Kalokhe Ameeta Shivdas, Iyer Sandhya, Katendra Tuman, Gadhe Keshav, Kolhe Ambika R, Paranjape Anuradha, Del Rio Carlos, Stephenson Rob, Sahay Seema
Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States.
Department of Global Health, Emory Rollins School of Public Health, Atlanta, GA, United States.
JMIR Res Protoc. 2019 Jan 18;8(1):e11533. doi: 10.2196/11533.
Intimate partner violence (IPV) is frequently experienced by women of low socioeconomic status in India. It is a human rights violation and associated with negative effects on physical and mental well-being, underscoring the need for effective prevention strategies.
This study aimed to develop a dyadic intervention for the primary prevention of IPV among newly married couples residing in slum communities in India.
The intervention was developed using a community-based, mixed-methods design rooted in couple-interdependence theory and guided by the intervention mapping (IM) framework. It used the six critical IM steps to inform the content and delivery of the intervention: (1) needs assessment, (2) preparation of matrices of change objectives, (3) selection of theory-based methods and practical applications, (4) production of intervention components and materials, (5) intervention adoption and implementation, and (6) evaluation planning.
The resulting Ghya Bharari Ekatra (Take a Flight Together) intervention is intended to be delivered in 6 weekly sessions by a trained pair of male and female lay community educators to groups of 3 to 5 newly married couples in the community in which they reside. It uses games, discussions, self-reflections, and skill-building exercises to cover the following topics: enhancing relationship quality time, self-esteem and resilience, communication and conflict management, goal setting and implementation, sexual communication and sexual health and reproductive health knowledge, and redefining and challenging norms surrounding IPV occurrence. The formative work guided the protocol, including module duration and timing (2-hour sessions of convenience to participants), ordering of modules (based on potential level of interest and sensitivity of the topics), content (ie, informed scripts of role plays and films), intervention delivery methods (ie, interactive activities), and selection of the interventionists (based on capacity to connect with participants) and venue (community-based, convenient, and safe spaces). Ghya Bharari Ekatra was piloted between January and May 2018, and evaluation is presently underway.
Ghya Bharari Ekatra is evidence-based, grounded in intervention-mapping, and developed and iteratively refined using a community-based participatory research approach, suggesting it has great potential to be an acceptable and effective solution to preventing IPV among newly married couples.
ClinicalTrials.gov NCT03332134; https://clinicaltrials.gov/ct2/show/NCT03332134.
在印度，社会经济地位较低的女性经常遭受亲密伴侣暴力（IPV）。这是一种侵犯人权的行为，会对身心健康产生负面影响，凸显了制定有效预防策略的必要性。
本研究旨在开发一种二元干预措施，用于对居住在印度贫民窟社区的新婚夫妇进行IPV的一级预防。
该干预措施采用基于社区的混合方法设计，植根于夫妻相互依存理论，并以干预映射（IM）框架为指导。它使用IM的六个关键步骤来指导干预措施的内容和实施：（1）需求评估，（2）制定变革目标矩阵，（3）选择基于理论的方法和实际应用，（4）制作干预组件和材料，（5）干预措施的采用和实施，以及（6）评估计划。
由此产生的“一起飞翔”（Ghya Bharari Ekatra）干预措施计划由一对经过培训的男女非专业社区教育工作者，为居住社区内每组3至5对新婚夫妇，每周进行一次，共6次授课。它通过游戏、讨论、自我反思和技能培养练习，涵盖以下主题：提高关系质量时间、自尊和恢复力、沟通与冲突管理、目标设定与实施、性沟通以及性健康和生殖健康知识，以及重新定义和挑战围绕IPV发生的规范。形成性工作指导了方案制定，包括模块时长和时间安排（方便参与者的2小时课程）、模块顺序（基于主题的潜在兴趣水平和敏感性）、内容（即角色扮演和电影的脚本）、干预实施方法（即互动活动），以及干预人员的选择（基于与参与者建立联系的能力）和场地（基于社区、方便且安全的空间）。“一起飞翔”于2018年1月至5月进行了试点，目前正在进行评估。
“一起飞翔”基于证据，以干预映射为基础，并采用基于社区的参与性研究方法进行开发和反复完善，表明它极有可能成为预防新婚夫妇中IPV的一种可接受且有效的解决方案。
ClinicalTrials.gov NCT03332134；https://clinicaltrials.gov/ct2/show/NCT03332134
