What Works to Prevent Violence Against Women and Girls in Somalia
NCT Number: NCT06554418
Status: RECRUITING
Study Type: INTERVENTIONAL
Phases: NA
Conditions: Violence Prevention
Interventions: BEHAVIORAL: Communities Care
Sponsor: Johns Hopkins University
Collaborators: Comitato Internazionale per los Sviluppo dei Popoli (CISP)
Sex: ALL
Age: CHILD, ADULT, OLDER_ADULT
Enrollment: 3500
Study Design: Allocation: RANDOMIZED|Intervention Model: PARALLEL|Masking: NONE|Primary Purpose: PREVENTION
Start Date: 2024-03-01
Completion Date: 2029-11-01
Locations: CISP Somalia, Mogadishu, Wadajir District, Somalia

Summary:
The Communities Care (CC) program has demonstrated promise in changing harmful social norms associated with Gender-based violence (GBV) and increasing confidence in services for women and girls. Therefore, the study will adapt the existing CC program based on previous learnings with adults and expand programming to include adolescent boys and girls, creating the CC adult and CC adolescent program. The CC program intervention implementation will be led by Comitato Internazionale per lo Sviluppo dei Popoli (CISP) non-Governmental Organization (NGO) in partnership with Somalia Ministry of Education and local Women led Organizations (WLO), public schools and mapped GBV and child protection (CP) service providers in Banadir and Galmudug regions of Somalia.

Johns Hopkins will collaborate with local research colleagues to evaluate the CC adult and CC adolescent program. The study will use a hybrid type 2 effectiveness-implementation design guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Quantitative methods will be used to measure outcomes at baseline and endline (24 months post baseline) with adults and adolescents (10 and older) participants in the CC programs in intervention compared to control districts in the two regions (Banadir and Galmudug) in South Central Somalia. Quantitative methods will also be used to measure outcomes with adults and adolescents (10 years and older) community members (members that do not participate in the CC program) in intervention and control districts in the 2 regions at baseline, midline (12-months), endline (24-months) and maintenance (36 months). In addition, quantitative and qualitative methods at midline and endline will be used to measure the CC adult and CC adolescent intervention reach, adoption, implementation and maintenance in intervention districts in the two regions.

Primary Outcome Measures: Cyber-Sexual Harassment survey score, Adolescent report of experience of peer-to-peer or adult on-line and in-person harassment, Mean scale score ranges from 1 to 5 with higher scores being worse outcome, 9 and 12 months|Peer-to-peer physical and sexual violence in school and community survey score, Adolescent report of experience of peer to peer violence in schools, Mean scale score ranges from 1 to 5 with higher scores being worse outcome, 9 and 12 months|Harsh punishment in school as assessed by the Parent-Child Conflict Scale adapted for teachers, Adolescent report of witness or experience harsh punishment in school using the Parent-Child Conflict Tactics Scale adapted for teachers, Mean scale score 1-5, with higher score being worse outcome, 9 and 12 months|Witnessing intimate partner violence (IPV) survey score, Adolescent report of witnessing IPV in the household, mean scale score ranges from 1 to 5 with higher scores being worse outcome, 9 and 12 months|Harsh Punishment in Household as assessed by the Parent-Child Conflict Scale, Adolescent report of witness and experience harsh punishment in household using Parent-Child Conflict Tactics Scale, mean scale score ranges from 1 to 5 with higher scores being worse outcome, 9 and 12 months|IPV victimization and/or perpetration as assessed by Somalia National Survey, Adult report of experience and/or perpetration of IPV, mean scale score ranges from 1 to 5 with higher scores being worse outcome, 9 and 12 months|Use of Harsh Punishment in Household as assessed by the Parent-Child Conflict Tactics Scale, Adult report of use of harsh punishment, mean scale score ranges from 1 to 5 with higher scores being worse outcome, 9 and 12 months|Non-partner harassment as assessed by the National Somalia Survey, Adult report of non-partner harassment, mean scale score ranges from 1 to 5 with higher scores being worse outcome, 9 and 12 months|Non-partner physical and/or sexual violence victimization as assessed by the National Somalia Survey, Adult report of physical and/or sexual violence victimization by non-partner, mean scale score ranges from 1 to 5 with higher scores being worse outcome, 9 and 12 months
Secondary Outcome Measures: Personal Beliefs and Social Norms about Gender Based Violence as assessed by the Social Norms and Beliefs about Gender Based Violence Scale, Adolescent and adult personal beliefs and social norms about gender based violence, mean scale scores range from 1-5, higher scores being worse outcome, 9 and 12 months|Gender equality survey score, Adult and adolescent report of equality in access to education, resources and decision making between women/girls and men/boys, mean scale score range from 1-5, higher score is worse outcome, 9 and 12 months|IPV acceptability survey score, Adult and adolescent report on acceptability of intimate partner violence (IPV), for example, It is justifiable for a husband to hit his wife because she argues with him, it is acceptable for a husband to force his wife to have sex when she does not want to. mean subscale score range from 1-5, higher score is worse outcome, 9 and 12 months|Sexual and reproductive health knowledge and empowerment score, Adolescent knowledge in the domains of puberty, female genital mutilation (FGM), child marriage, and sexually transmitted infection (STI) and empowerment measured for puberty, child marriage, FGM, PV, and contraception use, mean scale score range from 1-5, higher score is better outcomes, 9 and 12 months|Confidence in service providers (adolescents and adults) score, Adolescent and adult report on confidence in service providers in responding to gender based violence across several sectors (health care, justice system, elders, psychosocial services and community health workers). Mean scale score range from 1-5, higher score is better outcome, 9 and 12 months