NCT06059196

Brief Summary

Document evidence, via cluster randomized controlled trial, of the effectiveness of the ARCHES intervention, a brief, clinic-based counselling intervention demonstrated to reduce intimate partner violence and reproductive coercion and promote women's reproductive health, as scaled in government health facilities in Kenya, to (1) decrease unintended pregnancy, (2) increase family planning uptake and use/continuation, (3) decrease experiences of reproductive coercion and intimate partner violence of women and girls aged 15 to 49 years seeking family planning services, and, to (4) improve quality of care, (5) increase gender equitable attitudes, and, (6) increase self-efficacy to provide comprehensive family planning counseling among providers trained in ARCHES.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
3,928

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Sep 2023

Shorter than P25 for not_applicable

Geographic Reach
1 country

24 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

September 6, 2023

Completed
22 days until next milestone

First Posted

Study publicly available on registry

September 28, 2023

Completed
1 day until next milestone

Study Start

First participant enrolled

September 29, 2023

Completed
8 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 17, 2024

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

May 17, 2024

Completed
Last Updated

November 1, 2024

Status Verified

October 1, 2024

Enrollment Period

8 months

First QC Date

September 6, 2023

Last Update Submit

October 29, 2024

Conditions

Keywords

Reproductive coercionIntimate partner violenceContraceptive UsagePregnancy RelatedQuality of Care

Outcome Measures

Primary Outcomes (1)

  • Incident unintended pregnancy

    Difference in self-reported unintended pregnancy in the past 6 months at the 6-month follow-up in intervention compared to control group (single time point analysis)

    6-month follow-up

Secondary Outcomes (15)

  • Modern contraceptive use in the past 6 months

    Baseline (at facility prior to receiving care) and 6-month follow-up

  • Physical intimate partner violence in the past 6 months

    Baseline (combined report at facility prior to receiving care and report at facility immediately after receiving care (post-visit); combined due to increased reporting post-visit) and 6-month follow-up

  • Sexual intimate partner violence in the past 6 months

    Baseline (combined report at facility prior to receiving care and report at facility immediately after receiving care (post-visit); combined due to increased reporting post-visit) and 6-month follow-up

  • Emotional intimate partner violence in the past 6 months

    Baseline (combined report at facility prior to receiving care and report at facility immediately after receiving care (post-visit); combined due to increased reporting post-visit) and 6-month follow-up

  • Reproductive coercion from a male partner in the past 6 months

    Baseline (combined report at facility prior to receiving care and report at facility immediately after receiving care (post-visit); combined due to increased reporting post-visit) and 6-month follow-up

  • +10 more secondary outcomes

Study Arms (2)

Control - Standard contraceptive counseling

ACTIVE COMPARATOR

Standard contraceptive counseling, includes provider training on standard BCS+ counseling protocol and use of a companion mobile application to guide counseling

Behavioral: BCS+ (Balanced Counseling Strategy Plus)

Intervention - Integrated contraceptive counseling

EXPERIMENTAL

Integrated contraceptive counseling, includes provider training on ARCHES integrated in BCS+ counseling protocol and use of a companion mobile application to guide counseling

Behavioral: ARCHES (Addressing Reproductive Coercion in Health Settings)Behavioral: BCS+ (Balanced Counseling Strategy Plus)

Interventions

ARCHES (Addressing Reproductive Coercion in Health Settings) includes training existing contraceptive providers to (1) provide contraceptive clients with education on reproductive coercion and methods/ways to use contraceptive methods covertly if desired, (2) provide screening for reproductive coercion and intimate partner violence, (3) provide a referral to specialized services for those disclosing intimate partner violence, (4) and offer a palm-sized mini-booklet with educational information on reproductive coercion and intimate partner violence. A mobile application was developed to guide contraceptive providers through the counselling protocol.

Intervention - Integrated contraceptive counseling

BCS+ (Balanced Counseling Strategy Plus) is a contraceptive counseling protocol that contraceptive providers use to help clients identify suitable contraceptive methods based on their preferences and previous contraceptive experiences. The BCS+ also includes systematic screening for other health services such as HIV/STI, cervical cancer, and breast cancer. The BCS+ was adopted by the Kenya MOH as the standard contraceptive counseling protocol in the country.

Control - Standard contraceptive counselingIntervention - Integrated contraceptive counseling

Eligibility Criteria

Age15 Years - 49 Years
Sexfemale(Gender-based eligibility)
Gender Eligibility Detailsself-report biologically female
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • Seeking family planning services at a selected study facility
  • Aged 15-49 years old
  • Female
  • Able to provide informed consent
  • Able to speak and understand English, Kiswahili, or Kalenjin
  • Able to provide a safe phone number at which they can be recontacted for follow-up
  • Not planning to move out of the area in the coming 6 months

You may not qualify if:

  • Sterilized at baseline
  • Pregnant at baseline

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (24)

Burnt Forest Sub-county Hospital

Burnt Forest, Kenya

Location

Kipkabus Health Centre

Burnt Forest, Kenya

Location

Chepkigen Health Centre

Cheptiret, Kenya

Location

Huruma District Hospital

Eldoret, Kenya

Location

Kapsoya Health Centre

Eldoret, Kenya

Location

Kapteldon Health Centre

Eldoret, Kenya

Location

Kapyemit Dispensary

Eldoret, Kenya

Location

Kipkenyo

Eldoret, Kenya

Location

Pioneer Health Centre

Eldoret, Kenya

Location

Railways

Eldoret, Kenya

Location

Uasin Gishu District Hospital

Eldoret, Kenya

Location

Kesses Health Centre

Kesses, Kenya

Location

Chembulet Health Centre

Kimumu, Kenya

Location

Chepkanga Health Centre

Kimumu, Kenya

Location

Merewet Dispensary

Kimumu, Kenya

Location

Moiben Health Centre

Moiben, Kenya

Location

Moi's Bridge Health Centre

Moi‘s Bridge, Kenya

Location

Chepkero Dispensary

Naiberi, Kenya

Location

Soy Health Centre

Soy, Kenya

Location

Sosiani Health Centre

Turbo, Kenya

Location

Turbo Sub-County Hospital

Turbo, Kenya

Location

Kabobo Health Centre

Ziwa, Kenya

Location

Kipsigak Health Centre

Ziwa, Kenya

Location

Ziwa Sub-County Hospital

Ziwa, Kenya

Location

Related Publications (1)

  • Pearson E, Uysal J, Menzel J, Undie CC, Odwe G, Liambila W, Silverman JG. Evaluating a scalable ARCHES (Addressing Reproductive Coercion in Health Settings) model in government health facilities in Uasin Gishu county, Kenya: study protocol for a cluster-randomized controlled trial. Reprod Health. 2023 Oct 17;20(1):155. doi: 10.1186/s12978-023-01697-7.

MeSH Terms

Conditions

Contraception Behavior

Interventions

Mastectomy, Segmental

Condition Hierarchy (Ancestors)

Reproductive BehaviorBehavior

Intervention Hierarchy (Ancestors)

MastectomySurgical Procedures, Operative

Study Officials

  • Jay G Silverman, PhD

    University of California, San Diego

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Cluster-randomized controlled trial; stratified randomization based on facility type and urban/rural location.
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor of Medicine

Study Record Dates

First Submitted

September 6, 2023

First Posted

September 28, 2023

Study Start

September 29, 2023

Primary Completion

May 17, 2024

Study Completion

May 17, 2024

Last Updated

November 1, 2024

Record last verified: 2024-10

Data Sharing

IPD Sharing
Will share

Will share de-identified participant data analysis sets to the Dyrad public data repository upon publication of findings

Shared Documents
STUDY PROTOCOL, SAP, ICF, ANALYTIC CODE
Time Frame
Upon publication of findings
Access Criteria
Open access

Locations