mahlangu P, Shamu S, Shai N, Lombard C. RCT evaluation of Skhokho: A holistic school intervention to prevent gender-based violence among South African Grade 8s. PLoS One. 2019 Oct 29;14(10):e0223562. doi: 10.1371/journal.pone.0223562. eCollection 2019.
citation: Shamu S, Gevers A, Mahlangu BP, Jama Shai PN, Chirwa ED, Jewkes RK. Prevalence and risk factors for intimate partner violence among Grade 8 learners in urban South Africa: baseline analysis from the Skhokho Supporting Success cluster randomised controlled trial. Int Health. 2016 Jan;8(1):18-26. doi: 10.1093/inthealth/ihv068. Epub 2015 Dec 5.