Community interventions to prevent violence against women and girls in informal settlements in Mumbai: the SNEHA-TARA trial

ISRCTN ISRCTN84502355
DOI https://doi.org/10.1186/ISRCTN84502355
Protocol serial number CTRI/2018/02/012047, Wellcome 206417/Z/17/Z
Sponsor UCL Institute for Global Health
Funder Wellcome Trust
Submission date
19/02/2018
Registration date
22/02/2018
Last edited
18/11/2025
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Other
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
One in three women in India have survived physical or sexual violence, making it a major public health burden. Reviews recommend community mobilisation to address violence, but evidence is limited. The aim of this study is to test the effects of community mobilisation through groups and individual volunteers on the prevalence of violence against women and girls in informal settlements in Mumbai.

Who can participate?
Residents of informal settlements in Mumbai

What does the study involve?
Participating areas are randomly allocated to the control group or the intervention group. Residents in control group areas receive unrestricted access to services provided by the implementing organisation: crisis intervention, counselling, police liaison, medical attention, mental health intervention, family interventions, and legal recourse. Residents in intervention group areas receive the same services as the control group, with the addition of community mobilisation activities with groups of women, men, and adolescents, and with individual women volunteers. A salaried community mobiliser convenes three women’s groups, one men’s group, and one mixed-sex adolescent group monthly, following manuals over three years. Community mobilisers and group members organise local campaigns and events. Group members who show leadership are trained and supported to undertake identification of survivors of violence, crisis intervention and preliminary counseling, referral, and collective community campaigns. These community mobilisation activities are assessed through a follow-up survey after three years. Prevalence of domestic physical or sexual violence, and prevalence of domestic emotional or economic violence, control or neglect, are both measured by survey interview at 3 years after the start of intervention, along with disclosure of violence to support services, community attitudes to violence, bystander intervention, gender equality, common mental disorders, and prevalence of non-partner sexual violence.

What are the possible benefits and risks of participating?
Benefits to participants in interviews include information on support services, confidential disclosure, and access to crisis counselling and support services, including medical care, police intervention, and legal support. Participants in community activities have access to the same services, and benefit from joining support groups of women and men. Minimised by confidentiality procedures and response protocols, a woman’s disclosure of violence may lead to family tensions and possible escalation, or denial of access to support services. There is a small possibility of resistance from community members. Protocols are in place for response to disclosure, crisis, and threat.

Where is the study run from?
1. UCL Institute for Global Health (UK)
2. SNEHA (Society for Nutrition, Education and Health Action) (India)

When is the study starting and how long is it expected to run for?
July 2017 to March 2024

Who is funding the study?
Wellcome Trust (UK)

Who is the main contact?
1. Prof. David Osrin
d.osrin@ucl.ac.uk
2. Dr Nayreen Daruwalla
nayreen@snehamumbai.org

Contact information

Prof David Osrin
Scientific

Institute for Global Health
30 Guilford Street
London
WC1N 1EH
United Kingdom

ORCiD logoORCID ID 0000-0001-9691-9684
Phone +44 (0)2079052122
Email d.osrin@ucl.ac.uk
Dr Nayreen Daruwalla
Scientific

SNEHA, Urban Health Centre
Room 310, 60 Feet Road, Dharavi
Mumbai
400017
India

ORCiD logoORCID ID 0000-0002-5716-1281
Phone +91 (0)224040045
Email nayreen@snehamumbai.org

Study information

Primary study designInterventional
Study designSingle-centre parallel-group phased analyst-masked cluster randomised controlled superiority trial
Secondary study designCluster randomised trial
Scientific titleCommunity interventions to prevent violence against women and girls in informal settlements in Mumbai: the SNEHA-TARA pragmatic cluster randomised controlled trial
Study acronymSNEHA-TARA
Study objectivesOver and above a package of crisis intervention, counselling, and support services, a community mobilisation intervention delivered in informal settlements for three years and involving groups and volunteers will reduce the reported prevalence of domestic physical or sexual violence, and of domestic emotional or economic violence, control or neglect.
Ethics approval(s)1. UCL Research Ethics Committee, 27/09/2017, ref: 3546/003
2. PUKAR (Partners for Urban Knowledge, Action, and Research) Institutional Ethics Committee, 25/12/2017
Health condition(s) or problem(s) studiedViolence against women and girls
InterventionComputer pseudorandomised 1:1 allocation of 48 clusters blocked in 4 phases of 12 each. 24 areas receive support services, community group, and volunteer activities, and 24 areas receive support services only.

Intervention: as control, with the addition of community mobilisation activities with groups of women, men, and adolescents, and with individual women volunteers.
1. In each cluster, a salaried community mobiliser will convene three women’s groups, one men’s group, and one mixed-sex adolescent group monthly, following manuals over three years.
2. Community mobilisers and group members will organise local campaigns and events.
3. Group members who show leadership will be trained and supported to undertake identification of survivors of violence, crisis intervention and preliminary counseling, referral, and collective community campaigns.

Control: unrestricted access to services provided by the implementing organisation: crisis intervention, counselling, police liaison, medical attention, mental health intervention, family interventions, and legal recourse.

These community mobilisation activities will be evaluated through a follow-up survey after three years.
Intervention typeBehavioural
Primary outcome measure(s)

Measured by survey interview at 3 years after the start of intervention:
1. Prevalence of physical or sexual domestic violence against women 15-49 years in the preceding 12 months, based on Demographic and Health Survey (DHS) and WHO perpetration modules
2. Prevalence of emotional or economic domestic violence or gender-based household maltreatment of women 15-49 years in the preceding 12 months, based on DHS and WHO modules and the new Indian Family Violence and Control scale

Key secondary outcome measure(s)

Measured by survey interview at 3 years after the start of intervention:
1. Disclosure of violence against women and girls to support services (non government organisations, police, healthcare, government programmes)
2. Community attitudes to violence against women and girls, based on the National Community Attitudes towards Violence Against Women Survey
3. Bystander intervention, based on the Mentors in Violence Prevention Efficacy Scale
4. Gender equality, based on WHO modules
5. Prevalence of non-partner sexual violence in preceding 12 months, based on DHS and WHO modules
6. Prevalence of anxiety (GAD-7) and depression (PHQ-9)

Completion date31/03/2024

Eligibility

Participant type(s)All
Age groupMixed
Lower age limit18 Years
Upper age limit65 Years
SexAll
Target sample size at registration9600
Total final enrolment9600
Key inclusion criteriaAny resident of an intervention cluster may participate in the intervention

Survey 1 after 3 years of intervention:
200 women aged 18-49 in each of 48 clusters of 500 households will be asked about their health, wellbeing, common mental disorder, household decision-making, household power and control, neglect, experience of economic, emotional, physical, and sexual violence, disclosure and support (9600 participants)

Survey 2 after 3 years of intervention:
100 women and men aged 18-65 in each of 48 clusters, in different households from respondents to Survey 1, will be asked about gender roles, gender equality, ambivalent sexism, violence in their locality, attitudes to and justifiability of violence against women, bystander intervention, and potential sources of support (4800 participants)
Key exclusion criteria1. Aged under 18 or over 65
2. Unwilling to give consent for interview
Date of first enrolment05/03/2018
Date of final enrolment31/03/2024

Locations

Countries of recruitment

  • United Kingdom
  • England
  • India

Study participating centres

UCL Institute for Global Health
30 Guilford Street
London
WC1N 1EH
England
SNEHA (Society for Nutrition, Education and Health Action)
Urban Health Centre, 60 Feet Road, Dharavi
Mumbai
400017
India

Results and Publications

Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryStored in repository
IPD sharing planThe data and software outputs the research will generate and/or re-use:
1. Datasets from cross-sectional surveys on domestic violence survivorship and associated community attitudes: pre-intervention, midpoint, and post-intervention.
2. Qualitative data collected during process evaluation: interviews with key informants and beneficiaries.
3. The metadata and documentation that will accompany the outputs
3.1. Data will be discoverable through MeSH terms and keywords applied to open access publications
3.2. Codebooks for datasets
3.3. Indices and descriptions of qualitative data

Data will be available at the time of publication. Supporting data will be available on acceptance of each research paper, in sets that enable replication of published analyses. For example, unlinked data will accompany publications describing the prevalence of domestic violence from the pre-intervention survey.

Where the data and software will be made available: Open Science Framework (OSF)

How the data and software will be accessible to others:
1. Unlinked data will be available after being made public and registered in the Open Science Framework
2. Datasets will be discoverable through articles published with CC BY licences and DOIs

Whether limits to data and software sharing are required:
Participants will give written consent for sharing of unlinked data. No data will include identifiers of an individual or geographic nature. There will be no restrictions to access under CC BY licences.

How datasets and software will be preserved:
Data will be preserved for a minimum of 10 years, initially on Open Science Framework and subsequently with the UCL Research Data Storage Service (https://www.ucl.ac.uk/isd/services/research-it/research-data-storage-service)

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article cross-sectional survey results 16/12/2020 18/12/2020 Yes No
Results article 18/11/2025 Yes No
Protocol article 17/12/2019 19/12/2019 Yes No
Statistical Analysis Plan version 9 13/12/2022 04/01/2023 No No
Study website 11/11/2025 11/11/2025 No Yes

Additional files

40394 TARA_SAP_v9 13Dec2022.pdf
Statistical Analysis Plan

Editorial Notes

18/11/2025: Publication reference added.
12/12/2023: The following changes have been made:
1. The overall study end date was changed from 30/12/2023 to 31/03/2024.
2. The total final enrolment was added.
3. The recruitment end date was changed from 28/02/2023 to 31/03/2024.
16/06/2023: The following changes have been made and the plain English summary updated accordingly:
1. The overall end date was changed from 30/06/2023 to 31/12/2023.
2. The intention to publish date was changed from 31/12/2023 to 30/06/2024.
15/02/2023: The intention to publish date was changed from 31/12/2022 to 31/12/2023.
04/01/2023: The statistical analysis plan was uploaded as an additional file.
14/03/2022: The following changes were made to the trial record:
1. The overall end date was changed from 30/06/2022 to 30/06/2023.
2. The recruitment end date was changed from 04/03/2022 to 28/02/2023.
3. The trial website was added.
4. The plain English summary was updated to reflect these changes.
11/02/2021: Recruitment to this study is no longer paused. Publication and dissemination plan updated, IPD sharing statement added.
18/12/2020: Publication reference added.
23/04/2020: Due to current public health guidance, recruitment for this study has been paused.
19/12/2019: The following changes have been made:
1. Publication reference added.
2. Controlled Trials Registry of India number added from the reference
18/07/2019: Internal review.