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Boyce SC, Minnis AM, Deardorff J, McCoy SI, Challa S, Johns NE, Aliou S, Brooks MI, Nouhou AM, Baker H, Silverman JG. Effect of a gender-synchronized family planning intervention on inequitable gender norms in a cluster randomized control trial among husbands of married adolescent girls in Dosso, Niger. medRxiv 2023:2023.09.28.23296292. [PMID: 37808735 PMCID: PMC10557813 DOI: 10.1101/2023.09.28.23296292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Gender inequity is pervasive globally and has severe consequences for health and well-being, particularly for women and girls in Niger. The Reaching Married Adolescents in Niger (RMA) intervention aimed to promote equitable gender norms in order to increase modern contraceptive use and reduce intimate partner violence among married adolescent girls and their husbands in Niger. Using data from a 4-arm factorial cluster randomized control trial of the RMA intervention (2016-2019), the current study assesses effects of the RMA intervention on gender norms among husbands. We used an adjusted hierarchical difference-in-differences linear regression model to assess these effects. The mean score for perceived gender inequitable norms at baseline was 4.1 (n=1,055; range: 0-5). Assignment to the RMA small groups intervention was associated with a 0.62 lower score (95% CI: -1.05, -0.18) relative to controls at follow-up, after adjusting for baseline differences. No significant effects were detected for other intervention arms. As a low-cost, simple, scalable, and transferrable intervention with rigorous evidence of being able to change such gender norms, this community health worker-based small group intervention could be valuable to the field of public health for reducing the negative impact of inequitable gender norms on health and wellbeing in similar settings.
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Boyce SC, Minnis AM, Deardorff J, McCoy SI, Challa S, Johns N, Aliou S, Brooks M, Nouhou AM, Gochyyev P, Wilson M, Baker H, Silverman JG. Measuring social norms of intimate partner violence to exert control over wife agency, sexuality, and reproductive autonomy: an item response modelling of the IPV-ASRA scale. Reprod Health 2023; 20:90. [PMID: 37316890 DOI: 10.1186/s12978-023-01632-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 06/02/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND The field of violence prevention research is unequivocal that interventions must target contextual factors, like social norms, to reduce gender-based violence. Limited research, however, on the social norms contributing to intimate partner violence or reproductive coercion exists. One of the driving factors is lack of measurement tools to accurately assess social norms. METHODS Using an item response modelling approach, this study psychometrically assesses the reliability and validity of a social norms measure of the acceptability of intimate partner violence to exert control over wife agency, sexuality, and reproductive autonomy with data from a population-based sample of married adolescent girls (ages 13-18) and their husbands in rural Niger (n = 559 husband-wife dyads) collected in 2019. RESULTS A two-dimensional Partial Credit Model for polytomous items was fit, showing evidence of reliability and validity. Higher scores on the "challenging husband authority" dimension were statistically associated with husband perpetration of intimate partner violence. CONCLUSIONS This brief scale is a short (5 items), practical measure with strong reliability and validity evidence. This scale can help identify populations with high-need for social norms-focused IPV prevention and to help measure the impact of such efforts.
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Affiliation(s)
- Sabrina C Boyce
- Center on Gender Equity and Health, School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
| | - Alexandra M Minnis
- Women's Global Health Imperative, RTI International, 2150 Shattuck Ave. Ste 800, Berkeley, CA, 94704, USA
| | - Julianna Deardorff
- Community Health Sciences, School of Public Health, University of California Berkeley, 2121 Berkeley Way, Berkeley, CA, 94720-7360, USA
| | - Sandra I McCoy
- Division of Epidemiology, School of Public Health, University of California Berkeley, 2121 Berkeley Way, Berkeley, CA, 94720-7360, USA
| | - Sneha Challa
- School of Nursing, University of San Francisco, 3333 California Street, San Francisco, CA, 94118, USA
| | - Nicole Johns
- Center on Gender Equity and Health, School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Sani Aliou
- Niger Country Office, Pathfinder International, Niamey, Niger
| | - Mohamad Brooks
- Pathfinder International, 9 Galen Street, Suite 217, Watertown, MA, 02472, USA
| | | | - Perman Gochyyev
- Graduate School of Education, University of California, 2121 Berkeley Way, Berkeley, CA, 94720-1670, USA
| | - Mark Wilson
- Graduate School of Education, University of California, 2121 Berkeley Way, Berkeley, CA, 94720-1670, USA
| | - Holly Baker
- Center on Gender Equity and Health, School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Jay G Silverman
- Center on Gender Equity and Health, School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
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