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Table 1 Primary and secondary outcomes for the trial

From: An individually randomized controlled trial to determine the effectiveness of the Women for Women International Programme in reducing intimate partner violence and strengthening livelihoods amongst women in Afghanistan: trial design, methods and baseline findings

 

Number of items and origins

Example question and response categories

Scaling

Alpha

Hypothesized direction

Primary outcomes

Past year experience of physical IPV amongst currently married women

Five items ask about married women’s experience of physical IPV. The scale is based on the WHO’s multi-country study of IPV [25].

(Q) In the past 12 months how many times has your husband hit you with a fist or with something else which could hurt you?

(A) Never, once, few, many

A positive response to one or more items coded as yes

 

Decrease

Past year experience of severe physical IPV amongst currently married women

Same scale as above. Severe physical IPV is defined as experiencing more than one item of the five, or experiencing any one item more than once, creating a dichotomous measure equivalent to more than once experiencing physical IPV.

(Q) In the past 12 months how many times has your husband slapped you or thrown something at you which could hurt you?

(A) Never, once, few, many

Two or more items responded to as ‘once’ or responding to any single item as “few”, or “many”.

 

Decrease

Women’s past week depressive symptoms

Depressive symptoms are assessed using the Center for Epidemiological Studies Depression scale (CES-D), comprising 20 items asking about depressive symptoms in the past week [26].

(Q) During the past week I had crying spells

(A) Rarely or none of the time; some or little of the time; moderate amount of time; most or all of the time

Mean score created; higher mean’s more depressive symptoms

0.90

Decrease

Secondary outcomes

Household Food Insecurity in past 4 weeks

Three items comprising the Household Hunger Scale, developed for global use and comparability [27].

(Q) In the past 4 weeks, how often was there no food to eat of any kind in your house because of a lack of money?

(A) Never, Rarely, Sometimes, Often

Mean score created; higher indicates more food insecurity

0.94

Decrease

Financial shock resilience

One item asks about ability to mobilise money in an emergency. This measure was developed for use in South Africa, and has been used in Asia.

(Q) If you had an emergency at home and needed 500 Afghani, how easy would you say it would be to find the money?

(A) Very easy, fairly easy, somewhat difficult, very difficult

Recoded into binary of very or fairly easy and somewhat difficult or very difficult

 

Decrease

Women’s monthly income

A single item asks about earnings in the past month.

(Q) Considering all the money you earned from jobs or selling things, how much did you earn last month?

Mean

 

Increase

Women’s total savings

A single item asks women the total value that they have in savings.

(Q) How much money have you got in savings?

Mean

 

Increase

Life satisfaction

Life satisfaction is assessed using four-items derived from the Satisfaction With Life Scale [28]. This has been used across South Asia [29].

(Q) In most ways my life is close to my ideal

(A) Strongly agree, agree, disagree, strongly disagree

Mean; higher means less satisfied

0.90

Decrease

Past four week suicidal ideation

A single item assesses thoughts of suicide in the past month, with a binary response possible.

(Q) In the past four weeks, has the thought of ending your life been in your mind?

(A) Yes, No

Binary yes/no

 

Decrease

Women’s gender attitudes

This scale was developed locally from discussions with Afghan’s before being tested in Pakistan. A series of 11 questions ask about gender attitudes that individual women hold.

(Q) I think it is a good thing for a young wife in my family to be beaten to teach her how to behave properly

(A) Strongly disagree; disagree; agree; strongly agree

Mean score; higher score indicates less gender equitable attitudes

0.87

Decrease

Married women’s participation in household decision making

Five items are asked about women’s ability to participate in household decisions, based on the WHO Multi-Country Study on Domestic Violence [25].

(Q) In the last three months, how often your views been listened to on matters concerning the children and their schooling or work in your home?

(A) Never; sometimes; often

Mean score; higher scores indicate more participation

0.77

Increase

Past year emotional IPV amongst currently married women

Seven items ask about experiences of emotional abuse by the husband.

(Q) In the past 12 months how many times has your husband insulted you or made you feel bad about yourself?

(A) Never; once; few; many

Mean score; higher score indicates more emotional violence

 

Decrease

Perceptions of husband cruelty amongst currently married women

Five items ask about married women’s perceptions of her husband and his attitudes and relationship towards her.

(Q) My husband is very strict and controlling.

(A) Strongly disagree; disagree; agree; strongly agree

Mean score: higher scores indicate more cruelty

0.88

Decrease

Mother in law and sibling abuse:

Two items: A single item assesses whether mother-in-laws have hit the woman in the past 12 months and another item assesses whether siblings have hit the woman in the past 12 months, an affirmative response to either item would indicate abuse.

(Q) In the last 12 months were you slapped, hit or beaten by your mother-in-law?.

(A) Never, sometimes, often

A positive response to one or both items coded as yes

 

Decrease

Perceptions of mother-in-law cruelty.

For married women who currently live with their mothers-in-law, six items ask about their relationship and the mother-in-law’s attitudes towards her.

(Q) My mother-in-law can frighten me

(A) Strongly disagree; disagree; agree; strongly agree

Mean score: higher scores indicate more cruelty

0.84

Decrease