Clinical trial NCT06916377: The Economics of Domestic Violence: Evidence From Bangladesh
Official title: The Economics of Domestic Violence: Evidence From Bangladesh
Study type: INTERVENTIONAL
Overall status: ACTIVE_NOT_RECRUITING
Phase: NA
Conditions: Intimate Partner Violence (IPV)
Intimate Partner Violence Prevention
Lead sponsor: Yale University
Sponsor class: OTHER
Collaborators: name: Grand Challenges Canada
name: Weiss Foundation
name: World Bank - Sexual Violence Research Initiative (SVRI)
name: Fund for Innovation in Development
name: USAID Development Innovation Ventures
name: The Agency Fund, International Growth Centre (IGC)
name: National Science Foundation
First posted: 2025-04-08
Enrollment: 440
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: FACTORIAL
Intervention model description: Treatment assignment was stratified at the union level, the smallest administrative rural unit. From the two districts combined, a total of 88 unions were selected using Probability Proportional to Size (PPS). Each union contained 5 clusters (villages), yielding a total of 440 clusters. In each village, investigators randomly sampled 20 married couples aged 18-65, yielding a total of 8,800 married couples.
Primary purpose: PREVENTION

Brief summary: This project aims to test the scalability and cost-effectiveness of edutainment-soap operas designed to challenge harmful social norms and promote resilience-as a strategy to improve mental health and reduce intimate partner violence (IPV) in rural Bangladesh. Investigators will run a clustered randomized control trial in which villages will be randomized to one of three versions of the same soap opera: (i) Norms: Challenges harmful norms that condone IPV, targeting the belief that violence is an acceptable way to assert control or maintain reputation, (ii) Norms + Skills: builds on the norms campaign by adding CBT-based skills for stress management and non-violent conflict resolution, (iii) Placebo: No violence content. Investigators will evaluate the impact on attitudes towards IPV and IPV incidence.

Detailed description: Study design features two layers of commuity-level randomization based on a 3x2 factorial design:

First Treatment Variation: Edutainment Content. Communities are randomized into one of three versions of the same soap opera:

1. Norms Campaign (176 communities): Challenges harmful norms that condone IPV, targeting the belief that violence is an acceptable way to assert control or maintain reputation.
2. Norms + Skills Campaign (176 communities): Builds on the norms campaign by adding CBT-based skills for stress management and non-violent conflict resolution.
3. Placebo Campaign (88 communities): Features unrelated content to serve as a control group, isolating the effects of norms and resiliency messaging.

This variation allows for assessing the impact of addressing harmful norms alone from the additional benefits of equipping men with practical coping skills. By comparing the Norms Campaign to the Norms + Skills Campaign, investigators test whether adding stress-coping skills yields additional reductions in IPV and related outcomes.

Second Treatment Variation: Delivery Modes. Fifty percent of communities in each treatment arm are randomized into one of two delivery modes:

1. Private Delivery: Men watch the soap opera privately at home on handheld devices.
2. Public Delivery: Men watch the soap opera publicly through community screenings.

Randomizing delivery modes enables investigators to assess whether men's responses to the intervention are driven by self-esteem concerns (private delivery) or reputation concerns (public delivery). This distinction provides critical insights into the mechanisms underlying IPV and informs the scalability of different delivery methods.

In addition to the community-level randomizations, 50 percent of men in each community are randomized into participation in a cash-for-work program. This individual-level randomization allows us to evaluate the role of economic strain in IPV outcomes, testing whether alleviating financial stress enhances the intervention's effectiveness.

Eligibility criteria: Inclusion Criteria:

* married men and women over the legal age of majority in Bangladesh

Exclusion Criteria:

* No exclusion criteria were imposed.

Primary outcomes:
measure: Demographic and Health Survey (DHS) to assess Acceptability of IPV
timeFrame: 1 month post intervention
measure: Hypothetical vignettes to assess Acceptability of IPV
timeFrame: 1 month post intervention
measure: Hypothetical vignettes to assess Perceptions about others' acceptability of IPV.
timeFrame: 1 month post intervention
measure: Use of coping strategies to assess Men's resilience and mental health.
timeFrame: 1 month post intervention
measure: Patient Health Questionnaire-9 (PHQ-9) to assess Men's resilience and mental health.
timeFrame: 1 month post intervention
measure: Stressors and experiences to assess Men's resilience and mental health.
timeFrame: 1 month post intervention
measure: Biometric stress indicators to assess Men's resilience and mental health.
timeFrame: 1 month post intervention
measure: Adapted version of the DHS to assess Prevalence and frequency of IPV.
timeFrame: 1 month post intervention
measure: Number of participants with IPV-related injuries to assess Prevalence and frequency of IPV.
timeFrame: 1 month post intervention
measure: Health assessments to assess Prevalence and frequency of IPV.
timeFrame: 1 month post intervention
measure: Incidence of IPV to assess Prevalence and frequency of IPV.
timeFrame: Baseline and 6-12 months post intervention
Secondary outcomes:
measure: Respectable man scale to assess Men's self-esteem.
timeFrame: 1 month post intervention
measure: Perceived respectabillity to assess Men's reputation
timeFrame: 1 month post intervention
measure: Cost-effectiveness of the edutainment campaigns assessed by Reduction to IPV exposure
timeFrame: 1 month post intervention
measure: Cost-effectiveness of the edutainment campaigns assessed by benefit-to-cost ratio
timeFrame: 1 month post intervention
measure: Cost-effectiveness of the edutainment campaigns assessed by benefit-to-cost ratio
timeFrame: 1 month post intervention
Other outcomes:
Locations:
city: Dhaka
country: Bangladesh
facility: BRAC University
Study officials:
affiliation: Yale University
name: Nina Buchmann, PhD
role: PRINCIPAL_INVESTIGATOR
References: