Training Local Leaders to Prevent and Reduce Domestic Violence Evidence From Peru — LIA  

Domestic Violence Clinical Trial

Official title: Training Leaders to Prevent and Reduce Domestic Violence in Their Communities: Experimental Evidence From Peru

Status Recruiting

Clinical Trial Summary

Leaders in Action (LIA) is a norms-centered intervention that aims to reduce the acceptance and prevent the incidence of Gender-based Violence (GBV) in Peru by shifting social norms. This project takes advantage of the randomization of LIA across 250 villages.

LIA has two delivery models: a household-based module (HT), consisting of household training sessions by Community Health Volunteers, and a group-based module (GT) with education sessions in small gender-segregated groups organized by trained facilitators. The investigators will cross-randomize each approach to assess efficiency in reducing domestic violence and changing social norms about tolerance toward violence and gender roles. The study disentangles the impact of the two modules separately, as well as the interaction of the modules, while explicitly addressing methodological concerns of previous studies: reporting bias from self-reported domestic violence, limited statistical power and lack of long-term effects measures.

Potential and actual victims of GBV may profit from the intimate atmosphere of household visits, and that on the side of women, the transmission of information about GBV and services for victims may be facilitated in more private settings. At the same time, group-level workshops about harmful gender stereotypes and gender norms for women should, through social interactions and norm change, reinforce the effects of household-level treatments for women. The experiment will shed light on the potential mechanisms at play and the theoretical framework underlying GBV through extensive data collection and the calculation of heterogeneous effects. The goal of this project is to deliver new rigorous evidence to the scientific and policy community by experimentally evaluating the impact of a state-run GBV intervention and its main components. It provides insights into the effectiveness of distinct program components, assesses cost-effectiveness as well as potential to scale, and evaluates the mechanisms leading to the reduction of GBV.

Clinical Trial Description

Leaders in Action (LIA) is a norms-centered intervention that aims to reduce the acceptance and prevent the incidence of gender-based violence (GBV) in Peru by shifting social norms. LIA has two main phases: first, the recruitment of community health volunteers (CHVs) and second, delivering content against GBV to the population at risk in rural villages. There are two types of CHV. First, government's women centers' (CEM) Promotors (professionals from the Peruvian Ministry of Women (MIMP) working at local CEMs) recruit leaders of local social organizations and trained them to be Facilitators of LIA. These Facilitators are to be located in each district center and will conduct LIA activities across all treated villages in the district. The second type are leaders at the village level who will be trained by Facilitators to become Community Agents. Both Community Agents and Facilitators are to be known as CHVs and will work together to conduct the second phase of LIA: training sessions of the two delivery models, a household model (HT) and a group-based and gender-segregated model (GT).

Under the HT, LIA follows a door-to-door delivery approach: CHVs, in coordination with the local CEM, offer 8 training sessions to households at risk of domestic violence (Household Treatment - HT). However, the recipients of the HT are in practice primarily women. This is because the treatment is delivered door-to-door by mainly female CHVs, who are recruited disproportionately for this style of volunteer work in any setting. Female CHVs may be ineffective at influencing norms and beliefs of male participants given strong local masculinity norms. The household-centered approach is also expensive and difficult to scale. In order to strengthen the effect of LIA and to reach potential perpetrators as well as victims of GBV, the MIMP will implement a gender-segregated yet community-wide delivery approach in a group discussion format. This group-based approach (GT) will entail 4 workshops using media dramatizations of social problems/education entertainment ("edutainment"), on the same content as delivered in the HT.

Existing evidence suggests that interventions that target perpetrators as well as victims can have a substantial impact on attitudes towards and the incidence of domestic violence, and that simultaneously addressing GBV from different angles can be particularly effective. These approaches commonly stress the importance of collaborative learning in support-group style sessions to confront ideas of masculinity and gender norms. Norms change is dependent on belief change at the individual-level, which is more likely to happen when individuals are aware of relevant peers also changing beliefs. The investigators propose separating groups by gender to provide tailored settings. The series of workshops will engage potential GBV victims and perpetrators in group discussions about their social reality using participatory methods.

The topics for the series of workshops will be equivalent to those covered in household visits to ensure comparability: i) gender roles, beliefs and stereotypes; ii) violence, cultural patterns and human rights; iii) healthy relationships within the family; iv) good treatment between family members and self-care; v) Assertive communication; vi) resolution and conflict management; vii) resources for domestic violence cases; and viii) leadership and women agency.

Sessions will take place over four months in a village community center, school, or church, and will last for approximately two hours and consist of groups of 15-20 participants per session. Larger villages will hold multiple sessions per month to cover all potential participants. To maximize attendance, the workshops will have the same hierarchy as traditional village meetings - events the population of this setting attends regularly - and will be coordinated with the village leader. ;

Related Conditions & MeSH terms

• Domestic Violence

• NCT number: NCT05331248
• Study type: Interventional
• Source: Duke University
• Contact: Julianne Chambers
• Phone: 919-660-1800
• Email: julianne.chambers@duke.edu
• Status: Recruiting
• Phase: N/A
• Start date: May 2, 2022
• Completion date: June 30, 2025