Clinical trial NCT02434796: Study of the Preliminary Effect of TEVAW: a Program to Address Intimate Partner Violence in Northern Tanzania
Official title: A Mixed Methods Study to Test the Preliminary Effect of Together to End Violence Against Women (TEVAW): a Program to Address Intimate Partner Violence in Northern Tanzania
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Intimate Partner Violence
Keywords: Intimate Partner Violence
Gender-Based Violence
Gender
HIV
Lead sponsor: Boston University
Sponsor class: OTHER
Collaborators: name: World Education, Inc.
First posted: 2015-05-05
Enrollment: 900
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: SINGLE_GROUP
Primary purpose: PREVENTION

Brief summary: Women in Tanzania suffer alarming rates of intimate partner violence (IPV) that has detrimental effects on mental and physical health including an increased risk of HIV infection. The investigators will use a cluster randomized control study design to conduct a preliminary evaluation study of TEVAW, an intervention that aims to improve gender equitable attitudes and to decrease tolerance of IPV among men and women in rural Tanzania. Nine villages will be randomly assigned into one of three study arms, each comprised of 150 partnered women and their co-resident male partners. Women in the comparison arm are currently exposed to World Education's savings and lending group intervention (known as LIMCA), in which they receive training on business skills, literacy, child nutrition and health, child protection, intimate partner violence (IPV) and HIV prevention. Women in Intervention Arm 1 will be exposed to LIMCA, while their male partners will participate in male peer group workshops that explore gender norms, IPV and HIV prevention issues. In Intervention Arm 2, men and women will receive the same treatment as Intervention Arm 1 and participate in community dialogues with community leaders to explore similar topics as the male peer groups. Our hypothesis is that study participants in Arm 2 will report improved gender equitable attitudes and lower intolerance of intimate partner violence than participants in Arm 1 and participants in the control group. Data will be collected at baseline and endline using a structured questionnaire with questions from three validated instruments that measure gender equitable attitudes and attitudes about IPV.

Detailed description: Women in Tanzania suffer alarming rates of intimate partner violence (IPV) that has detrimental effects on mental and physical health including an increased risk of HIV infection. The investigators will use a cluster randomized control study design to conduct a preliminary evaluation study of TEVAW, an intervention that aims to improve gender equitable attitudes and to decrease tolerance of IPV among men and women in rural Tanzania. Nine villages will be randomly assigned into one of three study arms, each comprised of 150 partnered women and their co-resident male partners. A total of 450 women and their partners will be recruited for the study. Women in the comparison arm are currently exposed to World Education's savings and lending group intervention (known as LIMCA), in which they receive training on business skills, literacy, child nutrition and health, child protection, intimate partner violence (IPV) and HIV prevention. Women in Intervention Arm 1 will be exposed to LIMCA, while their male partners will participate in male peer group workshops that explore gender norms, IPV and HIV prevention issues. In Intervention Arm 2, men and women will receive the same treatment as Intervention Arm 1 and participate in community dialogues with community leaders to explore similar topics as the male peer groups. Our hypothesis is that study participants in Arm 2 will report improved gender equitable attitudes and lower intolerance of intimate partner violence than participants in Arm 1 and participants in the control group. Data will be collected at baseline and endline using a structured questionnaire with questions from three validated instruments that measure gender equitable attitudes and attitudes about IPV. The following are the specific aims of the study:

1. To test the feasibility, acceptability and proof of concept of two interventions (women's savings groups combined with male peer groups vs. women's savings groups combined with male peer groups and community dialogues) compared to a control group participating only in women's savings groups in Karatu District, Northern Tanzania.
2. To contribute to a better understanding of the attitudes, behaviors and social factors related to intimate partner violence through the exploration of cultural gender norms in Karatu District, Northern Tanzania.

Eligibility criteria: Inclusion Criteria:

* Married women, aged 18 and older, who live in Karatu District in Northern Tanzania with their male partners, who participate in the LIMCA program, are willing to participate, and provide informed consent.
* Male partners of women LIMCA members named above, aged 18 and older who live in Karatu District in Northern Tanzania, are willing to participate, and provide informed consent.

Exclusion Criteria:

* Women who are not partnered, who do not live in the study catchment area, who do not participate in the LIMCA program, and who do not provide informed consent
* Men who are not married or partnered, who do not live in the study catchment area; whose wives/partners do not participate in the LIMCA program, and who do not provide informed consent.

Primary outcomes:
measure: Difference in proportion of men who report a husband is justified in beating his wife
timeFrame: 4 months
Secondary outcomes:
measure: Difference in proportion of men who report gender-inequitable attitudes
timeFrame: 4 months
Other outcomes:
Locations:
Study officials:
affiliation: Boston University Center for Global Health and Development
name: Lisa Messersmith, PhD, MPH
role: PRINCIPAL_INVESTIGATOR
References:
citation: Halim N, Steven Mzilangwe E, Reich N, Badi L, Simmons E, Servidone M, Bingham Holmes N 2nd, Kawemama P, Messersmith LJ. Together to end violence against women in Tanzania: Results of a pilot cluster randomized controlled trial to evaluate preliminary effectiveness of interpersonal and community level interventions to address intimate partner violence. Glob Public Health. 2019 Dec;14(12):1653-1668. doi: 10.1080/17441692.2019.1609062. Epub 2019 May 13.