Gopalakrishnan Lakshmi, Patil Sumeet, Das Debangana, Paul Anshuman, Sharma Payal, Kachhwaha Ankur, Choudhary Usha, Diamond-Smith Nadia
University of California San Francisco.
Network for Economics Engineering Research and Management: Neerman.
Res Sq. 2024 Oct 16:rs.3.rs-4255712. doi: 10.21203/rs.3.rs-4255712/v1.
Newly married young women face increased susceptibility to adverse health outcomes, social isolation, and disempowerment, yet interventions targeting this vulnerable group remain limited. We examined the feasibility and acceptability of TARANG, a life skills and reproductive health empowerment intervention, developed for and with young newly married women.
We recruited 42 newly married women as participants in our study. We conducted a convergent mixed-methods, single-group cluster pilot study to the intervention in which 41 participants (retention rate=97.6%) completed both baseline and endline surveys in July 2023 and January 2024, respectively. We assessed three primary outcomes--feasibility using proportion of participants who completed at least 50% sessions, acceptability using proportion completely satisfied/somewhat satisfied with TARANG and usefulness using proportion who found TARANG useful/somewhat useful. We conducted in-depth interviews with a purposive sample of 12 participants to understand intervention acceptance and usefulness of the intervention and 6 program staff and moderators to understand barriers to implementing the intervention. We analyzed the quantitative data with descriptive statistics and qualitative data using thematic analysis. We triangulated data from monitoring data filled by moderators, quantitative surveys with participants, and qualitative data.
In the pilot study, 35/42 participants had completed at least one session. Overall, 82% participants attended at least 50% of the sessions. Among those who attended at least 1 session,97% were satisfied/somewhat satisfied with the intervention and 100% of participants found the intervention to be useful/somewhat useful. Qualitative findings reveal participants' appreciation for open discussions on sensitive topics, such as family planning, and highlight the intervention's role in filling knowledge gaps and fostering social connections, better sense of agency and improved relationships with mothers-in-law and husbands. While barriers to consistent participation were identified, feedback informed refinements to the intervention for the main trial, including session modifications, increased engagement strategies, and integration of educational videos.
Our community-based participatory approach, developed with input from end users, demonstrated not only high acceptability and feasibility but also had many benefits for newly married women in rural/tribal Rajasthan. Our findings also led to adaptations that may enhance delivery of, and satisfaction with TARANG intervention, which will be tested with a larger sample in a rigorous cluster randomized controlled trial in Rajasthan, India.
The study is registered at ClinicalTrials.gov (NCT06320964). Registered retrospectively on 13 March 2024, https://clinicaltrials.gov/study/NCT06320964.
新婚年轻女性面临着更易出现不良健康后果、社会孤立和权利丧失的问题，但针对这一弱势群体的干预措施仍然有限。我们研究了TARANG的可行性和可接受性，这是一项为新婚年轻女性开发并与她们共同设计的生活技能和生殖健康赋权干预措施。
我们招募了42名新婚女性作为研究参与者。我们对该干预措施进行了一项采用收敛性混合方法的单组整群试点研究，其中41名参与者（留存率=97.6%）分别于2023年7月和2024年1月完成了基线调查和终线调查。我们评估了三个主要结果——可行性用完成至少50%课程的参与者比例来衡量，可接受性用对TARANG完全满意/ somewhat满意的参与者比例来衡量，有用性用认为TARANG有用/ somewhat有用的参与者比例来衡量。我们对12名参与者进行了有目的抽样的深入访谈，以了解干预措施的可接受性和有用性，并对6名项目工作人员和主持人进行了访谈，以了解实施干预措施的障碍。我们用描述性统计分析定量数据，用主题分析分析定性数据。我们对主持人填写的监测数据、与参与者的定量调查以及定性数据进行了数据三角验证。
在试点研究中，42名参与者中有35名完成了至少一节课。总体而言，82%的参与者参加了至少50%的课程。在参加了至少一节课的参与者中，97%对干预措施感到满意/ somewhat满意，100%的参与者认为该干预措施有用/ somewhat有用。定性研究结果显示，参与者对诸如计划生育等敏感话题的公开讨论表示赞赏，并强调了该干预措施在填补知识空白、促进社会联系、增强自主意识以及改善与婆婆和丈夫关系方面的作用。虽然确定了持续参与的障碍，但反馈为主要试验的干预措施改进提供了信息，包括课程修改、增加参与策略以及整合教育视频。
我们基于社区的参与式方法是在终端用户的参与下开发的，不仅显示出高可接受性和可行性，而且对拉贾斯坦邦农村/部落地区的新婚女性有诸多益处。我们的研究结果还带来了一些调整，可能会提高TARANG干预措施的实施效果和满意度，这些调整将在印度拉贾斯坦邦进行的一项严格的整群随机对照试验中用更大的样本进行测试。
该研究已在ClinicalTrials.gov注册（NCT06320964）。于2024年3月13日追溯注册，https://clinicaltrials.gov/study/NCT06320964 。
