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| ID | Type | Description | Link |
|---|---|---|---|
| ECOVI, 101115963 | Other Grant/Funding Number | European Research Council |
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| Name | Class |
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| European Research Council | OTHER |
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This sub-study is part of a larger randomized controlled trial (RCT) titled Disentangling and Preventing Economic Violence against Women (ECOVI). It is conducted in rural and urban communities across Maharashtra, Andhra Pradesh, and Rajasthan, India. The sub-study evaluates the impact of a couples-based financial literacy and gender-transformative intervention on relationship strength, empathy, and mental health among married couples. Using a two-arm cluster RCT design, 150 clusters (villages or community units) are randomized to intervention or control, with ~15 husband-wife pairs per cluster (approximately 2,250 couples in total). Outcomes are measured at baseline (pre-intervention) and endline (post-intervention) approximately six months after delivery of the intervention to assess changes in perceived relationship strength, empathy (using an adapted relationship strengths and empathy scale), and mental health (General Health Questionnaire-6, GHQ-6). The study will also explore whether improvements in relationship strength and empathy mediate the intervention's effect on mental health outcomes.
Studies report that couples-based programs combining financial or economic empowerment content with gender-equity and relationship-building components often yield improved relationship quality. For example, a study for low-income African-American couples describe a 20-hour workshop that significantly reduced stress and improved conflict management and relationship satisfaction at 6 months. Another study observed improved overall relationship quality among low-income couples with children, while studies from Nigeria and India document enhanced communication, trust, and joint decision-making-with adjusted relative odds for improved communication.
Interventions that combine microfinance or business training with participatory gender or relationship education report reductions in intimate partner violence-one study noted a reduction in risk by more than 50%-and improved empowerment through enhanced decision-making.
Measures of mental health and well-being, such as stress reduction and improved financial autonomy, also improved in several evaluations, although mental health outcomes appear less consistently reported than relationship outcomes. Notably, partner empathy was not an explicitly measured outcome in any study. Programs varied in intensity-from 4-8 sessions and multi-day trainings to interventions extending over 24 months-and were implemented in diverse contexts spanning low-income and rural communities in the United States, Africa, and South Asia.
This sub-study provides a focused evaluation of psychosocial outcomes within the broader "Let us Grow Together: Economic Wellbeing for Families" intervention. The main trial is designed to improve families' economic well-being through financial literacy training, while also integrating gender-transformative content to address intra-household dynamics. The sub-study specifically evaluates program impacts on marital relationship quality and mental health. It is premised on the idea that empowering couples with financial skills and promoting equitable, empathetic relationships can strengthen partner bonds and reduce psychological distress.
Participants in the intervention arm attend six structured community-based sessions for couples. These sessions blend financial literacy education (e.g. budgeting, savings, financial planning) with content on gender equity, communication, and shared decision-making. The curriculum is gender-transformative, meaning it challenges traditional gender roles and encourages empathy and cooperation between spouses. Sessions are interactive and participatory, fostering dialogue on relationship expectations, emotional support, and joint problem-solving. Between sessions, couples receive SMS text message reinforcements to encourage practice of the skills learned and to sustain engagement.
The study uses a cluster randomized controlled trial design to avoid contamination between participants. Clusters (such as villages or community centers) are randomly assigned to either the intervention or control arm by an external trial statistician. All eligible couples within intervention clusters receive the couples' sessions program, whereas couples in control clusters do not receive any structured intervention during the study period (control participants continue with services as usual). Both arms undergo identical baseline and endline assessments. The endline survey, conducted after completion of the six sessions, collects data on relationship strength, empathy, and mental health to measure changes from baseline. By comparing these changes between the intervention and control arms, the study will estimate the intervention's causal effect on the targeted outcomes.
In addition to direct outcome evaluation, an exploratory mediation analysis is planned. This analysis will test whether any improvement in mental health (GHQ-6 scores) due to the intervention occurs indirectly through enhanced relationship strength and empathy. In other words, the study will examine if the intervention's effect on participants' mental well-being is mediated by stronger couple relationships and greater spousal empathy. This will help elucidate the mechanism of impact: whether the economic and gender content improves mental health by improving how partners relate to and support each other. Findings from this sub-study will contribute to understanding the added value of integrating relationship-building and gender equity components into economic empowerment programs for families.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Let's Grow Together Intervention | Experimental | Married couples in clusters assigned to the intervention receive a structured program of six community-based sessions. Each session lasts between 2.5 and 3 hours and includes participatory activities, discussions, and exercises. All six sessions would be conducted by the same two facilitators - one male and one female. The content integrates financial literacy (e.g., household budgeting, saving practices, joint financial planning) with gender-transformative training (e.g., equitable household roles, communication skills, conflict resolution, and fostering empathy between spouses). Sessions are delivered by trained facilitators in a group setting with fifteen couples, approximately every 2-4 weeks. Some sensitive content to address economic violence context would be done in a gender segregated manner separately to encourage reflections, ensure safety and reduce defensiveness. Between sessions, SMS reminders and tips are sent to participants' mobile phones to reinforce key messages and |
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| No Structured Support | No Intervention | Married couples in clusters assigned to the control arm do not receive the special couples training during the study period. Participants in control group continue with standard activities and resources available in the community but without the structured sessions provided to the intervention arm. This control condition represents the status quo against which the added effect of the intervention can be measured. After the conclusion of the study, control clusters may be offered the intervention materials or sessions via the NGO partners in case investigators find overall positive treatment effects, ensuring ethical considerations are met. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Let us Grow Together: Economic Wellbeing for Families | Behavioral | Married couples in clusters assigned to the intervention receive a structured program of six community-based sessions. Each session lasts between 2.5 and 3 hours and includes participatory activities, discussions, and exercises. All six sessions would be conducted by the same two facilitators - one male and one female. The content integrates financial literacy (e.g., household budgeting, saving practices, joint financial planning) with gender-transformative training (e.g., equitable household roles, communication skills, conflict resolution, and fostering empathy between spouses). Sessions are delivered by trained facilitators in a group setting with fifteen couples, approximately every 2-4 weeks. Some sensitive content to address economic violence context would be done in a gender segregated manner separately to encourage reflections, ensure safety and reduce defensiveness. Between sessions, SMS reminders and tips are sent to participants' mobile phones to reinforce key messages and e |
| Measure | Description | Time Frame |
|---|---|---|
| Mental Health Scale (General Health Questionnaire - 6) | Change in General Health Questionnaire-6 scores (psychological distress). It is scored on a scale of 0-4, where higher score indicates higher psychological distress. Hypothesis: Greater distress reduction (or well-being increase) in the intervention group. | T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline)) |
| Perceived Relationship Strength (PRS) | Change in the composite Relationship Satisfaction Index (adapted for study); looking at trust, communication, mutual support, conflict resolution. The scale is scored on 1-5 scale, with higher score indicating higher perceived relationship score. Hypothesis: Greater improvement in the intervention group than in controls. | T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline)) |
| Relational Empathy Scale (RE) | Adapted standardized Interpersonal Reactivity Index for Couples (emotional support, perspective-taking). The scale is scored on 1-5 scale, with higher score indicating higher empathy in relationship score. Hypothesis: Larger empathy gains in the intervention group. | T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline)) |
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| Measure | Description | Time Frame |
|---|---|---|
| Proportion of the mental-health effect that is mediated | Investigators will examine whether the intervention's impact on mental health (GHQ-6 at endline) operates partly through improvements in partner empathy and relationship strength measured at endline. Baseline levels of each construct will be adjusted for to improve precision. Empathy and relationship strength will be treated as parallel, potentially correlated mediators; investigators do not assume a temporal order between them because both are only re-measured at endline. Causal mediation effects will be estimated. Investigators will report (i) the indirect effect operating through endline empathy, (ii) the indirect effect operating through endline relationship strength, (iii) the remaining direct effect, and (iv) the percentage of the total treatment effect mediated by each pathway. Cluster-robust inference will be used to reflect community-level randomisation. |
Inclusion Criteria:
Exclusion Criteria:
Female: 18 - 49 years, Male: 18+
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Anushree Dirangane | Contact | 004917673856717 | anushree.dirangane@tum.de |
| Name | Affiliation | Role |
|---|---|---|
| Janina Steinert, Prof. Dr. | Technical University of Munich | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| 50 clusters across Maharashtra, Andhra Pradesh and Rajasthan | Recruiting | Mumbai | Maharashtra | India |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | Falconier, M. K., Kim, J., & Lachowicz, M. J. (2023). Together-A couples' program integrating relationship and financial education: A randomized controlled trial. Journal of Social and Personal Relationships, 40(1), 333-359. https://doi.org/10.1177/02654075221118816 | ||
| 18179329 | Background | Funk JL, Rogge RD. Testing the ruler with item response theory: increasing precision of measurement for relationship satisfaction with the Couples Satisfaction Index. J Fam Psychol. 2007 Dec;21(4):572-83. doi: 10.1037/0893-3200.21.4.572. | |
| 20954780 |
| Label | URL |
|---|---|
| Project Website | View source |
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Individual participant data (IPD) will not be shared. However, fully anonymized datasets may be shared with project partners and qualified researchers working on related topics (e.g., mental health and economic violence) for secondary analyses, including cross-country or pooled analyses, subject to data sharing agreements and ethical approvals.
Timeframe: Anonymized data may be shared beginning in 2026, following primary publications.
Access Criteria:
Available on request upon approval by overall study PI Prof. Dr. Steinert
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jul 25, 2025 | Jul 25, 2025 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D000092862 | Psychological Well-Being |
| ID | Term |
|---|---|
| D010549 | Personal Satisfaction |
| D001519 | Behavior |
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| T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline)) |
| Moderator: Gender Norm Attitudes | Binary classification based on baseline responses reflecting traditional vs progressive views on gender roles | T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline)) |
| Moderator: Household Economic Strain | Self-reported household financial pressure, split at the sample median into high vs low strain. | T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline)) |
| Moderator: Residence Type | Participant households categorized as rural or urban, based on official cluster classification. | T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline)) |
| Moderator: Living Arrangement | Dichotomous indicator of whether the couple lives with in-laws (co-residing) or not. | T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline)) |
| Moderator: Marriage Type | Reported as either a love marriage or an arranged marriage based on participant disclosure at baseline. | T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline)) |
| Moderator: Number of Children | Categorical variable capturing whether couples have no children, 1-2 children, or 3 or more children living in the household. To probe possible non-linear moderation by family size, investigators will run three binary subgroup models-(i) no children, (ii) 1-2 children, (iii) ≥ 3 children-each with its own Treatment × Subgroup interaction. If sample size permits, an additional exploratory model in the Statistical Analysis Plan will treat number of children as a three-category factor (0, 1-2, 3+) or count term; results will be clearly labelled as exploratory. | T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline)) |
| Vayam Organisation | Not yet recruiting | Noida | India |
|
| Background |
| Imai K, Keele L, Tingley D. A general approach to causal mediation analysis. Psychol Methods. 2010 Dec;15(4):309-34. doi: 10.1037/a0020761. |
| 34790432 | Background | Ismayilova L, Karimli L, Gaveras E, To-Camier A, Sanson J, Chaffin J, Nanema R. An Integrated Approach to Increasing Women's Empowerment and Reducing Domestic Violence: Results of a Cluster-Randomized Controlled Trial in a West African Country. Psychol Violence. 2018 Jul;8(4):448-459. doi: 10.1037/vio0000136. Epub 2017 Aug 7. |
| 35140139 | Background | John NA, Adebayo A, Boychuk NA, OlaOlorun F. Intimate partner violence (IPV) prevention using a cross-sectoral couple-based intervention: results from a cluster randomised control trial in Ibadan, Nigeria. BMJ Glob Health. 2022 Feb;7(2):e007192. doi: 10.1136/bmjgh-2021-007192. |
| 17761566 | Background | Kim JC, Watts CH, Hargreaves JR, Ndhlovu LX, Phetla G, Morison LA, Busza J, Porter JD, Pronyk P. Understanding the impact of a microfinance-based intervention on women's empowerment and the reduction of intimate partner violence in South Africa. Am J Public Health. 2007 Oct;97(10):1794-802. doi: 10.2105/AJPH.2006.095521. Epub 2007 Aug 29. |
| Background | Moore, Q., Wood, R. G., & Wu, A. Y. (2023). Impacts of healthy marriage and relationship education with integrated economic stability services. Family Relations, 72(4), 1422-1440. https://doi.org/10.1111/fare.12877 |
| 20155564 | Background | Peloquin K, Lafontaine MF. Measuring empathy in couples: validity and reliability of the Interpersonal Reactivity Index for couples. J Pers Assess. 2010 Mar;92(2):146-57. doi: 10.1080/00223890903510399. |
| 35274093 | Background | Raj A, Ghule M, Johns NE, Battala M, Begum S, Dixit A, Vaida F, Saggurti N, Silverman JG, Averbach S. Evaluation of a gender synchronized family planning intervention for married couples in rural India: The CHARM2 cluster randomized control trial. EClinicalMedicine. 2022 Mar 5;45:101334. doi: 10.1016/j.eclinm.2022.101334. eCollection 2022 Mar. |
| 21776115 | Background | Rao KN, Begum S, Siddappa K, Ravindra K. Validity of a 6-item version of general health questionnaire (g.h.q.) in the hands of a non - psychiatrist. Indian J Psychiatry. 1992 Apr;34(2):145-7. |