Assessing the role of depression in reducing intimate partner violence perpetration among young men living in urban informal settlements using a mediation analysis of the Stepping Stones and Creating Futures intervention

ABSTRACT

Background

Stepping Stones and Creating Futures (SS/CF) is a gender transformative and economic empowerment intervention that has effectively reduced the perpetration of intimate partner violence (IPV) by young men living in informal settlements in South Africa.

Objective

This study examines whether depression mediated the association between SS/CF intervention and decreased IPV.

Method

Data from a two-arm cluster randomised community-based controlled trial that evaluated the effectiveness of SS/CF in lowering IPV were obtained from 674 young men aged 18–30 within urban informal settlements in South Africa. After being randomly assigned to either the experimental arm (SS/CF) or the control arm, the participants were followed up for 24 months. Logistic regression using mediation analysis was conducted to see whether changes in depressive symptoms mediated the association between the intervention and reduced IPV perpetration.

Results

Findings from the mediation analysis indicated that those assigned to the SS/CF experimental group reported lower depression (β = -0.42, p < 0.05) at 12 months, and this was subsequently associated with reduced IPV (β = 0.43, p < 0.05) at 24 months. The direct path from SS/CF to IPV was originally (β = -0.46, p < 0.01), but reduced in the mediation model to (β = -0.13, p = 0.50). Depressive symptoms mediated the association between the SS/CF intervention and decreased IPV perpetration.

Conclusion

These findings suggest that one pathway through which SS/CF decreased IPV was through improvement in mental health (i.e. depression). Future IPV prevention interventions may consider incorporating components that focus on improving mental health as a way of also reducing IPV perpetration in disadvantaged settings.

KEYWORDS:

• Young men
• depression
• Stepping Stones and Creating Futures
• intimate partner violence
• informal settlement

Responsible Editor Jennifer Stewart Williams

Responsible Editor Jennifer Stewart Williams

Acknowledgments

We would like to express our gratitude to all the field workers who facilitated data collection for the Stepping Stones and Creating Futures trial and to all the participants for sharing their data with us.

Author contributions

Substantial contributions to the conception or design of the work (VO, AG, AT), acquisition (AG), analysis (VO), and interpretation of data for the work (VO, AG, AT). VO wrote the first draft of the report. All co-authors made a significant contribution to the data interpretation and final report revision.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics and consent

The University of KwaZulu-Natal Biomedical Research Ethics Committee (BFC043/15) and the South African Medical Research Council Ethics Review Committee (EC006–2/2015) both gave their ethical approval for the primary trial. Written informed consent was gotten from each participant. The University of KwaZulu-Biomedical Natal’s Research Ethics Committee gave their approval for the use of the data in the current study (00002795/2021). ClinicalTrials.gov registered the trial (NCT03022370).

Paper context

Stepping Stones and Creating Futures, gender-transformative economic empowerment interventions, reduced intimate partner violence (IPV) perpetration by young men. The study highlights the link between depression and IPV across cultural and global contexts and provides new evidence that men’s reduction of IPV perpetration was attributed to improved mental health. Findings from this study can be utilized to refine intervention and address unacceptably high levels of IPV in South Africa and globally, specifically in low-income nations.

Additional information

Funding

First author (VO) was funded by the “South African Medical Research Council (SAMRC) through its Division of Research Capacity Development under the Internship Scholarship Programme (HDID8459/KR/2021). The content hereof is the sole responsibility of the authors and does not necessarily represent the official views of the SAMRC”. The second (AT) and last (AG) authors received funding from the UK Global Challenge Research Fund (MR/T029803/1) and were managed by the SAMRC.