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

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  • Laura K Murray
  • Jeremy C Kane
  • Nancy Glass
  • Stephanie Skavenski van Wyk
  • Flor Melendez
  • Ravi Paul
  • Carla Kmett Danielson
  • Sarah M Murray
  • John Mayeya
  • Francis Simenda
  • Paul Bolton

Abstract

Background: Both intimate partner violence (IPV) and alcohol misuse are highly prevalent, and partner alcohol misuse is a significant contributor to women’s risk for IPV. There are few evidence-based interventions to address these problems in low- and middle-income countries (LMICs). We evaluated the effectiveness of an evidence-based, multi-problem, flexible, transdiagnostic intervention, the Common Elements Treatment Approach (CETA) in reducing (a) women’s experience of IPV and (b) their male partner’s alcohol misuse among couples in urban Zambia. Methods and findings: This was a single-blind, parallel-assignment randomized controlled trial in Lusaka, Zambia. Women who reported moderate or higher levels of IPV and their male partners with hazardous alcohol use were enrolled as a couple and randomized to CETA or treatment as usual plus safety checks (TAU-Plus). The primary outcome, IPV, was assessed by the Severity of Violence Against Women Scale (SVAWS) physical/sexual violence subscale, and the secondary outcome, male alcohol misuse, by the Alcohol Use Disorders Identification Test (AUDIT). Assessors were blinded. Analyses were intent-to-treat. Primary outcome assessments were planned at post-treatment, 12 months post-baseline, and 24 months post-baseline. Enrollment was conducted between May 23, 2016, and December 17, 2016. In total, 123 couples were randomized to CETA, 125 to TAU-Plus. The majority of female (66%) and a plurality of male (48%) participants were between 18 and 35 years of age. Mean reduction in IPV (via SVAWS subscale score) at 12 months post-baseline was statistically significantly greater among women who received CETA compared to women who received TAU-Plus (−8.2, 95% CI −14.9 to −1.5, p = 0.02, Cohen’s d effect size = 0.49). Similarly, mean reduction in AUDIT score at 12 months post-baseline was statistically significantly greater among men who received CETA compared to men who received TAU (−4.5, 95% CI −6.9 to −2.2, p

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  • Laura K Murray & Jeremy C Kane & Nancy Glass & Stephanie Skavenski van Wyk & Flor Melendez & Ravi Paul & Carla Kmett Danielson & Sarah M Murray & John Mayeya & Francis Simenda & Paul Bolton, 2020. "Effectiveness of the Common Elements Treatment Approach (CETA) in reducing intimate partner violence and hazardous alcohol use in Zambia (VATU): A randomized controlled trial," PLOS Medicine, Public Library of Science, vol. 17(4), pages 1-22, April.
  • Handle: RePEc:plo:pmed00:1003056
    DOI: 10.1371/journal.pmed.1003056
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    References listed on IDEAS

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    1. White, Halbert, 1980. "A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for Heteroskedasticity," Econometrica, Econometric Society, vol. 48(4), pages 817-838, May.
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    1. Murray, Sarah M. & Skavenski Van Wyk, Stephanie & Metz, Kristina & Mulemba, Saphira Munthali & Mwenge, Mwamba M. & Kane, Jeremy C. & Alto, Michelle & Venturo-Conerly, Katherine E. & Wasil, Akash R. & , 2021. "A qualitative exploration of mechanisms of intimate partner violence reduction for Zambian couples receiving the Common Elements Treatment Approach (CETA) intervention," Social Science & Medicine, Elsevier, vol. 268(C).
    2. Rachel Jewkes & Samantha Willan & Lori Heise & Laura Washington & Nwabisa Shai & Alice Kerr-Wilson & Andrew Gibbs & Erin Stern & Nicola Christofides, 2021. "Elements of the Design and Implementation of Interventions to Prevent Violence against Women and Girls Associated with Success: Reflections from the What Works to Prevent Violence against Women and Gi," IJERPH, MDPI, vol. 18(22), pages 1-16, November.
    3. Prado, Elizabeth L. & Sebayang, Susy K. & Adawiyah, Siti R. & Alcock, Katherine J. & Ullman, Michael T. & Muadz, Husni & Shankar, Anuraj H., 2021. "Maternal depression is the predominant persistent risk for child cognitive and social-emotional problems from early childhood to pre-adolescence: A longitudinal cohort study," Social Science & Medicine, Elsevier, vol. 289(C).
    4. Daniel P. Lakin & Claudia García-Moreno & Elisabeth Roesch, 2022. "Psychological Interventions for Survivors of Intimate Partner Violence in Humanitarian Settings: An Overview of the Evidence and Implementation Considerations," IJERPH, MDPI, vol. 19(5), pages 1-19, March.
    5. Catherine A Staton & João Ricardo Nickenig Vissoci & Deena El-Gabri & Konyinsope Adewumi & Tessa Concepcion & Shannon A Elliott & Daniel R Evans & Sophie W Galson & Charles T Pate & Lindy M Reynolds &, 2022. "Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary," PLOS Medicine, Public Library of Science, vol. 19(4), pages 1-27, April.
    6. Wendee M. Wechsberg & Isa van der Drift & Brittni N. Howard & Bronwyn Myers & Felicia A. Browne & Courtney Peasant Bonner & Tara Carney & Jacqueline Ndirangu & Yukiko Washio, 2022. "Gender and Context Matter: Behavioral and Structural Interventions for People Who Use Alcohol and Other Drugs in Africa," IJERPH, MDPI, vol. 19(14), pages 1-24, July.
    7. Muzyamba, Choolwe, 2022. "Community Mobilization as a tool against sexual and gender-based violence in SADC region," MERIT Working Papers 2022-036, United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology (MERIT).
    8. Etienne Lwamba & Shannon Shisler & Will Ridlehoover & Meital Kupfer & Nkululeko Tshabalala & Promise Nduku & Laurenz Langer & Sean Grant & Ada Sonnenfeld & Daniela Anda & John Eyers & Birte Snilstveit, 2022. "Strengthening women's empowerment and gender equality in fragile contexts towards peaceful and inclusive societies: A systematic review and meta‐analysis," Campbell Systematic Reviews, John Wiley & Sons, vol. 18(1), March.

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