Mediating effects of inequitable gender norms on intimate partner violence and contraceptive use in a cluster randomized control trial in Niger

Previous research has demonstrated that the Reaching Married Adolescents intervention (RMA) was associated with changes in inequitable gender norms, intimate partner violence (IPV), and modern contraceptive use. This study seeks to understand if changes in inequitable gender norms mediate the RMA in...

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Published in:American journal of epidemiology Vol. 194; no. 5; p. 1221
Main Authors: Boyce, Sabrina C, Minnis, Alexandra M, Deardorff, Julianna, McCoy, Sandra I, Goin, Dana E, Challa, Sneha, Johns, Nicole E, Aliou, Sani, Brooks, Mohamad I, Nouhou, Abdoul-Moumouni, Baker, Holly, Silverman, Jay G
Format: Journal Article
Language:English
Published: United States 07.05.2025
Subjects:
Adolescent
Adult
Contraception Behavior - psychology
Contraception Behavior - statistics & numerical data
Female
Humans
Intimate Partner Violence - prevention & control
Intimate Partner Violence - statistics & numerical data
Male
Niger - epidemiology
Social Norms
Young Adult
Niger
gender norms
intimate partner violence
mediation analysis
contraceptive use
Sub-Saharan Africa
married adolescents
ISSN:1476-6256, 1476-6256
Online Access:Get more information
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Summary:Previous research has demonstrated that the Reaching Married Adolescents intervention (RMA) was associated with changes in inequitable gender norms, intimate partner violence (IPV), and modern contraceptive use. This study seeks to understand if changes in inequitable gender norms mediate the RMA intervention's effects on contraceptive use and intimate partner violence (IPV). A 4-arm cluster randomized control trial was conducted to evaluate effects of the RMA intervention (household visits, small groups, combination, control) on married adolescent girls and their husbands in Dosso, Niger (baseline: 1042 dyads; 24 months follow-up: 737 dyads; 2016-2019). Mediation was assessed using inverse odds ratio weighting. In the small group intervention, of the total effect on IPV prevalence (8% reduction), indirect effects via inequitable gender norms are associated with a 2% decrease (95% CI, -0.07 to 0.12) and direct effects with a 6% decrease (95% CI, -0.20 to -0.02). For household visits, of the total effect on contraceptive use (20% increase), the indirect effect accounts for an 11% decrease (95% CI, -0.18 to -0.01) and direct effect, a 32% increase (95% CI, 0.13-0.44); this is similar to findings for the combination arm. This experimental evidence informs the value of changing underlying social norms to reduce IPV and increase contraception use.
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ISSN:1476-6256
1476-6256
DOI:10.1093/aje/kwae294