Safety alarm RCT in India

Background Sexual violence is a major threat to women in Indian slums, particularly among lower caste communities. Traditional interventions are often insufficient due to structural and environmental limitations. This study evaluated the effectiveness of a low-cost, community-based alarm intervention designed to prevent sexual victimisation in urban informal settlements. Methods A single-blind cluster randomised controlled trial was conducted six residential blocks in three slums of Delhi. A total of 500 adult women were randomised by residential block into intervention (9 blocks, n=239) and control (11 blocks, n=261) groups. The intervention consisted of distributing personal safety alarms and conducting community-based training sessions. Data on sexual victimisation and psychological sense of trust were collected before and after the six-months-intervention. Statistical analyses included logistic regression and repeated-measures analysis of variance. Findings A total of 485 participants (intervention: 226, control: 259) completed both the pre-test and post-test. The vast majority of participants have experienced wide range of sexual victimisation in their lifetime, including stalking (n=413, %), verbal sexual harassment (n=338, %), and non-consensual physical contact (n=304, %). Statistically significant group-by-time interaction effects were observed for underwear theft (OR=0·207, 95%CI [0·062; 0·694]) and non-consensual physical contact (OR=0·199, 95%CI [0·059; 0·670]), favouring the intervention group. Other victimisation types declined in both groups over time, including stalking (OR = 0·30, 95% CI [0·075, 1·176], p = 0·082), verbal harassment (OR = 0·86, 95% CI [0·187, 3·987], p = 0·852), voyeuristic behaviour (OR = 0·49, 95% CI [0·040, 6·126], p = 0·583), and indecent exhibition (OR = 0·31, 95% CI [0·054, 1·746], p = 0·183). Trust scores improved significantly in the intervention group, suggesting psychosocial benefit (F(1, 966) = 41·12, p < 0·001). Interpretation The intervention demonstrated potential in reducing opportunistic forms of sexual violence and promoting trust in vulnerable communities. This context-sensitive strategy may serve as a scalable model for similar settings lacking formal protection systems.