Love Shouldn't Hurt - E le Sauā le Alofa: Co-designing a Theory of Change for Preventing Violence against Women in Samoa

"[A]sking the potential recipients of an intervention what kind of intervention they would like to see and how they think it will work to achieve their own objectives is a necessary undertaking in and of itself."

Recognising the role of many research methodologies in reproducing long-standing inequities between researchers and research participants, decolonial approaches aim to bring marginalised voices into theory and intervention development. This article draws on a case study of theory of change (ToC) development as part of a participatory process for co-designing an intervention called E le Sauā le Alofa ("Love Shouldn't Hurt"), designed to prevent violence against women (VAW) in Samoa. In this study, researchers, non-governmental organisation (NGO) staff, peer researchers, and their local communities worked collaboratively to develop a ToC that reflected local priorities and needs. The article describes the process taken and reflect on the advantages and challenges of developing ToCs in partnership with communities as part of a bottom-up and decolonial approach to VAW research.

E le Sauā le Alofa is a 4-year participatory mixed-methods project to prevent VAW in Samoa through intervention co-development. A collaboration between 10 Samoan villages, the Samoa Victim Support Group (SVSG), the National University of Samoa (NUS), the Samoa Bureau of Statistics, and University College London (UCL), the project is part of EVE (Evidence for Violence prevention in the Extreme), a broader research study to understand community mechanisms of VAW reduction in the world's highest-prevalence settings. With a prevalence rate estimated at 39.6% of women experiencing physical, sexual, and/or emotional forms of violence in their lifetime (Samoa Bureau of Statistics, 2020), Samoa is above the global average of 1 in 4 women said to experience violence.

Since its inception in 2005, SVSG has developed a network of over 1,000 village representatives in villages across the country as a means of responding quickly and effectively to cases of violence. Drawing on this network, the E le Sauā le Alofa project is engaging and training 20 of these representatives and 10 village elders (mentors to the project) in collecting their own data from their local villages about VAW and strategies for its prevention, developing a ToC based on the data collected, and co-designing an intervention from the international evidence of what works to prevent VAW in community settings. E le Sauā le Alofa aims to centre indigenous perspectives on VAW and its reduction in the development of a local intervention to prevent VAW.

From November 2020 until September 2021, SVSG led a ToC development process with the 10 Samoan villages. ToCs are theories about the mechanisms through which an intervention is thought to bring about change in the health and social outcomes being addressed. The ToC process and the broader effort to co-design an intervention is based on a commitment to decolonising VAW research and honouring fa'asamoa ("the Samoan way"). The goal was to integrate Samoan cultural practices and meanings into the methods used to collect and analyse data and to put the locus of control over the project's results into the hands of SVSG's village representatives, hired as community-based researchers for the study for their intimate understanding of Samoan cultural practices and protocols.

The ToC was developed in 4 phases: (i) semi-structured interviews with village representatives (n = 20); (ii) peer-led semi-structured interviews with community members (n = 60) in which participants shared local "artefacts" from their village (songs, oral histories, proverbs, games, and traditional practices that would convey VAW; (iii) community conversations, drawing on the concept of talanoa as an open and inclusive dialogue in Pacific cultures, with 10 villages (n = 217) that featured a problem tree activity to explore the underlying causes of violence (roots), how it manifests (trunk), and its consequences for women (branches); and (iv) finalising the ToC pathways.

As reported here, the process of developing a ToC in collaboration with village representatives and their communities was complex, with several challenges arising from interactions between the social context of Samoa and global health as a field of research. The paper discusses 4 key challenges: (i) conflicting understandings of VAW as a problem (e.g., societal gender inequalities that position women as deserving of violence have shaped and framed how both men and women view women's experiences of violence); (ii) the linearity of the ToC framework in contrast to intersecting realities of people's lived experiences; (3) the importance of emotional engagement in VAW prevention (e.g., village representatives often shared stories and cried together during training workshops); and (iv) theory development as a contradictory and iterative process.

Reflecting on the experience, the researchers add that, as facilitators of a community-based process, they felt obliged not to share their own understandings of gender inequalities too early in the process, and not until community members had had a chance to fully express their own views - a process that took months of engagement, data collection, and listening through interviews, workshops, and community conversations/talanoa. They explain that this position was uncomfortable for them, particularly when community members blamed women for "frequently attending bingo" or otherwise acting in ways that were seen as "provoking" violence. However, they say, "it was through not being too quick to offer our own feminist opinions and in supporting community ownership over the process that we were able to bear witness to the ways in which unequal gender norms are often openly contested within communities."

On the other hand, the process also raised opportunities, including a deeper exploration of local meaning-making, iterative engagement with local mechanisms of violence prevention, and clear evidence of ownership by communities in developing a uniquely Samoan intervention to prevent VAW. For instance, one community presented their strategy for VAW prevention during an evening news broadcast, and another did so in the national newspaper. More broadly, the community conversations/talanoa "provided an essential space for bringing different understandings of violence and its prevention into conversation with one another at the community level, and the success of this approach appears to be in women telling their own personal stories of violence. Hearing such stories generates feelings of empathy and compassion...–...an emotional response that shifts the conversation and challenges us to think in new ways."

The ToC process of conducting workshops with village representatives and holding community conversations, while important as a process, did not produce a final consensus about what would change violence in communities. The project timeline required organisers to move on to develop and test a pilot intervention based on the ToC at the end of 2 years of fieldwork. The draft ToC will be used as a framework for ensuring that the pathways discussed during this formative stage of the study will be used to inform decisions made by village representatives about the aims of the interventions they develop for their communities. However, the researchers felt that the ToC process should continue and that hypothesised pathways of violence prevention need to be further refined and shaped as the pilot is implemented.

The article closes with three key recommendations for those interested in co-producing ToCs as part of intervention development, with a particular focus on local and indigenous communities:

1. Create an authentic space for indigenous worldviews to be used alongside the ToC development process. For example, this process may involve incorporating indigenous methodologies, such as talanoa and faafaletui (Pacific methods for holding open community conversations that weave together different perspectives and information).
2. Pay close attention to locally defined outcomes and objectives. As a concrete example from Samoa, a central thread of both cultural histories and social relationships is the church, which plays a key role in how violence is conceptualised in this context. As programme theories, ToCs often have outcomes that have been pre-defined by funders; instead, cultivating a critical openness to alternative options during the ToC development process can ensure more inclusivity in terms of how meanings of violence are appropriated and reproduced in particular contexts.
3. Be attentive to the iterative nature of the process and accepting of the fact that it may never be truly complete. ToCs are embedded within complex social systems that change over time. The researchers suggest a flexible and pragmatic approach to seeing ToCs as living co-constructed documents that are collaboratively produced and constantly updated.

The researchers conclude: "The key insight we think our study adds...is that the methodologies we use to ask communities about what they would like to see from interventions may be just as, if not more, important than the question itself."

Editor's note: Click here to listen to a podcast ("Love shouldn't hurt: What indigenous communities can tell us about preventing domestic violence") exploring this research.