title: Evaluating the relative effectiveness of high-intensity and low-intensity models of behaviour change communication interventions for abortion care-seeking in Bihar and Jharkhand, India: a cross-sectional study.
abstract: This study aimed to compare the effectiveness of a high-intensity model (HIM) and a low-intensity model (LIM) of behaviour change communication interventions in Bihar and Jharkhand states of India designed to improve women's knowledge and usage of safe abortion services, as well as the dose effect of intervention exposure.
  
  
  
  We conducted two cross-sectional household surveys among married women aged 15-49 years in intervention and comparison districts. Difference-in-difference models were used to assess the efficacy of the intervention, adjusting for sociodemographic characteristics.
  
  
  
  Although both intervention types improved abortion knowledge, the HIM intervention was more effective in improving comprehensive knowledge about abortion. In particular, there were improvements in knowledge on legality of abortion (AOR=2.2; 95% CI 1.6 to 2.9) and nearby sources of safe abortion care (AOR=1.7; 95% CI 1.2 to 1.3).
  
  
  
  Higher level of exposure to abortion-related messages was related to more accurate knowledge about abortion within both intervention groups. Evidence was mixed on changes in abortion care-seeking behaviour. More work is needed to ensure that women seek safe abortion services in lieu of informal services that may be more likely to lead to postabortion complications.
authors.affiliation: IDF, New Delhi, India.
authors.forename: Sushanta K
authors.initials: SK
authors.lastname: Banerjee
authors.affiliation: Ipas, Chapel Hill, North Carolina, USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Andersen
authors.affiliation: Harvard T. H. Chan School of Public Health, Global Health and Population, Boston, Massachusetts, USA.
authors.forename: Erin
authors.initials: E
authors.lastname: Pearson
authors.affiliation: IDF, New Delhi, India.
authors.forename: Janardan
authors.initials: J
authors.lastname: Warvadekar
authors.affiliation: IDF, New Delhi, India.
authors.forename: Danish U
authors.initials: DU
authors.lastname: Khan
authors.affiliation: IDF, New Delhi, India.
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Batra
mesh_terms: D000028:Abortion, Induced; D000293:Adolescent; D000328:Adult; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007194:India; D016014:Linear Models; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D014932:Women's Health Services; D055815:Young Adult
keywords: India; abortion; behaviour change; knowledge; post abortion