This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on http://formative.jmir.org, as well as this copyright and license information must be included.
The high global prevalence of intimate partner violence (IPV) and its association with poor physical and mental health underscore the need for effective primary prevention. We previously developed Ghya Bharari Ekatra (GBE), a couples-based primary prevention intervention for IPV among newly married couples residing in slum communities in Pune, India.
Through this pilot study, we aimed to explore the acceptance, safety, feasibility, and preliminary efficacy of GBE.
Between January and May 2018, we enrolled and assigned 20 couples to receive GBE plus information on IPV support services and 20 control couples to receive information on IPV support services alone. The GBE intervention was delivered over 6 weekly sessions to groups of 3 to 5 couples by lay peer educators in the communities in which the participants resided. Intervention components addressed relationship quality, resilience, communication and conflict negotiation, self-esteem, sexual communication and sexual health knowledge, and norms around IPV. Outcome evaluation included exit interviews with participants and peers to examine acceptance and feasibility challenges and baseline and 3-month follow-up interviews to examine change in IPV reporting and mental health (by women) and alcohol misuse (by men). The process evaluation examined dose delivered, dose received, fidelity, recruitment, participation rate, and context.
Half (40/83) of the eligible couples approached agreed to participate in the GBE intervention. Retention rates were high (17/20, 85% across all 6 sessions), feedback from exit interviews suggested the content and delivery methods were very well received, and the community was highly supportive of the intervention. The principal feasibility challenge involved recruiting men with the lowest income who were dependent on daily wages. No safety concerns were reported by female participants over the course of the intervention or at the 3-month follow-up. There were no reported physical or sexual IPV events in either group, but there were fewer incidents of psychological abuse in GBE participants (3/17, 18%) versus control participants (4/16, 25%) at 3-month follow-up. There was also significant improvement in the overall mental health of female intervention participants and declines in the control participants (change in mean General Health Questionnaire-12 score: –0.13 in intervention vs 0.13 in controls;
GBE has high acceptance, feasibility, and preliminary efficacy in preventing IPV and improving mental health among women. Next steps include refining the intervention content based on pilot findings and examining intervention efficacy through a large-scale randomized trial with longer follow-up.
ClinicalTrials.gov NCT03332134; https://clinicaltrials.gov/ct2/show/NCT03332134. Clinical Trials Registry of India CTRI/2018/01/011596; http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=21443
RR2-10.2196/11533
Intimate partner violence (IPV), defined by the World Health Organization (WHO) as “any behavior within an intimate relationship that causes physical, psychological, or sexual harm to those in the relationship,” is experienced by one-third of women globally [
In recognition of the gap, we previously developed Ghya Bharari Ekatra (GBE, Marathi for “Take a Flight Together”) [
The development of GBE has been previously described [
This pilot study used a prospective nonrandom design in which groups of 3 to 5 married couples were assigned to receive the intervention or the control condition. Couples assigned to the intervention arm received the 6-session GBE group intervention over a 6-week period plus the ethical standard of care, a list of IPV and mental health support services provided to the female dyadic member. Couples assigned to the control condition received the ethical standard of care alone. Ghya Bharari Ekatra (Marathi for “Take a Flight Together”) is composed of 6 weekly 2-hour sessions, 5 of which are facilitated by a pair of male-female lay community peer educators, with the sixth (focused on sexual communication and sexual and reproductive health) being co-led by medical officers and delivered in gender-concordant groups. Study outcomes assessed included intervention acceptance, feasibility, safety, and preliminary efficacy in preventing IPV, enhancing mental health among women, and reducing alcohol use among men at 3 months.
The study was approved by the National AIDS Research Institute Ethics Committee (Pune, India) and the Emory University Institutional Review Board (Atlanta, Georgia). Written informed consent was obtained from all participants prior to their participation in the study. The trial was registered at ClinicalTrials.gov (registration number NCT03332134) and the Clinical Trials Registry of India (registration number CTRI/2018/01/011596).
The study was conducted in slum communities in Pune, the second largest metropolis in the western state of Maharashtra, India. According to the most recent census, 22.28% (690,545/3,100,000) of Pune’s populations resides in slums [
Participants were recruited between January and May of 2018. To be eligible to participate, both members of the couple needed to be 18 years or older; married for ≤1 year; in their first marriage; cohabiting in a slum, chawl, or slum redevelopment community; and fluent in Marathi or Hindi. As GBE was designed to be a primary IPV prevention intervention, couples in which the female member screened positive for physical or sexual IPV using an abridged version of the Indian Family Violence and Control Scale (IFVCS) [
The participant identification process began with mapping and identifying individual slum communities in Pune (incorporating a geographic buffer around identified communities to prevent contamination). Next, we used a multistaged community sensitization and recruitment process. First, study staff and community-based organizations (CBOs) with whom the Indian Council of Medical Research National AIDS Research Institute (ICMR-NARI) had partnered in prior research studies together contacted community key leaders to notify them of the intent and overall delivery of the intervention. Second, the CBOs and key community leaders then led community sensitization meetings within each slum community to bring community-level awareness of GBE’s aim of fostering healthy relationships and help build intervention support and prevent potential community uprisings that could result from erroneous community speculation of GBE’s intent to preach family planning, publicly disclose household abuse, or treat HIV. Third, CBOs and key leaders identified potential peer educators (to be intervention facilitators) and potentially eligible couple participants. Fourth, study staff then met with families of the couples at their homes to seek initial permission (as per cultural norms). Fifth, study staff met with the couples individually at a private venue of convenience to them (ie, homes, workplaces, community halls) to obtain written informed consent, confirm eligibility, and conduct baseline surveys with each member individually. Once 3 to 5 couples were identified from a particular slum community, the group was assembled and intervention delivery began. In parallel, couples recruited from a neighboring slum community were assigned to the control arm.
GBE delivery employed a preimplementation phase (led by teams of community leaders and CBOs) and implementation phase (led by peer educators and government medical officers). Community leaders (ie, local government and political figures) and CBOs facilitated community sensitization and entry and helped recruit potential participants and peer educators. Peer educators (one man and one woman per GBE intervention group), who facilitated delivery of the GBE sessions, were lay community people who were married and demonstrated strong oratory, group facilitation, and critical thinking skills and community involvement. They were recruited from various local agencies, including
Peer educators underwent a weeklong training by study staff on IPV and gender equality; GBE intent, content, and intervention facilitation methods; methods for establishing rapport; and the safety protocol. The second half of each training day was dedicated to peer educators to practice intervention delivery and receive real-time feedback from the study team. Additionally, during the 6-week intervention delivery period, peer educators received 1-hour weekly paired retraining meetings with a study staff member to practice delivery of the specific module and have module-specific questions answered. These meetings also enabled a space for peer educators to notify study staff of concerns about the safety of particular participants and discuss emotional trauma they themselves were experiencing as intervention facilitators (with study staff facilitating peer referral to support services as necessary). Prior to delivering session 5, “Sexual Communication and the Sexual Relationship,” medical officers received a 2-hour training on the module intent, content, and delivery methods by the research team.
The GBE intervention was delivered to groups of 3 to 5 newly married couples in weekly 2-hour sessions over a 6-week period. It was facilitated by a male-female pair of trained peer educators, conducted in Marathi, and held at a community-based venue (eg, school, community hall,
Session 1, “You, Me, and Us: Spending Meaningful Time Together,” aimed to increase the quality time spent together in the relationship and employed a series of self-, couple, and group reflections on the benefits of a marital relationship, the current amount of time the couple spends together, barriers and facilitators to spending quality time with one another, and couple-based planning of strategies to increase quality relationship time.
Session 2, “I’m a Champion: I Can’t Be Broken and I Don’t Accept Defeat,” aimed to increase self-esteem and resilience and employed (1) facilitated group exercises in which participants brainstormed available community and human resources and methods to help address common adversities (eg, job loss, poor health, relationship difficulties) and (2) a guided interview between the two members of a couple in which each gets to know the other on a deeper level (ie, background, hobbies, sources of pride and worry, strengths, modifiable and less modifiable weaknesses), culminating with the recognition of the need to recognize each other as a unit and support the growth of one another.
Session 3, “Building Communication and Conflict Management Skills,” aimed to improve communication and conflict management skills and employed 2 short films that describe the initial hopes, dreams, and expectations of a newly married bride and groom and the subsequent challenges they face and emotions they feel in adjusting to married life in the context of a larger joint, low-income family. This was followed by a powerful peer-led discussion that culminated with the participant group together brainstorming strategies for handling each of the presented situations.
Session 4, “Empowerment of the Couple: Planning Ahead,” aimed to empower both members of the couple through improved goal setting and goal implementation skills and employed (1) couples-based reflections on their personal dreams followed by peer-assisted establishment of and planning for attainable goals and (2) role-plays demonstrating skills to effectively prepare for and participate in a job interview.
Session 5, “Sexual Communication and the Sexual Relationship,” aimed to improve sexual communication and the sexual relationship and was the only module co-led by peer educators and government medical officers and delivered in gender-concordant groups. It employed (1) medical officer–delivered lectures on sexual and reproductive health, (2) a quiz with facilitated discussion that addressed and dispelled commonly held reproductive and sexual health myths, (3) a Snakes and Ladders game adapted to methods for fostering romance in the relationship, and (4) a lecture regarding the importance of and methods for sexual communication with a follow-up question-and-answer period (which made use of an anonymous question box).
Session 6, “A Lens Into Domestic Violence,” aimed to expand participant definitions of behaviors constituting IPV and to challenge subjective norms of IPV occurrence. It employed (1) a facilitated discussion of the different forms and effects of IPV on all members of the family and (2) an exercise in which each participant ranked examples of violence by severity to initiate a discussion about the factors individuals use to define acts of violence, highlighting individual-level differences in conceptualization of violence, and to challenge participants to expand their definitions of IPV and commit to a life of nonviolence. The session ended with a closing video of scrolling photos of the participants engaged in the sessions, presentation to each couple of a framed photo of themselves, announcement of the winner of the competitions embedded in the intervention, and final words from the participants, in which they shared the changes they planned to implement as a result of participating in the intervention.
Both the control and intervention groups received the ethical standard of care. An appropriate ethical standard of care was designed in consultation with the WHO Ethical and Safety Recommendations for Research on Domestic Violence Against Women [
The main outcomes assessed included intervention acceptability, feasibility, and safety, and secondary outcomes assessed included preliminary efficacy. Outcome evaluation used semistructured group interviews with the intervention participants after each session, semistructured interviews with GBE facilitators after each session, and baseline and 3-month follow-up surveys with individual participants (both control and intervention). The interviews and surveys were conducted by trained research staff. All tools were translated in Marathi prior to use.
Acceptability of the intervention to the dyad was gauged through the postsession semistructured group interviews, wherein the group of participants were collectively asked by the research team about their satisfaction with session content and delivery. The group interview after the sixth (final) session additionally explored satisfaction with the number and duration of the intervention sessions and intervention facilitators, while the follow-up survey included items asking female participants about the perceived adequacy of the study safety procedures. Intervention feasibility was assessed during the postsession interviews with the intervention facilitators, during which they were asked about ease of and challenges with session delivery, their perceptions of participant understanding of the intervention, and logistical problems they encountered with the intervention setting, timing, trainings, and debriefings.
Safety of the intervention was gauged through the follow-up surveys with the women assessing incidents of IPV (using an abridged version of the IFVCS) [
Preliminary efficacy was assessed through survey responses measuring changes in (1) past 1-month IPV experience among women (using an abridged version of the IFVCS), (2) mental health among women (using the General Health Questionnaire-12 [GHQ-12]), and (3) past 3-month alcohol consumption among men (using the Alcohol Use Disorders Identification Test [AUDIT]) between baseline and 3-month follow-up.
The process evaluation was conducted by trained study staff members and examined key elements proposed by Saunders et al [
Intervention acceptance was assessed by exploring trends across the postsession group interviews regarding participant satisfaction with module content and suggested changes. Similarly, feasibility was explored by examining trends across postsession facilitator interviews regarding ease of and difficulty with delivering sessions. Safety was assessed through descriptive analysis of the corresponding items in the follow-up survey. Past 1-month IPV was assessed through the reporting of any physical, sexual, or psychological violence or control using the IFVCS. Mental health was measured using the GHQ-12 total score and past 3-month alcohol consumption was assessed using the AUDIT total score. Intervention efficacy was assessed using the difference in change in each of the 3 parameters from baseline to 3 months between the intervention and control group. Bivariate analyses utilized unpaired
Community gatekeepers identified 135 potentially eligible couples, of which 17 were not reachable, resulting in 118 couples being assessed for eligibility (
Baseline participant characteristics are described in
Recruitment and enrollment of participants into Ghya Bharari Ekatra intervention and control groups.
Baseline participant characteristics.
Characteristic | Women (n=40) | Men (n=40) | ||||
Intervention |
Control |
Intervention |
Control |
|||
Age (years), mean (σ) | 21.0 (3.1) | 22.2 (2.5) | .16 | 27.0 (3.3) | 25.8 (2.8) | .22 |
Secondary education or higher, n (%) | 15 (75) | 11 (45) | .05 | 14 (70) | 10 (50) | .20 |
Employed, n (%) | 5 (25) | 7 (35) | .49 | 20 (100) | 19 (95) | —a |
Women’s income (none), n (%) | 15 (75) | 13 (65) | .49 | N/Ab | N/A | N/A |
Men’s income Rs >10,000c, n (%) | N/A | N/A | N/A | 17 (85) | 7 (35) | .001 |
Religion (Hindu), n (%) | 16 (80) | 16 (80) | >.99 | 15 (75) | 16 (80) | .14 |
Reserved caste, n (%) | 10 (50) | 12 (60) | .53 | — | — | — |
Family type (joint), n (%) | 14 (70) | 18 (90) | .11 | — | — | — |
Premarital family type (joint), n (%) | 6 (30) | 9 (45) | .33 | — | — | — |
Household members, mean (σ) | 5.6 (3.0) | 4.8 (1.6) | .34 | — | — | — |
Marital duration (months), mean (σ) | — | — | — | 5.5 (3.6) | 6.8 (4.2) | .28 |
Marriage type (arranged), n (%) | 14 (70) | 15 (75) | .72 | — | — | — |
Within-caste marriage, n (%) | 18 (90) | 18 (90) | >.99 | — | — | — |
Within-family marriage, n (%) | 15 (75) | 11 (55) | .18 | — | — | — |
Pregnant, n (%) | 2 (10) | 4 (20) | .38 | — | — | — |
aNot available.
bN/A: not applicable.
cRs 10,000=US $136.63.
The intervention had high overall acceptance by the participants. At 3-month follow-up, 100% (17/17) of female intervention participants reported they would recommend participating in the intervention to their friends, reporting that the intervention presented them with new information; enabled the couple to build partnership and closeness, understand one another’s goals, and resolve existing misunderstandings; and resulted in their valuing and dedicating more time to their relationship.
Group exit interviews after the individual GBE sessions suggested all 6 sessions were highly accepted, with participants specifically mentioning they enjoyed the participatory nature and integrated games and competitions. Session 3, “Building Communication and Conflict Management Skills,” and Session 5, “Sexual Communication and the Sexual Relationship,” were the most favored. Participants endorsed easily connecting with the session 3 video content, as the dialogs paralleled the frustrations participants faced in their own relationships and family circumstances. Many reported that the videos and subsequent group reflections enabled them to recognize their shared histories and broaden their understanding of their partner’s perspective, thereby fostering cohesion within and among couples in the group. Session 5, “Sexual Communication and the Sexual Relationship,” was highly accepted, as participants reported it filled a key gap in their knowledge and was delivered by trusted health professionals in Marathi. Session 2, “I’m a Champion: I Can’t Be Broken and I Don’t Accept Defeat,” was the least favored, as the delivery of many activities required a higher level of literacy and critical thinking among participants and peer educators. Specific session-specific feedback is presented in
Suggested session modifications to enhance acceptance and feasibility of Ghya Bharari Ekatra intervention delivery.
Session | Suggested modifications |
1 |
The exercise 2 “Prioritizing Time in Relationship” reflections should include additional probes to foster depth of discussion. |
2 |
In the group reflection, peer educators should be reminded to use existing probes about barriers to and strategies for addressing completion of the home assignment, which would enable effective group reflection, even among couples unable to complete the assignment. Exercise 1, “Increased Social Participation,” should directly link participants to community-based organizations hosting social events in place of relying on peers to collect and convey the social event information. The exercise 2 “Enhanced Social Support” group diagramming exercise should be replaced with role-plays and reflections to reduce reliance on literacy and peer critical thinking skills and foster participation. Additionally, scenarios of greater relevance to female group members should be included. |
3 |
To foster depth of discussion and reflection among participants, the film for exercise 2, “Vadal Manache: Film and Discussion,” should incorporate a scene depicting the couple attempting to reconcile differences. |
4 |
Exercise 3 “Getting the Job I Want” mock interviews should be prerecorded to address differences in facilitator skill and comfort level with acting. The resume-building exercise should be replaced with a presentation on the importance of job retention, budget management, and financial resources, as this knowledge is of greater relevance to the intervention population. |
5 |
Two items (No. 7 and No. 10) on the exercise 2 “Misconceptions Quiz” need clarification. Incorporate additional information on HIV, oral sex, and sham infertility treatments. |
6 |
Exercise 1.2, “Expanding My Definition of Violence,” needs additional probes and examples of violence by in-laws and violence related to dowry to foster depth of discussion during reflection. Also, pictures should be added to address literacy challenges with the exercise. |
No adverse events or safety concerns were raised during the intervention period by participants to research staff. At 3-month follow-up, 100% (17/17) of women reported feeling safe during the 6-week intervention period and none (0/17) reported spousal or family conflicts arising from their participation in the intervention. Study safety procedures were overall well received, with 16 of 17 women reporting the resource diary (which included domestic violence resources) helpful and 15 of 17 women reporting that having the contact information of study staff to be able to contact them at any time was helpful. No women used the women’s day optional session to disclose safety concerns. CBO and peer educator passive monitoring of how the intervention was being discussed in the community also did not identify community tension or safety concerns caused by holding GBE in the communities.
Feasibility concerns with the delivery of GBE were minor and included (1) challenges with recruitment of male peer facilitators, as many men, while interested in the position, were unwilling to leave their jobs given the temporary nature; (2) challenges with delivering group-based activities (ie, games, group discussions) in sessions where the group size declined from 5 couples to 3 couples due to attrition; (3) delays in initiating session 1 due to the first portion of the study visit being dedicated to obtaining informed consent; (4) occasional temporary difficulties with showing session 3 films due to power outages; and (5) heat exhaustion of facilitators and participants due to lack of fans and air conditioning in most community venues in intense summer temperatures. Sessions 2 and 4 relied on guest key informants (ie, of community-based organizations) who were variably in attendance; while their in-person presence enhanced the quality of the information presented and the discussion, their absence did not significantly impact session delivery, as the material was instead gathered and presented by the peer educators.
GBE was piloted in 5 separate groups of 3 to 5 participants.
In 4 of 5 groups, all 6 sessions were delivered. One of the 5 groups did not receive session 3 due to participant absence. Expected session content was delivered for all 6 sessions, with the exception of the session 2 group reflection on the home assignment, which was not consistently feasible, as it was dependent on participants having completed the associated home assignment. All intended GBE materials were used across sessions. The average duration of sessions 1 to 6 were 130, 138, 128, 123, 134, and 125 minutes, respectively.
The 1-week peer educator and health educator training was provided as planned for all GBE sessions. Overall, peer educators and health educators delivered GBE activities without difficulty during the training. The exception was session 2’s exercises 2 and 3 and the session end summaries, during which facilitators improvised rather than following the script during the training. During the weekly refresher training sessions that preceded each session delivery, the study team focused on retraining the peer educators on the activities they found most challenging. During the actual intervention delivery, all activities were delivered as intended with the exception of session 2’s group reflection (as delivery required that participants had completed the home assignment, which often was not the case), exercise 1 (as it required peers having researched social activities in their communities, which often was not the case), and exercise 2 (as it required a higher level of critical thinking by the facilitator); session 4’s exercise 3 (“The Bad Interview”), as peers had difficulty acting out the bad interview; and session 6’s exercise 1.1, as peers improvised rather than reading directly from the script.
Overall participant engagement was high across all session activities. Exceptions were the activities in which the facilitators experienced challenges with delivery (session 1 exercise 2, “Prioritizing the Time Spent in the Relationship”; session 2 exercise 2.1, “Realizing I Have Social Support”; and session 6 exercise 1.2, “Expanding My Definition of Violence”)
A total of 85% (17/20) of couples attended at least 5 of the 6 intervention sessions; 100% (20/20) attended session 1, 80% (16/20) attended session 2, 85% (17/20) attended session 3, 70% (14/20) attended session 4, 85% (17/20) attended session 5, and 85% (17/20) attended session 6. A total of 16% (19/120) of the total sessions were missed due to participant work (7/19, 37%), personal illness (5/19, 26%), family illness (3/19, 16%), the participant being out of town (3/19, 16%), or the participants attending a place of worship (1/19, 5%).
A total of 118 couples were approached, of which 28 (23.7%) did not meet inclusion criteria, 43 (36.4%) declined to participate, and 7 (5.9%) were not included due to insufficient other eligible couples in their community to form an intervention group. The remaining 40 were assigned to the intervention (n=20) and control group (n=20), with all providing informed consent and completing the baseline assessment (
During the preimplementation process, study staff approached key community leaders and law enforcement officials to garner support. Community leaders were highly supportive, helping identify venue space (eg, community childcare centers, community halls) and waiving venue fees, providing electricity, and helping the study team make contacts with peers and potential participants. Law enforcement officials were also highly supportive of the intervention, warned female staff members of security risks at night, and vowed to be alert and responsive if security concerns arose in the community during the intervention. Preimplementation community sensitization meetings had variable attendance (3 to 11 members). Often, only men and mothers-in-law attended, but the meetings enabled study staff to clarify the intent of the intervention, foster dialogue around gatekeeper concerns for the intervention, and conduct an initial eligibility assessment. Preimplementation home visits by study staff to inform the families (particularly the mothers-in-law as household gatekeepers) of the intervention, assess interest, and establish eligibility of the couple were critical to participant recruitment and retention. During the intervention delivery, as the venues were located within often crowded slum communities, ambient noise and maintenance of privacy was often a challenge and required study staff to guard the door and distract onlookers. Additional challenges included adequacy of cooling and emergency lighting.
As the study was a pilot, the sample was small and the follow-up period was short. In this context, there were no reported physical or sexual IPV events in either group but fewer incidents of psychological abuse in GBE participants (3/17, 18%) versus control participants (4/16, 25%) at 3-month follow-up. There was significant improvement in overall mental health of female intervention participants and declines in mental health among the control participants (change in mean GHQ-12 score: –0.13 intervention, 0.13 controls;
GBE is the first documented couples-based primary prevention intervention for IPV developed and piloted in resource-limited settings. The exhaustive pilot evaluation demonstrated high acceptance, feasibility, safety, and preliminary efficacy of GBE in preventing IPV and improving mental health in the female partner. It also identified challenges with participant recruitment and delivery, which could be easily addressed to improve acceptance and fidelity.
The high acceptance, participation, retention rate, safety, and overall feasibility can be attributed to the extensive use of community-based participatory methods during GBE development [
Although the pilot study used a small sample with a short follow-up, GBE was associated with significantly less reporting of psychological IPV and enhanced mental health among female participants. The prevention of IPV can be attributed to GBE being designed to address the determinants of IPV perpetration and experience identified in these communities [
The study had several strengths and limitations. Strengths included the rigor of the process evaluation, the use of a community-based participatory approach that was inclusive of community sensitization predelivery of the intervention, the engaging interactive nature of the intervention, and the community-based delivery by lay peer educators from within the same community. One limitation was the significantly lower enrollment of couples of the lowest socioeconomic status into the intervention versus the control group due to lack of randomization. This bias was likely toward the null, however, as we would expect those of the lowest income to benefit most. A second limitation was the short follow-up period due to the pilot nature of the study, leaving unknown the longitudinal impact of the intervention on participant safety, IPV, mental health, and alcohol use. Future evaluation studies should extend the follow-up period to a minimum of 1 to 2 years to examine sustainability of effect.
In conclusion, GBE has high acceptance, feasibility, and preliminary efficacy in preventing IPV and improving mental health among women. Next steps include refining the intervention content based on the pilot findings and examining intervention efficacy through a large-scale randomized trial with longer follow-up across other regions of India. Implementation data will be collected as part of the trial to inform future dissemination and scaling. If deemed effective, GBE could be scaled across similar settings in Southeast Asia to address the high burden of IPV and mental health disorders.
Alcohol Use Disorders Identification Test
community-based organization
Ghya Bharari Ekatra
General Health Questionnaire-12
Indian Council of Medical Research National AIDS Research Institute
Indian Family Violence and Control Scale
intimate partner violence
We would like to thank the community educators (Bharat Bhadve, Pooja Bhadve, Nityanand Diggikar, Vimal Bhosale, Arjun Bhadve, Lata Mahankale, Mufid Baig, Bharati Kalal, Anuradha Patil, Surya Prakash Lahade, and Anita Pawar) for wholeheartedly delivering the intervention, Mangala Patil for her support with implementation, the ICMR-NARI Community Advisory Board and gender-based violence experts for the insightful feedback, and the many study participants for their invaluable contributions in developing the intervention. Further, we express sincere gratitude to Nayana Yenbhar for her meticulous entry and management of the data. Last, we acknowledge the continued support of this work by the ICMR-NARI director, Dr Samiran Panda, as well as the Indian Council of Medical Research.
The work was funded by the Fogarty International Center of the National Institutes of Health (Award K01TW009664). The content does not necessarily represent the views of the National Institutes of Health.
None declared.