{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T03:21:10Z","timestamp":1788924070990,"version":"build-2803163510"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T00:00:00Z","timestamp":1697500800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T00:00:00Z","timestamp":1697500800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV-004273"],"award-info":[{"award-number":["INV-004273"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Reprod Health"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Since 2013, the World Health Organization has recommended that reproductive coercion (RC) and intimate partner violence (IPV) be addressed within reproductive health services and, in 2018, the Lancet Commission on Sexual and Reproductive Health and Rights found that RC and IPV were significant contributors to unmet need for family planning (FP) and unintended pregnancy. In Kenya, the Ministry of Health (MOH) has made reduction of unintended pregnancy and gender-based violence a primary objective. Despite this need and guidance, no clinic-based intervention models outside of the U.S. (apart from the\u00a0one described here) have demonstrated efficacy to improve FP use and reduce IPV or RC thereby reducing unintended pregnancy. ARCHES (Addressing Reproductive Coercion in Health Settings) is a brief, clinic-based intervention delivered by existing FP providers aiming to: (1) Increase women\u2019s ability to use FP without interference, (2) Provide a safe and supportive environment for IPV disclosure and referral to support services, and (3) Improve quality of FP counseling, including addressing RC and IPV. The objective of this study is to generate evidence on scaling integrated FP services (including FP, RC, and IPV) in public sector health facilities in Uasin Gishu county, Kenya via adaptation and implementation of ARCHES in partnership with the Kenya MOH.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A cluster-randomized controlled trial paired with concurrent implementation science assessments will test effectiveness of the ARCHES model, adapted for scale by the Kenya MOH, in reducing unintended pregnancy. Female FP clients aged 15\u201349\u00a0years at selected sites will complete baseline surveys (immediately prior to receiving care), immediately post-visit exit surveys, and 6-month follow-up surveys. Provider surveys will assess changes in gender-equitable attitudes and self-efficacy to address violence reported by their clients. Costs associated with scaling ARCHES will be tracked and utilized in combination with results of the effectiveness trial to assess costs and cost-effectiveness relative to the standard of care.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Discussion<\/jats:title>\n                <jats:p>This study will provide evidence of the effectiveness of a facility-based intervention to address RC and IPV within public sector FP services at scale, as adapted and implemented in Uasin Gishu county, Kenya.<\/jats:p>\n                <jats:p><jats:italic>Trial registration<\/jats:italic> Trial registered on 28 September 2023 with clinicaltrials.gov NCT06059196.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12978-023-01697-7","type":"journal-article","created":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T17:02:40Z","timestamp":1697562160000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Evaluating a scalable ARCHES (Addressing Reproductive Coercion in Health Settings) model in government health facilities in Uasin Gishu county, Kenya: study protocol for a cluster-randomized controlled trial"],"prefix":"10.1186","volume":"20","clinical-trial-number":[{"clinical-trial-number":"nct06059196","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Erin","family":"Pearson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine","family":"Uysal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Menzel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Chi","family":"Undie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Odwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilson","family":"Liambila","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay G.","family":"Silverman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,10,17]]},"reference":[{"key":"1697_CR1","unstructured":"KNBS, ICF. Kenya Demographic and Health Survey 2022: Volume 1 [Internet]. Nairobi, Kenya, and Rockville, Maryland, USA: KNBS and ICF; 2023. Available from: https:\/\/www.dhsprogram.com\/pubs\/pdf\/FR380\/FR380.pdf."},{"issue":"1","key":"1697_CR2","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1186\/1471-2393-13-69","volume":"13","author":"L Ikamari","year":"2013","unstructured":"Ikamari L, Izugbara C, Ochako R. Prevalence and determinants of unintended pregnancy among women in Nairobi, Kenya. BMC Pregnancy Childbirth. 2013;13(1):69.","journal-title":"BMC Pregnancy Childbirth"},{"key":"1697_CR3","unstructured":"Kenya Ministry of Health. Reducing Maternal Deaths in Kenya. Nairobi: Ministry of Health; 2019."},{"key":"1697_CR4","unstructured":"Hindin MJ, Kishor S, Ansara DL. Intimate partner violence among couples in 10 DHS countries: Predictors and health outcomes. 2008 Dec 1 [cited 2023 May 30]; Available from: https:\/\/www.dhsprogram.com\/publications\/publication-AS18-Analytical-Studies.cfm."},{"issue":"9","key":"1697_CR5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001723","volume":"11","author":"JG Silverman","year":"2014","unstructured":"Silverman JG, Raj A. Intimate partner violence and reproductive coercion: global barriers to women\u2019s reproductive control. PLOS Med. 2014;11(9): e1001723.","journal-title":"PLOS Med"},{"issue":"4","key":"1697_CR6","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1016\/j.contraception.2009.12.004","volume":"81","author":"E Miller","year":"2010","unstructured":"Miller E, Decker MR, McCauley HL, Tancredi DJ, Levenson RR, Waldman J, et al. Pregnancy coercion, intimate partner violence and unintended pregnancy. Contraception. 2010;81(4):316\u201322.","journal-title":"Contraception"},{"key":"1697_CR7","unstructured":"World Health Organization. Responding to intimate partner violence and sexual violence against women: WHO clinical and policy guidelines [Internet]. World Health Organization; 2013 [cited 2023 May 30]. viii, 55 p. Available from: https:\/\/apps.who.int\/iris\/handle\/10665\/85240."},{"key":"1697_CR8","doi-asserted-by":"crossref","unstructured":"ACOG Committee opinion no. 554: reproductive and sexual coercion. Obstet Gynecol. 2013;121(2 Pt 1):411\u20135.","DOI":"10.1097\/01.AOG.0000426427.79586.3b"},{"issue":"1","key":"1697_CR9","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.contraception.2016.02.009","volume":"94","author":"E Miller","year":"2016","unstructured":"Miller E, Tancredi DJ, Decker MR, McCauley HL, Jones KA, Anderson H, et al. A family planning clinic-based intervention to address reproductive coercion: a cluster randomized controlled trial. Contraception. 2016;94(1):58\u201367.","journal-title":"Contraception"},{"issue":"3","key":"1697_CR10","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1016\/j.contraception.2010.07.013","volume":"83","author":"E Miller","year":"2011","unstructured":"Miller E, Decker MR, McCauley HL, Tancredi DJ, Levenson RR, Waldman J, et al. A family planning clinic partner violence intervention to reduce risk associated with reproductive coercion. Contraception. 2011;83(3):274\u201380.","journal-title":"Contraception"},{"issue":"1","key":"1697_CR11","doi-asserted-by":"publisher","first-page":"2227371","DOI":"10.1080\/26410397.2023.2227371","volume":"31","author":"J Uysal","year":"2023","unstructured":"Uysal J, Boyce SC, Undie CC, Liambila W, Wendoh S, Pearson E, et al. Effects of a clinic-based reproductive empowerment intervention on proximal outcomes of contraceptive use, self-efficacy, attitudes, and awareness and use of survivor services: a cluster-controlled trial in Nairobi, Kenya. Sex Reprod Health Matters. 2023;31(1):2227371.","journal-title":"Sex Reprod Health Matters"},{"key":"1697_CR12","unstructured":"Silverman J, Gray K, Fonseka R, Uysal J, Boyce S, Andersen K, et al. Adaptation and efficacy of ARCHES in Kenya and Bangladesh: evidence for a brief intervention to address and prevent reproductive coercion and intimate partner violence within routine family planning counseling. Sex Violence Res Initiat SVRI Forum 2019 [Internet]. 2019 Oct 23; Available from: https:\/\/scholarworks.sjsu.edu\/faculty_rsca\/608."},{"key":"1697_CR13","unstructured":"Silverman J, Uysal J, Carter N, Muketo E, Undie C, Liambila W. Promoting female reproductive health and autonomy by addressing reproductive coercion and intimate partner violence: the ARCHES Model. In 2018."},{"key":"1697_CR14","unstructured":"Statistics KNB of, Health\/Kenya M of, Council\/Kenya NAC, Institute KMR, Development\/Kenya NC for P and. Kenya Demographic and Health Survey 2014. 2015 Dec 1 [cited 2023 May 31]; Available from: https:\/\/www.dhsprogram.com\/publications\/publication-fr308-dhs-final-reports.cfm."},{"issue":"sup1","key":"1697_CR15","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1080\/00031305.2018.1527253","volume":"73","author":"BB McShane","year":"2019","unstructured":"McShane BB, Gal D, Gelman A, Robert C, Tackett JL. Abandon statistical significance. Am Stat. 2019;73(sup1):235\u201345.","journal-title":"Am Stat"},{"key":"1697_CR16","unstructured":"International Committee of Medical Journal Editors. Defining the Role of Authors and Contributors [Internet]. 2023. Available from: https:\/\/www.icmje.org\/recommendations\/browse\/roles-and-responsibilities\/defining-the-role-of-authors-and-contributors.html."}],"container-title":["Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12978-023-01697-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12978-023-01697-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12978-023-01697-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T03:32:35Z","timestamp":1700623955000},"score":1,"resource":{"primary":{"URL":"https:\/\/reproductive-health-journal.biomedcentral.com\/articles\/10.1186\/s12978-023-01697-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,17]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["1697"],"URL":"https:\/\/doi.org\/10.1186\/s12978-023-01697-7","relation":{},"ISSN":["1742-4755"],"issn-type":[{"value":"1742-4755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,17]]},"assertion":[{"value":"28 September 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 October 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 October 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Signed informed consent will be obtained from all participants in the study. All study protocols have been approved by the IRBs at the University of California, San Diego (protocol number 201922S, 07 July 2021), the Population Council (protocol number 969, 15 May 2021), and the local IRB at Kenyatta National Hospital University of Nairobi in Kenya (protocol number P369\/05\/2021, 21 July 2021). Any modifications to this protocol will be reported to and approved by all ethics committees, updated in the trial registry and disclosed during dissemination of results. Renewals are valid through July 2024.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no completing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"155"}}