Feasibility and acceptability of a life skills and reproductive health empowerment intervention for young newly married women in Rajasthan, India: a pre-post convergent mixed methods pilot study - PubMed (original) (raw)

Feasibility and acceptability of a life skills and reproductive health empowerment intervention for young newly married women in Rajasthan, India: a pre-post convergent mixed methods pilot study

Lakshmi Gopalakrishnan et al. Pilot Feasibility Stud. 2025.

Abstract

Background: In India, newly married young women (18-25 years of age) face high rates of unintended pregnancy. Poor sexual and reproductive health knowledge combined with restrictive social norms leads to adverse pregnancy outcomes among young women, while limited female autonomy prevents them from accessing accurate healthcare information and support. We examined the feasibility and acceptability of TARANG, a life skills and reproductive health empowerment intervention developed for and with young newly married women using a community-engaged approach.

Methods: We report the findings from a convergent mixed-methods, single-group cluster pilot study in Rajasthan, India. We recruited 42 newly married women as participants in our study. Of these, 41 participants (retention rate = 97.6%) completed both baseline and endline surveys in July 2023 and January 2024, respectively. The intervention comprised 16 weekly sessions. Attendance was tracked electronically. We assessed three primary outcomes: feasibility (proportion completing ≥ 50% sessions), acceptability (proportion satisfied/somewhat satisfied), and usefulness (proportion finding TARANG useful/somewhat useful). Twelve participants were interviewed to understand intervention acceptance and usefulness, and 6 program staff and moderators were interviewed to understand implementation barriers. We analyzed quantitative data using descriptive statistics and qualitative data using thematic analysis.

Results: Thirty-five participants completed at least one session, with 73.8% attending at least half of the sessions (6 did not attend any sessions). Among those who attended at least one session, 97.1% were satisfied/somewhat satisfied, and 100% found the intervention useful/somewhat useful. Qualitative findings revealed participants' appreciation for open discussions on sensitive topics like family planning. The intervention filled knowledge gaps in family planning methods, fostered social connections through rapport building, enhanced sense of agency, and improved relationships with mothers-in-law and husbands. Implementation barriers included women's workload, cultural norms of extended stays at natal homes, and the need for intense rapport building. These insights informed intervention refinements, including session modifications, increased engagement strategies, and integration of educational videos.

Conclusion: Our pilot study demonstrated high acceptability and feasibility, with multiple benefits for young, newly married women. Our findings informed adaptations to enhance TARANG's delivery and satisfaction. The effectiveness of TARANG will be tested in a larger cluster randomized controlled trial currently underway.

Trial registration: The study is registered at ClinicalTrials.gov (NCT06320964). Registered retrospectively on 13 March 2024, https://clinicaltrials.gov/study/NCT06320964.

Keywords: Contraception; Empowerment interventions; Family planning; Gender equality; Health education; Rural and tribal communities; South Asia.

© 2025. The Author(s).

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Study protocols were reviewed and approved by institutional review boards at the University of California, San Francisco (IRB number: 22–37173), and the India-based Center for Media Studies (IRB00006230). The study is registered at ClinicalTrials.gov (NCT06320964). Registered retrospectively on 13 March 2024, https://clinicaltrials.gov/study/NCT06320964 . The procedures for obtaining verbal audio-recorded informed consent from participants before data collection were approved by both the institutional review boards at the University of California, San Francisco and the India-based Center for Media Studies. Verbal audio-recorded informed consent was obtained from the participants prior to data collection. All methods were carried out in accordance with the Declaration of Helsinki guidelines and regulations. Consent for publication: Not applicable. Competing interests: The authors declare that they have no competing interests.

Figures

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Fig. 1

Timeline of TARANG intervention sessions and different modes of data collection

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