Strengthening Relationships and Mental Health Through a Couples-Based Economic Empowerment Intervention
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorTechnical University of Munich
About this trial
This sub-study is part of a larger randomized controlled trial (RCT) titled Disentangling and Preventing Economic Violence against Women (ECOVI). It is conducted in rural and urban communities across Maharashtra, Andhra Pradesh, and Rajasthan, India. The sub-study evaluates the impact of a couples-based financial literacy and gender-transformative intervention on relationship strength, empathy, and mental health among married couples. Using a two-arm cluster RCT design, 150 clusters (villages or community units) are randomized to intervention or control, with \~15 husband-wife pairs per cluster (approximately 2,250 couples in total). Outcomes are measured at baseline (pre-intervention) and endline (post-intervention) approximately six months after delivery of the intervention to assess changes in perceived relationship strength, empathy (using an adapted relationship strengths and empathy scale), and mental health (General Health Questionnaire-6, GHQ-6). The study will also explore whether improvements in relationship strength and empathy mediate the intervention's effect on mental health outcomes.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Women: 18 - 49 years, Men: 18+
Couples: Married and co-habitating, husband-wife pairs, who regard the selected cluster in the states Maharashtra, Andhra Pradesh, or Rajasthan of India as their primary residence for the study period.
Consent: Both partners provide written informed consent and agree to six sessions, baseline and endline surveys, and SMS follow-ups.
Education: Primary schooling (4th grade) complete
Disqualifiers
Either partner < 18 years
Refusal of consent or unwillingness to participate in sessions or data collection by either partner.
Serious physical or mental condition that prevents safe, active participation (e.g., severe mental illness, debilitating disease).
Trial design
Design model
Parallel
Treatments tested in this trial
Let us Grow Together: Economic Wellbeing for Families
BehavioralMarried couples in clusters assigned to the intervention receive a structured program of six community-based sessions. Each session lasts between 2.5 and 3 hours and includes participatory activities, discussions, and exercises. All six sessions would be conducted by the same two facilitators - one male and one female. The content integrates financial literacy (e.g., household budgeting, saving practices, joint financial planning) with gender-transformative training (e.g., equitable household roles, communication skills, conflict resolution, and fostering empathy between spouses). Sessions are delivered by trained facilitators in a group setting with fifteen couples, approximately every 2-4 weeks. Some sensitive content to address economic violence context would be done in a gender segregated manner separately to encourage reflections, ensure safety and reduce defensiveness. Between sessions, SMS reminders and tips are sent to participants' mobile phones to reinforce key messages and e
Treatment groups
4,500 Participants
are divided into 2 treatment groupsGroup A: Let's Grow Together InterventionExperimental treatment 1 intervention
Group B: No Structured SupportNo intervention 0 interventions
Trial outcomes
Primary outcomes
1
Mental Health Scale (General Health Questionnaire - 6)
Change in General Health Questionnaire-6 scores (psychological distress). It is scored on a scale of 0-4, where higher score indicates higher psychological distress. Hypothesis: Greater distress reduction (or well-being increase) in the intervention group.
Time frame
T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))2
Perceived Relationship Strength (PRS)
Change in the composite Relationship Satisfaction Index (adapted for study); looking at trust, communication, mutual support, conflict resolution. The scale is scored on 1-5 scale, with higher score indicating higher perceived relationship score. Hypothesis: Greater improvement in the intervention group than in controls.
Time frame
T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))3
Relational Empathy Scale (RE)
Adapted standardized Interpersonal Reactivity Index for Couples (emotional support, perspective-taking). The scale is scored on 1-5 scale, with higher score indicating higher empathy in relationship score. Hypothesis: Larger empathy gains in the intervention group.
Time frame
T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))Other outcomes
1
Proportion of the mental-health effect that is mediated
Investigators will examine whether the intervention's impact on mental health (GHQ-6 at endline) operates partly through improvements in partner empathy and relationship strength measured at endline. Baseline levels of each construct will be adjusted for to improve precision. Empathy and relationship strength will be treated as parallel, potentially correlated mediators; investigators do not assume a temporal order between them because both are only re-measured at endline. Causal mediation effects will be estimated. Investigators will report (i) the indirect effect operating through endline empathy, (ii) the indirect effect operating through endline relationship strength, (iii) the remaining direct effect, and (iv) the percentage of the total treatment effect mediated by each pathway. Cluster-robust inference will be used to reflect community-level randomisation.
Time frame
T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))2
Moderator: Gender Norm Attitudes
Binary classification based on baseline responses reflecting traditional vs progressive views on gender roles
Time frame
T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))3
Moderator: Household Economic Strain
Self-reported household financial pressure, split at the sample median into high vs low strain.
Time frame
T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))4
Moderator: Residence Type
Participant households categorized as rural or urban, based on official cluster classification.
Time frame
T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))Sponsors and contacts
Click on the lead sponsor to view all of their trials.
Technical University of Munich
Lead sponsor
European Research Council
Collaborator
Source ClinicalTrials.gov