An intimate partner violence prevention intervention for men, women, and couples in Ethiopia: Additional findings on substance use and depressive symptoms from a cluster-randomized controlled trial
Background Intimate partner violence (IPV) is linked to substance use by male perpetrators and is associated with an increased risk of depression for women who experience violence. Unite for a Better Life (UBL) is a gender-transformative intervention delivered to men, women, and couples in Ethiopia;...
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| description | Background
Intimate partner violence (IPV) is linked to substance use by male perpetrators and is associated with an increased risk of depression for women who experience violence. Unite for a Better Life (UBL) is a gender-transformative intervention delivered to men, women, and couples in Ethiopia; previous evidence demonstrated the intervention significantly reduced experience of and perpetration of IPV when delivered to men and led to more equitable household task-sharing when delivered to men and couples. The aim of this analysis is to assess engagement in the UBL intervention and to examine the relationship between random assignment to the intervention and men's past-year substance use and women's reported depressive symptoms as measured at the individual level.
Methods and findings
A sample of 64 villages in Gurague zone, Ethiopia, was randomly allocated to 4 arms (men's UBL, women's UBL, couples' UBL, or control). In each village, 106 households were randomly sampled, and households in the intervention arms were invited to participate in UBL, consisting of 14 sessions delivered by trained facilitators. Households in the control arm were offered a short educational session on IPV. Descriptive data on participant engagement in the intervention are reported, and outcomes assessed in an intention-to-treat (ITT) analysis include male use of substances (alcohol and khat) and women's depressive symptoms as measured by the Patient Health Questionnaire (PHQ-9). Results from both adjusted and unadjusted specifications are reported, the latter adjusting for baseline covariates including age, education level, marriage length, polygamy, socioeconomic status, months between intervention and endline, and the baseline level of the outcome variable. The baseline sample includes 6,770 respondents surveyed in 2014-2015, and follow-up data were available from 88% of baseline respondents surveyed in 2017-2018; the majority of respondents report no education, and 61% are Muslim. Respondents reported high attendance rates and engagement in the intervention. In addition, there was evidence of a significant reduction in frequent past-year alcohol intoxication self-reported by men (adjusted odds ratio [AOR] = 0.56, 95% CI 0.36-0.85,p= 0.007), and a significant increase in the probability of frequent khat use self-reported by men (AOR = 3.09, 95% CI 1.37-6.96,p= 0.007), both observed in the couples' UBL arm at 24 months' follow-up relative to the control arm. There was a sign |
| doi_str_mv | 10.1371/journal.pmed.1003131 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1371_journal_pmed_1003131</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_8f3625d5d681491383f5b0459362ac6a</doaj_id><sourcerecordid>2479466052</sourcerecordid><originalsourceid>FETCH-LOGICAL-c503t-f01f6377388ae2d40d67ce69b228a0a64e046af9ce3633ccbfeb4565f2eff3c43</originalsourceid><addsrcrecordid>eNqNUk1v1DAQjRCIlsI_QMISR9jFX3ESDpWqVYFKlbjA2XKcceuVYwfb2ar8P_4Xzu62Ug9InDyeeW_eaOZV1VuC14Q15NM2zNErt55GGNYEY0YYeVadkpp3KyIa8fwhpk1zUr1KaYsx7XCHX1YnjLYEE96cVn8uPLI-21FlQJOK2UNEOxsceF0SEXZQqmEPgvjwMSGiEfxHdBf2j_ID0mGeHKQCRJf51obJqs_oYhjswlAOGesH628SKvw09ymrRWFOsGcPULRSsjtA6X6cchgTMjGMSCHt5lS0V7Hgwmh_w6LlcwzOlTBHq9zr6oVRLsGb43tW_fxy-WPzbXX9_evV5uJ6pWvM8spgYgRrGta2CujA8SAaDaLrKW0VVoID5kKZTgMTjGndG-h5LWpDwRimOTur3h36Ti4kebxAkpQ3HRcC17Qgrg6IIaitnGJZbLyXQVm5T4R4I8uSrXYgW8MErYd6EC3hHWEtM3WPed2VtNJClV7nR7W5L0fWZflRuSdNn1a8vZU3YScbzlhbL-O-PzaI4dcMKf9jZH5A6RhSimAeFQiWi9UeWHKxmjxardA-HGh30AeTtF0c80jFGNeC8ZrSEuEF3f4_emOzWlyzCbPP7C_zpe7p</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2479466052</pqid></control><display><type>article</type><title>An intimate partner violence prevention intervention for men, women, and couples in Ethiopia: Additional findings on substance use and depressive symptoms from a cluster-randomized controlled trial</title><source>Public Library of Science (PLoS) Journals Open Access</source><source>DOAJ Directory of Open Access Journals</source><source>Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>Web of Science - Social Sciences Citation Index – 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><creator>Leight, Jessica ; Deyessa, Negussie ; Verani, Fabio ; Tewolde, Samuel ; Sharma, Vandana</creator><contributor>Patel, Vikram</contributor><creatorcontrib>Leight, Jessica ; Deyessa, Negussie ; Verani, Fabio ; Tewolde, Samuel ; Sharma, Vandana ; Patel, Vikram</creatorcontrib><description>Background
Intimate partner violence (IPV) is linked to substance use by male perpetrators and is associated with an increased risk of depression for women who experience violence. Unite for a Better Life (UBL) is a gender-transformative intervention delivered to men, women, and couples in Ethiopia; previous evidence demonstrated the intervention significantly reduced experience of and perpetration of IPV when delivered to men and led to more equitable household task-sharing when delivered to men and couples. The aim of this analysis is to assess engagement in the UBL intervention and to examine the relationship between random assignment to the intervention and men's past-year substance use and women's reported depressive symptoms as measured at the individual level.
Methods and findings
A sample of 64 villages in Gurague zone, Ethiopia, was randomly allocated to 4 arms (men's UBL, women's UBL, couples' UBL, or control). In each village, 106 households were randomly sampled, and households in the intervention arms were invited to participate in UBL, consisting of 14 sessions delivered by trained facilitators. Households in the control arm were offered a short educational session on IPV. Descriptive data on participant engagement in the intervention are reported, and outcomes assessed in an intention-to-treat (ITT) analysis include male use of substances (alcohol and khat) and women's depressive symptoms as measured by the Patient Health Questionnaire (PHQ-9). Results from both adjusted and unadjusted specifications are reported, the latter adjusting for baseline covariates including age, education level, marriage length, polygamy, socioeconomic status, months between intervention and endline, and the baseline level of the outcome variable. The baseline sample includes 6,770 respondents surveyed in 2014-2015, and follow-up data were available from 88% of baseline respondents surveyed in 2017-2018; the majority of respondents report no education, and 61% are Muslim. Respondents reported high attendance rates and engagement in the intervention. In addition, there was evidence of a significant reduction in frequent past-year alcohol intoxication self-reported by men (adjusted odds ratio [AOR] = 0.56, 95% CI 0.36-0.85,p= 0.007), and a significant increase in the probability of frequent khat use self-reported by men (AOR = 3.09, 95% CI 1.37-6.96,p= 0.007), both observed in the couples' UBL arm at 24 months' follow-up relative to the control arm. There was a significant increase in symptoms of moderate depression among women in the women's UBL arm only (AOR = 1.65, 95% CI 1.13-2.41,p= 0.010), again relative to the control arm. There was no evidence of shifts in symptoms of mild or severe depression. The primary limitation of this study is the reliance on self-reported data around sensitive behaviors.
Conclusions
The findings suggest that the UBL intervention was associated with a reduction in men's use of alcohol when delivered to couples, but there was no evidence of a decrease in reported symptoms of depression among women in any experimental arm, and some evidence of an increase in symptoms of moderate depression in the women's UBL arm. Further research should explore how to optimize IPV prevention interventions to target related risks of mental health and substance use.</description><identifier>ISSN: 1549-1277</identifier><identifier>ISSN: 1549-1676</identifier><identifier>EISSN: 1549-1676</identifier><identifier>DOI: 10.1371/journal.pmed.1003131</identifier><identifier>PMID: 32810147</identifier><language>eng</language><publisher>SAN FRANCISCO: Public Library Science</publisher><subject>Abuse ; Aggression ; Alcohol use ; Biology and Life Sciences ; Clinical trials ; Couples ; Decision making ; Domestic violence ; Drug use ; Gender ; General & Internal Medicine ; HIV ; Human immunodeficiency virus ; Intervention ; Life Sciences & Biomedicine ; Medicine and Health Sciences ; Medicine, General & Internal ; Mental depression ; Mental health ; Mental task performance ; People and Places ; Post traumatic stress disorder ; Public health ; Science & Technology ; Social interactions ; Social organization ; Social Sciences ; Substance use ; Systematic review ; Women</subject><ispartof>PLoS medicine, 2020-08, Vol.17 (8), p.e1003131, Article 1003131</ispartof><rights>2020 Leight et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Leight et al 2020 Leight et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>8</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000563452200001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c503t-f01f6377388ae2d40d67ce69b228a0a64e046af9ce3633ccbfeb4565f2eff3c43</citedby><cites>FETCH-LOGICAL-c503t-f01f6377388ae2d40d67ce69b228a0a64e046af9ce3633ccbfeb4565f2eff3c43</cites><orcidid>0000-0002-1691-9682 ; 0000-0001-7223-3928 ; 0000-0002-8642-2786 ; 0000-0002-4156-0229</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7433854/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7433854/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,729,782,786,866,887,2106,2118,2932,23875,27933,27934,28257,28258,53800,53802</link.rule.ids></links><search><contributor>Patel, Vikram</contributor><creatorcontrib>Leight, Jessica</creatorcontrib><creatorcontrib>Deyessa, Negussie</creatorcontrib><creatorcontrib>Verani, Fabio</creatorcontrib><creatorcontrib>Tewolde, Samuel</creatorcontrib><creatorcontrib>Sharma, Vandana</creatorcontrib><title>An intimate partner violence prevention intervention for men, women, and couples in Ethiopia: Additional findings on substance use and depressive symptoms from a cluster-randomized controlled trial</title><title>PLoS medicine</title><addtitle>PLOS MED</addtitle><description>Background
Intimate partner violence (IPV) is linked to substance use by male perpetrators and is associated with an increased risk of depression for women who experience violence. Unite for a Better Life (UBL) is a gender-transformative intervention delivered to men, women, and couples in Ethiopia; previous evidence demonstrated the intervention significantly reduced experience of and perpetration of IPV when delivered to men and led to more equitable household task-sharing when delivered to men and couples. The aim of this analysis is to assess engagement in the UBL intervention and to examine the relationship between random assignment to the intervention and men's past-year substance use and women's reported depressive symptoms as measured at the individual level.
Methods and findings
A sample of 64 villages in Gurague zone, Ethiopia, was randomly allocated to 4 arms (men's UBL, women's UBL, couples' UBL, or control). In each village, 106 households were randomly sampled, and households in the intervention arms were invited to participate in UBL, consisting of 14 sessions delivered by trained facilitators. Households in the control arm were offered a short educational session on IPV. Descriptive data on participant engagement in the intervention are reported, and outcomes assessed in an intention-to-treat (ITT) analysis include male use of substances (alcohol and khat) and women's depressive symptoms as measured by the Patient Health Questionnaire (PHQ-9). Results from both adjusted and unadjusted specifications are reported, the latter adjusting for baseline covariates including age, education level, marriage length, polygamy, socioeconomic status, months between intervention and endline, and the baseline level of the outcome variable. The baseline sample includes 6,770 respondents surveyed in 2014-2015, and follow-up data were available from 88% of baseline respondents surveyed in 2017-2018; the majority of respondents report no education, and 61% are Muslim. Respondents reported high attendance rates and engagement in the intervention. In addition, there was evidence of a significant reduction in frequent past-year alcohol intoxication self-reported by men (adjusted odds ratio [AOR] = 0.56, 95% CI 0.36-0.85,p= 0.007), and a significant increase in the probability of frequent khat use self-reported by men (AOR = 3.09, 95% CI 1.37-6.96,p= 0.007), both observed in the couples' UBL arm at 24 months' follow-up relative to the control arm. There was a significant increase in symptoms of moderate depression among women in the women's UBL arm only (AOR = 1.65, 95% CI 1.13-2.41,p= 0.010), again relative to the control arm. There was no evidence of shifts in symptoms of mild or severe depression. The primary limitation of this study is the reliance on self-reported data around sensitive behaviors.
Conclusions
The findings suggest that the UBL intervention was associated with a reduction in men's use of alcohol when delivered to couples, but there was no evidence of a decrease in reported symptoms of depression among women in any experimental arm, and some evidence of an increase in symptoms of moderate depression in the women's UBL arm. Further research should explore how to optimize IPV prevention interventions to target related risks of mental health and substance use.</description><subject>Abuse</subject><subject>Aggression</subject><subject>Alcohol use</subject><subject>Biology and Life Sciences</subject><subject>Clinical trials</subject><subject>Couples</subject><subject>Decision making</subject><subject>Domestic violence</subject><subject>Drug use</subject><subject>Gender</subject><subject>General & Internal Medicine</subject><subject>HIV</subject><subject>Human immunodeficiency virus</subject><subject>Intervention</subject><subject>Life Sciences & Biomedicine</subject><subject>Medicine and Health Sciences</subject><subject>Medicine, General & Internal</subject><subject>Mental depression</subject><subject>Mental health</subject><subject>Mental task performance</subject><subject>People and Places</subject><subject>Post traumatic stress disorder</subject><subject>Public health</subject><subject>Science & Technology</subject><subject>Social interactions</subject><subject>Social organization</subject><subject>Social Sciences</subject><subject>Substance use</subject><subject>Systematic review</subject><subject>Women</subject><issn>1549-1277</issn><issn>1549-1676</issn><issn>1549-1676</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>ARHDP</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNqNUk1v1DAQjRCIlsI_QMISR9jFX3ESDpWqVYFKlbjA2XKcceuVYwfb2ar8P_4Xzu62Ug9InDyeeW_eaOZV1VuC14Q15NM2zNErt55GGNYEY0YYeVadkpp3KyIa8fwhpk1zUr1KaYsx7XCHX1YnjLYEE96cVn8uPLI-21FlQJOK2UNEOxsceF0SEXZQqmEPgvjwMSGiEfxHdBf2j_ID0mGeHKQCRJf51obJqs_oYhjswlAOGesH628SKvw09ymrRWFOsGcPULRSsjtA6X6cchgTMjGMSCHt5lS0V7Hgwmh_w6LlcwzOlTBHq9zr6oVRLsGb43tW_fxy-WPzbXX9_evV5uJ6pWvM8spgYgRrGta2CujA8SAaDaLrKW0VVoID5kKZTgMTjGndG-h5LWpDwRimOTur3h36Ti4kebxAkpQ3HRcC17Qgrg6IIaitnGJZbLyXQVm5T4R4I8uSrXYgW8MErYd6EC3hHWEtM3WPed2VtNJClV7nR7W5L0fWZflRuSdNn1a8vZU3YScbzlhbL-O-PzaI4dcMKf9jZH5A6RhSimAeFQiWi9UeWHKxmjxardA-HGh30AeTtF0c80jFGNeC8ZrSEuEF3f4_emOzWlyzCbPP7C_zpe7p</recordid><startdate>20200801</startdate><enddate>20200801</enddate><creator>Leight, Jessica</creator><creator>Deyessa, Negussie</creator><creator>Verani, Fabio</creator><creator>Tewolde, Samuel</creator><creator>Sharma, Vandana</creator><general>Public Library Science</general><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>17B</scope><scope>AOWDO</scope><scope>ARHDP</scope><scope>BLEPL</scope><scope>DTL</scope><scope>DVR</scope><scope>EGQ</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope><scope>DOA</scope><scope>CZK</scope><orcidid>https://orcid.org/0000-0002-1691-9682</orcidid><orcidid>https://orcid.org/0000-0001-7223-3928</orcidid><orcidid>https://orcid.org/0000-0002-8642-2786</orcidid><orcidid>https://orcid.org/0000-0002-4156-0229</orcidid></search><sort><creationdate>20200801</creationdate><title>An intimate partner violence prevention intervention for men, women, and couples in Ethiopia: Additional findings on substance use and depressive symptoms from a cluster-randomized controlled trial</title><author>Leight, Jessica ; Deyessa, Negussie ; Verani, Fabio ; Tewolde, Samuel ; Sharma, Vandana</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c503t-f01f6377388ae2d40d67ce69b228a0a64e046af9ce3633ccbfeb4565f2eff3c43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abuse</topic><topic>Aggression</topic><topic>Alcohol use</topic><topic>Biology and Life Sciences</topic><topic>Clinical trials</topic><topic>Couples</topic><topic>Decision making</topic><topic>Domestic violence</topic><topic>Drug use</topic><topic>Gender</topic><topic>General & Internal Medicine</topic><topic>HIV</topic><topic>Human immunodeficiency virus</topic><topic>Intervention</topic><topic>Life Sciences & Biomedicine</topic><topic>Medicine and Health Sciences</topic><topic>Medicine, General & Internal</topic><topic>Mental depression</topic><topic>Mental health</topic><topic>Mental task performance</topic><topic>People and Places</topic><topic>Post traumatic stress disorder</topic><topic>Public health</topic><topic>Science & Technology</topic><topic>Social interactions</topic><topic>Social organization</topic><topic>Social Sciences</topic><topic>Substance use</topic><topic>Systematic review</topic><topic>Women</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leight, Jessica</creatorcontrib><creatorcontrib>Deyessa, Negussie</creatorcontrib><creatorcontrib>Verani, Fabio</creatorcontrib><creatorcontrib>Tewolde, Samuel</creatorcontrib><creatorcontrib>Sharma, Vandana</creatorcontrib><collection>Web of Knowledge</collection><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science - Social Sciences Citation Index – 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Social Sciences Citation Index</collection><collection>Web of Science Primary (SCIE, SSCI & AHCI)</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><collection>PLoS Medicine</collection><jtitle>PLoS medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leight, Jessica</au><au>Deyessa, Negussie</au><au>Verani, Fabio</au><au>Tewolde, Samuel</au><au>Sharma, Vandana</au><au>Patel, Vikram</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An intimate partner violence prevention intervention for men, women, and couples in Ethiopia: Additional findings on substance use and depressive symptoms from a cluster-randomized controlled trial</atitle><jtitle>PLoS medicine</jtitle><stitle>PLOS MED</stitle><date>2020-08-01</date><risdate>2020</risdate><volume>17</volume><issue>8</issue><spage>e1003131</spage><pages>e1003131-</pages><artnum>1003131</artnum><issn>1549-1277</issn><issn>1549-1676</issn><eissn>1549-1676</eissn><abstract>Background
Intimate partner violence (IPV) is linked to substance use by male perpetrators and is associated with an increased risk of depression for women who experience violence. Unite for a Better Life (UBL) is a gender-transformative intervention delivered to men, women, and couples in Ethiopia; previous evidence demonstrated the intervention significantly reduced experience of and perpetration of IPV when delivered to men and led to more equitable household task-sharing when delivered to men and couples. The aim of this analysis is to assess engagement in the UBL intervention and to examine the relationship between random assignment to the intervention and men's past-year substance use and women's reported depressive symptoms as measured at the individual level.
Methods and findings
A sample of 64 villages in Gurague zone, Ethiopia, was randomly allocated to 4 arms (men's UBL, women's UBL, couples' UBL, or control). In each village, 106 households were randomly sampled, and households in the intervention arms were invited to participate in UBL, consisting of 14 sessions delivered by trained facilitators. Households in the control arm were offered a short educational session on IPV. Descriptive data on participant engagement in the intervention are reported, and outcomes assessed in an intention-to-treat (ITT) analysis include male use of substances (alcohol and khat) and women's depressive symptoms as measured by the Patient Health Questionnaire (PHQ-9). Results from both adjusted and unadjusted specifications are reported, the latter adjusting for baseline covariates including age, education level, marriage length, polygamy, socioeconomic status, months between intervention and endline, and the baseline level of the outcome variable. The baseline sample includes 6,770 respondents surveyed in 2014-2015, and follow-up data were available from 88% of baseline respondents surveyed in 2017-2018; the majority of respondents report no education, and 61% are Muslim. Respondents reported high attendance rates and engagement in the intervention. In addition, there was evidence of a significant reduction in frequent past-year alcohol intoxication self-reported by men (adjusted odds ratio [AOR] = 0.56, 95% CI 0.36-0.85,p= 0.007), and a significant increase in the probability of frequent khat use self-reported by men (AOR = 3.09, 95% CI 1.37-6.96,p= 0.007), both observed in the couples' UBL arm at 24 months' follow-up relative to the control arm. There was a significant increase in symptoms of moderate depression among women in the women's UBL arm only (AOR = 1.65, 95% CI 1.13-2.41,p= 0.010), again relative to the control arm. There was no evidence of shifts in symptoms of mild or severe depression. The primary limitation of this study is the reliance on self-reported data around sensitive behaviors.
Conclusions
The findings suggest that the UBL intervention was associated with a reduction in men's use of alcohol when delivered to couples, but there was no evidence of a decrease in reported symptoms of depression among women in any experimental arm, and some evidence of an increase in symptoms of moderate depression in the women's UBL arm. Further research should explore how to optimize IPV prevention interventions to target related risks of mental health and substance use.</abstract><cop>SAN FRANCISCO</cop><pub>Public Library Science</pub><pmid>32810147</pmid><doi>10.1371/journal.pmed.1003131</doi><tpages>23</tpages><orcidid>https://orcid.org/0000-0002-1691-9682</orcidid><orcidid>https://orcid.org/0000-0001-7223-3928</orcidid><orcidid>https://orcid.org/0000-0002-8642-2786</orcidid><orcidid>https://orcid.org/0000-0002-4156-0229</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Abuse Aggression Alcohol use Biology and Life Sciences Clinical trials Couples Decision making Domestic violence Drug use Gender General & Internal Medicine HIV Human immunodeficiency virus Intervention Life Sciences & Biomedicine Medicine and Health Sciences Medicine, General & Internal Mental depression Mental health Mental task performance People and Places Post traumatic stress disorder Public health Science & Technology Social interactions Social organization Social Sciences Substance use Systematic review Women |
| title | An intimate partner violence prevention intervention for men, women, and couples in Ethiopia: Additional findings on substance use and depressive symptoms from a cluster-randomized controlled trial |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-01T05%3A57%3A53IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=An%20intimate%20partner%20violence%20prevention%20intervention%20for%20men,%20women,%20and%20couples%20in%20Ethiopia:%20Additional%20findings%20on%20substance%20use%20and%20depressive%20symptoms%20from%20a%20cluster-randomized%20controlled%20trial&rft.jtitle=PLoS%20medicine&rft.au=Leight,%20Jessica&rft.date=2020-08-01&rft.volume=17&rft.issue=8&rft.spage=e1003131&rft.pages=e1003131-&rft.artnum=1003131&rft.issn=1549-1277&rft.eissn=1549-1676&rft_id=info:doi/10.1371/journal.pmed.1003131&rft_dat=%3Cproquest_cross%3E2479466052%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2479466052&rft_id=info:pmid/32810147&rft_doaj_id=oai_doaj_org_article_8f3625d5d681491383f5b0459362ac6a&rfr_iscdi=true |