TY  - SER
AU  - Abramsky, Tanya.
AU  - Devries, Karen
AU  - Michau, Lori
AU  - Nakuti, Janet
AU  - Masuya, Tina
AU  - Kiss, Ligia
AU  - Kyegombe, Nambusi
AU  - Watts, Charlotte
TI  - Ecological pathways to prevention : : how does the SASA! community mobilisation model work to prevent physical intimate partner violence against women? 
PY  - 2016///
PB  - BioMed Central, 
KW  - ATTITUDES
KW  - DOMESTIC VIOLENCE
KW  - COMMUNITY ACTION
KW  - INTERVENTION
KW  - INTIMATE PARTNER VIOLENCE
KW  - PHYSICAL ABUSE
KW  - PRIMARY PREVENTION
KW  - RANDOMISED CONTROLLED TRIALS
KW  - SASA! study
KW  - PREVENTION
KW  - AFRICA
N1  - BMC Public Health, 2016, 16: 339
N2  - Background: Intimate partner violence (IPV) against women is a global public health concern. While community-level gender norms and attitudes to IPV are recognised drivers of IPV risk, there is little evidence on how interventions might tackle these drivers to prevent IPV at the community-level. This secondary analysis of data from the SASA! study explores the pathways through which SASA!, a community mobilisation intervention to prevent violence against women, achieved community-wide reductions in physical IPV.
Methods: From 2007 to 2012 a cluster randomised controlled trial (CRT) was conducted in eight communities in Kampala, Uganda. Cross-sectional surveys of a random sample of community members, aged 18 – 49, were undertaken at baseline (n= 1583) and 4 years post intervention implementation (n= 2532). We used cluster-level intention to treat analysis to estimate SASA!'s community-level impact on women's past year experience of physical IPV and men’s past
year perpetration of IPV. The mediating roles of community-, relationship- and individual-level factors in intervention effect on past year physical IPV experience (women)/perpetration (men) were explored using modified Poisson regression models.
Results: SASA! was associated with reductions in women’s past year experience of physical IPV (0.48, 95 % CI 0.16 – 1.39), as well as men’s perpetration of IPV (0.39, 95 % CI 0.20
– 0.73). Community-level normative attitudes were the most important mediators of intervention impact on physical IPV risk, with norms around the acceptability of IPV explaining 70 % of the intervention effect on women’s experience of IPV and 95 % of the effect on men’s perpetration. The strongest relationship-level mediators were men’s reduced suspicion of
partner infidelity (explaining 22 % of effect on men’s perpetration), and improved communication around sex
(explaining 16 % of effect on women’s experience). Reduced acceptability of IPV among men was the most important individual-level mediator (explaining 42 % of effect on men’s perpetration). 
Conclusions: These results highlight the important role of community-level norm-change in achieving community-wide reductions in IPV risk. They lend strong support for the more widespread adoption of community-level approaches to preventing violence." (Authors' abstract). Record #4995
UR  - http://dx.doi.org/10.1186/s12889-016-3018-9
ER  -