BackgroundIntimate partner violence (IPV) is a significant public health issue that affects 1 in 3 women globally and a similarly large number of women in Nepal. Over the past decade, important policy and programmatic steps have been taken to address violence against women in Nepal. There remains a dearth of evidence on the effectiveness of primary violence prevention strategies. The Change Starts at Home study begins to fill this gap by utilizing a multi-component social behaviour change communication (SBCC) strategy involving a radio drama and community mobilization to shift attitudes, norms and behaviours that underpin IPV perpetration in Nepal.Methods/DesignThe study uses a concurrent mixed-methods design. The quantitative aspect of the evaluation is a pair-matched, repeated cross-sectional 2-armed, single-blinded cluster trial (RCT: N = 36 clusters, 1440 individuals), comparing a social behaviour change communication (SBCC) strategy to radio programming alone for its impact on physical and / or sexual IPV at the end of programming (12 months’ post-baseline) and 6-months post the cessation of project activities (18-months post baseline). The qualitative aspects of the design include several longitudinal approaches to understand the impact of the intervention and to examine mechanisms of change including in-depth interviews with participants (N = 18 couples), and focus group discussions with community leaders (N = 3 groups), and family members of participants (N = 12 groups). Treatment effects will be estimated with generalized logistic mixed models specified to compare differences in primary outcome from baseline to 12-month follow-up, and baseline to 18-months follow-up in accordance with intention-to-treat principles.DiscussionThe study rigorously evaluates the effectiveness of a promising strategy to prevent IPV. The results of the trial will be immediately useful for governmental, nongovernmental, and donor funded programs targeting partner violence or social norms that underpin it. Findings of the study will also contribute to global knowledge on the effectiveness of media and community engagement as a primary prevention strategy for IPV.Trial registrationTrial was registered in clinicaltrials.gov, NCT02942433, 10/13/2016, retrospectively registered.

Little is known about Jordanian women's help seeking for intimate partner violence (IPV), despite local and international investment in victim services. Using a clinic based survey (n = 517; response rate 70%) and focus group discussions (FGDs, n = 17) we explored Jordanian women's nonfamily help seeking for physical or sexual IPV. We evaluated survey data using bivariate and multivariate regression and examined FGD transcripts using open coding methodology. Nonfamily help seeking was uncommon, an option only in serious circumstances after familial help was ineffective, and correlated with violence severity and relative violence. Nonfamily resources are underutilized but critical for vulnerable Jordanian women.

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Laws that prohibit child marriage should be strengthened and health sector screening for violence experience could help identify women at risk of unmet need and improve women's reproductive agency.

WHAT'S KNOWN ON THIS SUBJECT: Partner violence victimization is associated with mental and behavioral health effects linked to weight gain. Childhood maltreatment is directly linked to obesity and associated with neuroanatomic and psychosocial changes, which heighten vulnerability to subsequent stressors. WHAT THIS STUDY ADDS:This study finds that dating violence victimization is associated with greater increases in BMI from adolescence to young adulthood among women. Women with previous exposure to childhood sexual abuse are especially vulnerable to dating violence-related increases in BMI. abstract BACKGROUND AND OBJECTIVES: This study tested whether dating violence (DV) victimization is associated with increases in BMI across the transition from adolescence to young adulthood and whether gender and previous exposure to child maltreatment modify such increases.METHODS: Data were from participants (N = 9295; 49.9% female) in the National Longitudinal Study of Adolescent Health. BMI was calculated from measured height and weight at waves 2, 3, and 4 of the study. DV victimization was measured at waves 2, 3, and 4 by using items from the revised Conflict Tactics Scales. Linear regression by using generalized estimating equations with robust SEs was used to test the association. Models were stratified according to gender and history of child maltreatment. RESULTS:From baseline to wave 4, BMI increased on average 6.5 units (95% confidence interval [CI]: 6.2-6.7) and 6.8 units (95% CI: 6.5-7.1) among men and women, respectively, and nearly one-half (45.5% of men; 43.9% of women) reported DV at some point. In stratified models, DV victimization (b: 0.3 [95% CI: 0.0-0.6]) independently predicted BMI increase over time in women. Exposure to childhood sexual abuse magnified the increase in BMI associated . No other types of childhood maltreatment were significant modifiers of the DV-BMI association. Violence victimization was not associated with BMI among men.CONCLUSIONS: Screening and support for DV victims, especially women who have also experienced childhood maltreatment, may be warranted to reduce the likelihood of health consequences associated with victimization. Dr Clark conceptualized and designed the study, obtained the data set, conducted the final analyses, drafted the initial manuscript, and contributed to the manuscript revisions; Ms Spencer contributed to the interpretation of the findings and to the original drafting of the manuscript, and took the lead in revising the manuscript and formatting it for publication; Drs Everson-Rose, Connett, Brady, Suglia, and Mason contributed to the design of the study and the interpretation of findings and critically reviewed the manuscript drafts; Ms Henderson conducted the initial analyses and critically reviewed the manuscript drafts; and Ms To contributed to drafting the initial manuscript and critically reviewed the manuscript drafts. All authors approved the final manuscript as submitted. DV victimization,4 little is known about the potential relationship between...