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| ID | Type | Description | Link |
|---|---|---|---|
| MR/X004090/1 | Other Grant/Funding Number | UKRI |
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| Name | Class |
|---|---|
| Medical Research Council, South Africa | OTHER |
| University College, London | OTHER |
| Project Empower | OTHER |
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The goal of this uncontrolled intervention study is to assess whether Zithandani Stepping Stones and Creating Futures is feasible to deliver, acceptable for participants, safe for participants and to estimate effect sizes, in young (ages 18-40 years) heterosexual couples, living in urban informal settlements in eThekwini Municipality, South Africa. The main questions it aims to answer are:
Participants will be recruited as heterosexual couples and participate in 14 sessions, each approximately 3 hours long, with between 4 and 6 other couples, focused on gender norms, livelihoods and communication.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Zithandani Stepping Stones and Creating Futures | Experimental | Couples intervention delivered in groups of 4-7 heterosexual couples. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Zithandani Stepping Stones and Creating Futures | Behavioral | Delivered to heterosexual couples. 14 group based sessions, with each session lasting approximately 3 hours. Sessions are delivered by two trained facilitators. Intervention focused on transforming gender norms, strengthening communication, reducing symptoms of poor mental health and improving relationship dynamics. Mixture of couples focused, same-gender discussions, and whole group discussions. |
| Measure | Description | Time Frame |
|---|---|---|
| Physical IPV | Self-reports focused on men's perpetration and women's experience of physical intimate partner violence in the past 3 months, based on the WHO Violence Against Women Module - with 5 items. Recoded as a binary (yes/no) | 6 months post baseline |
| Sexual IPV | Self-reports focused on men's perpetration and women's experience of sexual intimate partner violence in the past 3 months, based on the WHO Violence Against Women Module - with 3 items. Recoded as a binary (yes/no) | 6 months post baseline |
| Emotional IPV | Self-reports focused on men's perpetration and women's experience of sexual intimate partner violence in the past 3 months, based on the WHO Violence Against Women Module - with 8 items. Recoded as a binary (yes/no) | 6 months post baseline |
| Economic IPV | Self-reports focused on men's perpetration and women's experience of sexual intimate partner violence in the past 3 months, based on the WHO Violence Against Women Module - with 7 items. Recoded as a binary (yes/no) | 6 months post baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Gender Attitudes | Attitudes in relation to gender and acceptability of violence (9 items) based on prior research in South Africa. Responses (Strongly Disagree to Strongly Agree) range 9-45, higher scores indicative of greater inequitable gender attitudes. | 6 months post baseline |
| Violence towards children |
| Measure | Description | Time Frame |
|---|---|---|
| Individual Attendance at Intervention | Proportion of sessions attended by individuals who provide informed consent. | From enrollment to end of intervention deliver at ~7 weeks |
| Couples Attendance at Intervention |
Individual inclusion:
Joint inclusion criteria:
Exclusion criteria individuals is as follows:
Joint couples exclusion criteria
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| South African Medical Research Council | Durban | South Africa |
Data will be shared at data repository 12 months after data collection is completed. Data will either be at the SAMRC data repository or the UK Data Service.
12 months after study completion.
Free to download once registered on appropriate sites.
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| ID | Term |
|---|---|
| D000092862 | Psychological Well-Being |
| ID | Term |
|---|---|
| D010549 | Personal Satisfaction |
| D001519 | Behavior |
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|
Among those reporting a child living in their home, perpetration of physical and/or emotional abuse in the past 4 weeks against the child, using 4 items. Recoded into yes/no. |
| 6 months post baseline |
| Trust in relationship/partner measured using the Dyadic Trust scale | 8 Items forming the Dyadic Trust (Larzelere & Huston, 1980), summed with range 8-45. Higher scores indicate more trust in relationship/partner. | 6 months post baseline |
| Relationship Satisfaction | 5 items (Woolf-King et al., 2019) focused on satisfaction in relationship, with scores from 0-50, and higher scores indicate greater satisfaction in relationship. | 6 months post baseline |
| Fear of Emotional Intimacy | 35 items, from (Descutner & Thelen, 1991) responses Strongly Disagree to Strongly Agree (5 point Likert), range 35-175. Higher scores indicate greater fear of emotional intimacy. | 6 months post baseline |
| Empathy for Partner assessed with the Interpersonal Reactivity Index for Couples (IRIC) scale. | 13 items, Empathetic concern using the Interpersonal Reactivity Index for Couples (IRIC) scale. (Péloquin & Lafontaine, 2010) summed together to create score. Score range: 0-52, with higher scores indicating greater empathy for partner. | 6 months post baseline |
| Sexual Intimacy | 13 items, drawn from Conroy et al. (2021), developed in Malawi, and previously used in South Africa. Responses: Strongly disagree to strongly agree (4 point Likert response). Individual items summed together to create a continuous score (13-52). Higher scores indicative of greater sexual intimacy | 6 months post baseline |
| Communication with partner assessed using the Communications Pattern Questionnaire | 11 items, from the Communications Pattern Questionnaire and previously used in South Africa (Woolf-King et al., 2019). Range 11-55, higher scores indicate 'better' communication with partner. | 6 months post baseline |
| Depressive Symptoms assessed using the Patient Health Questionnaire - 9 (PHQ9) | Patient Health Questionnaire - 9 (PHQ9) asking about past 2 week symptoms of depression. Range 0-27. Higher scores indicative of more symptoms of depression. | 6 months post baseline |
| Anxiety Symptoms assessed using the Generalised Anxiety Disorder 7 (GAD7) questionnaire | Generalised Anxiety Disorder 7 (GAD7) (Spitzer et al., 2006) asking about past 2 weeks symptoms of anxiety. Range 0-21. Highers scores indicative of more symptoms of anxiety. | 6 months post baseline |
| Emotional Dysregulation assessed using the Difficulties in Emotional Regulation Scale 16 | Difficulties in Emotional Regulation Scale 16 (DERS-16) - 16 items (Bjureberg et al., 2016) adapted for use in South Africa. Range 16-80, with higher scores indicating greater emotional dysregulation. | 6 months post baseline |
| Alcohol Consumption in past 3 months, assessed with modified Alcohol use disorders identification test consumption (AUDIT C) | Alcohol use disorders identification test consumption (AUDIT C) (3 items). Rather than asking about past 12 months as is normal, items reworded to ask about past 3 months (e.g. In the last 3 months, how often do you have a drink containing alcohol?). Response options as in original scale. Scores range from 0-13, with higher scores indicating more alcohol consumption. | 6 months post baseline |
| Earnings in past month | A single item question asks "Considering all the money you earned from jobs or selling things (excluding grants), how much did you earn last month?" Responses are in Rands (ZAR) and a continuous scale, with no upper limit. | 6 months post baseline |
| Money participant saved in past month | A single item question asks "In the last month how much did you put aside for savings?" Responses are in Rands (ZAR) and are on a continuous scale, with no upper limit. | 6 months post baseline |
| Hunger in the past month | Household food-security questionnaire (3 items) asking about hunger in the household in the past 4 weeks. Range 3-12 with higher scores indicative of greater food insecurity. | 6 months post baseline |
| Frequency of work efforts | 7 items asking about work effort in the past 3 months, adapted for use in South Africa. Scored 0-3, with range 0-21, with higher scores indicative of greater livelihoods effort. | 6 months post baseline |
Proportion of sessions attended by couples who provide informed consent.
| From enrollment to end of intervention deliver at ~7 weeks |