The Economics of Domestic Violence: Evidence From Bangladesh

Yale University

Status: Active, not recruiting

Conditions: Intimate Partner Violence Prevention; Intimate Partner Violence (IPV)

Treatments: Behavioral: Edutainment Content: Norms Campaign; Behavioral: Cognitive Behavioral Therapy (CBT)-based skills; Behavioral: Edutainment Content: Placebo Campaign

Study type: Interventional

Funder types: Other

Identifiers

NCT06916377

2000026184

Details and patient eligibility

About

This project aims to test the scalability and cost-effectiveness of edutainment-soap operas designed to challenge harmful social norms and promote resilience-as a strategy to improve mental health and reduce intimate partner violence (IPV) in rural Bangladesh. Investigators will run a clustered randomized control trial in which villages will be randomized to one of three versions of the same soap opera: (i) Norms: Challenges harmful norms that condone IPV, targeting the belief that violence is an acceptable way to assert control or maintain reputation, (ii) Norms + Skills: builds on the norms campaign by adding CBT-based skills for stress management and non-violent conflict resolution, (iii) Placebo: No violence content. Investigators will evaluate the impact on attitudes towards IPV and IPV incidence.

Full description

Study design features two layers of commuity-level randomization based on a 3x2 factorial design:

First Treatment Variation: Edutainment Content. Communities are randomized into one of three versions of the same soap opera:

1. Norms Campaign (176 communities): Challenges harmful norms that condone IPV, targeting the belief that violence is an acceptable way to assert control or maintain reputation.
2. Norms + Skills Campaign (176 communities): Builds on the norms campaign by adding CBT-based skills for stress management and non-violent conflict resolution.
3. Placebo Campaign (88 communities): Features unrelated content to serve as a control group, isolating the effects of norms and resiliency messaging.

This variation allows for assessing the impact of addressing harmful norms alone from the additional benefits of equipping men with practical coping skills. By comparing the Norms Campaign to the Norms + Skills Campaign, investigators test whether adding stress-coping skills yields additional reductions in IPV and related outcomes.

Second Treatment Variation: Delivery Modes. Fifty percent of communities in each treatment arm are randomized into one of two delivery modes:

1. Private Delivery: Men watch the soap opera privately at home on handheld devices.
2. Public Delivery: Men watch the soap opera publicly through community screenings.

Randomizing delivery modes enables investigators to assess whether men's responses to the intervention are driven by self-esteem concerns (private delivery) or reputation concerns (public delivery). This distinction provides critical insights into the mechanisms underlying IPV and informs the scalability of different delivery methods.

In addition to the community-level randomizations, 50 percent of men in each community are randomized into participation in a cash-for-work program. This individual-level randomization allows us to evaluate the role of economic strain in IPV outcomes, testing whether alleviating financial stress enhances the intervention's effectiveness.

Enrollment: 440 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• married men and women over the legal age of majority in Bangladesh

Exclusion criteria

• No exclusion criteria were imposed.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: Single Blind

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440 participants in 12 patient groups

Norms with Private Delivery

Experimental group

Description:

Soap opera that challenges harmful norms that condone IPV, targeting the belief that violence is an acceptable way to assert control or maintain reputation Private Delivery Mode: Men watch the soap opera privately at home on handheld devices.

Treatment:

Behavioral: Edutainment Content: Norms Campaign

Norms + Skills with Private Delivery

Experimental group

Description:

Soap opera that builds on the norms campaign by adding CBT-based skills for stress management and non-violent conflict resolution Private Delivery Mode: Men watch the soap opera privately at home on handheld devices.

Treatment:

Behavioral: Cognitive Behavioral Therapy (CBT)-based skills

Behavioral: Edutainment Content: Norms Campaign

Placebo with Private Delivery

Experimental group

Description:

Soap opera that features unrelated content to serve as a control group, isolating the effects of norms and resiliency messaging. Private Delivery Mode: Men watch the soap opera privately at home on handheld devices.

Treatment:

Behavioral: Edutainment Content: Placebo Campaign

Norms with Public Delivery

Experimental group

Description:

Soap opera that challenges harmful norms that condone IPV, targeting the belief that violence is an acceptable way to assert control or maintain reputation Public Delivery Mode: Men watch the soap opera publicly through community screenings.

Treatment:

Behavioral: Edutainment Content: Norms Campaign

Norms + Skills with Public Delivery

Experimental group

Description:

Soap opera that builds on the norms campaign by adding CBT-based skills for stress management and non-violent conflict resolution Public Delivery Mode: Men watch the soap opera publicly through community screenings.

Treatment:

Behavioral: Cognitive Behavioral Therapy (CBT)-based skills

Behavioral: Edutainment Content: Norms Campaign

Placebo with Public Delivery

Experimental group

Description:

Soap opera that features unrelated content to serve as a control group, isolating the effects of norms and resiliency messaging. Public Delivery Mode: Men watch the soap opera publicly through community screenings.

Treatment:

Behavioral: Edutainment Content: Placebo Campaign

Norms with Private Delivery and Cash-for-Work program

Experimental group

Description:

Soap opera that challenges harmful norms that condone IPV, targeting the belief that violence is an acceptable way to assert control or maintain reputation Private Delivery Mode: Men watch the soap opera privately at home on handheld devices. Cash-for-Work: Small weekly payments for viewing and providing feedback on the media content.

Treatment:

Behavioral: Edutainment Content: Norms Campaign

Norms + Skills with Private Delivery and Cash-for-Work program

Experimental group

Description:

Soap opera that builds on the norms campaign by adding CBT-based skills for stress management and non-violent conflict resolution Private Delivery Mode: Men watch the soap opera privately at home on handheld devices. Cash-for-Work: Small weekly payments for viewing and providing feedback on the media content.

Treatment:

Behavioral: Cognitive Behavioral Therapy (CBT)-based skills

Behavioral: Edutainment Content: Norms Campaign

Placebo with Private Delivery and Cash-for-Work program

Experimental group

Description:

Soap opera that features unrelated content to serve as a control group, isolating the effects of norms and resiliency messaging. Private Delivery Mode: Men watch the soap opera privately at home on handheld devices. Cash-for-Work: Small weekly payments for viewing and providing feedback on the media content.

Treatment:

Behavioral: Edutainment Content: Placebo Campaign

Norms with Public Delivery and Cash-for-Work program

Experimental group

Description:

Soap opera that challenges harmful norms that condone IPV, targeting the belief that violence is an acceptable way to assert control or maintain reputation Public Delivery Mode: Men watch the soap opera publicly through community screenings. Cash-for-Work: Small weekly payments for viewing and providing feedback on the media content.

Treatment:

Behavioral: Edutainment Content: Norms Campaign

Norms + Skills with Public Delivery and Cash-for-Work program

Experimental group

Description:

Soap opera that builds on the norms campaign by adding CBT-based skills for stress management and non-violent conflict resolution Public Delivery Mode: Men watch the soap opera publicly through community screenings. Cash-for-Work: Small weekly payments for viewing and providing feedback on the media content.

Treatment:

Behavioral: Cognitive Behavioral Therapy (CBT)-based skills

Behavioral: Edutainment Content: Norms Campaign

Placebo with Public Delivery and Cash-for-Work program

Experimental group

Description:

Soap opera that features unrelated content to serve as a control group, isolating the effects of norms and resiliency messaging. Public Delivery Mode: Men watch the soap opera publicly through community screenings. Cash-for-Work: Small weekly payments for viewing and providing feedback on the media content.

Treatment:

Behavioral: Edutainment Content: Placebo Campaign