International Rescue Committee, Airbel Impact Lab, Washington, DC, USA
International Rescue Committee, Violence Prevention and Reponse, Washington, DC, USA.
BMJ Open. 2023 Mar 6;13(3):e065759. doi: 10.1136/bmjopen-2022-065759.
To test the effectiveness of the Safe at Home programme which was developed to improve family well-being and prevent multiple forms of violence in the home.
Waitlisted pilot cluster randomised controlled trial.
North Kivu, Democratic Republic of Congo.
202 heterosexual couples.
The Safe at Home programme.
The primary outcome was family functioning, with secondary outcomes of past-3 month co-occurring violence, intimate partner violence (IPV) and harsh discipline. Pathway mechanisms assessed included attitudes related to acceptance of harsh discipline, gender equitable attitudes, positive parenting skills and power sharing within the couple.
No significant improvements in family functioning were documented for women (β=1.49; 95% CI: -2.75 to 5.74; p=0.49) and men (β=1.09; 95% CI: -3.13 to 4.74; p=0.69). However, women in Safe at Home reported a OR=0.15 (p=0.000), OR=0.23 (p=0.001) and OR=0.29 (p=0.013) change in co-occurring IPV and harsh discipline; physical/sexual/emotional IPV by their partner and use of physical and/or emotional harsh discipline against their child, respectively, as compared with women in the waitlisted group. Men participating in Safe at Home reported a OR=0.23 (p=0.005) change in perpetration of co-occurring violence, OR=0.26 (p=0.003) change in any form of IPV perpetration and OR=0.56 (p=0.19) change in use of harsh discipline against their child as compared with the waitlist arm. Positive changes were also noted in pathway variables around attitudes, skills and behaviours within couples.
This pilot trial demonstrated the Safe at Home programme to be highly effective in preventing multiple forms of violence in the home and improving equitable attitudes and skills in couples. Future research should assess longitudinal impact and implementation at scale.
NCT04163549.
测试 Safe at Home 项目的有效性，该项目旨在改善家庭福祉并预防家庭中多种形式的暴力。
候补名单试点群组随机对照试验。
刚果民主共和国北基伍省。
202 对异性夫妇。
Safe at Home 项目。
主要结果是家庭功能，次要结果是过去 3 个月的共发暴力、亲密伴侣暴力（IPV）和严厉管教。评估的途径机制包括与接受严厉管教、性别平等态度、积极育儿技能和夫妻之间权力共享相关的态度。
没有记录到女性（β=1.49；95%CI：-2.75 至 5.74；p=0.49）和男性（β=1.09；95%CI：-3.13 至 4.74；p=0.69）的家庭功能显著改善。然而，参加 Safe at Home 的女性报告说，共发 IPV 和严厉管教、伴侣对其实施的身体/性/情感 IPV 以及对其子女实施的身体和/或情感严厉管教的发生变化的比值比（OR）分别为 0.15（p=0.000）、0.23（p=0.001）和 0.29（p=0.013），与候补组的女性相比。参加 Safe at Home 的男性报告说，共发暴力、任何形式的 IPV 实施和对子女实施严厉管教的比值比（OR）分别为 0.23（p=0.005）、0.26（p=0.003）和 0.56（p=0.19），与候补组相比，这些比值比发生了积极变化。夫妇之间的态度、技能和行为方面的途径变量也发生了积极变化。
这项试点试验表明，Safe at Home 项目在预防家庭中多种形式的暴力和改善夫妻之间平等态度和技能方面非常有效。未来的研究应该评估纵向影响和大规模实施。
NCT04163549。
