Primary Prevention of Intimate Partner Violence Among Recently Married Dyads Residing in the Slums of Pune, India: Development and Rationale for a Dyadic Intervention

Abstract

BackgroundIntimate 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.ObjectiveThis study aimed to develop a dyadic intervention for the primary prevention of IPV among newly married couples residing in slum communities in India.MethodsThe 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.ResultsThe 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.ConclusionsGhya 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.Trial RegistrationClinicalTrials.gov NCT03332134; https://clinicaltrials.gov/ct2/show/NCT03332134

Addressing the Needs of Abused Chinese Women Through a Community‐Based Participatory Approach

“…Application of the CBPA (Barnack‐Tavlaris, Garcini, Sanchez, Hernandez, & Navarro, 2013; Harris, Pensa, Redlich, Pisani, & Rosenthal, 2016; Kalokhe et al, 2019; Leff et al, 2010; Lincoln et al, 2016; Smith et al, 2016;) has yielded promising positive outcomes in violence‐related or disease‐related programs. It was apparent that interventions or programs that were developed through the CBPA had demonstrated several benefits for abused Chinese women—the abused women had actively participated and were fully engaged in the development of the intervention by providing ideas and input, and they were involved in the whole implementation process.…”

Evidence-based Health Promotion for Youth, Farmers and Families of the Gore Community: A Focus on Mental Health and Family Violence

“…Some programmes were primarily prevention-focused and aimed at high schools or colleges (Jaime et al, 2018), while others were aimed at individuals who were at risk of, or had engaged in, violent behaviours. The interventions reported by these studies include working with couples to improve relationship skills (Kalokhe et al, 2019); teaching self-regulation techniques (Wistow, Kelly, & Westmarland, 2017); stopping violence group education (Hayward, Steiner, & Sproule, 2007); and peer support groups (Casey, Leek, Tolman, Allen, & Carlson, 2017).…”

“…The following strategies were identified in the literature as effective and were taken into consideration during the development of a health promotion resource for family violence prevention in Gore: (Kalokhe et al, 2019) To achieve effective engagement with such prevention strategies, the barriers of masculine ideology, stigmatisation and isolation must also be addressed, particularly in a rural New Zealand community (Jackson et al, 2009;Rural Women New Zealand, 2018). A health promotion resource has the potential to challenge social norms and stigmas through education, language and imagery, while also raising awareness and encouraging healthy conversations (World Health Organization, 1986).…”

A Couples-Based Intervention (Ghya Bharari Ekatra) for the Primary Prevention of Intimate Partner Violence in India: Pilot Feasibility and Acceptability Study

“…In recognition of the gap, we previously developed Ghya Bharari Ekatra (GBE, Marathi for “Take a Flight Together”) [ 18 ], the first published couples-based intervention for primary IPV prevention in a resource-limited setting. GBE was designed in Pune, India, to prevent IPV among newly married couples of low socioeconomic status, given the high IPV prevalence in this group and limited availability of support services to them [ 19 ].…”

“…The development of GBE has been previously described [ 18 ]. Briefly, GBE is grounded in the couples interdependence theory [ 23 ], which posits that both intrapersonal and interpersonal dyadic processes serve as determinants of a couple’s behavior change, underscoring the need for IPV prevention to engage the couple as a unit.…”