Testing the effectiveness of a transdiagnostic treatment approach in reducing violence and alcohol abuse among families in Zambia: study protocol of the Violence and Alcohol Treatment (VATU) trial

Abstract

BackgroundViolence against women and girls (VAWG) is an urgent global health problem. Root causes for VAWG include the individual- and family-level factors of alcohol abuse, mental health problems, violence exposure, and related adverse experiences. Few studies in low- and middle-income countries (LMIC) have assessed the effectiveness of psychological interventions for reducing VAWG. This randomized controlled trial, part of the What Works to Prevent Violence Against Women and Girls consortium, examines the effectiveness of a common elements treatment approach (CETA) for reducing VAWG and comorbid alcohol abuse among families in Zambia.Methods/designStudy participants are families consisting of three persons: an adult woman, her male husband or partner, and one of her children aged 8–17 (if available). Eligibility criteria include experience of moderate-to-severe intimate partner violence by the woman and hazardous alcohol use by her male partner. Family units are randomized to receive CETA or treatment as usual. The primary outcome is VAWG as measured by the Severity of Violence Against Women Scale, assessed along with secondary outcomes at 24 months post-baseline. Interim assessments are also conducted at 4–5 months (following CETA completion) and 12 months post-baseline.ConclusionsThis ongoing trial is one of the first in sub-Saharan Africa to evaluate the use of an evidence-based common elements approach for reducing VAWG by targeting a range of individual- and family-level factors, including alcohol abuse. Results of this trial will inform policy on what interventions work to prevent VAWG in LMIC with local perspectives on scale up and wider implementation.

Effectiveness of the Common Elements Treatment Approach (CETA) in reducing intimate partner violence and hazardous alcohol use in Zambia (VATU): A randomized controlled trial

“…The trial protocol was submitted to Clinical-Trials.gov in early May 2016, before study commencement; following an administrative review, the record was released from the investigator's institution on May 24, 2016, and following quality control and administrative changes, it was publicly released on June 6, 2016 (NCT02790827). The protocol was also previously published in the peer-reviewed literature [25].…”

“…CETA was modified to address IPV and alcohol/substance misuse, which is fully described in the previously published protocol paper [25]. Briefly, 2 elements were added to CETA: one on substance use and one on safety for violence.…”

Concordance of Self‐ and Partner‐Reported Alcohol Consumption Among Couples Experiencing Intimate Partner Violence in Zambia

“…Methods for the RCT have been published elsewhere (Kane et al., ). In brief, 248 family units consisting of an adult woman, her male partner, and a child of the couple (if applicable) were recruited by lay mental health counselors in Lusaka, Zambia.…”

Transdiagnostic treatment approaches for greater public health impact: Implementing principles of evidence‐based mental health interventions

“…Turning to global mental health work as an example, before initiating treatment efforts, qualitative work is used to gain an understanding of the local population's mental health needs, their prioritization of problems, and the context, with results informing treatment selection and modification (e.g., Murray et al, 2013). For instance, when qualitative work on mental health problems showed distinct problems with substance abuse among families in Zambia, a substance use module was integrated into the CETA protocol relatively easily (Kane et al, 2017), given that CETA is both modular and flexible. For instance, when qualitative work on mental health problems showed distinct problems with substance abuse among families in Zambia, a substance use module was integrated into the CETA protocol relatively easily (Kane et al, 2017), given that CETA is both modular and flexible.…”

“…Aspects of treatment that require adaptation may include translation into the local language, tailoring strategies to treat local idioms of distress, and including culturally relevant examples to explain treatment concepts and techniques (Chowdhary et al, 2014). For instance, when qualitative work on mental health problems showed distinct problems with substance abuse among families in Zambia, a substance use module was integrated into the CETA protocol relatively easily (Kane et al, 2017), given that CETA is both modular and flexible.…”