Abstract
Design
The study’s design was a cluster-randomized, matched-pairs, parallel trial of a behavior-based sexual assault prevention intervention in the informal settlements.
Methods
The participants were primary school girls aged 10–16. Classroom-based interventions for girls and boys were delivered by instructors from the same settlements, at the same time, over six 2-h sessions. The girls’ program had components of empowerment, gender relations, and self-defense. The boys’ program promotes healthy gender norms. The control arm of the study received a health and hygiene curriculum. The primary outcome was the rate of sexual assault in the prior 12 months at the cluster level (school level). Secondary outcomes included the generalized self-efficacy scale, the distribution of number of times victims were sexually assaulted in the prior period, skills used, disclosure rates, and distribution of perpetrators. Difference-in-differences estimates are reported with bootstrapped confidence intervals.
Results
Fourteen schools with 3147 girls from the intervention group and 14 schools with 2539 girls from the control group were included in the analysis. We estimate a 3.7 % decrease, p = 0.03 and 95 % CI = (0.4, 8.0), in risk of sexual assault in the intervention group due to the intervention (initially 7.3 % at baseline). We estimate an increase in mean generalized self-efficacy score of 0.19 (baseline average 3.1, on a 1–4 scale), p = 0.0004 and 95 % CI = (0.08, 0.39).
Interpretation
This innovative intervention that combined parallel training for young adolescent girls and boys in school settings showed significant reduction in the rate of sexual assault among girls in this population.
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Acknowledgments
The authors would like to thank Zhi Ping Teo, the Stanford Gender-Based Violence Prevention Collaborative, and the Stanford Quantitative Sciences Unit for the thoughtful comments and suggestions during the course of this study. The authors would also like to thank the NMNW trainers, who provided the intervention, and the adolescents who participated with enthusiasm.
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Conflicts of interest
Members of the Stanford evaluation team did not have their time compensated for by Ujamaa-Africa and do not have ongoing financial connections with Ujamaa-Africa. Drs. Mulinge and Githua have ongoing financial connections to Ujamaa-Africa. The instructors, and thus the survey interviewers, were employees of Ujamaa-Africa. Thus, the in-country data collection was funded by Ujamaa-Africa.
Ethical approval
Approval for the study in Kenya was provided by the Kenyan National Commission for Science, Technology and Innovation (NACOSTI). All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study is an evaluation of a preexisting program, already being delivered by Ujamaa, in schools in these communities. The study consisted of anonymous, two-page surveys completed at baseline and follow-up. The Stanford internal review board (IRB) did a preliminary review of this project and determined that this short, anonymous survey did not raise human subject research issues and therefore did not require a full review.
Informed consent
Ujamaa-Africa obtained assent from all study participants.
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Neville H. Golden and Clea Sarnquist co-senior authors.
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Baiocchi, M., Omondi, B., Langat, N. et al. A Behavior-Based Intervention That Prevents Sexual Assault: the Results of a Matched-Pairs, Cluster-Randomized Study in Nairobi, Kenya. Prev Sci 18, 818–827 (2017). https://doi.org/10.1007/s11121-016-0701-0
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DOI: https://doi.org/10.1007/s11121-016-0701-0