Physical and sexual gender-based violence research embedded within ‘care as usual’ sexual and reproductive health programming in rural Bolivia: a study protocol

BACKGROUND: The global effects of gender-based violence necessitate coordinated, evidence-based efforts across scientific and programmatic communities of practice. Transparent accounting of protocol implementation serves as a critical mechanism for knowledge scaffolding and fostering iterative learning, methodological refinement, and accountability. Our study purpose was to establish baseline prevalence and descriptive characteristics of physical and sexual gender-based violence experienced by adolescent and emerging adult women living in rural, resource-variable settings in Eastern Bolivia. We present a transparent account of our study protocol to strengthen and accelerate intervention efforts addressing gender-based violence. METHOD: The partnership-centered and trauma-informed protocol was implemented within an innovative embedded 'care as usual' model. Data collection occurred within a clinic-based sexual and reproductive health initiative that our programmatic partner facilitates within the communities it serves. A cohort of trained community health promoters were participant-facing, field-based study team members. An on-site study team psychologist held immediate sessions with participants who disclosed experiences of physical and sexual violence and led post-event study team debrief sessions to mitigate secondary trauma. CONCLUSIONS: The study protocol description outlines a rigorous and contextually grounded approach to gender-based violence research in rural Bolivia. We disseminate actionable steps in study implementation that prioritize equity and the safety and wellbeing of participants and study team members. Findings contribute to a deeper understanding of the dynamics of interpersonal violence in rural settings and inform culturally responsive interventions and health policy advocacy.