Key Social Norms Take-aways This study deepens the field’s understanding of how multicomponent communication strategies can influence gender norms and intimate partner violence in complex social environments. While the Change Starts at Home trial did not demonstrate a community-level reduction in intimate partner violence, it showed that intensive engagement through structured discussion groups can shift individual behaviors and attitudes. Importantly, it illustrates the value and challenge of norm change interventions: measurable transformation requires not only meaningful content but also high exposure, sustained engagement, and diffusion within social networks. The study highlights the importance of capturing micro-level and network-based norm shifts that may be masked in community-wide data.
Objectives The study aimed to evaluate the effectiveness of a social and behavior change communication intervention combining media and community engagement in reducing women’s experiences of intimate partner violence in Nepal. It specifically compared the impact of a full intervention package against radio programming alone.
Methods A mixed-methods, cluster randomized, repeat cross-sectional trial was conducted across 36 village communities. Women’s past-year experiences of physical, sexual, emotional, and economic violence were measured through structured surveys at baseline, midline, and 28 months post-baseline. Social norms were assessed using validated scales for gender equitable attitudes and decision-making. A nested qualitative cohort of listening group participants provided additional insight into mechanisms of change.
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 There was no significant reduction in intimate partner violence at the community level. However, among participants with high attendance in listening groups, reductions in physical, sexual, and financial violence were observed, particularly at midline. These participants also reported improved communication and greater participation in household decision-making. Greater diffusion of intervention messages within communities was associated with increased support for survivors and awareness of violence.
Conclusions The intervention showed promise for shifting norms and behaviors among directly engaged participants but was insufficient in its breadth and duration to produce measurable change at the population level. Future interventions should incorporate formal social network approaches, ensure sufficient exposure, and plan for long-term engagement to enable sustainable social norms transformation.