We describe the development of a theory of change for Background: community mobilisation activities to prevent violence against women and girls. These activities are part of a broader program in urban India that works toward primary, secondary, and tertiary prevention of violence and includes crisis response and counselling and medical, police, and legal assistance.The theory of change was developed in five phases, via expert Methods: workshops, use of primary data, recurrent team meetings, adjustment at further meetings and workshops, and a review of published theories.The theory summarises inputs for primary and secondary Results: prevention, consequent changes (positive and negative), and outcomes. It is fully adapted to the program context, was designed through an extended consultative process, emphasises secondary prevention as a pathway to primary prevention, and integrates community activism with referral and counselling interventions.The theory specifies testable causal pathways to impact and Conclusions: will be evaluated in a controlled trial. How to cite this article: et al. A theory of change for community interventions to prevent domestic Wellcome Open Research violence against women and girls in Mumbai, India [version 1; peer review: 2 approved with reservations] 2019, :54 ( ) 4 https://doi.54 ( ) First published: 4 https://doi.org/10.12688/wellcomeopenres.15128.1 References Abramsky T, Devries K, Kiss L, et al.: Findings from the SASA! Study: a cluster randomized controlled trial to assess the impact of a community mobilization intervention to prevent violence against women and reduce HIV risk in Kampala, Uganda. BMC Med. 2014; 12: 122. PubMed Abstract | Publisher Full Text | Free Full Text Abramsky T, Devries KM, Michau L, et al.: Ecological pathways to prevention: How does the SASA! community mobilisation model work to prevent physical intimate partner violence against women? BMC Public Health. 2016; 16: 339. PubMed Abstract | Publisher Full Text | Free Full Text Archibald T, Sharrock G, Buckley J, et al.: Assumptions, conjectures, and other miracles: The application of evaluative thinking to theory of change models in community development. Eval Program Plann. 2016; 59: 119-127. PubMed Abstract | Publisher Full Text Auspos P, Kubisch AC: Building knowledge about community change: moving beyond evaluations. New York, NY, Aspen Institute Roundtable on Community Change. 2004. Reference Source Birckmayer JD, Weiss CH: Theory-based evaluation in practice. what do we learn? Eval Rev. 2000; 24(4): 407-431. PubMed Abstract | Publisher Full Text Bonell C, Jamal F, Melendez-Torres GJ, et al.: 'Dark logic': theorising the harmful consequences of public health interventions. J Epidemiol Community Health. 2015; 69(1): 95-98. PubMed Abstract | Publisher Full Text Bonell C, Melendez-Torres GJ, Quilley S: The potential role for sociologists in designing RCTs and of RCTs in refining sociological theory: A commentary on Deaton and Cartwright. Soc Sci Med. 2018; 210: 29-31. PubMed Abstract | Publisher Full Text Bo...

Background Almost one in three married Indian women have ever experienced physical, sexual, or emotional violence from husbands in their lifetime. We aimed to investigate the preliminary effects of community mobilisation through participatory learning and action groups facilitated by Accredited Social Health Activists (ASHAs), coupled with access to counselling, to prevent violence against women and girls in Jharkhand, eastern India. Methods We piloted a cycle of 16 participatory learning and action meetings with women’s groups facilitated by ASHAs in rural Jharkhand. Participants identified common forms of violence against women and girls, prioritised the ones they wanted to address, developed locally feasible strategies to address them, implemented the strategies, and evaluated the process. We also trained two counsellors and two ASHA supervisors to support survivors, and gave ASHAs information about legal, health, and police services. We did a before-and-after pilot study involving baseline and endline surveys with group members to estimate preliminary effects of these activities on the acceptability of violence, prevalence of past year emotional and physical violence, and help-seeking. Results ASHAs successfully conducted monthly participatory learning and action meetings with 39 women’s groups in 22 villages of West Singhbhum district, Jharkhand, between June 2016 and September 2017. We interviewed 59% (679/1149) of women registered with groups at baseline, and 63% (861/1371) at endline. More women reported that violence was unacceptable in all seven scenarios presented to them at endline compared to baseline (adjusted Odds Ratio [aOR]: 1.87, 95%: 1.39–2.52). Fewer women reported experiencing emotional violence from their husbands in the last 12 months (aOR: 0.55, 95% CI: 0.43–0.71), and more sought help if it occurred (aOR: 2.19, 95% CI: 1.51–3.17). In addition, fewer women reported experiencing emotional or physical violence from family members other than their husbands in the last 12 months (aOR: 0.41, 95% CI: 0.32–0.53, and aOR: 0.36, 95% CI: 0.26–0.50, respectively). Conclusion Combining participatory learning and action meetings facilitated by ASHAs with access to counselling was an acceptable strategy to address violence against women and girls in rural communities of Jharkhand. The approach warrants further implementation and evaluation as part of a comprehensive response to violence.

Background: The contribution of structural inequalities and societal legitimisation to violence against women, which 30% of women in India survive each year, is widely accepted. There is a consensus that interventions should aim to change gender norms, particularly through community mobilisation. How this should be done is less clear. Methods: We did a qualitative study in a large informal settlement in Mumbai, an environment that characterises 41% of households. After reviewing the anonymised records of consultations with 1653 survivors of violence, we conducted 5 focus group discussions and 13 individual interviews with 71 women and men representing a range of age groups and communities. We based the interviews on fictitious biographical vignettes to elicit responses and develop an understanding of social norms. We wondered whether, in trying to change norms, we might exploit the disjunction between descriptive norms (beliefs about what others actually do) and injunctive norms (beliefs about what others think one ought to do), focusing program activities on evidence that descriptive norms are changing. Results: We found that descriptive and injunctive norms were relatively similar with regard to femininity, masculinity, the need for marriage and childbearing, resistance to separation and divorce, and disapproval of friendships between women and men. Some constraints on women’s dress and mobility were relaxing, but there were more substantial differences between descriptive and injunctive norms around women’s education, control of income and finances, and premarital sexual relationships. Conclusions: Programmatically, we hope to exploit these areas of mismatch in the context of injunctive norms generally inimical to violence against women. We propose that an under-appreciated strategy is expansion of the reference group: induction of relatively isolated women and men into broader social groups whose descriptive and injunctive norms do not tolerate violence

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Background: We describe the development of a theory of change for community mobilisation activities to prevent violence against women and girls. These activities are part of a broader program in urban India that works toward primary, secondary, and tertiary prevention of violence and includes crisis response and counselling and medical, police, and legal assistance. Methods: The theory of change was developed in five phases, via expert workshops, use of primary data, recurrent team meetings, adjustment at further meetings and workshops, and a review of published theories. Results: The theory summarises inputs for primary and secondary prevention, consequent changes (positive and negative), and outcomes. It is fully adapted to the program context, was designed through an extended consultative process, emphasises secondary prevention as a pathway to primary prevention, and integrates community activism with referral and counselling interventions. Conclusions: The theory specifies testable causal pathways to impact and will be evaluated in a controlled trial.