Procedures
RMA is a community-based, gender-synchronized program implemented by Pathfinder International and designed to increase use of modern spacing contraception among married adolescent girls and their husbands. Based on the Theory of Reasoned Action [Gender-matched, trained community health workers (CHWs) conducted household visits to married adolescent girls and their husbands. Household visits to married adolescent girls included monthly visits providing information and counseling on healthy timing and spacing of pregnancies and how to access and use modern contraceptive methods. Monthly household visits to husbands included these same topics. Selected female and male community members served as “mentors” and were trained to facilitate small, single-sex groups for married adolescent girls (twice monthly) and their husbands (once monthly). Content delivered in these groups included general health and life skills, reproductive health and anatomy, use of modern contraceptive methods for healthy timing and spacing of pregnancies, gender norms that impede contraceptive use and female autonomy, couple communication regarding fertility decisions, and gender-based violence. Community dialogues were convened by two trained facilitators each month at the village-level, engaging community gatekeepers and key influencers (e.g., religious and community leaders, parents, and in-laws) to create an environment supportive of healthy timing and spacing of pregnancies, including modern contraceptive use among married adolescent girls and their husbands.Data for the current study were collected via in-person surveys administered at two time points: April through June 2016 (baseline; T1) and April through June 2018 (24-month follow-up). Surveys were conducted verbally with participating wives and husbands (separately) in locations deemed to provide audio privacy. Gender-matched, trained research assistants obtained verbal consent from study participants prior to survey administration; questions were administered using tablet computers in either Hausa or Zarma and required 40–60 min to complete. Protocols incorporated World Health Organization guidelines for conducting research on violence against womenPatient privacy and confidentiality was maintained through de-identified data collection, separate encrypted file storage of any personally identifiable information collected, daily survey data backup, and sharing/analysis of only de-identified data [Ethics review boards of the University of California San Diego and the Niger Ministry of Health approved all study procedures (see protocol [