A cluster randomised controlled trial to determine the effect of community mobilisation and advocacy on men's use of violence in periurban South Africa: study protocol

Nicola J Christofides, Abigail M Hatcher, Angelica Pino, Dumisani Rebombo, Ruari Santiago McBride, Althea Anderson, Dean Peacock, Nicola J Christofides, Abigail M Hatcher, Angelica Pino, Dumisani Rebombo, Ruari Santiago McBride, Althea Anderson, Dean Peacock

Abstract

Objective: This paper describes the design and methods of a cluster randomised controlled trial (C-RCT) to determine the effectiveness of a community mobilisation intervention that is designed to reduce the perpetration of violence against women (VAW).

Methods and analysis: A C-RCT of nine intervention and nine control clusters is being carried out in a periurban, semiformal settlement near Johannesburg, South Africa, between 2016 and 2018. A community mobilisation and advocacy intervention, called Sonke CHANGE is being implemented over 18 months. It comprises local advocacy and group activities to engage community members to challenge harmful gender norms and reduce VAW. The intervention is hypothesised to improve equitable masculinities, reduce alcohol use and ultimately, to reduce VAW. Intervention effectiveness will be determined through an audio computer-assisted self-interview questionnaire with behavioural measures among 2600 men aged between 18 and 40 years at baseline, 12 months and 24 months. The primary trial outcome is men's use of physical and/or sexual VAW. Secondary outcomes include harmful alcohol use, gender attitudes, controlling behaviours, transactional sex and social cohesion. The main analysis will be intention-to-treat based on the randomisation of clusters. A qualitative process evaluation is being conducted alongside the C-RCT. Implementers and men participating in the intervention will be interviewed longitudinally over the period of intervention implementation and observations of the workshops and other intervention activities are being carried out.

Ethics and dissemination: Ethical approval was obtained from the University of the Witwatersrand Human Research Ethics Committee and procedures comply with ethical recommendations of the United Nations Multi-Country Study on Men and Violence. Dissemination of research findings will take place with local stakeholders and through peer-reviewed publications, with data available on request or after 5 years of trial completion.

Trial registration number: NCT02823288; Pre-result.

Keywords: South Africa; behavioural intervention; cluster randomized controlled trial; gender-based violence; perpetration of violence against women; working with men and boys.

Conflict of interest statement

Competing interests: None declared.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Figures

Figure 1
Figure 1
Flow diagram showing trial recruitment and follow-up at 12 and 24 months.
Figure 2
Figure 2
Power calculation showing a reduction in the prevalence of men’s use of intimate partner violence in the previous 12 months from 12% to 7% with six, seven, eight or nine clusters per arm and approximately 150 men per cluster.
Figure 3
Figure 3
Schedule of enrolment, intervention and assessments for the Sonke CHANGE trial. PTSD, post-traumatic stress disorder.
Figure 4
Figure 4
Sonke CHANGE trial theory of change. VAWG, violence against women and girls.

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