A Behavior-Based Intervention That Prevents Sexual Assault: the Results of a Matched-Pairs, Cluster-Randomized Study in Nairobi, Kenya

Baiocchi, Michael; Omondi, Benjamin; Langat, Nickson; Boothroyd, Derek B.; Sinclair, Jake; Pavia, Lee; Mulinge, Munyae M.; Githua, Oscar; Golden, Neville H.; Sarnquist, Clea

doi:10.1007/s11121-016-0701-0

Cited by 56 publications

(81 citation statements)

References 22 publications

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“…Several potential mechanisms may underlie the reductions observed in sexual violence among ESD participation in this study, and in past evaluations [ 27 , 28 , 32 ]. The observed increases in self-defense knowledge in the intervention arm relative to controls, may in part explain the reductions in sexual violence.…”

Section: Discussionmentioning

confidence: 65%

“…It is also possible that natural maturation is responsible for the observed increases in confidence across both arms. Our findings should be interpreted with caution given measurement limitations in assessing self-confidence (2 items), particularly given recent evidence from Nairobi, which showed increases in self-efficacy as assessed on a generalized scale, when IMpower was implemented in concert with programming for young men [ 32 ]. Finally, it is possible that IMpower shifted participants’ interpersonal power in ways that were perceived by potential sexual violence perpetrators and changed their behavior.…”

Section: Discussionmentioning

confidence: 99%

“…There are possible harms that could result from self-defense, including injury. No adverse events have been reported in past trials [ 27 , 32 ] of this intervention. For this implementation trial, study staff were directed to immediately report any adverse events to the Ujamaa office; no adverse events were detected.…”

Section: Methodsmentioning

confidence: 97%

“…All measures were self-reported. They were adapted from prior evaluations of the IMPower program in Kenya [ 27 , 28 , 32 ] for comparability, and piloted in Malawian primary and secondary schools and with Chichewa-speaking instructor groups for feasibility and acceptability. Survey instruments were designed to maximize efficiency and feasibility for this demonstration study, as well as confidentiality.…”

Section: Methodsmentioning

confidence: 99%

“…Primary outcomes were past year prevalence and past year incident rate of forced sex; for comparability with past evaluations. The forced sex outcome was assessed with a single item used for Kenya-based evaluations of IMPower [ 27 , 28 , 32 ], specifically, “Since you took the No Means No survey or in the past one year, have you ever been forced against your will to have sex (penetration of your vagina, anus or mouth with a man’s penis or another object)?” with a follow-up question “If so, how many times?”. School-level prevalence reflects the total number of participants who reported any forced sex over the referent period, divided by the total number of participants in the school.…”

Section: Methodsmentioning

confidence: 99%

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Sexual violence among adolescent girls and young women in Malawi: a cluster-randomized controlled implementation trial of empowerment self-defense training

et al. 2018

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BackgroundGlobally, sexual violence is prevalent, particularly for adolescent women. This cluster-randomized controlled implementation trial examines empowerment self-defense (ESD) for sexual assault risk reduction among school-age women in Malawi.MethodsThe unit of randomization and analysis was the school (n = 141). Intervention participants received a 12-h intervention over 6 weeks, with refreshers. Primary outcomes were past-year prevalence and incident rate of sexual violence. Secondary outcomes included confidence, self-defense knowledge, and, for those victimized, violence disclosure. Interaction effects on outcomes were evaluated with Poisson models with school-correlated robust variance estimates for risk ratios and incident rate ratios (baseline n = 6644, follow-up n = 4278).ResultsPast-year sexual assault prevalence was reduced among intervention students (risk ratio [RR] 0.68, 95% CI 0.56, 0.82), but not control students (interaction effect p < 0.001). Significant increases in self-defense knowledge were observed solely among intervention students (RR 3.33, 95% CI 2.76, 4.02; interaction effect p < 0.001). Significant changes in sexual violence prevalence and knowledge were observed for both primary and secondary students. Favorable reductions were also observed in sexual violence incident rate among students overall (interaction effect p = 0.01).ConclusionsThis intervention reduced sexual violence victimization in both primary and secondary school settings. Results support the effectiveness of ESD to address sexual violence, and approach the elimination of violence against women and girls set forth with Sustainable Development Goal #5. Implementation within the education system can enable sustainability and reach.Trial registrationPan African Clinical Trials Registry PACTR201702002028911. Registered 09 February 2017. Retrospectively registered.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 97%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Sexual violence among adolescent girls and young women in Malawi: a cluster-randomized controlled implementation trial of empowerment self-defense training

et al. 2018

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Interventions for reducing violence against children in low‐ and middle‐income countries: An evidence and gap map

Pundir

Saran

White

et al. 2020

Campbell Systematic Reviews

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Background: More than half of the children in the world experience some form of interpersonal violence every year. As compared with high-income countries, policy responses in low-and middle-income countries (LMICs) are limited due to resource constraints and paucity of evidence for effective interventions to reduce violence against children in their own contexts, amongst other factors. Objectives: The aim of this evidence and gap map (EGM) is to provide an overview of the existing evidence available and to identify gaps in the evidence base on the effectiveness of interventions to reduce violence against children in LMICs. This report covers evidence published in English; a follow-up study is under preparation focusing on evidence in five additional languages-Arabic, Chinese, French, Portuguese and Spanish. Methods: The intervention-outcome framework for this EGM is based on INSPIRE-Seven Strategies for Ending Violence against Children, published by WHO and other partners in 2016. The seven strategies include implementation and enforcement of laws; norms and values, safe environment; parent-child and caregiver support; income and economic strengthening; response and support services; education and life skills. The search included both academic and grey literature available online. We included impact evaluations and systematic reviews that assessed the effectiveness of interventions to reduce interpersonal violence against children (0-18 years) in LMICs (World Bank, 2018b). Interventions targeting subpopulation of parents, teachers and caregivers of 0-18 years' age group were also included. A critical appraisal of all included studies was carried out using standardised tools.

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Interventions that address institutional child maltreatment: An evidence and gap map

Finch

Featherston

Chakraborty³

et al. 2021

Campbell Systematic Reviews

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Background Child maltreatment has serious short and long‐term negative impacts for those experiencing it. Child maltreatment occurring in institutional settings has recently received substantial attention. However, evidence about the effectiveness of interventions that prevent, disclose, respond to, or treat maltreatment that has occurred in these environments is fragmented and can be difficult to access. This evidence and gap map (EGM) collates this research evidence. It was developed as a resource for stakeholders operating in the child health, welfare and protection sectors, including practitioners, organisational leaders, policy developers and researchers, wanting to access high quality evidence on interventions addressing institutional child maltreatment. Objectives The objectives of this EGM were twofold: (a) To provide a structured and accessible collection of existing evidence from finalised and ongoing overviews of systematic reviews, systematic reviews and effectiveness studies of interventions addressing institutional child maltreatment—for those who work to fund, develop, implement and evaluate interventions aimed at ensuring children's safety in institutional settings; (b) to identify gaps in the available evidence on interventions addressing institutional child maltreatment—thereby helping to inform the research agendas of funders and other organisations. Search Methods A comprehensive search strategy identified relevant studies from published and grey literature, comprising: (1) 10 electronic academic databases; (2) five trial and systematic review registries; (3) nine organisational websites; (4) websites and reference lists of inquiry reports associated with seven international inquiries into child abuse and (4) the lists of included studies within systematic reviews identified by the search strategy. Members of this EGM's Subject Matter Experts group were also invited to forward relevant unpublished studies or grey literature. Selection Criteria The selection criteria were developed to identify finalised and ongoing overviews of reviews, systematic reviews and primary studies that reported on the effectiveness of interventions addressing child maltreatment (including sexual abuse, physical abuse, neglect and emotional abuse) within institutional settings. Eligible effectiveness study designs included: randomised controlled trials (RCTs), nonrandomised trials, controlled before‐and‐after studies and quasi‐experimental studies. Reviews were eligible if they reported a systematic literature search strategy. Data Collection and Analysis All screening, data extraction, coding and critical appraisals were undertaken by two or more reviewers working independently, with discrepancies resolved via consensus or by a third reviewer. The titles and abstracts of studies identified by the search strategy were screened, and each full text of potentially relevant studies was further assessed for inclusion. Key data were extracted from all included studies and reviews. This included information about: p...

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A Behavior-Based Intervention That Prevents Sexual Assault: the Results of a Matched-Pairs, Cluster-Randomized Study in Nairobi, Kenya

Abstract: 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.

Cited by 56 publications

References 22 publications

Sexual violence among adolescent girls and young women in Malawi: a cluster-randomized controlled implementation trial of empowerment self-defense training

Sexual violence among adolescent girls and young women in Malawi: a cluster-randomized controlled implementation trial of empowerment self-defense training

Interventions for reducing violence against children in low‐ and middle‐income countries: An evidence and gap map

Interventions that address institutional child maltreatment: An evidence and gap map

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