Effectiveness of the Common Elements Treatment Approach (CETA) in reducing intimate partner violence and hazardous alcohol use in Zambia (VATU): A randomized controlled trial
Autoři:
Laura K. Murray aff001; Jeremy C. Kane aff001; Nancy Glass aff003; Stephanie Skavenski van Wyk aff001; Flor Melendez aff001; Ravi Paul aff004; Carla Kmett Danielson aff005; Sarah M. Murray aff001; John Mayeya aff006; Francis Simenda aff007; Paul Bolton aff008
Působiště autorů:
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
aff001; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, United States of America
aff002; Johns Hopkins University School of Nursing, Baltimore, Maryland, United States of America
aff003; Department of Psychiatry, School of Medicine, University of Zambia, University Teaching Hospital, Lusaka, Zambia
aff004; National Crime Victims Research and Treatment Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, United States of America
aff005; Ministry of Health–Zambia, Chainama Hills College Hospital, Lusaka, Zambia
aff006; Chainama Hills College Hospital, Lusaka, Zambia
aff007; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
aff008
Vyšlo v časopise:
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 Med 17(4): e32767. doi:10.1371/journal.pmed.1003056
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pmed.1003056
Souhrn
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 < 0.001, Cohen’s d effect size = 0.43). The Data and Safety Monitoring Board recommended the trial be stopped early due to treatment effectiveness following the 12-month post-baseline assessment, and CETA was offered to control participants. Limitations of the trial included the lack of a true control condition (i.e., that received no intervention), self-reported outcomes that may be subject to social desirability bias, and low statistical power for secondary IPV outcomes.
Conclusions
Results showed that CETA was more effective than TAU-Plus in reducing IPV and hazardous alcohol use among high-risk couples in Zambia. Future research and programming should include tertiary prevention approaches to IPV, such as CETA, rather than offering only community mobilization and primary prevention.
Trial registration
The trial was registered on ClinicalTrials.gov (NCT02790827).
Klíčová slova:
Alcohol consumption – Alcohols – Behavioral and social aspects of health – Employment – Intimate partner violence – Mental health and psychiatry – Randomized controlled trials – Zambia
Zdroje
1. Decker MR, Latimore AD, Yasutake S, Haviland M, Ahmed S, Blum RW, et al. Gender-based violence against adolescent and young adult women in low- and middle-income countries. J Adolesc Health. 2015;56:188–96. doi: 10.1016/j.jadohealth.2014.09.003 25620301
2. Devries KM, Mak JYT, García-Moreno C, Petzold M, Child JC, Falder G, et al. The global prevalence of intimate partner violence against women. Science. 2013;340:1527–8. doi: 10.1126/science.1240937 23788730
3. Garcia-Moreno C, Jansen HAFM, Ellsberg M, Heise L, Watts CH. Prevalence of intimate partner violence: findings from the WHO multi-country study on women’s health and domestic violence. Lancet. 2006;368:1260–9. doi: 10.1016/S0140-6736(06)69523-8 17027732
4. Inter-Agency Standing Committee. Guidelines for integrating gender-based violence interventions in humanitarian action: reducing risk, promoting resilience and aiding recovery. Geneva: Inter-Agency Standing Committee; 2015.
5. World Health Organization. Violence against women. Geneva: World Health Organization; 2017 [cited 2020 Mar 16]. Available from: http://www.who.int/news-room/fact-sheets/detail/violence-against-women
6. Central Statistical Office, Ministry of Health, University of Zambia Teaching Hospital Virology Laboratory, University of Zambia Department of Population Studies, Tropical Diseases Research Centre, DHS Program. Zambia: Zambia demographic and health survey 2013–14. Rockville (MD): ICF International; 2015.
7. Ellsberg M, Jansen HAFM, Heise L, Watts CH, Garcia-Moreno C. Intimate partner violence and women’s physical and mental health in the WHO multi-country study on women’s health and domestic violence: an observational study. Lancet. 2008;371:1165–72. doi: 10.1016/S0140-6736(08)60522-X 18395577
8. Coker AL, Davis KE, Arias I, Desai S, Sanderson M, Brandt HM, et al. Physical and mental health effects of intimate partner violence for men and women. Am J Prev Med. 2002;23:260–8. doi: 10.1016/s0749-3797(02)00514-7 12406480
9. Stöckl H, Devries K, Rotstein A, Abrahams N, Campbell J, Watts C, et al. The global prevalence of intimate partner homicide: a systematic review. Lancet. 2013;382:859–65. doi: 10.1016/S0140-6736(13)61030-2 23791474
10. Garcia-Linares MI, Sanchez-Lorente S, Coe CL, Martinez M. Intimate male partner violence impairs immune control over herpes simplex virus type 1 in physically and psychologically abused women. Psychosom Med. 2004;66:965–72. doi: 10.1097/01.psy.0000145820.90041.c0 15564366
11. Goodman LA, Smyth KF, Borges AM, Singer R. When crises collide. Trauma Violence Abuse. 2009;10:306–29. doi: 10.1177/1524838009339754 19776085
12. World Health Organization. Violence prevention: the evidence. Preventing violence by reducing the availability and harmful use of alcohol. Geneva: World Health Organization; 2009.
13. Black MC. Intimate partner violence and adverse health consequences: implications for clinicians. Am J Lifestyle Med. 2011;5:428–39. doi: 10.1177/1559827611410265
14. Abramsky T, Watts CH, Garcia-Moreno C, Devries K, Kiss L, Ellsberg M, et al. What factors are associated with recent intimate partner violence? Findings from the WHO multi-country study on women’s health and domestic violence. BMC Public Health. 2011;11:109. doi: 10.1186/1471-2458-11-109 21324186
15. Fulu E, Jewkes R, Roselli T, Garcia-Moreno C. Prevalence of and factors associated with male perpetration of intimate partner violence: findings from the UN Multi-country Cross-sectional Study on Men and Violence in Asia and the Pacific. Lancet Glob Health. 2013;1:e187–207. doi: 10.1016/S2214-109X(13)70074-3 25104345
16. Roldós MI, Corso P. The economic burden of intimate partner violence in Ecuador: setting the agenda for future research and violence prevention policies. West J Emerg Med. 2013;14:347–53. doi: 10.5811/westjem.2013.2.15697 23930148
17. United Nations. Sustainable development goal 5: achieve gender equality and empower all women and girls. New York: United Nations; 2018.
18. Abrahams N, Jewkes R, Hoffman M, Laubsher R. Sexual violence against intimate partners in Cape Town: prevalence and risk factors reported by men. Bull World Health Organ. 2004;82:330–7. 15298223
19. Jewkes R, Dunkle K, Nduna M, Levin J, Jama N, Khuzwayo N, et al. Factors associated with HIV sero-status in young rural South African women: connections between intimate partner violence and HIV. Int J Epidemiol. 2006;35:1461–8. doi: 10.1093/ije/dyl218 17008362
20. Capaldi DM, Knoble NB, Shortt JW, Kim HK. A systematic review of risk factors for intimate partner violence. partner abuse. 2012;3:231–80. doi: 10.1891/1946-6560.3.2.231 22754606
21. Foran HM, O’Leary KD. Alcohol and intimate partner violence: a meta-analytic review. Clin Psychol Rev. 2008;28:1222–34. doi: 10.1016/j.cpr.2008.05.001 18550239
22. Tirado-Muñoz J, Gilchrist G, Farré M, Hegarty K, Torrens M. The efficacy of cognitive behavioural therapy and advocacy interventions for women who have experienced intimate partner violence: a systematic review and meta-analysis. Ann Med. 2014;46:567–86. doi: 10.3109/07853890.2014.941918 25211469
23. Wilson IM, Graham K, Taft A. Alcohol interventions, alcohol policy and intimate partner violence: a systematic review. BMC Public Health. 2014;14:881. doi: 10.1186/1471-2458-14-881 25160510
24. Murray LK, Dorsey S, Haroz E, Lee C, Alsiary MM, Haydary A, et al. A common elements treatment approach for adult mental health problems in low- and middle-income countries. Cogn Behav Pract. 2014;21:111–23. doi: 10.1016/j.cbpra.2013.06.005 25620867
25. Kane JC, Skavenski Van Wyk S, Murray SM, Bolton P, Melendez F, Danielson CK, et al. 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. Glob Ment Health (Camb). 2017;4:e18. doi: 10.1017/gmh.2017.10 29230314
26. Murray LK, Skavenski S, Kane JC, Mayeya J, Dorsey S, Cohen JA, et al. Effectiveness of trauma-focused cognitive behavioral therapy among trauma-affected children in Lusaka, Zambia: a randomized clinical trial. JAMA Pediatr. 2015;169:761–9. doi: 10.1001/jamapediatrics.2015.0580 26111066
27. Kane JC, Murray LK, Bass JK, Johnson RM, Bolton P. Validation of a substance and alcohol use assessment instrument among orphans and vulnerable children in Zambia using Audio Computer Assisted Self-Interviewing (ACASI). Drug Alcohol Depend. 2016;166:85–92. doi: 10.1016/j.drugalcdep.2016.06.026 27402551
28. Kane JC, Murray LK, Sughrue S, DeMulder J, Skavenski van Wyk S, Queenan J, et al. Process and implementation of Audio Computer Assisted Self-Interviewing (ACASI) assessments in low resource settings: a case example from Zambia. Glob Ment Health (Camb). 2016;3:e24. doi: 10.1017/gmh.2016.19 28596892
29. Kane JC, Vinikoor MJ, Haroz EE, Al-Yasiri M, Bogdanov S, Mayeya J, et al. Mental health comorbidity in low-income and middle-income countries: a call for improved measurement and treatment. Lancet Psychiatry. 2018;5:864–88. doi: 10.1016/S2215-0366(18)30301-8 30174288
30. Bolton P, Lee C, Haroz EE, Murray L, Dorsey S, Robinson C, et al. A Transdiagnostic community-based mental health treatment for comorbid disorders: development and outcomes of a randomized controlled trial among Burmese refugees in Thailand. PLoS Med. 2014;11(11):e1001757. doi: 10.1371/journal.pmed.1001757 25386945
31. Weiss WM, Murray LK, Zangana GAS, Mahmooth Z, Kaysen D, Dorsey S, et al. Community-based mental health treatments for survivors of torture and militant attacks in Southern Iraq: a randomized control trial. BMC Psychiatry. 2015;15:249. doi: 10.1186/s12888-015-0622-7 26467303
32. Murray LK, Hall BJ, Dorsey S, Ugueto AM, Puffer ES, Sim A, et al. An evaluation of a common elements treatment approach for youth in Somali refugee camps. Glob Ment Health (Camb). 2018;5:e16. doi: 10.1017/gmh.2018.7 29868236
33. Danielson CK, McCart MR, Walsh K, de Arellano MA, White D, Resnick HS. Reducing substance use risk and mental health problems among sexually assaulted adolescents: a pilot randomized controlled trial. J Fam Psychol. 2012;26:628–35. doi: 10.1037/a0028862 22686269
34. Marlatt GA, Donovan DM, editors. Relapse prevention: maintenance strategies in the treatment of addictive behaviors. 2nd edition. New York: Guilford Press; 2005.
35. Copello A, Velleman R, Templeton L. Family interventions in the treatment of alcohol and drug problems. Drug Alcohol Rev. 2005;24:369–85. doi: 10.1080/09595230500302356 16234133
36. Murray LK, Dorsey S, Bolton P, Jordans MJ, Rahman A, Bass J, et al. Building Capacity in Mental Health Interventions in Low-resource countries: An Apprenticeship Model for Training Local Providers. International Journal of Mental Health Systems. 2011; Nov 18;5(1):30. doi: 10.1186/1752-4458-5-30 22099582. PMCID: PMC3284435
37. Murray LK, Skavenski S, Bass J, Wilcox HC, Bolton P, Imasiku M, et al. Implementing evidence-based mental health care in low-resource settings: a focus on safety planning procedures. J Cogn Psychother. 2014;28:168–85. doi: 10.1891/0889-8391.28.3.168 31602096
38. Marshall LL. Development of the severity of violence against women scales. J Fam Violence. 1992;7:103–21. doi: 10.1007/BF00978700
39. Peltzer K, Pengpid S. The severity of violence against women by intimate partners and associations with perpetrator alcohol and drug use in the Vhembe district, South Africa. Afr Saf Promot. 2013;11:13–24.
40. World Health Organization. WHO multi-country study on women’s health and domestic violence against women: summary report of initial results on prevalence, health outcomes and women’s responses. Geneva: World Health Organization; 2005.
41. Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption—II. Addiction. 1993;88:791–804. doi: 10.1111/j.1360-0443.1993.tb02093.x 8329970
42. Chishinga N, Kinyanda E, Weiss HA, Patel V, Ayles H, Seedat S. Validation of brief screening tools for depressive and alcohol use disorders among TB and HIV patients in primary care in Zambia. BMC Psychiatry. 2011;11:75. doi: 10.1186/1471-244X-11-75 21542929
43. National Institute on Alcohol Abuse and Alcoholism. Recommended alcohol questions. Bethesda (MD): National Institute on Alcohol Abuse and Alcoholism; 2003 [cited 2020 Mar 16]. Available from: http://www.niaaa.nih.gov/research/guidelines-and-resources/recommended-alcohol-questions
44. Azur MJ, Stuart EA, Frangakis C, Leaf PJ. multiple imputation by chained equations: what is it and how does it work? Int J Methods Psychiatr Res. 2011;20:40–9. doi: 10.1002/mpr.329 21499542
45. White IR, Royston P, Wood AM. Multiple imputation using chained equations: issues and guidance for practice. Stat Med. 2011;30:377–99. doi: 10.1002/sim.4067 21225900
46. StataCorp. Stata Statistical Software. Release 15. College Station (TX): StataCorp; 2017.
47. Huber PJ. The behavior of maximum likelihood estimates under nonstandard conditions. In: Le Cam LM, Neyman J, editors. Proceedings of the fifth Berkeley symposium on mathematical statistics and probability, volume 1: statistics. Berkeley: University of California Press; 1967. pp. 221–33.
48. White H. A heteroskedasticity-consistent covariance matrix estimator and a direct test for heteroskedasticity. Econometrica. 1980;48:817–38. doi: 10.2307/1912934
49. Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Meas. 1960;20:37–46.
50. Bourey C, Williams W, Bernstein EE, Stephenson R. Systematic review of structural interventions for intimate partner violence in low- and middle-income countries: organizing evidence for prevention. BMC Public Health. 2015;15:1165. doi: 10.1186/s12889-015-2460-4 26597715
51. Glass N, Perrin NA, Kohli A, Campbell J, Remy MM. Randomised controlled trial of a livestock productive asset transfer programme to improve economic and health outcomes and reduce intimate partner violence in a postconflict setting. BMJ Glob Health. 2017;2:e000165. doi: 10.1136/bmjgh-2016-000165 28589002
52. World Health Organization. Global status report on violence prevention 2014. Geneva: World Health Organization; 2014.
53. Papas RK, Sidle JE, Gakinya BN, Baliddawa JB, Martino S, Mwaniki MM, et al. Treatment outcomes of a stage 1 cognitive-behavioral trial to reduce alcohol use among human immunodeficiency virus-infected out-patients in western Kenya. Addiction. 2011;106:2156–66. doi: 10.1111/j.1360-0443.2011.03518.x 21631622
54. Cornelius JR, Maisto SA, Pollock NK, Martin CS, Salloum IM, Lynch KG, et al. Rapid relapse generally follows treatment for substance use disorders among adolescents. Addict Behav. 2003;28:381–6. doi: 10.1016/s0306-4603(01)00247-7 12573689
55. Visschers J, Jaspaert E, Vervaeke G. Social desirability in intimate partner violence and relationship satisfaction reports: an exploratory analysis. J Interpers Violence. 2017;32:1401–20. doi: 10.1177/0886260515588922 26058978
56. Williams EC, Hahn JA, Saitz R, Bryant K, Lira MC, Samet JH. Alcohol use and human immunodeficiency virus (HIV) infection: current knowledge, implications, and future directions. Alcohol Clin Exp Res. 2016;40:2056–72. doi: 10.1111/acer.13204 27696523
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