Two-year treatment effects of the common elements treatment approach (CETA) for reducing intimate partner violence and unhealthy alcohol use in Zambia.

Jeremy C Kane,Paul A Bolton,Mwamba Mwenge,John Mayeya,Nancy Glass,Laura K Murray,Ravi Paul

doi:10.1017/gmh.2021.2

Abstract

Intimate partner violence (IPV) and unhealthy alcohol use are common yet often unaddressed public health problems in low- and middle-income countries. In a randomized trial, we found that the common elements treatment approach (CETA), a multi-problem, flexible, transdiagnostic intervention, was effective in reducing IPV and unhealthy alcohol use among couples in Zambia at a 12-month post-baseline assessment. In this follow-up study, we investigated whether treatment effects were sustained among CETA participants at 24-months post-baseline. Participants were heterosexual couples in Zambia in which the woman reported IPV perpetrated by the male partner and in which the male had hazardous alcohol use. Couples were randomized to CETA or treatment as usual plus safety checks. Measures were the Severity of Violence Against Women Scale (SVAWS) and the Alcohol Use Disorders Identification Test (AUDIT). The trial was stopped early upon recommendation by the trial's DSMB due to CETA's effectiveness following the 12-month assessment. Control participants exited the study and were offered CETA. This brief report presents data from an additional follow-up assessment conducted among original CETA participants at a 24-month visit. There were no meaningful changes in SVAWS or AUDIT scores between 12- and 24-months. The within-group treatment effect for SVAWS from baseline to 24-months was d = 1.37 (p < 0.0001) and AUDIT was d = 0.85 (p < 0.0001). The lack of change in levels of IPV and unhealthy alcohol use between the 12- and 24-month post-baseline timepoints suggests that treatment gains were sustained among participants who received CETA for at least two years from intervention commencement.

Highlights

Intimate partner violence (IPV) is a substantial contributor to disease burden, increased health expenditures, and economic costs in low- and middle-income countries (LMIC) such as Zambia (Zambia Central Statistical Office, 2014)
In a randomized-controlled trial, we found that the common elements treatment approach (CETA), an evidence-based transdiagnostic psychotherapy, was effective in reducing both IPV and unhealthy alcohol use compared to treatment as usual plus safety check (TAU-Plus) among heterosexual adult couples in Zambia at a post-treatment follow-up and at a 12-month post-baseline assessment
Interested couples were referred to the research team, consented, and completed a screener housed on an audio computer-assisted self-interviewing (ACASI) laptop

Summary

Introduction

Intimate partner violence (IPV) is a substantial contributor to disease burden, increased health expenditures, and economic costs in low- and middle-income countries (LMIC) such as Zambia (Zambia Central Statistical Office, 2014). In a randomized-controlled trial, we found that the common elements treatment approach (CETA), an evidence-based transdiagnostic psychotherapy, was effective in reducing both IPV and unhealthy alcohol use compared to treatment as usual plus safety check (TAU-Plus) among heterosexual adult couples in Zambia at a post-treatment follow-up and at a 12-month post-baseline assessment. We found that the common elements treatment approach (CETA), a multi-problem, flexible, transdiagnostic intervention, was effective in reducing IPV and unhealthy alcohol use among couples in Zambia at a 12-month post-baseline assessment. In this follow-up study, we investigated whether treatment effects were sustained among CETA participants at 24-months post-baseline. The lack of change in levels of IPV and unhealthy alcohol use between the 12and 24-month post-baseline timepoints suggests that treatment gains were sustained among participants who received CETA for at least two years from intervention commencement

Methods

Results

Conclusion