8. UCT: Insights into the implementation study

OPTIMIZING SEXUAL AND REPRODUCTIVE HEALTH FOR OUR ADOLESCENTS AND YOUNG PEOPLE

Prof Cathy Ward, Dr Hlengiwe Sacolo, Chelsea Coakley, Consolata Nsanzimpaka Nsanzubuhoro, A/ Prof Elona Toska

OUTLINE

AFRICA YOUTH’S CHALLENGES!

Africa has the youngest population in the world and will count

100 millions more youth by 2030 (UN DESA, 2019)

4,500

New HIV infections among adults (aged 15 years and older) every day

Among young men (aged 15-24 years)

Among young women (aged 15-24 years)

Among young people (aged 15-24 years)

Africa has the highest number of HIV infections and highest number of new infections among among youth (UNAID, 2020)

WHY AN APP FOR SRH?

MOBILE PHONE USE & ADOLESCENTS’ SRH?

Access to internet: 69% of youth worldwide (40% only in Africa)

Public health experts and policymakers suggest that the use mobile phone for health will improve ASRHR

With the increasing internet coverage, mHealth presents opportunities to increase adolescent’s SRH knowledge

Future mHealth programme implementations can benefit from ongoing research on the topic

SEX DIFFERENCES

SOUTH AFRICA

Findings – only health use combined with social media makes a difference!

• No significant association between phone access and sexual risk behaviours

• Health content use is associated with reduced risks of sex after substance use (in general and mainly for boys) and infrequent condom use (in general and for both boys and girls)

Banougnin, Toska, et al. analyses in progress.

DESIGNING PUBLIC HEALTH INTERVENTIONS COMPLEX ISSUES, COMPLEX SOLUTIONS

STUDY TEAM

Prof Cathy Ward

Investigator

Investigator

Dr

PHASE 1. FORMATIVE RESEARCH

1.

To understand initial impressions of the look and feel, usability and content of the App including the acceptability of survey questions.

To explore potential barriers and facilitators to initial engagement.

To explore experiences and lessons learnt (what worked well and what didn’t)

PHASE 2. RESEARCH OBJECTIVES

1. To use the inbuilt data collection system, pre- and postintervention surveys, and qualitative interviews to investigate initial evidence of effectiveness on target outcomes by evaluating the effect of the programme on primary and secondary outcomes

2. To examine the impact of the Love Land App in promoting positive behaviour change (including developing adolescents’ decision making, communication and negotiation skills in a safe virtual environment to prevent early sexual initiation, unwanted pregnancies, STIs and sexual violence).

WHAT DO WE NEED TO ESTABLISH EFFECTIVENESS

• POPULATION: age-group, location, platform (school, community), etc.

• INTERVENTION: design refined and tested with young people

• CONTROL: school-based study?

• OUTCOME(S): knowledge, beliefs, norms, self-reported practices, access to SRH services

• TIMELINE: how long do we expect change to take place in/ happen

How do we get what works to people with greater quality, speed, fidelity, efficiency, and relevant coverage?

IMPLEMENTATION SCIENCE: REQUIREMENTS FOR SUCCESS

WHAT HOW WHO + WHERE

Implementation Science

Adapted from the

Research Network

SEX DIFFERENCES

Mzantsi Wakho: access & social media use works differently for boys and girls!

Access and social media use were non-protective of multiple sexual partnership for boys but protective for girls

IMPLEMENTATION SCIENCE RESEARCH QUESTIONS (e.g.)

• Does it work the same for adolescent boys and girls?

• Does it work differently when delivered in schools or out-of-school clubs?

• Are facilitators (peers, teachers, etc.) needed?

• YOUR EXAMPLES?

STEPS

Partnerships and stakeholder engagement

development/ update

funding applications