Effect of behavioural intervention package on empowerment and resilience among the pregnant women in India experiencing domestic violence: A facility-based randomized control trial

Effect of behavioural intervention package on empowerment and resilience among the pregnant women in India experiencing domestic violence: A facility-based randomized control trial | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Effect of behavioural intervention package on empowerment and resilience among the pregnant women in India experiencing domestic violence: A facility-based randomized control trial Meerambika Mahapatro, Sudeshna Roy, Poonam Nayar, Ashwini Jadhav, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5795896/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background Women empowerment programs may reduce domestic violence (DV) by taking control of their lives. In a cognizant effort to empower pregnant women who have experienced DV, a Behaviour Intervention Package (BIP) was developed and used. It incorporates yoga-based techniques for self-development, interpersonal skill development, and awareness sessions. The study aims to assess the effects of a BIP on empowerment and resilience among pregnant women who have experienced violence and were attending antenatal care at a tertiary care hospital in India. Methods A randomised controlled trial was conducted with 211 pregnant women recruited between 18 to 20 weeks of pregnancy and randomly assigned to intervention (n = 105) or control (n = 106). The intervention group received behavioural intervention and standard care, while the control group received only standard care for 28 weeks. The study tools were completed once before the intervention and again at six weeks postnatal. The assessments were compared using methods as appropriate to estimate the effect size at baseline and post-intervention. Results The results showed that at a personal, relational, and socio-environmental level, the BIP intervention effectively improved quality of life, reduced DV, reduced stress and depression, and all parameters enabled women to develop a positive self-perception. They also reported being resilient and hopeful about their future. Conclusion The BIP may effectively empower pregnant women from low socioeconomic backgrounds facing DA in India, enhancing their quality of life. With no standardized intervention currently available, the BIP can be implemented in supportive settings to address the psychosocial health needs of women in distress and protect their health. Trial registration The Indian Registry of Clinical Trials number is CTRI/2019/01/017009 dated 9.1.2019. Earth and environmental sciences/Environmental social sciences Health sciences/Health care empowerment resilience domestic violence quality of life behavioural intervention RCT Figures Figure 1 Figure 2 Introduction Women experiencing domestic violence (DV) is a worldwide acknowledged public health challenge demanding attention from public health practitioners and policymakers (Chen & Tanaka, 2014 ; Mahapatro, 2018 ). This seeks holistic deliberations among stakeholders to sensitively address the problem and empower women to manage their life challenges, participate in decision-making, and access resources to fully realize their capacities (Leder, 2023 , UNICEF, 2017 ). Over the years, numerous international deliberations have taken place to steer women's empowerment (Leder, 2023 ). Interventions include individual counselling, support groups, safety planning, referrals to other services, empowerment training, anger management, and a combination (Mittal et al., 2023 ; Dinmohammadi et al., 2021 ; Evans et al, 2018 ; Tiwari et al., 2005 ; Hartmann et al, 2021 ; Aminnasab et al, 2018). However, a study in India reports that the patrilineal culturalism stance strategically encumbers women's agency, limiting their individuality. Women's lack of choice and restricted power and control over resources pessimistically convey the denial of women's rights (Mahapatro, 2016 ; Jejeebhoy & Santhya, 2014 ). It is vital to understand that gender inequality strategically disempowers women, reinforcing their manifold susceptibilities. Elaborating on the context further, women experiencing DV have serious health consequences and develop poor coping mechanisms, resulting in lower levels of self-esteem (Shahin et al., 2022 ). Several policies and programmes in India, such as DV Act 2005, POSH Act 2013, one stop centre at every hospital, gender budgeting, etc., were initiated to promote women's empowerment and support the development of skills, self-esteem, and access to information and resources, positioning women as assertive decision-makers and leaders in their homes and communities (MWCD n.a; Dhungel & Ojha, 2012 ). Women's perspectives and understandings of empowerment, as stated by Guérin et al. ( 2013 ), point out that women are "not necessarily looking for autonomy and independence from men, but rather for respect within their own community," the ability "to solve problems" and "to manage suffering" (Cornwall, 2007 ; Kabeer, 2002 ). Some related empowerment to material constraints, while others related it to the freedom of mobility and being respected by their family. Studies show that women perceive their empowerment not as emancipation from male dominance but as harmonious relationships with other women, their husbands, families, and communities (Guérin et al., 2013 ; Charmes & Wieringa, 2003 ; Rowlands, 1998 ). In an attempt to uncover the meaning of empowerment as it is used in the discourse and practice of development, Rowlands ( 1998 ), as well as Charmes and Wieringa ( 2003 ), distinguish between different modes of power visibility linked to the various dimensions of power. "Power within" refers to enabling personal self-acceptance, self-respect, or spiritual strength. Charmes and Wieringa ( 2003 ) also differentiate between the modes of operation of power (oppressive, challenging, and creative) and the modes of appearance (in speech acts and texts, institutions, and daily practices) (Rowlands, 1998 ; Charmes & Wieringa, 2003 ). Women's self-esteem is particularly relevant to empowerment, which could strongly influence their perception and attitudes towards their adaptive capacities and, therefore, their resilience. Furthermore, the underlying conceptualization of power needs to be unpacked in particular settings to determine how resilience can be increased (Mahmudi et al., 2015 ; Chen & Tanaka, 2014 ). One could estimate to what extent different dimensions or indicators of empowerment influence resilience and how Luke's three-dimensional view of power could be linked to resilience (Lukes, 2005; Stephanie, 2015). Taking Kabeer's (2012) definition into account, the relationship between material, social, and human resources, the decision-making process, and well-being outcomes can be examined for their impact on resilience (Guérin et al., 2013 ). Most importantly, the awareness and individual availability of and ability to make choices need to be placed in the particular setting. Finally, the degree to which a setting is an enabling environment needs to be considered separately because some dimensions of empowerment are more relevant to resilience than others (Kabeer, 2002 ). Hence, it is important to understand subjectivities and the respective influencing factors in specific contexts and how they are interlinked. Approaches to understanding empowerment as a relational and processual concept consider social structures and agency. People-centered approaches can be considered for understanding the level of resilience (Aryal, 2014 ; Oppenheim et al., 2014) as they can provide a pathway for making changes in gender relations and empowering women. The study aims to assess the effects of a BIP on empowerment and resilience among pregnant women who have experienced violence and were attending antenatal care at a tertiary care hospital in India. Conceptual framework Women's empowerment is explained as a "process whereby the lives of women and girls are transformed from a situation where they have limited power, to one where their power is enhanced" (VeneKlasen, & Miller, 2002 ). In elaborating on the empowerment framework, several studies, measured women's empowerment using diverse metrics and some common factors (Goulart et al., 2021 ; Mahmud et al., 2012 ). The three-dimensional empowerment framework (Huis et al., 2017 ) outlines three key indicators for assessing women's empowerment, i.e., personal, relational, and environmental-level indicators. Rowland's (1998) dimension of power, i.e., "power within," refers to enabling personal qualities of self-acceptance and self-respect. In contrast, others examined women's beliefs about their strength, specifically self-esteem and self-efficacy (Kato & Kratzer, 2013 ), self-confidence (Bura et al, 2005; Kim et al., 2007 ), and control beliefs (Hansen, 2015 ). This led to a greater sense of agency in transforming and widening their aspiration due to a greater awareness of choices and rights, which they aspired to transform into action. The Behavioural Intervention Package (BIP) was developed in the empowerment framework and culturally specific consideration in the DV context (Mahapatro et al., 2024). It was assessed and contextualized at three levels to understand the process enabling women to act on and improve issues important for their lives, families, communities, and society. The personal level of empowerment comprises an individual's enhanced quality of life, ability to regulate their emotional state (diminish stress and depression), changes in the dimension of spirituality, and readiness to deal with the abusive situation. Empowerment at the relational level refers to changes in the social dynamics of the individual. This comprises the relationships with family members as well as the immediate neighbourhood. It empowers them to influence the perceived social support system and their incidence of DV. At the societal level, empowerment has been contextualised at a broader level, i.e., awareness regarding understanding their rights, entitlements, and available resources. It enables women to access and reach out to the Family Counseling Centre, women police, one-stop centers, etc. Methods Trial design, setting, and participants The study was a randomised controlled trial (RCT) with 2 groups (intervention and control) among the pregnant women who experienced DV. It was conducted from November 2018 to June 2020 at a tertiary-care Lok Nayak (LN) hospital in New Delhi. The LN hospital has the capacity of a 2000-bed government hospital that provides free services and caters to people of low and middle socio-economic status. It is located in Delhi, India. The Ethical Committee of the Maulana Azad Medical College (MAMC), New Delhi (Ref. F.1/IEC/MAMC/51/5/2015/No28), approved the study. Recruitment and consent The researcher screened all the pregnant women who met the eligibility criteria in an excluded room using the Abuse Assessment Screening Tool (AAST) (ICMR, 2009 ), maintaining privacy and confidentiality. The respondents who answered "yes" to any type of violence within the last year of the study (2019) were considered and enrolled. The participants were explained about the study's purpose, potential risks and benefits, instruments, administration time, and follow-up schedules and approached with the subject information sheet for consent. If a participant agreed to participate, written informed consent was obtained, and the participant was enrolled in the study. Sample size In a study conducted in Hongkong (Tiwari et al., 2005 ), an outcome indicator, general health, was considered for sample size calculation. It was assumed that the general health is 53 ± 7.5 in the experiment group and 50 ± 7 in the control group; a minor change is expected. It was further, assuming α (type I error) of 5% and power taken as 80%, that a sample of 184 cases was required to be enrolled. It was rounded to hundreds to achieve a figure of 200. The required sample size was 220, assuming a non-compliance rate of 20%, considering the probability of abortion due to genetic markers and culture-specific reasons for dropouts. The inclusion criteria comprised all married pregnant women (18 to 20 weeks of pregnancy) attending the LN hospital's obstetrics outpatient department (OPD) for antenatal registration; high-risk pregnancy, primigravida, and multigravida were considered. Other inclusion criteria were having been screened positive for DV during the year using the AAST, continuing to live with the husband or in-laws (family) for at least 2 years, being likely to continue the treatment till delivery, and being willing to come to the hospital for follow-up as per schedule. Consent was sought for participation in the study by taking signatures on the informed consent form. Women excluded from this study were those who had already been registered as medico-legal cases related to abuse and those who had an intellectual disability that prevented them from comprehending and complying with the intervention. Intervention The groups were assigned to two types of intervention. The intervention comprised of A- behavioural intervention package (BIP) and B. standard care. The intervention group received A + B and the control group received B only. BIP: The BIP is a comprehensively designed package addressing all 3 key dimensions of women's empowerment, focusing on their individual development, relationship management, and societal support in accordance with the empowerment framework. The BIP addressed the complex life situation of the victim at 3 interrelated levels, i.e., personal, relational, or social, and the larger legal/societal contextual or environmental levels. It addressed the key challenges women face, i.e., making strategic life choices by having access to resources, acknowledging their achievements, and enabling them to exercise agency. BIP consisted of five components, while the standard care focused on the routine services provided by health professionals at the antenatal clinic (Mahapatro et al., 2024). Study outcomes The primary outcome of the study is quality of life (QOL) measured by SF-36. The secondary outcomes included empowerment measured at the personal level through i. reduction in stress and depression using N2 and ADI, ii. changes in the dimension of spirituality using WHO-Spirituality, Religiousness and Personal Beliefs Scale (WHO-SRPB), and iii. readiness to change using visual analog. At the relational level, empowerment was measured through the iv. changes in perceived social support using visual analogue, and v. the recurrence of DV was measured by the AAST. At the socio-environmental level, it was measured through vi. changes in awareness regarding entitlements and rights using an awareness assessment tool (AAT). All the indicators were measured at baseline and post-intervention. Randomization and blinding Eligible participants were randomized to either the intervention or the control group at a 1:1 ratio to avoid bias in selection. The list was generated by a computer, concealed in consecutively numbered, sealed envelopes, and recorded by an investigator who was not involved in the study. Outcome assessors and research assistants who entered and analysed the data were recruited in the third phase after data collection. Therefore, they did not know the study hypotheses or design and were blinded to group assignment. The person administering the intervention and standard care packages differed for the groups and were not interchangeable. Questionnaire measures and data collection tools Measuring at a personal level Quality of life (QOL): The SF-36 comprises eight multi-item scales (Ware et al., 1993 ). The SF-36 measures two distinct concepts: a physical dimension, represented by the Physical Component Summary (PCS), and a mental dimension, represented by the Mental Component Summary (MCS). All scales contribute in different proportions to the scoring of both PCS and MCS measures. The PGI Health Questionnaire N2 consists of 60 items. It is a self-reported measure of stress with a dichotomous (yes/no) answer format: 50 questions to assess stress. In comparison, another 10 questions give a "lie score," or the tendency to give socially desirable answers. The cutoff score is used to identify people with a clinically significant stress level (Ware, 1978). The higher the score, the greater the level of neuroticism. The Amritsar Depression Inventory (ADI) comprises 30 questions that evaluate feelings of guilt, helplessness, hopelessness, and worthlessness that characterize depression. The individual item scores are summed up to get the total scores. The higher the score, the greater the level of neuroticism. The various cutoff scores helped to categories the person according to the severity of depression (Singh et al., 1974 ). The WHO-SRPB scale consists of 8 facets: spiritual connection, meaning and purpose of life, experiences of awe and wonder, wholeness and integration, spiritual strength, inner peace, hope and optimism, and faith. Each facet comprises 4 questions rated on a 5-point Likert scale (WHO, 2002 ; Grover et al., 2013 ). The higher the score, the better the quality of life. Readiness to change was assessed based on the woman's subjective self-perception regarding her ability to extricate herself from the abusive situation. Her global assessment was based on the situation, its challenges, and her ability to initiate change. It was her subjective core feelings, which can be an important precursor to attempting to change her life milieu. The tool is rated from 0 to 4, where 0 is 'not ready,' and 4 is 'completely ready' (Mahapatro et al., 2016 ). The higher the score, the better the readiness to change. Measuring at the relational level The abuse assessment screening tool (AAST) has 15 items developed and validated in Indian culture. It evaluates the type, frequency, duration, abuser-relationship fabric, and severity of violence (ICMR, 2009 ). The higher the score, the greater the intensity of abuse. Perceived social support: This is a visual analogue scale where the respondents were asked to rate their perception of receiving social support from 0 to 10 where 0 represents ‘no support,’ and 10 stands for ‘complete support’ (Nehra et al., 1998 ). The higher the score, the better the perceived social support. Measuring at the socio-environmental level The awareness assessment tool (AAT) has seven themes with 24 questions. It was developed to assess the level of awareness among the women experiencing DV about the rights and entitlements given by the government of India. It includes questions like whom to approach to seek help, assistance facilities, and procedures to exercise their rights (ICMR, 2009 ). The greater the percentage increase in score, the greater the increase in the level of awareness. Administering the BIP and the standard care The BIP and standard care were administered to each woman in the intervention group. The control group did not receive the BIP. Standard care was provided alone. The intervention was administered by senior researchers trained in clinical psychology, community medicine, gynecology, anthropology, and yoga. Each one-to-one session for administering the intervention package lasted about 45–70 minutes in an excluded room near OPD without the male partner or other family members being present. We even tried to adjust it within their waiting period in the OPD. On average, 5–6 women attended the session daily. Over 28 weeks, 11 sessions with each of the women were made to administer the entire intervention package. The intervention package was administered over seven months, i.e., six weeks postnatal. The control group received the standard care intervention, which consisted of 11 sessions with the researcher, similar to the intervention group (Mahapatro et al., 2024). In order to ensure that the women were secure and comfortable, the researcher took the women from the common OPD area. The women who met the inclusion criteria of the duration of pregnancy were taken to another room designated for the study, maintaining confidentiality and trust. Further, these women were screened for DV. The researcher requested that the family members wait outside so that they could establish a rapport with the women exclusively and help her to express herself freely. At times, the family was inquisitive and wanted to accompany the woman inside, but the researcher firmly and politely asked them to wait outside. All the measures were administered to participants in both groups at the baseline and the end line. To ensure the women's continued participation and compliance with the BIP, after each session the time for the next session was confirmed, then a reminder call was given before their scheduled next visit. However, utmost importance was given to ensuring the woman's safety and adhering to the principle above all of "doing no harm." The research team addressed any difficulty or challenge reported by the women. If the participant could not come to the hospital for some reason, the researcher fixed up another convenient time after discussing it with the participant. Data analysis Statistical analysis was conducted using SPSS 20 software. The measuring tools such as QOL, AAST, AAT, N2, ADI, SRPB, social support, perceived social support contemplation ladder, and their subscales were compared pre- and post-intervention using a paired t-test or Wilcoxon signed test as appropriate to estimate the effect size (Cohen’s d) at baseline and post-intervention, with 95% CI. Continuous data is represented as the mean ± SD or median (inter-quartile range, or IQR) as appropriate. Per protocol, analysis was done. Although 243 women entered the study, baseline information was collected for all. However, for various reasons, 211 respondents completed the intervention session, and therefore, an analysis was conducted on 211 (Mahapatro et al., 2024). Results Participants Overall, 921 pregnant women were screened, of whom 678 also had DV but were not eligible for or excluded from the study. In total 243 women were randomized into either the intervention (n = 121) or control (n = 122) group. Thirty-two women (13.2%) dropped out of the analysis, and the major reasons were that women (n = 12) had miscarriages after recruitment, were lost to follow-up (n = 16), and could not complete the intervention session (n = 4). Therefore, 211 women entered the intervention and control groups, and data collection was completed for all 211 women (Fig. 1 ). Most of them (205/211 = 97%) attended all the intervention sessions. All the participants were enumerated, and there is no missing data. There were no reports of adverse events or harm arising from participation in the study (Mahapatro et al., 2024). The preliminary analysis The mean (SD) of the women's age in the intervention group was 25.3 (3.6) years, and in the control group, it was 24.5 (3.6) years (Table-1). About 18% of the women in the intervention group and 25% in the control group had 12 years of schooling or more. Women were predominantly housewives (95%) and belonged to a lower economic category. At baseline, the intervention and control groups were comparable on all but one of the characteristics—specifically, more women were living in joint families in the control group (about 87%) than in the intervention group (about 70%). In India, a joint family can be viewed as having conflict and stress, with women deprived of decision-making power and a sense of security from the family members due to the collectiveness of the group. The socio-demographic characteristics of the women respondents can be found in Table-1. These studies provide a more nuanced understanding of factors influencing and mediating empowerment. These studies provide a more nuanced understanding of factors influencing and mediating empowerment. These studies provide a more nuanced understanding of factors influencing and mediating empowerment. These studies provide a more nuanced understanding of factors influencing and mediating empowerment. Empowerment needs to be viewed as a highly contextualized, multi-dimensional process of which women themselves have differing perspectives. Hence, it is important to understand subjectivities and the respective influencing factors in specific contexts, as well as how they interlink. Approaches to understanding empowerment as a relational and processual concept take social structures and agency into account. The link to resilience sheds light on how project interventions and policies can target particular dimensions of empowerment to foster coping, adaptation and transformative capacities so women can effectively participate in decision-making processes, which translate into resilience. Changes at the personal level : Intervention effect on quality of life (QOL) The primary outcome was QOL. In the post-intervention period, there were significant mean changes in the intervention group in QOL subscales for both domains compared to the baseline. After 28 weeks, the between-group difference indicated a statistically significant increase in the QOL in the intervention group compared to the control group (Mahapatro et al., 2024). Intervention effects on mental health (Stress and Depression) The baseline characteristics of mental health parameters were stress (study group = 27.4(±)9.1, control group = 26.4(±)8.9) and depression (intervention group = 16.6(±)6.9, control group = 15.9(±) 6.3). They are balanced initially and, therefore, comparable at the baseline. The intervention effect in the study group shows a significant difference in post-test values in psychological test scores for stress and depression, respectively. The effect size for stress in the intervention group was 11.3 (95% CI, 9.288–13.283) and 1.6 (95% CI, -0.596-3.671) in the control group. The effect size for depression in the intervention group was found to be 7.3 (95% CI, 5.922–8.668), and in the control group, 0.8 (95% CI, (-0.694-2.204). The intervention effect shows a significant improvement in reducing stress and depression (p < 0.001), whereas, in the control group, there was no difference in stress (p = 0.156) or depression (0.304) (Table 2). Intervention effects on readiness to change The intervention effect shows a significant improvement in readiness to change (P < 0.001) in the intervention group compared to the control group. There is an improvement of 1.51 mean scores. Post-intervention, in the control group, there was no significant difference in the value (p = 0.193) (Table 3). Intervention effects on the dimension of spirituality The intervention effect in the intervention group reveals a significant difference between pre-intervention and post-intervention values in all six parameters: spiritual connection, meaning and purpose of life, enjoy (experiences of awe and wonder), wholeness and integration, spiritual strength, inner peace, hope and optimism, and faith. The intervention effect significantly improves all the parameters of spirituality (p < 0.001). The control group has also shown a significant improvement in the 3 domains of spiritual connection, enjoy (experiences of awe & wonder), wholeness, and integration (Table 4). Changes at the relational level: Intervention effects on perceived social support There is no significant difference in baseline regarding perceived social support for the intervention or control groups. The intervention effect significantly improves social support in the intervention group. An increase of 3.038 scores indicates improved perceived social support (Table 5). Intervention effects on DV DV in the study has been studied under three categories: physical, sexual, and psychological violence. Psychological violence was present in every participant. Thus, when mentioning physical and sexual violence, a psychological violence component is inherently understood. Pre-intervention, all three types of violence for the intervention and control groups were comparable (Fig. 2). In the intervention group, post-intervention showed a significant decrease in physical (15%) and sexual violence (about 3%) compared to the control group (0.9% and 0.9% respectively). The three types of violence experienced by women also show a significant decrease of 12.4% in the intervention group compared to 9% in the control group. The control group had no change in physical or sexual violence from baseline to post-intervention. There was a shift to ‘no violence’ in both the groups and to psychological violence (Table 6). Changes at the larger socio-environmental level: Intervention effects on awareness To enhance women's social functioning at an environmental level, BIP intended robust awareness generation amongst women experiencing DV regarding their legal rights, resources, and entitlements to facilitate financial independence and uplift the standard of living. BIP is an endeavour to improve women's health outcomes by empowering them to manage the challenges presented by society's discriminatory and rigid gender-biased attitude. Table 7 depicts that women were largely unaware of their rights and entitlements. Pre-intervention, there was no difference in awareness levels between the intervention and control groups. Post-intervention shows an increase in awareness that is statistically significant in the intervention group compared to the control group. Discussion Overall, the study showed the potential of BIP intervention, which was significantly effective at all three levels (personal, relational, and socio-environmental) for pregnant women who experienced DV in India. The holistic strategies of BIP, which use yoga-based techniques, interpersonal skill development techniques, regular counselling sessions, group activities, and awareness sessions, have been instrumental in addressing the core issues curtailing women’s agency and rights. At a personal level, the BIP intervention was effective in improving QOL, reducing stress and depression, and increasing their readiness to change. In addition, the post-intervention effect significantly improves all the parameters of spirituality. It was revealed that regular practice of yoga-based techniques, spiritual immersion, and self-care enabled women to develop a positive self-perception. Even the women in the control group showed a positive effect on three sub-scales of the spirituality parameter, which may be because they were given personal and individual time to explain all the facets of routine ANC care empathetically and respectfully. Regular follow-up, which was part of the study design, helped them develop a sense of trust and rapport, leading to a cathartic release. Further, it highlights the therapeutic importance of just listening attentively. Similar study outcomes have been reported elsewhere (Dinmohammadi et al., 2021 ; Evans et al., 2018 ; Faltinsen et al., 2022 ). At the relational level, the post-BIP intervention effect shows a significant improvement in perceived social support in the intervention group. Psychological violence was present in every participant. There was a shift from physical and sexual violence to psychological violence and ‘no violence’. Both groups showed this phenomenon, explaining the apparent increase in psychological violence and further cementing the reduction in the number of those who faced physical and sexual violence and all three types of violence. The trauma and the humiliation of physical and sexual violence leave a deep impact. Thus, a significant reduction in physical and sexual violence indicates the effectiveness of BIP. The reduced severity of DV may also be due to quality of life and empowerment of women as the intervention was focused on women only during the study period. However, the psychological violence persisted (Chen et al., 2022 ). It may be further corrected with long-term interventions, which include psycho-education programme for other family members. At societal level, post-intervention shows a significant increase in awareness. During the pre-intervention in both groups, women were largely unaware of various rights and entitlements. Post-intervention, there was a significant increase in awareness in the intervention group. There is an increase in awareness in the control group. The reason may be that they became aware while asking the women about various policies, programmes, and schemes. It establishes that making women aware of their rights and ensuring their legal and welfare entitlements enables them to become financially stable and empowers them to stand up for themselves and cope with the challenges of daily life (Ahmed, 2005 ; Morgan & Coombes, 2013 ). The type of power relationship under the empowerment framework focuses on power from within, as was very much indicated by this BIP intervention (Sardenberg, 2010 ). The linkage to resilience focused on how interventions targeted particular dimensions of empowerment to reduce stress and depression, readiness to change, and transformative capacities to effectively utilize their rights and entitlements, translating into resilience (Chen & Tanaka, 2014 ). Other factors may also influence the effectiveness of BIP; for example, with increasing gestational age, women were more focused on self-care and a deeper sense of spirituality, and family members and spouses were less likely to commit severe forms of violence and seek social support. This result was consistent with studies conducted in Asian countries and worldwide (Tiwari et al., 2005 ; Sardenberg, 2010 ). Although the women in the intervention group acquired the skills learned during the intervention, retaining them longer would build their resilience (Kabeer, 2012 ). Strengths and limitations To the best of our knowledge, this is the first RCT to examine the effects of a BIP intervention on the empowerment and resilience of pregnant women in India who have experienced DV. We highlighted the effectiveness and feasibility of employing an innovative, integrated approach. This study has several limitations. First, all measures were self-reported, introducing potential subjective bias. Women's initial responses may also be influenced by their level of trust and rapport established during the intervention. Additionally, focusing solely on women's coping efforts without considering their partners' and families' roles in the therapeutic process is a limitation. Without fully understating the action of the perpetrator (due to attitude, value, psychopathology, personality disorder, socio-cultural conditioning, etc.) in which DV occurs is a limitation. Conclusion Given India's diverse culture, the BIP may be an effective approach for empowering pregnant women from low socioeconomic backgrounds facing DV who seek ANC at public hospitals in India, ultimately enhancing their quality of life. Currently, there is no standardized intervention in India that specifically addresses the psychosocial health needs of women experiencing violence. The BIP can be broadly adopted and implemented in settings focused on support, screening, management, and empowerment of women in distress, thereby protecting the health of pregnant women. Declarations Data availability statements: All data generated or analysed during this study are included in this published article [and are available from the corresponding author on reasonable request. Please check the table 7 has it is referenced but not uploaded: included in the manuscript Please add the full date of first registration in the format DD/MM/. . (09/01/2021), alongside the registration number, in the text of your manuscript- included The Indian Registry of Clinical Trials number is CTRI/2019/01/017009 dated 9.1.2019. Manuscripts reporting results of a clinical trial must conform to CONSORT 2010 guidelines- CONSORT checklist attached Please could you also provide a separate document detailing the trial protocol- Attached Please upload the detailed trial protocol and CONSORT Checklist in the 'Related manuscript files' section only as these documents are not subjected to publication. Author Contribution • Dr. Meerambika Mahapatro: Conceived the project, developed tools and the intervention package, validated the data, and wrote the report.• Dr. Sudeshna Roy, Dr. Poonam Nayar, Dr. Ashwini Jadhav, Ms. Suruchi Panchkaran and Gunjan Chandhok: Data collection.• Ms. Divyanshu Srivastava: Data analysis.• Prof. Sudha Prasad: Managed resources at the hospital. Acknowledgement The authors would like to thank Dr. Manoj Kumar Das (Inclen Indian) and Dr. Guresh Kumar (AIIMS, New Delhi) for their valuable contributions and support. 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Tables Table-1 Comparison of socio-demographic variable data in intervention and control groups Variables Intervention Group N=105 Control Group N= 106 P-Value Age (in years) 25.3(±)4.2 24.5±3.6 0.14 Caste General 36(34.3) 36(34.0) 0.487 OBC 57(54.3) 60(56.6) Others 12(11.4) 10(9.4) Religion Hindu 34(32.4) 40(37.7) 0.999 Muslim 71(67.6) 66(62.3) Women Education Illiterate 8(7.6) 10(9.4) 0.318 Primary 10(9.5) 17(16.0) Middle 26(24.8) 16(15.1) High-school 34(32.4) 44(41.5) Above higher-secondary school 27(25.7) 19(17.9) Husband education Illiterate 12(11.4) 12(11.3) 0.227 Primary 8(7.6) 11(10.4) Middle 29(27.6) 27(25.5) High-school 33(31.4) 32(30.2) Above higher-secondary school 23(21.9) 24(22.6) Women occupation House-wife 100(95.2) 101(95.3) 0.999 Working 5(4.8) 5(4.7) Husband occupation Organized sector 68(64.8) 58(54.7) 0.460 Self-employed 15(14.3) 30(28.3) Unemployed 22(21.0) 18(17.0) Type of family Nuclear 31(29.5) 14(13.2) 0.754 Joint 74(70.5) 92(86.8) Total family income (in Rs per month) 20599.0(±)23795.2 22845.3(±)28706.6 0.545 Values are expressed as mean ± SD or frequency (%) Table-2: Comparison of stress and depression between intervention and control group, pre and post-intervention Mental health Intervention Group N=105 (mean±S.D) Control N=106 (mean±S.D.) Effect Size Mean difference (95% C.I.) P-Value Stress (N2) Pre 26.4(±)8.9 27.4(±)9.1 0.996 (-1.451,3.444) 0.423 Post 15.1(±)9.0 25.8(±)11.1 10.744 (7.993,13.495) <0.001 Effect Size (9.288,13.283) (-0.596,3.671) P-value <0.001 0.156 Depression (ADI) Pre 15.9(±)6.3 16.6(±)6.9 0.642 (-1.155,2.440) 0.482 Post 8.6(±)5.7 15.8(±)7.2 7.183 (5.401,8.964) <0.001 Effect Size (5.922,8.668) (-0.694,2.204) P-value <0.001 0.304 Table-3 Comparison of readiness to change between intervention and control group, pre and post-intervention Outcome Variable Pre-Intervention (mean±S.D.) Post-Intervention (mean±S.D) Two-sided P value Intervention Group N=105 1.32(±)1.08 2.83(±)0.8 <0.001 Control N=106 1.25(±)0.84 1.37(±)1.02 0.193 Table-4: Comparison of spirituality domains between intervention and control group, pre and post-intervention Outcome Variable Intervention Group N=105 (mean ± SD) Control N=106 (mean ± SD) Effect Size Mean diff(95% C.I.) P-Value Spiritual Connection Pre 11.8(±)3.5 11.8(±)3.8 0.087* (-0.92,1.09) 0.865 Post 13.1(±)2.9 10.9(±)3.8 -2.190 (-3.12,-1.25) <0.001 Effect Size (1.97,-0.65) (0.33,1.59) P-value <0.001 0.003 Meaning & Purpose of Life Pre 11.0(±)3.4 11.0(±)3.5 0.075* (-0.87,1.02) 0.876 Post 12.5(±)3.1 10.8(±)3.4 -1.675 (-2.57,-0.77) <0.001 Effect Size (-2.24,-0.76) (-0.42,0.91) P-value <0.001 0.466 Enjoy (Experiences of Awe & Wonder) Pre 10.9(±)2.9 11.0(±)3.5 0.171 (-0.72,1.06) 0.708 Post 12.3(±)3.2 10.2(±)3.1 -2.012 (-2.88,-1.13) <0.001 Effect Size (-2.06,-0.73) (0.16,1.40) P-value <0.001 0.014 Wholeness & Integration Pre 10.3(±)2.9 10.8(±)3.1 0.51 (-0.32,1.33) 0.230 Post 12.0(±)3.0 10.1(±)3.1 -1.94 (-2.78,-1.08) <0.001 Effect size (-2.44,-1.11) (0.07,1.25) P-Value <0.001 0.029 Spiritual Strength Pre 11.2(±)3.8 10.7(±)3.4 -0.43 (-1.41,0.56) 0.396 Post 12.7(±)3.4 10.3(±)3.3 -2.403(-3.32,-1.48) <0.001 Effect size (-2.22,-0.78) (-0.23,1.17) P-Value <0.001 0.188 Inner Peace Pre 10.9(±)5.4 10.2(±)3.1 -0.74 (-1.94,0.47) 0.231 Post 12.2(±)3.4 10.0(±)3.0 -2.191 (-3.07,-1.30) <0.001 Effect size (-2.37,-0.27) (-0.51,0.77) P-Value 0.014 0.684 Hope & Optimism Pre 10.5(±)3.4 10.4(±)3.3 -0.33* (-0.95,0.89) 0.944 Post 11.9(±)3.2 10.3(±)3.2 -1.594 (-2.48,-0.70) <0.001 Effect size (-2.18,-0.76) (-0.56,0.73) P-Value <0.001 0.794 Faith Pre 11.3(±)3.5 10.8(±)3.5 -0.494 (-1.45,0.46) 0.311 Post 13.1(±)3.0 10.5(±)3.6 -2.57 (-3.48,-1.64) <0.001 Effect size (-2.47,-1.04) (-0.38,1.00) P-Value <0.001 0.375 * the difference is because of the rounding effect Table-5 Comparison of perceived social support between intervention and control group, pre and post-intervention Outcome variable Pre-Intervention Post-Intervention Two sided P Intervention group (N=105) (mean ± S.D.) 3.03 (±) 1.92 6.1(±)1.86 <0.001 Control group (N=106) (mean ± S.D.) 4.08(±)1.96 4.33(±)2.19 0.281 Effect size 1.02(0.50,1.55) -1.76(-2.31,-1.21) P-value <0.001 <0.001 Table-6: Comparison of domestic violence between intervention and control group, pre and post-intervention Type of Violence Intervention Group N=105 Control group N=106 Pre-intervention N=105 (%) Post-intervention N=105 ( %) p-value Pre-intervention N=106 (%) Post-intervention N=106 (%) p-value Psychological 43(41.0) 65(62) <0.001 47(44.3) 51(48.1) 0.047 Physical 33(31.4) 17(16.2) 0.006 23(21.7) 22(20.8) 0.32 Sexual 5(4.8) 2(1.9) 0.083 12(11.3) 11(10.4) 0.32 All 3 types 24(22.9) 11(10.5) <0.001 24(22.6) 14(13.2) 0.002 No violence 0 10(9.5) 0.002 0 8(7.5) 0.005 Table-7: Comparison of awareness between intervention and control group, pre and post-intervention Outcome Variable- Awareness Intervention N=105 Frequency (%) Control N=106 frequency(%) Within Group (Chi-square) P-value DV Act Pre Yes 21(20) 33(31.1) 3.43 0.082 No 84(80) 73(68.9) Post Yes 104(99) 67(63.2) 44.10 <0.001 No 1(1.0) 39(36.8) Between group (McNemar) 81.012 19.446 P-value <0.001 <0.001 Help line Pre Yes 23(22.1) 26(24.5) 0.17 0.745 No 81(77.9) 80(75.5) Post Yes 104(99) 102(96.2) 1.815 0.369 No 1(1.0) 4(3.8) Between group (McNemar) 78.013 68.598 P-value <0.001 <0.001 Shelter Services Pre Yes 2(1.9) 11(10.4) 6.54 0.019 No 103(98.1) 95(89.6) Post Yes 104(99) 36(34.0) 100.082 <0.001 No 1(1.0) 70(66.0) Between group (McNemar) 100.010 14.049 P-value <0.001 <0.001 Family Counseling Cell Pre Yes 5(4.8) 13(12.3) 3.72 0.082 No 99(95.2) 93(87.7) Post Yes 104(99) 27(25.5) 121.308 <0.001 No 1(1.0) 79(74.5) Between group (McNemar) 96.010 4.971 P-value <0.001 0.026 Legal Protection Measures Pre Yes 3(2.9) 17(16.0) 10.68 0.002 No 102(97.1) 89(84.0) Post Yes 104(99) 42(39.6) 87.38 <0.001 No 1(1.0) 64(60.4) Between group (McNemar) 99.010 12.255 P-value <0.001 <0.001 NGO/Civil Society Pre Yes 4(3.8) 15(14.2) 6.77 0.014 No 100(96.2) 91(85.8) Post Yes 104(99) 66(62.3) 45.58 <0.001 No 1(1.0) 40(37.7) Between group (McNemar) 97.010 40.984 P-value <0.001 <0.001 One Stop Centre Pre Yes 1(1.0) 6(5.7) 3.64 0.119 No 104(99.0) 100(94.3) Post Yes 104(99) 34(32.1) 104.56 <0.001 No 1(1.0) 72(67.9) Between group (McNemar) 101.010 20.250 P-value <0.001 <0.001 Additional Declarations No competing interests reported. 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18:07:24","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":35455,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eComparison of domestic violence between intervention and control group, pre and post-intervention\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5795896/v1/8acf87495b2916c0441254fa.jpg"},{"id":75363518,"identity":"59ce26fd-6681-47e6-b28f-08072a98916e","added_by":"auto","created_at":"2025-02-03 18:23:41","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1956222,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5795896/v1/fc954f5a-3129-4b36-b2fd-3c6fa8122f65.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effect of behavioural intervention package on empowerment and resilience among the pregnant women in India experiencing domestic violence: A facility-based randomized control trial","fulltext":[{"header":"Introduction","content":"\u003cp\u003eWomen experiencing domestic violence (DV) is a worldwide acknowledged public health challenge demanding attention from public health practitioners and policymakers (Chen \u0026amp; Tanaka, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Mahapatro, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). This seeks holistic deliberations among stakeholders to sensitively address the problem and empower women to manage their life challenges, participate in decision-making, and access resources to fully realize their capacities (Leder, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2023\u003c/span\u003e, UNICEF, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Over the years, numerous international deliberations have taken place to steer women's empowerment (Leder, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Interventions include individual counselling, support groups, safety planning, referrals to other services, empowerment training, anger management, and a combination (Mittal et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Dinmohammadi et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Evans et al, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Tiwari et al., \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2005\u003c/span\u003e; Hartmann et al, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Aminnasab et al, 2018). However, a study in India reports that the patrilineal culturalism stance strategically encumbers women's agency, limiting their individuality. Women's lack of choice and restricted power and control over resources pessimistically convey the denial of women's rights (Mahapatro, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Jejeebhoy \u0026amp; Santhya, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). It is vital to understand that gender inequality strategically disempowers women, reinforcing their manifold susceptibilities. Elaborating on the context further, women experiencing DV have serious health consequences and develop poor coping mechanisms, resulting in lower levels of self-esteem (Shahin et al., \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSeveral policies and programmes in India, such as DV Act 2005, POSH Act 2013, one stop centre at every hospital, gender budgeting, etc., were initiated to promote women's empowerment and support the development of skills, self-esteem, and access to information and resources, positioning women as assertive decision-makers and leaders in their homes and communities (MWCD n.a; Dhungel \u0026amp; Ojha, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Women's perspectives and understandings of empowerment, as stated by Gu\u0026eacute;rin et al. (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2013\u003c/span\u003e), point out that women are \"not necessarily looking for autonomy and independence from men, but rather for respect within their own community,\" the ability \"to solve problems\" and \"to manage suffering\" (Cornwall, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2007\u003c/span\u003e; Kabeer, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2002\u003c/span\u003e). Some related empowerment to material constraints, while others related it to the freedom of mobility and being respected by their family. Studies show that women perceive their empowerment not as emancipation from male dominance but as harmonious relationships with other women, their husbands, families, and communities (Gu\u0026eacute;rin et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2013\u003c/span\u003e; Charmes \u0026amp; Wieringa, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2003\u003c/span\u003e; Rowlands, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e1998\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn an attempt to uncover the meaning of empowerment as it is used in the discourse and practice of development, Rowlands (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e1998\u003c/span\u003e), as well as Charmes and Wieringa (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2003\u003c/span\u003e), distinguish between different modes of power visibility linked to the various dimensions of power. \"Power within\" refers to enabling personal self-acceptance, self-respect, or spiritual strength. Charmes and Wieringa (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2003\u003c/span\u003e) also differentiate between the modes of operation of power (oppressive, challenging, and creative) and the modes of appearance (in speech acts and texts, institutions, and daily practices) (Rowlands, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e1998\u003c/span\u003e; Charmes \u0026amp; Wieringa, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2003\u003c/span\u003e). Women's self-esteem is particularly relevant to empowerment, which could strongly influence their perception and attitudes towards their adaptive capacities and, therefore, their resilience. Furthermore, the underlying conceptualization of power needs to be unpacked in particular settings to determine how resilience can be increased (Mahmudi et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Chen \u0026amp; Tanaka, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). One could estimate to what extent different dimensions or indicators of empowerment influence resilience and how Luke's three-dimensional view of power could be linked to resilience (Lukes, 2005; Stephanie, 2015). Taking Kabeer's (2012) definition into account, the relationship between material, social, and human resources, the decision-making process, and well-being outcomes can be examined for their impact on resilience (Gu\u0026eacute;rin et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). Most importantly, the awareness and individual availability of and ability to make choices need to be placed in the particular setting. Finally, the degree to which a setting is an enabling environment needs to be considered separately because some dimensions of empowerment are more relevant to resilience than others (Kabeer, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2002\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eHence, it is important to understand subjectivities and the respective influencing factors in specific contexts and how they are interlinked. Approaches to understanding empowerment as a relational and processual concept consider social structures and agency. People-centered approaches can be considered for understanding the level of resilience (Aryal, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Oppenheim et al., 2014) as they can provide a pathway for making changes in gender relations and empowering women. The study aims to assess the effects of a BIP on empowerment and resilience among pregnant women who have experienced violence and were attending antenatal care at a tertiary care hospital in India.\u003c/p\u003e \u003cp\u003eConceptual framework\u003c/p\u003e \u003cp\u003eWomen's empowerment is explained as a \"process whereby the lives of women and girls are transformed from a situation where they have limited power, to one where their power is enhanced\" (VeneKlasen, \u0026amp; Miller, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2002\u003c/span\u003e). In elaborating on the empowerment framework, several studies, measured women's empowerment using diverse metrics and some common factors (Goulart et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Mahmud et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). The three-dimensional empowerment framework (Huis et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) outlines three key indicators for assessing women's empowerment, i.e., personal, relational, and environmental-level indicators. Rowland's (1998) dimension of power, i.e., \"power within,\" refers to enabling personal qualities of self-acceptance and self-respect. In contrast, others examined women's beliefs about their strength, specifically self-esteem and self-efficacy (Kato \u0026amp; Kratzer, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2013\u003c/span\u003e), self-confidence (Bura et al, 2005; Kim et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2007\u003c/span\u003e), and control beliefs (Hansen, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). This led to a greater sense of agency in transforming and widening their aspiration due to a greater awareness of choices and rights, which they aspired to transform into action.\u003c/p\u003e \u003cp\u003eThe Behavioural Intervention Package (BIP) was developed in the empowerment framework and culturally specific consideration in the DV context (Mahapatro et al., 2024). It was assessed and contextualized at three levels to understand the process enabling women to act on and improve issues important for their lives, families, communities, and society.\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eThe personal level of empowerment comprises an individual's enhanced quality of life, ability to regulate their emotional state (diminish stress and depression), changes in the dimension of spirituality, and readiness to deal with the abusive situation.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eEmpowerment at the relational level refers to changes in the social dynamics of the individual. This comprises the relationships with family members as well as the immediate neighbourhood. It empowers them to influence the perceived social support system and their incidence of DV.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eAt the societal level, empowerment has been contextualised at a broader level, i.e., awareness regarding understanding their rights, entitlements, and available resources. It enables women to access and reach out to the Family Counseling Centre, women police, one-stop centers, etc.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003eTrial design, setting, and participants\u003c/h2\u003e\n \u003cp\u003eThe study was a randomised controlled trial (RCT) with 2 groups (intervention and control) among the pregnant women who experienced DV. It was conducted from November 2018 to June 2020 at a tertiary-care Lok Nayak (LN) hospital in New Delhi. The LN hospital has the capacity of a 2000-bed government hospital that provides free services and caters to people of low and middle socio-economic status. It is located in Delhi, India. The Ethical Committee of the Maulana Azad Medical College (MAMC), New Delhi (Ref. F.1/IEC/MAMC/51/5/2015/No28), approved the study.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eRecruitment and consent\u003c/h3\u003e\n\u003cp\u003eThe researcher screened all the pregnant women who met the eligibility criteria in an excluded room using the Abuse Assessment Screening Tool (AAST) (ICMR, \u003cspan class=\"CitationRef\"\u003e2009\u003c/span\u003e), maintaining privacy and confidentiality. The respondents who answered \u0026quot;yes\u0026quot; to any type of violence within the last year of the study (2019) were considered and enrolled. The participants were explained about the study\u0026apos;s purpose, potential risks and benefits, instruments, administration time, and follow-up schedules and approached with the subject information sheet for consent. If a participant agreed to participate, written informed consent was obtained, and the participant was enrolled in the study.\u003c/p\u003e\n\u003ch3\u003eSample size\u003c/h3\u003e\n\u003cp\u003eIn a study conducted in Hongkong (Tiwari et al., \u003cspan class=\"CitationRef\"\u003e2005\u003c/span\u003e), an outcome indicator, general health, was considered for sample size calculation. It was assumed that the general health is 53\u0026thinsp;\u0026plusmn;\u0026thinsp;7.5 in the experiment group and 50\u0026thinsp;\u0026plusmn;\u0026thinsp;7 in the control group; a minor change is expected. It was further, assuming \u0026alpha; (type I error) of 5% and power taken as 80%, that a sample of 184 cases was required to be enrolled. It was rounded to hundreds to achieve a figure of 200. The required sample size was 220, assuming a non-compliance rate of 20%, considering the probability of abortion due to genetic markers and culture-specific reasons for dropouts.\u003c/p\u003e\n\u003cp\u003eThe inclusion criteria comprised all married pregnant women (18 to 20 weeks of pregnancy) attending the LN hospital\u0026apos;s obstetrics outpatient department (OPD) for antenatal registration; high-risk pregnancy, primigravida, and multigravida were considered. Other inclusion criteria were having been screened positive for DV during the year using the AAST, continuing to live with the husband or in-laws (family) for at least 2 years, being likely to continue the treatment till delivery, and being willing to come to the hospital for follow-up as per schedule. Consent was sought for participation in the study by taking signatures on the informed consent form. Women excluded from this study were those who had already been registered as medico-legal cases related to abuse and those who had an intellectual disability that prevented them from comprehending and complying with the intervention.\u003c/p\u003e\n\u003ch3\u003eIntervention\u003c/h3\u003e\n\u003cp\u003eThe groups were assigned to two types of intervention. The intervention comprised of A- behavioural intervention package (BIP) and B. standard care. The intervention group received A\u0026thinsp;+\u0026thinsp;B and the control group received B only.\u003c/p\u003e\n\u003cp\u003eBIP: The BIP is a comprehensively designed package addressing all 3 key dimensions of women\u0026apos;s empowerment, focusing on their individual development, relationship management, and societal support in accordance with the empowerment framework. The BIP addressed the complex life situation of the victim at 3 interrelated levels, i.e., personal, relational, or social, and the larger legal/societal contextual or environmental levels. It addressed the key challenges women face, i.e., making strategic life choices by having access to resources, acknowledging their achievements, and enabling them to exercise agency. BIP consisted of five components, while the standard care focused on the routine services provided by health professionals at the antenatal clinic (Mahapatro et al., 2024).\u003c/p\u003e\n\u003ch3\u003eStudy outcomes\u003c/h3\u003e\n\u003cp\u003eThe primary outcome of the study is quality of life (QOL) measured by SF-36. The secondary outcomes included empowerment measured at the personal level through i. reduction in stress and depression using N2 and ADI, ii. changes in the dimension of spirituality using WHO-Spirituality, Religiousness and Personal Beliefs Scale (WHO-SRPB), and iii. readiness to change using visual analog. At the relational level, empowerment was measured through the iv. changes in perceived social support using visual analogue, and v. the recurrence of DV was measured by the AAST. At the socio-environmental level, it was measured through vi. changes in awareness regarding entitlements and rights using an awareness assessment tool (AAT). All the indicators were measured at baseline and post-intervention.\u003c/p\u003e\n\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n \u003ch2\u003eRandomization and blinding\u003c/h2\u003e\n \u003cp\u003eEligible participants were randomized to either the intervention or the control group at a 1:1 ratio to avoid bias in selection. The list was generated by a computer, concealed in consecutively numbered, sealed envelopes, and recorded by an investigator who was not involved in the study. Outcome assessors and research assistants who entered and analysed the data were recruited in the third phase after data collection. Therefore, they did not know the study hypotheses or design and were blinded to group assignment. The person administering the intervention and standard care packages differed for the groups and were not interchangeable.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eQuestionnaire measures and data collection tools\u003c/h3\u003e\n\u003cp\u003e\u003cstrong\u003eMeasuring at a personal level\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eQuality of life (QOL): The SF-36 comprises eight multi-item scales (Ware et al., \u003cspan class=\"CitationRef\"\u003e1993\u003c/span\u003e). The SF-36 measures two distinct concepts: a physical dimension, represented by the Physical Component Summary (PCS), and a mental dimension, represented by the Mental Component Summary (MCS). All scales contribute in different proportions to the scoring of both PCS and MCS measures.\u003c/p\u003e\u003cspan\u003e\n \u003cp\u003eThe PGI Health Questionnaire N2 consists of 60 items. It is a self-reported measure of stress with a dichotomous (yes/no) answer format: 50 questions to assess stress. In comparison, another 10 questions give a \u0026quot;lie score,\u0026quot; or the tendency to give socially desirable answers. The cutoff score is used to identify people with a clinically significant stress level (Ware, 1978). The higher the score, the greater the level of neuroticism.\u003c/p\u003e\n\u003c/span\u003e\u003cspan\u003e\n \u003cp\u003eThe Amritsar Depression Inventory (ADI) comprises 30 questions that evaluate feelings of guilt, helplessness, hopelessness, and worthlessness that characterize depression. The individual item scores are summed up to get the total scores. The higher the score, the greater the level of neuroticism. The various cutoff scores helped to categories the person according to the severity of depression (Singh et al., \u003cspan class=\"CitationRef\"\u003e1974\u003c/span\u003e).\u003c/p\u003e\n\u003c/span\u003e\u003cspan\u003e\n \u003cp\u003eThe WHO-SRPB scale consists of 8 facets: spiritual connection, meaning and purpose of life, experiences of awe and wonder, wholeness and integration, spiritual strength, inner peace, hope and optimism, and faith. Each facet comprises 4 questions rated on a 5-point Likert scale (WHO, \u003cspan class=\"CitationRef\"\u003e2002\u003c/span\u003e; Grover et al., \u003cspan class=\"CitationRef\"\u003e2013\u003c/span\u003e). The higher the score, the better the quality of life.\u003c/p\u003e\n\u003c/span\u003e\u003cspan\u003e\n \u003cp\u003eReadiness to change was assessed based on the woman\u0026apos;s subjective self-perception regarding her ability to extricate herself from the abusive situation. Her global assessment was based on the situation, its challenges, and her ability to initiate change. It was her subjective core feelings, which can be an important precursor to attempting to change her life milieu. The tool is rated from 0 to 4, where 0 is \u0026apos;not ready,\u0026apos; and 4 is \u0026apos;completely ready\u0026apos; (Mahapatro et al., \u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e). The higher the score, the better the readiness to change.\u003c/p\u003e\n\u003c/span\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003ch3\u003eMeasuring at the relational level\u003c/h3\u003e\n\u003cp\u003e\u003cspan\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eThe abuse assessment screening tool (AAST) has 15 items developed and validated in Indian culture. It evaluates the type, frequency, duration, abuser-relationship fabric, and severity of violence (ICMR, \u003cspan class=\"CitationRef\"\u003e2009\u003c/span\u003e). The higher the score, the greater the intensity of abuse.\u003c/p\u003e\u003cspan\u003e\n \u003cp\u003ePerceived social support: This is a visual analogue scale where the respondents were asked to rate their perception of receiving social support from 0 to 10 where 0 represents \u0026lsquo;no support,\u0026rsquo; and 10 stands for \u0026lsquo;complete support\u0026rsquo; (Nehra et al., \u003cspan class=\"CitationRef\"\u003e1998\u003c/span\u003e). The higher the score, the better the perceived social support.\u003c/p\u003e\n\u003c/span\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n \u003ch2\u003eMeasuring at the socio-environmental level\u003c/h2\u003e\u003cspan\u003e\n \u003cp\u003eThe awareness assessment tool (AAT) has seven themes with 24 questions. It was developed to assess the level of awareness among the women experiencing DV about the rights and entitlements given by the government of India. It includes questions like whom to approach to seek help, assistance facilities, and procedures to exercise their rights (ICMR, \u003cspan class=\"CitationRef\"\u003e2009\u003c/span\u003e). The greater the percentage increase in score, the greater the increase in the level of awareness.\u003c/p\u003e\n \u003c/span\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\n \u003ch2\u003eAdministering the BIP and the standard care\u003c/h2\u003e\n \u003cp\u003eThe BIP and standard care were administered to each woman in the intervention group. The control group did not receive the BIP. Standard care was provided alone. The intervention was administered by senior researchers trained in clinical psychology, community medicine, gynecology, anthropology, and yoga. Each one-to-one session for administering the intervention package lasted about 45\u0026ndash;70 minutes in an excluded room near OPD without the male partner or other family members being present. We even tried to adjust it within their waiting period in the OPD. On average, 5\u0026ndash;6 women attended the session daily. Over 28 weeks, 11 sessions with each of the women were made to administer the entire intervention package. The intervention package was administered over seven months, i.e., six weeks postnatal. The control group received the standard care intervention, which consisted of 11 sessions with the researcher, similar to the intervention group (Mahapatro et al., 2024).\u003c/p\u003e\n \u003cp\u003eIn order to ensure that the women were secure and comfortable, the researcher took the women from the common OPD area. The women who met the inclusion criteria of the duration of pregnancy were taken to another room designated for the study, maintaining confidentiality and trust. Further, these women were screened for DV. The researcher requested that the family members wait outside so that they could establish a rapport with the women exclusively and help her to express herself freely. At times, the family was inquisitive and wanted to accompany the woman inside, but the researcher firmly and politely asked them to wait outside.\u003c/p\u003e\n \u003cp\u003eAll the measures were administered to participants in both groups at the baseline and the end line. To ensure the women\u0026apos;s continued participation and compliance with the BIP, after each session the time for the next session was confirmed, then a reminder call was given before their scheduled next visit. However, utmost importance was given to ensuring the woman\u0026apos;s safety and adhering to the principle above all of \u0026quot;doing no harm.\u0026quot; The research team addressed any difficulty or challenge reported by the women. If the participant could not come to the hospital for some reason, the researcher fixed up another convenient time after discussing it with the participant.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\n \u003ch2\u003eData analysis\u003c/h2\u003e\n \u003cp\u003eStatistical analysis was conducted using SPSS 20 software. The measuring tools such as QOL, AAST, AAT, N2, ADI, SRPB, social support, perceived social support contemplation ladder, and their subscales were compared pre- and post-intervention using a paired t-test or Wilcoxon signed test as appropriate to estimate the effect size (Cohen\u0026rsquo;s d) at baseline and post-intervention, with 95% CI. Continuous data is represented as the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD or median (inter-quartile range, or IQR) as appropriate. Per protocol, analysis was done. Although 243 women entered the study, baseline information was collected for all. However, for various reasons, 211 respondents completed the intervention session, and therefore, an analysis was conducted on 211 (Mahapatro et al., 2024).\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\n \u003ch2\u003eParticipants\u003c/h2\u003e\n \u003cp\u003eOverall, 921 pregnant women were screened, of whom 678 also had DV but were not eligible for or excluded from the study. In total 243 women were randomized into either the intervention (n\u0026thinsp;=\u0026thinsp;121) or control (n\u0026thinsp;=\u0026thinsp;122) group. Thirty-two women (13.2%) dropped out of the analysis, and the major reasons were that women (n\u0026thinsp;=\u0026thinsp;12) had miscarriages after recruitment, were lost to follow-up (n\u0026thinsp;=\u0026thinsp;16), and could not complete the intervention session (n\u0026thinsp;=\u0026thinsp;4). Therefore, 211 women entered the intervention and control groups, and data collection was completed for all 211 women (Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). Most of them (205/211\u0026thinsp;=\u0026thinsp;97%) attended all the intervention sessions. All the participants were enumerated, and there is no missing data. There were no reports of adverse events or harm arising from participation in the study (Mahapatro et al., 2024).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\n \u003ch2\u003eThe preliminary analysis\u003c/h2\u003e\n \u003cp\u003eThe mean (SD) of the women\u0026apos;s age in the intervention group was 25.3 (3.6) years, and in the control group, it was 24.5 (3.6) years (Table-1). About 18% of the women in the intervention group and 25% in the control group had 12 years of schooling or more. Women were predominantly housewives (95%) and belonged to a lower economic category. At baseline, the intervention and control groups were comparable on all but one of the characteristics\u0026mdash;specifically, more women were living in joint families in the control group (about 87%) than in the intervention group (about 70%). In India, a joint family can be viewed as having conflict and stress, with women deprived of decision-making power and a sense of security from the family members due to the collectiveness of the group. The socio-demographic characteristics of the women respondents can be found in Table-1.\u003c/p\u003e\n \u003cp\u003eThese\u003c/p\u003e\n \u003cp\u003estudies provide a more nuanced understanding of factors influencing and mediating empowerment.\u003c/p\u003e\n \u003cp\u003eThese\u003c/p\u003e\n \u003cp\u003estudies provide a more nuanced understanding of factors influencing and mediating empowerment.\u003c/p\u003e\n \u003cp\u003eThese\u003c/p\u003e\n \u003cp\u003estudies provide a more nuanced understanding of factors influencing and mediating empowerment.\u003c/p\u003e\n \u003cp\u003eThese\u003c/p\u003e\n \u003cp\u003estudies provide a more nuanced understanding of factors influencing and mediating empowerment.\u003c/p\u003e\n \u003cp\u003eEmpowerment needs to be viewed as a highly contextualized, multi-dimensional process of which\u003c/p\u003e\n \u003cp\u003ewomen themselves have differing perspectives. Hence, it is important to understand subjectivities and\u003c/p\u003e\n \u003cp\u003ethe respective influencing factors in specific contexts, as well as how they interlink. Approaches to\u003c/p\u003e\n \u003cp\u003eunderstanding empowerment as a relational and processual concept take social structures and agency\u003c/p\u003e\n \u003cp\u003einto account. The link to resilience sheds light on how project interventions and policies can target\u003c/p\u003e\n \u003cp\u003eparticular dimensions of empowerment to foster coping, adaptation and transformative capacities so\u003c/p\u003e\n \u003cp\u003ewomen can effectively participate in decision-making processes, which translate into resilience.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eChanges at the personal level\u003c/strong\u003e:\u003c/p\u003e\u003cspan\u003e\n \u003cp\u003eIntervention effect on quality of life (QOL)\u003c/p\u003e\n \u003c/span\u003e\n \u003cp\u003eThe primary outcome was QOL. In the post-intervention period, there were significant mean changes in the intervention group in QOL subscales for both domains compared to the baseline. After 28 weeks, the between-group difference indicated a statistically significant increase in the QOL in the intervention group compared to the control group (Mahapatro et al., 2024).\u003c/p\u003e\u003cspan\u003e\n \u003cp\u003eIntervention effects on mental health (Stress and Depression)\u003c/p\u003e\n \u003c/span\u003e\n \u003cp\u003eThe baseline characteristics of mental health parameters were stress (study group\u0026thinsp;=\u0026thinsp;27.4(\u0026plusmn;)9.1, control group\u0026thinsp;=\u0026thinsp;26.4(\u0026plusmn;)8.9) and depression (intervention group\u0026thinsp;=\u0026thinsp;16.6(\u0026plusmn;)6.9, control group\u0026thinsp;=\u0026thinsp;15.9(\u0026plusmn;) 6.3). They are balanced initially and, therefore, comparable at the baseline. The intervention effect in the study group shows a significant difference in post-test values in psychological test scores for stress and depression, respectively. The effect size for stress in the intervention group was 11.3 (95% CI, 9.288\u0026ndash;13.283) and 1.6 (95% CI, -0.596-3.671) in the control group. The effect size for depression in the intervention group was found to be 7.3 (95% CI, 5.922\u0026ndash;8.668), and in the control group, 0.8 (95% CI, (-0.694-2.204). The intervention effect shows a significant improvement in reducing stress and depression (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), whereas, in the control group, there was no difference in stress (p\u0026thinsp;=\u0026thinsp;0.156) or depression (0.304) (Table 2).\u003c/p\u003e\u003cspan\u003e\n \u003cp\u003eIntervention effects on readiness to change\u003c/p\u003e\n \u003c/span\u003e\n \u003cp\u003eThe intervention effect shows a significant improvement in readiness to change (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001) in the intervention group compared to the control group. There is an improvement of 1.51 mean scores. Post-intervention, in the control group, there was no significant difference in the value (p\u0026thinsp;=\u0026thinsp;0.193) (Table 3).\u003c/p\u003e\u003cspan\u003e\n \u003cp\u003eIntervention effects on the dimension of spirituality\u003c/p\u003e\n \u003c/span\u003e\n \u003cp\u003eThe intervention effect in the intervention group reveals a significant difference between pre-intervention and post-intervention values in all six parameters: spiritual connection, meaning and purpose of life, enjoy (experiences of awe and wonder), wholeness and integration, spiritual strength, inner peace, hope and optimism, and faith. The intervention effect significantly improves all the parameters of spirituality (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The control group has also shown a significant improvement in the 3 domains of spiritual connection, enjoy (experiences of awe \u0026amp; wonder), wholeness, and integration (Table\u0026nbsp;4).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\n \u003ch2\u003eChanges at the relational level:\u003c/h2\u003e\u003cspan\u003e\n \u003cp\u003eIntervention effects on perceived social support\u003c/p\u003e\n \u003c/span\u003e\n \u003cp\u003eThere is no significant difference in baseline regarding perceived social support for the intervention or control groups. The intervention effect significantly improves social support in the intervention group. An increase of 3.038 scores indicates improved perceived social support (Table 5).\u003c/p\u003e\u003cspan\u003e\n \u003cp\u003eIntervention effects on DV\u003c/p\u003e\n \u003c/span\u003e\n \u003cp\u003eDV in the study has been studied under three categories: physical, sexual, and psychological violence. Psychological violence was present in every participant. Thus, when mentioning physical and sexual violence, a psychological violence component is inherently understood. Pre-intervention, all three types of violence for the intervention and control groups were comparable (Fig.\u0026nbsp;2). In the intervention group, post-intervention showed a significant decrease in physical (15%) and sexual violence (about 3%) compared to the control group (0.9% and 0.9% respectively). The three types of violence experienced by women also show a significant decrease of 12.4% in the intervention group compared to 9% in the control group. The control group had no change in physical or sexual violence from baseline to post-intervention. There was a shift to \u0026lsquo;no violence\u0026rsquo; in both the groups and to psychological violence (Table\u0026nbsp;6).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e\n \u003ch2\u003eChanges at the larger socio-environmental level:\u003c/h2\u003e\u003cspan\u003e\n \u003cp\u003eIntervention effects on awareness\u003c/p\u003e\n \u003c/span\u003e\n \u003cp\u003eTo enhance women\u0026apos;s social functioning at an environmental level, BIP intended robust awareness generation amongst women experiencing DV regarding their legal rights, resources, and entitlements to facilitate financial independence and uplift the standard of living. BIP is an endeavour to improve women\u0026apos;s health outcomes by empowering them to manage the challenges presented by society\u0026apos;s discriminatory and rigid gender-biased attitude. Table\u0026nbsp;7 depicts that women were largely unaware of their rights and entitlements. Pre-intervention, there was no difference in awareness levels between the intervention and control groups. Post-intervention shows an increase in awareness that is statistically significant in the intervention group compared to the control group.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eOverall, the study showed the potential of BIP intervention, which was significantly effective at all three levels (personal, relational, and socio-environmental) for pregnant women who experienced DV in India. The holistic strategies of BIP, which use yoga-based techniques, interpersonal skill development techniques, regular counselling sessions, group activities, and awareness sessions, have been instrumental in addressing the core issues curtailing women\u0026rsquo;s agency and rights. At a personal level, the BIP intervention was effective in improving QOL, reducing stress and depression, and increasing their readiness to change. In addition, the post-intervention effect significantly improves all the parameters of spirituality. It was revealed that regular practice of yoga-based techniques, spiritual immersion, and self-care enabled women to develop a positive self-perception. Even the women in the control group showed a positive effect on three sub-scales of the spirituality parameter, which may be because they were given personal and individual time to explain all the facets of routine ANC care empathetically and respectfully. Regular follow-up, which was part of the study design, helped them develop a sense of trust and rapport, leading to a cathartic release. Further, it highlights the therapeutic importance of just listening attentively. Similar study outcomes have been reported elsewhere (Dinmohammadi et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Evans et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Faltinsen et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAt the relational level, the post-BIP intervention effect shows a significant improvement in perceived social support in the intervention group. Psychological violence was present in every participant. There was a shift from physical and sexual violence to psychological violence and \u0026lsquo;no violence\u0026rsquo;. Both groups showed this phenomenon, explaining the apparent increase in psychological violence and further cementing the reduction in the number of those who faced physical and sexual violence and all three types of violence. The trauma and the humiliation of physical and sexual violence leave a deep impact. Thus, a significant reduction in physical and sexual violence indicates the effectiveness of BIP. The reduced severity of DV may also be due to quality of life and empowerment of women as the intervention was focused on women only during the study period. However, the psychological violence persisted (Chen et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). It may be further corrected with long-term interventions, which include psycho-education programme for other family members.\u003c/p\u003e \u003cp\u003eAt societal level, post-intervention shows a significant increase in awareness. During the pre-intervention in both groups, women were largely unaware of various rights and entitlements. Post-intervention, there was a significant increase in awareness in the intervention group. There is an increase in awareness in the control group. The reason may be that they became aware while asking the women about various policies, programmes, and schemes. It establishes that making women aware of their rights and ensuring their legal and welfare entitlements enables them to become financially stable and empowers them to stand up for themselves and cope with the challenges of daily life (Ahmed, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2005\u003c/span\u003e; Morgan \u0026amp; Coombes, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2013\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe type of power relationship under the empowerment framework focuses on power from within, as was very much indicated by this BIP intervention (Sardenberg, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). The linkage to resilience focused on how interventions targeted particular dimensions of empowerment to reduce stress and depression, readiness to change, and transformative capacities to effectively utilize their rights and entitlements, translating into resilience (Chen \u0026amp; Tanaka, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Other factors may also influence the effectiveness of BIP; for example, with increasing gestational age, women were more focused on self-care and a deeper sense of spirituality, and family members and spouses were less likely to commit severe forms of violence and seek social support. This result was consistent with studies conducted in Asian countries and worldwide (Tiwari et al., \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2005\u003c/span\u003e; Sardenberg, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). Although the women in the intervention group acquired the skills learned during the intervention, retaining them longer would build their resilience (Kabeer, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2012\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eStrengths and limitations\u003c/p\u003e \u003cp\u003eTo the best of our knowledge, this is the first RCT to examine the effects of a BIP intervention on the empowerment and resilience of pregnant women in India who have experienced DV. We highlighted the effectiveness and feasibility of employing an innovative, integrated approach.\u003c/p\u003e \u003cp\u003eThis study has several limitations. First, all measures were self-reported, introducing potential subjective bias. Women's initial responses may also be influenced by their level of trust and rapport established during the intervention. Additionally, focusing solely on women's coping efforts without considering their partners' and families' roles in the therapeutic process is a limitation. Without fully understating the action of the perpetrator (due to attitude, value, psychopathology, personality disorder, socio-cultural conditioning, etc.) in which DV occurs is a limitation.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eGiven India's diverse culture, the BIP may be an effective approach for empowering pregnant women from low socioeconomic backgrounds facing DV who seek ANC at public hospitals in India, ultimately enhancing their quality of life. Currently, there is no standardized intervention in India that specifically addresses the psychosocial health needs of women experiencing violence. The BIP can be broadly adopted and implemented in settings focused on support, screening, management, and empowerment of women in distress, thereby protecting the health of pregnant women.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eData availability statements: All data generated or analysed during this study are included in this published article [and are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003ePlease check the table 7 has it is referenced but not uploaded: included in the manuscript\u003c/p\u003e\n\u003cp\u003ePlease add the full date of first registration in the format DD/MM/. . (09/01/2021), alongside the registration number, in the text of your manuscript- included The Indian Registry of Clinical Trials number is CTRI/2019/01/017009 dated 9.1.2019.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eManuscripts reporting results of a clinical trial must conform to CONSORT 2010 guidelines- CONSORT checklist attached\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePlease could you also provide a separate document detailing the trial protocol- Attached\u003c/p\u003e\n\u003cp\u003ePlease upload the detailed trial protocol and CONSORT Checklist in the \u0026apos;Related manuscript files\u0026apos; section only as these documents are not subjected to publication.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003e\u0026bull; Dr. Meerambika Mahapatro: Conceived the project, developed tools and the intervention package, validated the data, and wrote the report.\u0026bull; Dr. Sudeshna Roy, Dr. Poonam Nayar, Dr. Ashwini Jadhav, Ms. Suruchi Panchkaran and Gunjan Chandhok: Data collection.\u0026bull; Ms. Divyanshu Srivastava: Data analysis.\u0026bull; Prof. Sudha Prasad: Managed resources at the hospital.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThe authors would like to thank Dr. Manoj Kumar Das (Inclen Indian) and Dr. Guresh Kumar (AIIMS, New Delhi) for their valuable contributions and support.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eAll data generated or analysed during this study are included in this published article [and are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAbbasi, A., Davarniya, R., Mohammadi, M. \u0026amp; Babaiegarmkhani, M. 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(1993). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.researchgate.net/profile/John-Ware-6/publication/313050850_SF-36_Health_Su rvey_Manual_Interpretation_Guide/links/594a5b83aca2723195de5c3d/SF-36-Health-Survey\u003c/span\u003e\u003cspan address=\"https://www.researchgate.net/profile/John-Ware-6/publication/313050850_SF-36_Health_Su rvey_Manual_Interpretation_Guide/links/594a5b83aca2723195de5c3d/SF-36-Health-Survey\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e -Manual-Interpretation-Guide.pdf.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWHO. WHOQOL-SRPB User\u0026rsquo;s Manual. Scoring and Coding for the WHOQOL-SRPB Field-test Instrument. Mental Health: Evidence \u0026amp; Research, Department of Mental Health \u0026amp; Substance Dependence. (2002). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://iris.who.int/bitstream/handle/10665/77778/WHO_MSD_MER_Rev.2012.05_eng.pdf?\u003c/span\u003e\u003cspan address=\"https://iris.who.int/bitstream/handle/10665/77778/WHO_MSD_MER_Rev.2012.05_eng.pdf?\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e sequence\u0026thinsp;=\u0026thinsp;1.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable-1 Comparison of socio-demographic variable data in intervention and control groups\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 283px;\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003eIntervention Group\u003c/p\u003e\n \u003cp\u003eN=105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eControl Group\u003c/p\u003e\n \u003cp\u003eN= 106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003eP-Value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 283px;\"\u003e\n \u003cp\u003eAge (in years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e25.3(\u0026plusmn;)4.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e24.5\u0026plusmn;3.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eCaste\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eGeneral\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e36(34.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e36(34.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.487\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eOBC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e57(54.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e60(56.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e12(11.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e10(9.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eReligion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eHindu\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e34(32.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e40(37.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.999\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eMuslim\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e71(67.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e66(62.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eWomen Education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eIlliterate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e8(7.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e10(9.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.318\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e10(9.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e17(16.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eMiddle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e26(24.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e16(15.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eHigh-school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e34(32.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e44(41.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eAbove higher-secondary school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e27(25.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e19(17.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eHusband education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eIlliterate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e12(11.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e12(11.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.227\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e8(7.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e11(10.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eMiddle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e29(27.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e27(25.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eHigh-school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e33(31.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e32(30.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eAbove higher-secondary school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e23(21.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e24(22.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eWomen occupation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eHouse-wife\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e100(95.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e101(95.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.999\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eWorking\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e5(4.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e5(4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eHusband occupation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eOrganized sector\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e68(64.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e58(54.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.460\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eSelf-employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e15(14.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e30(28.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e22(21.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e18(17.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eType of family\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e31(29.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e14(13.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.754\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eJoint\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e74(70.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e92(86.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 283px;\"\u003e\n \u003cp\u003eTotal family income (in Rs per month)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e20599.0(\u0026plusmn;)23795.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e22845.3(\u0026plusmn;)28706.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.545\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eValues are expressed as mean \u0026plusmn; SD or frequency (%)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable-2: Comparison of stress and depression between intervention and control group, pre and post-intervention\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"638\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMental health\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntervention Group\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;N=105\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(mean\u0026plusmn;S.D)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eControl\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;N=106\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(mean\u0026plusmn;S.D.)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEffect Size\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMean difference (95% C.I.)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-Value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003eStress (N2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003ePre\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e26.4(\u0026plusmn;)8.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e27.4(\u0026plusmn;)9.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.996\u003c/p\u003e\n \u003cp\u003e(-1.451,3.444)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.423\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003ePost\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e15.1(\u0026plusmn;)9.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e25.8(\u0026plusmn;)11.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e10.744\u003c/p\u003e\n \u003cp\u003e(7.993,13.495)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eEffect Size\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e(9.288,13.283)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e(-0.596,3.671)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eP-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e0.156\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003eDepression (ADI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003ePre\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e15.9(\u0026plusmn;)6.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e16.6(\u0026plusmn;)6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.642\u003c/p\u003e\n \u003cp\u003e(-1.155,2.440)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.482\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003ePost\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e8.6(\u0026plusmn;)5.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e15.8(\u0026plusmn;)7.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e7.183\u003c/p\u003e\n \u003cp\u003e(5.401,8.964)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eEffect Size\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e(5.922,8.668)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e(-0.694,2.204)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eP-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e0.304\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable-3 Comparison of readiness to change between intervention and control group, pre and post-intervention\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"529\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOutcome Variable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre-Intervention (mean\u0026plusmn;S.D.)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost-Intervention (mean\u0026plusmn;S.D)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTwo-sided\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntervention Group\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;N=105\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e1.32(\u0026plusmn;)1.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e2.83(\u0026plusmn;)0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;N=106\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e1.25(\u0026plusmn;)0.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1.37(\u0026plusmn;)1.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.193\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable-4: Comparison of spirituality domains between intervention and control group, pre and post-intervention\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"638\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 181px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOutcome Variable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntervention Group\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;N=105\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(mean \u0026plusmn; SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eControl\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;N=106\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(mean \u0026plusmn; SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEffect Size\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMean diff(95% C.I.)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-Value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSpiritual Connection\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e11.8(\u0026plusmn;)3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e11.8(\u0026plusmn;)3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e0.087*\u003c/p\u003e\n \u003cp\u003e(-0.92,1.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.865\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e13.1(\u0026plusmn;)2.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e10.9(\u0026plusmn;)3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-2.190\u003c/p\u003e\n \u003cp\u003e(-3.12,-1.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEffect Size\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e(1.97,-0.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e(0.33,1.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMeaning \u0026amp; Purpose of Life\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e11.0(\u0026plusmn;)3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e11.0(\u0026plusmn;)3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e0.075*\u003c/p\u003e\n \u003cp\u003e(-0.87,1.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.876\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e12.5(\u0026plusmn;)3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e10.8(\u0026plusmn;)3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-1.675\u003c/p\u003e\n \u003cp\u003e(-2.57,-0.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEffect Size\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e(-2.24,-0.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e(-0.42,0.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e0.466\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEnjoy (Experiences of Awe \u0026amp; Wonder)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e10.9(\u0026plusmn;)2.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e11.0(\u0026plusmn;)3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e0.171\u003c/p\u003e\n \u003cp\u003e(-0.72,1.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.708\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e12.3(\u0026plusmn;)3.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e10.2(\u0026plusmn;)3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-2.012\u003c/p\u003e\n \u003cp\u003e(-2.88,-1.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEffect Size\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e(-2.06,-0.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e(0.16,1.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWholeness \u0026amp; Integration\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e10.3(\u0026plusmn;)2.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e10.8(\u0026plusmn;)3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e0.51\u003c/p\u003e\n \u003cp\u003e(-0.32,1.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.230\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e12.0(\u0026plusmn;)3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e10.1(\u0026plusmn;)3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-1.94\u003c/p\u003e\n \u003cp\u003e(-2.78,-1.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEffect size\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e(-2.44,-1.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e(0.07,1.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-Value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e0.029\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSpiritual Strength\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e11.2(\u0026plusmn;)3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e10.7(\u0026plusmn;)3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-0.43\u003c/p\u003e\n \u003cp\u003e(-1.41,0.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.396\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e12.7(\u0026plusmn;)3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e10.3(\u0026plusmn;)3.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-2.403(-3.32,-1.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEffect size\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e(-2.22,-0.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e(-0.23,1.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-Value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e0.188\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInner Peace\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e10.9(\u0026plusmn;)5.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e10.2(\u0026plusmn;)3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-0.74\u003c/p\u003e\n \u003cp\u003e(-1.94,0.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.231\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e12.2(\u0026plusmn;)3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e10.0(\u0026plusmn;)3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-2.191\u003c/p\u003e\n \u003cp\u003e(-3.07,-1.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEffect size\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e(-2.37,-0.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e(-0.51,0.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-Value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e0.684\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHope \u0026amp; Optimism\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e10.5(\u0026plusmn;)3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e10.4(\u0026plusmn;)3.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-0.33*\u003c/p\u003e\n \u003cp\u003e(-0.95,0.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.944\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e11.9(\u0026plusmn;)3.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e10.3(\u0026plusmn;)3.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-1.594\u003c/p\u003e\n \u003cp\u003e(-2.48,-0.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEffect size\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e(-2.18,-0.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e(-0.56,0.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-Value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e0.794\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFaith\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e11.3(\u0026plusmn;)3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e10.8(\u0026plusmn;)3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-0.494\u003c/p\u003e\n \u003cp\u003e(-1.45,0.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.311\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e13.1(\u0026plusmn;)3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e10.5(\u0026plusmn;)3.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-2.57\u003c/p\u003e\n \u003cp\u003e(-3.48,-1.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEffect size\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e(-2.47,-1.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e(-0.38,1.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-Value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e0.375\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e* the difference is because of the rounding effect\u003cstrong\u003e\u003cbr\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable-5 Comparison of perceived social support between intervention and control group, pre and post-intervention\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOutcome variable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre-Intervention\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost-Intervention\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTwo sided P\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntervention group\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(N=105)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(mean\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u0026plusmn; S.D.)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e3.03 (\u0026plusmn;) 1.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e6.1(\u0026plusmn;)1.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eControl group\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(N=106)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(mean\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u0026plusmn;\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;S.D.)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e4.08(\u0026plusmn;)1.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e4.33(\u0026plusmn;)2.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e0.281\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEffect size\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e1.02(0.50,1.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e-1.76(-2.31,-1.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable-6: Comparison of domestic violence between intervention and control group, pre and post-intervention\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"627\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of Violence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 269px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntervention Group\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eN=105\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 254px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eControl group N=106\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre-intervention N=105 (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost-intervention N=105 ( %)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre-intervention N=106 (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost-intervention\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eN=106 (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003ePsychological\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e43(41.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e65(62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e47(44.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e51(48.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e0.047\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003ePhysical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e33(31.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e17(16.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e23(21.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e22(20.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003eSexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e5(4.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e2(1.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e0.083\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e12(11.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e11(10.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003eAll 3 types\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e24(22.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e11(10.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e24(22.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e14(13.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003eNo violence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e10(9.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e8(7.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable-7: Comparison of awareness between intervention and control group, pre and post-intervention\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"638\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eOutcome Variable- Awareness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eIntervention\u003c/p\u003e\n \u003cp\u003eN=105\u003c/p\u003e\n \u003cp\u003eFrequency (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003cp\u003eN=106\u003c/p\u003e\n \u003cp\u003efrequency(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eWithin Group\u003c/p\u003e\n \u003cp\u003e(Chi-square)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003eP-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eDV Act\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003ePre\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e21(20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e33(31.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e3.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e0.082\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e84(80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e73(68.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003ePost\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e104(99)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e67(63.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e44.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e1(1.0)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e39(36.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eBetween group (McNemar)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e81.012\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e19.446\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eP-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eHelp line\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003ePre\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e23(22.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e26(24.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e0.745\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e81(77.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e80(75.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003ePost\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e104(99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e102(96.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e1.815\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e0.369\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e1(1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e4(3.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eBetween group (McNemar)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e78.013\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e68.598\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eP-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eShelter Services\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003ePre\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e2(1.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e11(10.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e6.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e0.019\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e103(98.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e95(89.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003ePost\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e104(99)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e36(34.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e100.082\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e1(1.0)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e70(66.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eBetween group (McNemar)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e100.010\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e14.049\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eP-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eFamily Counseling Cell\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003ePre\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e5(4.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e13(12.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e3.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e0.082\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e99(95.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e93(87.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003ePost\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e104(99)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e27(25.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e121.308\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e1(1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e79(74.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eBetween group (McNemar)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e96.010\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e4.971\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eP-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e0.026\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eLegal Protection Measures\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003ePre\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e3(2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e17(16.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e10.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e102(97.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e89(84.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003ePost\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e104(99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e42(39.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e87.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e1(1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e64(60.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eBetween group (McNemar)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e99.010\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e12.255\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eP-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eNGO/Civil Society\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003ePre\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e4(3.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e15(14.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e6.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e100(96.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e91(85.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003ePost\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e104(99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e66(62.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e45.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e1(1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e40(37.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eBetween group (McNemar)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e97.010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e40.984\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eP-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eOne \u0026nbsp; \u0026nbsp; Stop Centre\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003ePre\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e1(1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e6(5.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e3.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e0.119\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e104(99.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e100(94.3)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003ePost\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e104(99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e34(32.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e104.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e1(1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e72(67.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eBetween group (McNemar)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e101.010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e20.250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eP-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"empowerment, resilience, domestic violence, quality of life, behavioural intervention, RCT","lastPublishedDoi":"10.21203/rs.3.rs-5795896/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5795896/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eWomen empowerment programs may reduce domestic violence (DV) by taking control of their lives. In a cognizant effort to empower pregnant women who have experienced DV, a Behaviour Intervention Package (BIP) was developed and used. It incorporates yoga-based techniques for self-development, interpersonal skill development, and awareness sessions. The study aims to assess the effects of a BIP on empowerment and resilience among pregnant women who have experienced violence and were attending antenatal care at a tertiary care hospital in India.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA randomised controlled trial was conducted with 211 pregnant women recruited between 18 to 20 weeks of pregnancy and randomly assigned to intervention (n\u0026thinsp;=\u0026thinsp;105) or control (n\u0026thinsp;=\u0026thinsp;106). The intervention group received behavioural intervention and standard care, while the control group received only standard care for 28 weeks. The study tools were completed once before the intervention and again at six weeks postnatal. The assessments were compared using methods as appropriate to estimate the effect size at baseline and post-intervention.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe results showed that at a personal, relational, and socio-environmental level, the BIP intervention effectively improved quality of life, reduced DV, reduced stress and depression, and all parameters enabled women to develop a positive self-perception. They also reported being resilient and hopeful about their future.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe BIP may effectively empower pregnant women from low socioeconomic backgrounds facing DA in India, enhancing their quality of life. With no standardized intervention currently available, the BIP can be implemented in supportive settings to address the psychosocial health needs of women in distress and protect their health.\u003c/p\u003e\u003ch2\u003eTrial registration\u003c/h2\u003e \u003cp\u003eThe Indian Registry of Clinical Trials number is CTRI/2019/01/017009 dated 9.1.2019.\u003c/p\u003e","manuscriptTitle":"Effect of behavioural intervention package on empowerment and resilience among the pregnant women in India experiencing domestic violence: A facility-based randomized control trial","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-02-03 18:07:18","doi":"10.21203/rs.3.rs-5795896/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-08-19T14:50:58+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-16T05:02:00+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"13536913226229695898239816620785711067","date":"2025-07-22T11:58:21+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-12T21:28:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"98733500837893453554125528981624309937","date":"2025-05-12T20:38:28+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-05-11T18:22:23+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-04-02T21:20:43+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-01-30T18:17:31+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-01-30T07:23:17+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2025-01-09T11:00:40+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e1d4a3d7-1be2-4f12-8f8b-ce238aceb555","owner":[],"postedDate":"February 3rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":43640162,"name":"Earth and environmental sciences/Environmental social sciences"},{"id":43640163,"name":"Health sciences/Health care"}],"tags":[],"updatedAt":"2025-11-11T15:38:18+00:00","versionOfRecord":[],"versionCreatedAt":"2025-02-03 18:07:18","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5795896","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5795896","identity":"rs-5795896","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}