Background
Stepping Stones and Creating Futures (SS/CF) is a gender transformative and economic empowerment intervention that has effectively reduced the perpetration of intimate partner violence (IPV) by young men living in informal settlements in South Africa.
Objective
This study examines whether depression mediated the association between SS/CF intervention and decreased IPV.
Method
Data from a two-arm cluster randomised community-based controlled trial that evaluated the effectiveness of SS/CF in lowering IPV were obtained from 674 young men aged 18–30 within urban informal settlements in South Africa. After being randomly assigned to either the experimental arm (SS/CF) or the control arm, the participants were followed up for 24 months. Logistic regression using mediation analysis was conducted to see whether changes in depressive symptoms mediated the association between the intervention and reduced IPV perpetration.
Results
Findings from the mediation analysis indicated that those assigned to the SS/CF experimental group reported lower depression (β = -0.42,
p
< 0.05) at 12 months, and this was subsequently associated with reduced IPV (β = 0.43,
p
< 0.05) at 24 months. The direct path from SS/CF to IPV was originally (β = -0.46,
p
< 0.01), but reduced in the mediation model to (β = -0.13,
p
= 0.50). Depressive symptoms mediated the association between the SS/CF intervention and decreased IPV perpetration.
Conclusion
These findings suggest that one pathway through which SS/CF decreased IPV was through improvement in mental health (i.e. depression). Future IPV prevention interventions may consider incorporating components that focus on improving mental health as a way of also reducing IPV perpetration in disadvantaged settings.
Background: Informal settlements are high density areas in and around cities, characterized by a lack of formal planning and basic amenities, being known in South Africa for high levels of mental disorder driven by violence, and complex social and economic challenges. In particular, young men’s poor mental health goes untreated, with relatively few evidenced-based interventions available in this setting. Aim: This cluster randomized controlled trial investigated the effectiveness of Stepping Stones and Creating Futures (SS/CF), a participatory gender transformative and economic empowerment intervention, on the mental health of young men living in South African informal settlement. Methods: A total of 674 young men ages 18 to 30 years were recruited in 34 clusters in Durban’s urban informal settlements. Clusters were randomly allocated (1:1) to either the experimental SS/CF or control arm and participants were followed-up over 24-months. Intention-to-treat analysis based on generalized estimating equations (GEE) were fitted to quantify the impact of SS/CF on the men’s anxiety and post-traumatic stress (PTS) symptomatology. Results: At end of the 24 months follow-period, anxiety (adjusted odds ratio [aOR]: 0.62, p = .04, 95% CI [0.39, 0.99]) and PTS (aOR = 0.52, p = .03, 95% CI [0.29, 0.93]) were significantly lower for group assigned to the SS/CF compared to the control group. Conclusion: SS/CF, a gender transformative and livelihoods strengthening intervention designed to address poverty and other socio-economic challenges in informal settlements reduced anxiety and PTS among men with mental health challenges living in informal settlements.
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