Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa; Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
Project Empower, Durban, South Africa.
J Adolesc Health. 2020 Mar;66(3):323-335. doi: 10.1016/j.jadohealth.2019.10.004. Epub 2019 Nov 26.
PURPOSE: Young people, not in formal employment or education, face exceedingly high levels of intimate partner violence (IPV). We evaluated whether Stepping Stones and Creating Futures, compared with a wait-list control, can reduce IPV and strengthen livelihoods. METHODS: A cluster randomized controlled trial with 34 clusters in urban informal settlements in eThekwini Municipality, South Africa. Participant inclusion criteria were aged 18-30 years, resident in the informal settlement, and not working or in education. A total of 676 women and 646 men were recruited from September 2015 to September 2016. At recruitment, participants were not blinded to study arm. Endline data were collected from March to October 2018 (24 months postenrollment). Analyses were by intention-to-treat and separate for men and women. No clusters withdrew; endline retention was 74.9% (n = 505) men and 80.6% (n = 545) women. RESULTS: At endline in the intervention arm, men's self-reported past year IPV perpetration was lower (physical IPV [adjusted odds ratio [aOR]: .71, 95% confidence interval [CI]: .51-.97], severe IPV [aOR: .70, 95% CI: .52-.94], and sexual IPV [aOR: .74, 95% CI: .54-1.03]). There was no difference in men's controlling behaviors (β = .06, 95% CI: -.51 to .63) or past month earnings (β = .21, 95% CI: -.42 to .83). For women, earnings were significantly higher in the intervention arm (β = .97, 95% CI: .43-1.51), but there were no differences for past year IPV experience (physical IPV [aOR: .92, 95% CI: .62-1.37]; sexual IPV [aOR: .90, 95% CI: .64-1.28], severe IPV [aOR: .93, 95% CI: .66-1.31]) or controlling behaviors (β = -.01, 95% CI: -.88 to .86). CONCLUSION: Stepping Stones and Creating Futures is effective in reducing men's self-reported perpetration of IPV and strengthening women's livelihoods, but not women's experiences of IPV. TRIAL REGISTRATION: NCT03022370. Registered January 13, 2017.
目的:未就业或未接受教育的年轻人面临极高水平的亲密伴侣暴力(IPV)。我们评估了 Stepping Stones and Creating Futures 是否能降低 IPV 发生率并增强生计,与候补名单对照。
方法:这是一项在南非 eThekwini 市市区非正规住区的 34 个集群进行的集群随机对照试验。参与者纳入标准为年龄 18-30 岁、居住在非正规住区、未就业或接受教育。共有 676 名妇女和 646 名男子于 2015 年 9 月至 2016 年 9 月被招募。入组时,参与者对研究组未设盲。终点数据于 2018 年 3 月至 10 月(入组后 24 个月)收集。分析采用意向治疗,并分别对男性和女性进行分析。无集群退出;终点保留率为男性 74.9%(n=505)和女性 80.6%(n=545)。
结果:在干预组中,男性自我报告的过去一年 IPV 发生率较低(身体暴力 [校正优势比(aOR):.71,95%置信区间(CI):.51-.97]、严重暴力 [aOR:.70,95% CI:.52-.94] 和性暴力 [aOR:.74,95% CI:.54-1.03])。男性的控制行为(β=0.06,95% CI:-0.51 至 0.63)或过去一个月的收入(β=0.21,95% CI:-0.42 至 0.83)没有差异。对于女性,干预组的收入显著较高(β=0.97,95% CI:0.43-1.51),但过去一年的 IPV 经历(身体暴力 [aOR:.92,95% CI:.62-1.37];性暴力 [aOR:.90,95% CI:.64-1.28];严重暴力 [aOR:.93,95% CI:.66-1.31])或控制行为(β=-0.01,95% CI:-0.88 至 0.86)没有差异。
结论:Stepping Stones and Creating Futures 可有效降低男性自我报告的 IPV 发生率并增强女性的生计,但不能降低女性的 IPV 经历。
试验注册:NCT03022370。于 2017 年 1 月 13 日注册。
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