Key Social Norms Take-aways This study highlights the critical role of organized diffusion in shifting social norms related to intimate partner violence. The findings suggest that diffusion is particularly effective in communities with lower baseline levels of gender equity, where greater normative change is possible. By facilitating interpersonal discussions of intervention messages, the program challenged prevailing norms around male dominance, spousal obedience, and the acceptability of violence. This demonstrates that social norms interventions must not only deliver content but also intentionally foster message sharing within social networks to catalyze broader community-level change.
Objectives The study aimed to evaluate the role of diffusion in social norms change about intimate partner violence among women in rural Nepal, within the Change Starts at Home intervention.
Methods A repeated cross-sectional cluster randomized trial was conducted in 72 wards across three districts. Thirty-six wards received the intervention and were surveyed at baseline, midline, and endline. Injunctive norms around intimate partner violence were measured using the Partner Violence Norms Scale, a locally developed eight-item scale reflecting beliefs about violence, gender roles, and women’s autonomy. Diffusion was measured at midline by assessing with whom participants discussed anti-violence messages received through various media. Multivariable regression models were used to assess associations between diffusion and endline norms, adjusting for baseline levels and covariates.
Intervention Details The Change Starts at Home intervention combined a 39-week radio drama with listening and discussion groups, couples’ sessions, and community engagement activities. Participants discussed topics such as gender norms, communication, conflict resolution, consent, and alcohol use. In the final months, participants led public events including street dramas and radio listening sessions to promote wider community awareness and engagement.
Results Each additional person with whom participants shared messages was associated with higher gender-equitable norms at endline. This effect was strongest in communities with low baseline gender equity norms. Exposure to the intervention, combined with interpersonal diffusion, led to measurable improvements in attitudes around the acceptability of violence and spousal roles. However, in communities with already high baseline equity norms, diffusion had less impact, suggesting a ceiling effect.
Conclusions Norms change is most achievable in communities with greater initial inequity, and diffusion is a vital mechanism for amplifying the impact of social norms interventions. Programs should be designed to strategically facilitate interpersonal message sharing and prioritize communities where normative change is most needed.