Stepping Stones and Creating Futures Intervention to Prevent Intimate Partner Violence Among Young People: Cluster Randomized Controlled Trial

Andrew Gibbs; Laura Washington; Nada Abdelatif; Esnat Chirwa; Samantha Willan; Nwabisa Shai; Yandisa Sikweyiya; Smanga Mkhwanazi; Nolwazi Ntini; Rachel Jewkes

doi:10.1016/j.jadohealth.2019.10.004

Stepping Stones and Creating Futures Intervention to Prevent Intimate Partner Violence Among Young People: Cluster Randomized Controlled Trial

J Adolesc Health. 2020 Mar;66(3):323-335. doi: 10.1016/j.jadohealth.2019.10.004. Epub 2019 Nov 26.

Authors

Affiliations

¹ 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. Electronic address: Andrew.gibbs@mrc.ac.za.
² Project Empower, Durban, South Africa.
³ Biostatistics Research Unit, South African Medical Research Council, Durban, South Africa.
⁴ Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa; School of Public Health, University of Witwatersrand, Johannesburg, South Africa.
⁵ Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa.
⁶ Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa; School of Public Health, University of Witwatersrand, Johannesburg, South Africa; Office of the Executive Scientist, South African Medical Research Council, Cape Town, South Africa.

PMID: 31784410
DOI: 10.1016/j.jadohealth.2019.10.004

Abstract

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.

Keywords: Dating violence; Livelihoods; South Africa; Trial.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Alcoholism / epidemiology
Alcoholism / psychology
Behavior Therapy / methods*
Cluster Analysis
Depression / epidemiology
Depression / psychology*
Female
HIV Infections / prevention & control
HIV Infections / psychology*
Humans
Income
Interpersonal Relations*
Intimate Partner Violence / prevention & control*
Intimate Partner Violence / psychology
Male
Self Report
Sexual Behavior
Sexual Partners / psychology
South Africa
Treatment Outcome
Young Adult

Associated data

ClinicalTrials.gov/NCT03022370