Strengthening Relationships and Mental Health Through a Couples-Based Economic Empowerment Intervention

NCT07108049 | Recruiting DMC

• 2 other identifiers: TUM-EcoVi-01ECOVI, 101115963
• Study Type: interventional
• Target: 4,500
• Locations: 1 country
• Sites: 2

Brief Summary

This sub-study is part of a larger randomized controlled trial (RCT) titled Disentangling and Preventing Economic Violence against Women (ECOVI). It is conducted in rural and urban communities across Maharashtra, Andhra Pradesh, and Rajasthan, India. The sub-study evaluates the impact of a couples-based financial literacy and gender-transformative intervention on relationship strength, empathy, and mental health among married couples. Using a two-arm cluster RCT design, 150 clusters (villages or community units) are randomized to intervention or control, with \~15 husband-wife pairs per cluster (approximately 2,250 couples in total). Outcomes are measured at baseline (pre-intervention) and endline (post-intervention) approximately six months after delivery of the intervention to assess changes in perceived relationship strength, empathy (using an adapted relationship strengths and empathy scale), and mental health (General Health Questionnaire-6, GHQ-6). The study will also explore whether improvements in relationship strength and empathy mediate the intervention's effect on mental health outcomes.

Conditions

Mental Health; Empathy; Relation, Interpersonal

Keywords

Couples Intervention; Economic Empowerment; Gender Transformation; Relationship Strength; Empathy; Mental Health; GHQ-6; Cluster RCT; India; Family Economic Wellbeing; Marital Relationship Strength; Couple-based Empathy

Outcome Measures

Primary Outcomes (3)

• Mental Health Scale (General Health Questionnaire - 6)

  Change in General Health Questionnaire-6 scores (psychological distress). It is scored on a scale of 0-4, where higher score indicates higher psychological distress. Hypothesis: Greater distress reduction (or well-being increase) in the intervention group.

  T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))

• Perceived Relationship Strength (PRS)

  Change in the composite Relationship Satisfaction Index (adapted for study); looking at trust, communication, mutual support, conflict resolution. The scale is scored on 1-5 scale, with higher score indicating higher perceived relationship score. Hypothesis: Greater improvement in the intervention group than in controls.

  T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))

• Relational Empathy Scale (RE)

  Adapted standardized Interpersonal Reactivity Index for Couples (emotional support, perspective-taking). The scale is scored on 1-5 scale, with higher score indicating higher empathy in relationship score. Hypothesis: Larger empathy gains in the intervention group.

  T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))

Other Outcomes (7)

• Proportion of the mental-health effect that is mediated

  T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))

• Moderator: Gender Norm Attitudes

  T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))

• Moderator: Household Economic Strain

  T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))

Study Arms (2)

Let's Grow Together Intervention

EXPERIMENTAL

Married couples in clusters assigned to the intervention receive a structured program of six community-based sessions. Each session lasts between 2.5 and 3 hours and includes participatory activities, discussions, and exercises. All six sessions would be conducted by the same two facilitators - one male and one female. The content integrates financial literacy (e.g., household budgeting, saving practices, joint financial planning) with gender-transformative training (e.g., equitable household roles, communication skills, conflict resolution, and fostering empathy between spouses). Sessions are delivered by trained facilitators in a group setting with fifteen couples, approximately every 2-4 weeks. Some sensitive content to address economic violence context would be done in a gender segregated manner separately to encourage reflections, ensure safety and reduce defensiveness. Between sessions, SMS reminders and tips are sent to participants' mobile phones to reinforce key messages and

Behavioral: Let us Grow Together: Economic Wellbeing for Families

No Structured Support

NO INTERVENTION

Married couples in clusters assigned to the control arm do not receive the special couples training during the study period. Participants in control group continue with standard activities and resources available in the community but without the structured sessions provided to the intervention arm. This control condition represents the status quo against which the added effect of the intervention can be measured. After the conclusion of the study, control clusters may be offered the intervention materials or sessions via the NGO partners in case investigators find overall positive treatment effects, ensuring ethical considerations are met.

Interventions

Let us Grow Together: Economic Wellbeing for Families BEHAVIORAL

Married couples in clusters assigned to the intervention receive a structured program of six community-based sessions. Each session lasts between 2.5 and 3 hours and includes participatory activities, discussions, and exercises. All six sessions would be conducted by the same two facilitators - one male and one female. The content integrates financial literacy (e.g., household budgeting, saving practices, joint financial planning) with gender-transformative training (e.g., equitable household roles, communication skills, conflict resolution, and fostering empathy between spouses). Sessions are delivered by trained facilitators in a group setting with fifteen couples, approximately every 2-4 weeks. Some sensitive content to address economic violence context would be done in a gender segregated manner separately to encourage reflections, ensure safety and reduce defensiveness. Between sessions, SMS reminders and tips are sent to participants' mobile phones to reinforce key messages and e

Let's Grow Together Intervention

Eligibility Criteria

• Age: 18 Years+
• Gender Eligibility Details: Female: 18 - 49 years, Male: 18+
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Women: 18 - 49 years, Men: 18+
• Couples: Married and co-habitating, husband-wife pairs, who regard the selected cluster in the states Maharashtra, Andhra Pradesh, or Rajasthan of India as their primary residence for the study period.
• Consent: Both partners provide written informed consent and agree to six sessions, baseline and endline surveys, and SMS follow-ups.
• Education: Primary schooling (4th grade) complete
• Comprehension: Both partners understand the local language used in sessions.
• Availability: No plans for relocation or prolonged absence before endline.

You may not qualify if:

• Either partner \< 18 years
• Refusal of consent or unwillingness to participate in sessions or data collection by either partner.
• Serious physical or mental condition that prevents safe, active participation (e.g., severe mental illness, debilitating disease).

Sponsors & Collaborators

• Technical University of Munich: lead
• European Research Council: collaborator

Study Sites (2)

50 clusters across Maharashtra, Andhra Pradesh and Rajasthan

Mumbai, Maharashtra, India

RECRUITING

Vayam Organisation

Noida, India

NOT YET RECRUITING

Related Publications (10)

• Falconier, M. K., Kim, J., & Lachowicz, M. J. (2023). Together-A couples' program integrating relationship and financial education: A randomized controlled trial. Journal of Social and Personal Relationships, 40(1), 333-359. https://doi.org/10.1177/02654075221118816

  BACKGROUND

• Funk JL, Rogge RD. Testing the ruler with item response theory: increasing precision of measurement for relationship satisfaction with the Couples Satisfaction Index. J Fam Psychol. 2007 Dec;21(4):572-83. doi: 10.1037/0893-3200.21.4.572.

  PMID: 18179329 BACKGROUND

• Imai K, Keele L, Tingley D. A general approach to causal mediation analysis. Psychol Methods. 2010 Dec;15(4):309-34. doi: 10.1037/a0020761.

  PMID: 20954780 BACKGROUND

• Ismayilova L, Karimli L, Gaveras E, To-Camier A, Sanson J, Chaffin J, Nanema R. An Integrated Approach to Increasing Women's Empowerment and Reducing Domestic Violence: Results of a Cluster-Randomized Controlled Trial in a West African Country. Psychol Violence. 2018 Jul;8(4):448-459. doi: 10.1037/vio0000136. Epub 2017 Aug 7.

  PMID: 34790432 BACKGROUND

• John NA, Adebayo A, Boychuk NA, OlaOlorun F. Intimate partner violence (IPV) prevention using a cross-sectoral couple-based intervention: results from a cluster randomised control trial in Ibadan, Nigeria. BMJ Glob Health. 2022 Feb;7(2):e007192. doi: 10.1136/bmjgh-2021-007192.

  PMID: 35140139 BACKGROUND

• Kim JC, Watts CH, Hargreaves JR, Ndhlovu LX, Phetla G, Morison LA, Busza J, Porter JD, Pronyk P. Understanding the impact of a microfinance-based intervention on women's empowerment and the reduction of intimate partner violence in South Africa. Am J Public Health. 2007 Oct;97(10):1794-802. doi: 10.2105/AJPH.2006.095521. Epub 2007 Aug 29.

  PMID: 17761566 BACKGROUND

• Moore, Q., Wood, R. G., & Wu, A. Y. (2023). Impacts of healthy marriage and relationship education with integrated economic stability services. Family Relations, 72(4), 1422-1440. https://doi.org/10.1111/fare.12877

  BACKGROUND

• Peloquin K, Lafontaine MF. Measuring empathy in couples: validity and reliability of the Interpersonal Reactivity Index for couples. J Pers Assess. 2010 Mar;92(2):146-57. doi: 10.1080/00223890903510399.

  PMID: 20155564 BACKGROUND

• Raj A, Ghule M, Johns NE, Battala M, Begum S, Dixit A, Vaida F, Saggurti N, Silverman JG, Averbach S. Evaluation of a gender synchronized family planning intervention for married couples in rural India: The CHARM2 cluster randomized control trial. EClinicalMedicine. 2022 Mar 5;45:101334. doi: 10.1016/j.eclinm.2022.101334. eCollection 2022 Mar.

  PMID: 35274093 BACKGROUND

• Rao KN, Begum S, Siddappa K, Ravindra K. Validity of a 6-item version of general health questionnaire (g.h.q.) in the hands of a non - psychiatrist. Indian J Psychiatry. 1992 Apr;34(2):145-7.

  PMID: 21776115 BACKGROUND

Related Links

• Project Website

MeSH Terms

Conditions

Psychological Well-Being

Condition Hierarchy (Ancestors)

Personal Satisfaction; Behavior

Study Officials

• Janina Steinert, Prof. Dr.

  Technical University of Munich

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Anushree Dirangane

CONTACT

004917673856717; anushree.dirangane@tum.de

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PhD Researcher

Study Record Dates

• First Submitted: July 25, 2025
• First Posted: August 6, 2025
• Study Start: July 29, 2025
• Primary Completion (Estimated): June 1, 2027
• Study Completion (Estimated): June 1, 2027
• Last Updated: September 24, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

IN (2)