This Article Free Full Text (Free PDF) Free References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Scopus Google Scholar Articles by Mukoma, W. Articles by Schaalma, H. PubMed PubMed Citation Articles by Mukoma, W. Articles by Schaalma, H. Social Bookmarking                         What's this?

Process evaluation of a school-based HIV/AIDS intervention in South Africa

Wanjir Mukoma

Childrenës Institute, University of Cape Town, South Africa, wanjiru.mukoma{at}uct.uct.ac.za, Adolescent Health Research Institute, University of Cape Town, South Africa, Department of Psychiatry and Mental Health, University of Cape Town, South Africa

Alan J. Flisher

Adolescent Health Research Institute, University of Cape Town, South Africa, Department of Psychiatry and Mental Health, University of Cape Town, South Africa

Nazeema Ahmed

Adolescent Health Research Institute, University of Cape Town, South Africa, Department of Psychiatry and Mental Health, University of Cape Town, South Africa

Shahieda Jansen

Adolescent Health Research Institute, University of Cape Town, South Africa, Department of Psychiatry and Mental Health, University of Cape Town, South Africa

Catherine Mathews

Adolescent Health Research Institute, University of Cape Town, South Africa, Health Systems Research Unit, Medical Research Council, South Africa, Department of Community and Public Health, University of Cape Town

Knut-Inge Klepp

Centre for Prevention of Global infections, and Department of Nutrition, University of Oslo

Herman Schaalma

Department of Health Education and Promotion, and Department of Experimental Psychology, Maastricht University, The Netherlands

Aims: This paper presents a process evaluation that assessed the fidelity and quality of implementation, as well as the acceptability and subjective evaluations of a HIV/AIDS intervention among students and teachers. Methods: The process evaluation was conducted as part of a cluster randomized controlled trial of a theory- and evidence-based school HIV/AIDS intervention in Cape Town. The intervention was designed for grade 8 high school students and delivered by teachers over a six-month period. Twenty-six schools participated in the trial, 13 in the intervention group and 13 in the control group. Results: The success of implementation was varied within and across the schools, with some teachers implementing the intervention with more fidelity than others. This was influenced by a combination of individual characteristics and institutional factors. The factors that aided implementation included compliance with the current outcomes-based education approach; provision of teacher training; provision of teacher manuals with detailed information and instructions about the lessons and activities; continued monitoring and support for teachers; and student enthusiasm for the lessons. Proper implementation was hindered by large class sizes; too many activities in the intervention; teacher resistance to and inexperience in using participatory methods; teacher turnover; the low status of life orientation compared to other subjects; and a general disregard for life orientation among students. Conclusions: These findings are important for improving the intervention and contextualizing the results of the outcome evaluation; and to better plan for further large scale dissemination of school-based HIV/AIDS intervention programmes.

Key Words: HIV/AIDS • process evaluation • adolescents • school • South Africa

Scandinavian Journal of Public Health, Vol. 37, No. 2 Suppl, 37-47 (2009)
DOI: 10.1177/1403494808090631


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?