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Abstract
Introduction Despite widespread calls to end violence against women, there remains limited evidence on how to prevent it. Community-level programmes seek to engage all levels of the community in changing norms that drive intimate partner violence (IPV). However, little is known about what predisposes ordinary people to become active in violence prevention.
Methods Using data from the SASA! study, a cluster randomised trial of a community mobilisation intervention in Kampala, Uganda, we explore which community members are most likely to intervene when they witness IPV. A cross-sectional survey of community members (18–49 years) was conducted 4 years after intervention implementation began (2012). Among those who had seen IPV in their community (past year), multivariate logistic regression, disaggregated by sex and trial arm, explored the associations between ‘trying to help’ and demographics, IPV experience (women)/perpetration (men), childhood abuse experiences, IPV attitudes and SASA! exposure.
Results Overall, SASA! community members were more likely to intervene than their control counterparts (57% vs 31%). In control communities, older age (women), increasing relationship duration (men), talking to neighbours (men) and believing it is okay for a woman to tell if she is experiencing IPV (men) were positively associated with trying to help. In SASA! communities associated factors were increasing relationship duration (women/men), employment (women), talking to neighbours (women), childhood abuse experiences (women), lifetime IPV (women/men), IPV-related attitudes (women/men) and greater SASA! exposure (women/men).
Conclusions Differing results between intervention and control communities suggest contextual factors may modify the effects of personal characteristics/experiences on helping behaviours. Motivation to act brought about by personal experiences of IPV, for example, might only propel individuals into action if they are equipped with the skills, confidence and support of others to do so. Community mobilisation can help create environments and synergies supportive of action.
Trial registration number NCT00790959.
Study protocol Available at http://www.trialsjournal.com/content/13/1/96.
- intimate partner violence
- violence prevention
- community mobilisation
- bystander intervention
- Uganda
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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Footnotes
Handling editor Sanni Yaya
Contributors CW, LM and TM were the principal investigators on the SASA! study, responsible for the overall conceptualisation, design and management of the study. TA was responsible for major aspects of study design, sampling, development of research instruments, interviewer training and supervision of the quantitative survey. TA and SN formulated the objectives and conceptual framework for this paper. TA drafted the manuscript and conducted the statistical analysis for this paper. All authors have contributed to the writing of this paper, offering substantial edits and comments to the original draft. All have read and approved the final version.
Funding This research was funded by Irish Aid, the Sigrid Rausing Trust, 3ie (International Initiative for Impact Evaluation), an anonymous donor, AusAID and the Stephen Lewis Foundation. Irish Aid, the American Jewish World Service, HIVos and the NoVo Foundation supported the implementation and monitoring of SASA! in the study communities. The analysis and writing of this article were supported by an anonymous donor. The study sponsors had no role in the study design, data collection, analysis and interpretation of the data, the writing of this report, or the decision to submit this paper for publication. The views expressed are those of the authors alone.
Competing interests LM is Co-Director of Raising Voices and designed the SASA! intervention. TM is the Director of CEDOVIP and in charge of the implementation of the SASA! intervention. They have played a central role in ensuring the appropriate conceptualisation and implementation of the evaluation, including the topics covered in the study questionnaire, the implementation of the fieldwork and ensuring the provision of support to women requesting assistance. They have had no involvement in the randomisation of matched community pairs, no direct involvement in data collection for the CRT and no involvement with the data analysis. SN joined Raising Voices as the Learning Coordinator after the completion of the CRT. LM, TM and SN have input into the interpretation of the findings. The other authors declare that they have no competing interests.
Patient consent for publication Obtained.
Ethics approval The study received ethical approval from institutional review boards at the London School of Hygiene and Tropical Medicine (UK) (ref 5210), Makerere University (Uganda) (ref 2007–101) and the Uganda National Council for Science and Technology (SS 2048). The study conformed to the principles embodied in the Declaration of Helsinki.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Survey tools are available from the London School of Hygiene and Tropical Medicine data repository via the following link: http://datacompass.lshtm.ac.uk/19/. Applications to use data from the follow-up survey and limited data from the baseline survey can be submitted via the same link.