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Multilevel Intervention for Preventing Men's Use of Violence in Urban South Africa (Sonke CHANGE Trial) (Sonke CHANGE)

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ClinicalTrials.gov Identifier: NCT02823288
Recruitment Status : Unknown
Verified October 2017 by Abigail Hatcher, University of Witwatersrand, South Africa.
Recruitment status was:  Active, not recruiting
First Posted : July 6, 2016
Last Update Posted : October 26, 2017
Sonke Gender Justice
Medical Research Council, South Africa
Department for International Development, United Kingdom
Information provided by (Responsible Party):
Abigail Hatcher, University of Witwatersrand, South Africa

Brief Summary:
South Africa has one of the highest rates of violence towards women globally. However, little is known about how to prevent men's use of violence. The Sonke CHANGE Trial tests an intervention that targets men as individuals, groups, and community members in a peri-urban setting in South Africa. Eighteen neighborhoods will be randomly assigned to either the intervention condition or a control group. By speaking to men at baseline, 12 months, and 24 months, investigators will learn whether violence and other health behaviors shift over time. Alongside the trial, qualitative research will explore how the intervention took place and why participants may change attitudes or behaviors.

Condition or disease Intervention/treatment Phase
Domestic Violence Sexual Assault and Rape Masculinity Other: Sonke CHANGE intervention Not Applicable

Detailed Description:

This study will refine and evaluate a multi-level model for reducing violence against women and girls in urban South Africa.

The intervention is a refinement of an existing gender-transformative programme that includes community mobilisation and advocacy. Called the Sonke CHANGE intervention, it will extend beyond a conventional group-based workshop approach to address the multi-level nature of violence and create an enabling environment for men to embrace more equitable forms of masculinity. Given the strong associations between masculinities and men's use of partner violence, now is an opportune moment to test the Sonke CHANGE model to determine its impact on men's use of violence.

The multi-level Sonke intervention will be evaluated using a cluster randomised controlled trial design. In a peri-urban setting of Diepsloot, neighbourhood "clusters" (n=18) will be randomly assigned to receive the intervention or a wait-list condition. Baseline, 12 month, and 24 month measures will assess changes in primary outcomes (men's reported use of intimate partner and non-partner violence) and secondary outcomes (severe violence, masculinity norms, harmful alcohol use, mental health). Formative qualitative research will explore the environmental context of Diepsloot, community views on violence, men's mobility, and their experiences of fathering. A longitudinal process evaluation will explore intervention delivery, unfolding of the advocacy element of Sonke CHANGE intervention, and potential mechanisms to change amongst participants.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 2603 participants
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: Refinement and Evaluation of a Multilevel Intervention for Preventing Men's Use of Violence in Urban South Africa (Sonke CHANGE Trial)
Study Start Date : February 2016
Estimated Primary Completion Date : July 2018
Estimated Study Completion Date : August 2018

Arm Intervention/treatment
Experimental: Sonke CHANGE intervention condition
This arm (n=9 clusters) will receive the Sonke CHANGE intervention for 12 months.
Other: Sonke CHANGE intervention

The Sonke CHANGE intervention is a multi-level model aimed at individual, group, community, and societal levels. Sonke's programming is comprised of three core components:

  1. Workshops based on the premise that deeply held gender and sexuality beliefs can be critically examined and transformed in a reflective group setting. Workshops aim to challenge inequitable and harmful ideas about manhood and encourage men to take action to promote equality.
  2. Community Action Teams (CATs) are comprised of interested men and women, who mobilize on a voluntary basis around issues in their neighborhoods. Methods include ambush theatre, murals painting, door to door campaigns, street soccer festivals, rallies, and community dialogues.
  3. Local Advocacy is undertaken by CAT members, who aim to hold government and other duty bearers to account for VAWG prevention. CAT members join local community structures to advance community education and local government accountability.

No Intervention: Control condition
In this arm (n=9 clusters), no activities will take place during the trial period outside of data collection.

Primary Outcome Measures :
  1. Change in intimate partner violence [ Time Frame: 12 months, 24 months ]
    Men's use of violence towards an intimate partner will be measured using an adapted version of the questionnaire from the South African Medical Research Council's Study on Men's Health and Relationships (6, 61). The questionnaire includes items around emotional abuse, economic abuse, physical violence, and sexual violence. Primary outcomes will be defined as dichotomous outcomes: any use of physical violence and / or any use of sexual violence.

Secondary Outcome Measures :
  1. Change in severe violence [ Time Frame: 12 months, 24 months ]
    Men's use of severe violence is defined as any instance of men reporting more than once response to a single physical or sexual IPV item OR a response of once or more than once to two or more physical and/or sexual items.

  2. Change in controlling behavior [ Time Frame: 12 months, 24 months ]
    Male Controlling Behaviour will be measured using the Pulerwitz Sexual Relationship Power and Control scale items (65). This scale has been validated in South Africa (66), and has been used by members of our team in previous studies (67).

  3. Change in gender attitudes [ Time Frame: 12 months, 24 months ]
    Gender Attitudes will be measured using the Gender Equitable Men's Scale (GEM Scale) (63), an 18-item Likert scale. Gender Norms will be comprised of similar items, but phrased in a Likert scale for whether a man's friends hold those beliefs.

  4. Change in harmful alcohol use [ Time Frame: 12 months, 24 months ]
    Harmful alcohol use will be measured using the Alcohol Use Disorders Identification Test (AUDIT), a 10-item scale designed to measure alcohol consumption and identify risks for alcohol abuse and dependence (62).

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 40 Years   (Adult)
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • between 18 and 40 years of age (inclusive)
  • lives in a trial cluster
  • willing to participate on basis of written, informed consent

Exclusion Criteria:

  • younger than 18 years or older than 40 years
  • lives outside of a trial cluster
  • unwilling to participate or sign written, informed consent

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02823288

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South Africa
Wits School of Public Health
Johannesburg, Gauteng, South Africa, 2192
Sponsors and Collaborators
University of Witwatersrand, South Africa
Sonke Gender Justice
Medical Research Council, South Africa
Department for International Development, United Kingdom
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Principal Investigator: Nicola J Christofides, PhD University the Witwatersrand
Additional Information:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Abigail Hatcher, Senior Researcher, University of Witwatersrand, South Africa
ClinicalTrials.gov Identifier: NCT02823288    
Other Study ID Numbers: M150443
First Posted: July 6, 2016    Key Record Dates
Last Update Posted: October 26, 2017
Last Verified: October 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: Data will be available 5 years after the end of the research through an institutional repository managed by the South African MRC. Data sharing will be managed through an application process, whereby the original investigators will be invited to participate in future papers.
Keywords provided by Abigail Hatcher, University of Witwatersrand, South Africa:
intimate partner violence
community mobilization
social intervention