A couples-based intervention (Ghya Bharari Ekatra) for the primary prevention of intimate partner violence in India: Pilot feasibility and acceptability study

• Type of Material: Article
• Authors: Ameeta Kalokhe, Emory University; Sandhya Iyer, National AIDS Research Institute India; Keshav Gadhe, National AIDS Research Institute India; Tuman Katendra, National AIDS Research Institute India; Ambika Kolhe, National AIDS Research Institute India; Girish Rahane, National AIDS Research Institute India; Robert Stephenson, Emory University; Seema Sahay, National AIDS Research Institute India
• Language: English
• Date: 2021-02-01
• Publisher: JMIR Publications
• Publication Version: Final Published Version
• Copyright Statement: ©Ameeta Shivdas Kalokhe, Sandhya Iyer, Keshav Gadhe, Tuman Katendra, Ambika Kolhe, Girish Rahane, Rob Stephenson, Seema Sahay. Originally published in JMIR Formative Research (http://formative.jmir.org), 01.02.2021.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.2196/26130
• Title of Journal or Parent Work: JMIR Formative Research
• Volume: 5
• Issue: 2
• Start Page: e26130
• End Page: e26130
• Grant/Funding Information: The work was funded by the Fogarty International Center of the National Institutes of Health (Award K01TW009664). The content does not necessarily represent the views of the National Institutes of Health.
• Keywords: gender-based violence; prevention; pilot study; efficacy; acceptance; India; feasibility; domestic violence; mental health; safety; intimate partner violence; violence; intervention; prevalence
• Research Categories: Psychology, Behavioral; Psychology, Social; Health Sciences, Public Health

Abstract

Background: The high global prevalence of intimate partner violence (IPV) and its association with poor physical and mental health underscore the need for effective primary prevention. We previously developed Ghya Bharari Ekatra (GBE), a couples-based primary prevention intervention for IPV among newly married couples residing in slum communities in Pune, India. Objective: Through this pilot study, we aimed to explore the acceptance, safety, feasibility, and preliminary efficacy of GBE. Methods: Between January and May 2018, we enrolled and assigned 20 couples to receive GBE plus information on IPV support services and 20 control couples to receive information on IPV support services alone. The GBE intervention was delivered over 6 weekly sessions to groups of 3 to 5 couples by lay peer educators in the communities in which the participants resided. Intervention components addressed relationship quality, resilience, communication and conflict negotiation, self-esteem, sexual communication and sexual health knowledge, and norms around IPV. Outcome evaluation included exit interviews with participants and peers to examine acceptance and feasibility challenges and baseline and 3-month follow-up interviews to examine change in IPV reporting and mental health (by women) and alcohol misuse (by men). The process evaluation examined dose delivered, dose received, fidelity, recruitment, participation rate, and context. Results: Half (40/83) of the eligible couples approached agreed to participate in the GBE intervention. Retention rates were high (17/20, 85% across all 6 sessions), feedback from exit interviews suggested the content and delivery methods were very well received, and the community was highly supportive of the intervention. The principal feasibility challenge involved recruiting men with the lowest income who were dependent on daily wages. No safety concerns were reported by female participants over the course of the intervention or at the 3-month follow-up. There were no reported physical or sexual IPV events in either group, but there were fewer incidents of psychological abuse in GBE participants (3/17, 18%) versus control participants (4/16, 25%) at 3-month follow-up. There was also significant improvement in the overall mental health of female intervention participants and declines in the control participants (change in mean General Health Questionnaire-12 score: –0.13 in intervention vs 0.13 in controls; P=.10). Conclusions: GBE has high acceptance, feasibility, and preliminary efficacy in preventing IPV and improving mental health among women. Next steps include refining the intervention content based on pilot findings and examining intervention efficacy through a large-scale randomized trial with longer follow-up.