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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
References
- Gallant M., Maticka-Tyndale E. School-based HIV prevention programmes for African youth. Soc Sci Med 2004; 58:1337-51.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Kaaya SF, Mukoma W., Flisher AJ, et al. School-based sexual health interventions in Sub-Saharan Africa: A review. J Social Dynamics 2002;28(1):46-74.
- Campbell C., Foulis CA, Maimane S., Sibiya Z. The impact of social environments on the effectiveness of youth HIV prevention: a South African case study. AIDS Care 2005;17(14):471-8.[Web of Science][Medline]
[Order article via Infotrieve]
- Visser M., Schoeman JB, Perold J. Evaluation of HIV/AIDS prevention in South African schools. J Health Psychology 2004;9(2):263-80.[CrossRef]
- Oakley A., Strange V., Stephenson J., Forrest S., MonteiroH.. Evaluating processes: A case study of a randomized controlled trial of sex education. Evaluation 2004;10(4):440-62.[Abstract]
- Wight D., Raab GM, Henderson M., et al. Limits of teacher delivered sex education: interim behavioural outcomes from randomised trial. BMJ 2002;324:1430.[Abstract/Free Full Text]
- Aarø LE, Flisher AJ, Kaaya S., Onya H., Fuglesang M., Klepp K-I., et al. Promoting sexual and reproductive health in early adolescence in South Africa and Tanzania: Development of a theory- and evidence based intervention programme. Scan J Public Health 2005;34(2):150-8.
- Bartholomew LK, Parcel GS, Kok G. Intervention Mapping: a process for developing theory- and evidence-based health education programmes. Health Education and Behaviour 1998;25(5):564-8.[Free Full Text]
- Kok G., Schaalma H., Ruiter RAC, Brug J., Empelen P.Van. Intervention Mapping: A protocol for applying health psychology theory to prevention programmes. J Health Psychol 2004;9(1):85-98.[Abstract/Free Full Text]
- Ahmed N., Flisher AJ, Jansen S. Mukoma W., Mathews C. A qualitative investigation of educators' beliefs, attitudes and behaviours towards sexual and reproductive health. 2nd African conference on Social Aspects of HIV/AIDS Research (SAHARA) Human Science Research Council, 9-12 May 2003, Cape Town.
- Chrisholm L. A. South African curriculum for the twenty first century: Report on the Review Committee on Curriculum 2005. Department of Education, South Africa; 2000. http://education.pwv.gov.za/content/documents/44.pdf
- Department of Education. Revised National Curriculum Statement grades R-9 (Schools): Life Orientation. Pretoria: Department of Education; 2002. http://education.pwv.gov.za/DoE_Sites/Curriculum/Final%20curriculum/policy/English/life%20orientation%2015-5-02.pdf
- Ajzen I. The theory of planned behavior. Organiz Behav Hum Dec Proc 1991;50:179-211.[CrossRef]
- Fishbein M. The role of theory in HIV prevention. AIDS Care 2000;12(2):273-8.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Ahmed N., Flisher AJ, Mathews C., Jansen S., Mkona W., Schaalma H. Process evaluation of the teacher training for an AIDS prevention programme. Health Ed Res 2006;21: 621-632.[CrossRef]
- NVivo qualitative data analysis software. QSR International Pty Ltd.; 2002.
- Levine S., Ross F. Perceptions and attitudes to HIV/AIDS among young adults at UCT. Occasional Paper. AIDS Services and Research Unit, UCT; 2001.
- Paulussen T., Kok G., Schaalma H., Parcel GS Diffusion of AIDS curricula among Dutch secondary school teachers. Health Ed Quarterly 1995;22(2):227-43.
- Kinsman J., Harrison S., Kengeya-Kayondo J., Kanyesigye E., Musoke S., Whitworth J. Implementation of a comprehensive AIDS education programme for schools in Masaka District, Uganda. AIDS Care 1999;11(5):591-601.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Reddy P., et al. Horizons Research Summary. Programming for HIV prevention in South African schools. Washington, DC: Population Council, 2003.
- Bandura A. Health promotion from the perspective of social cognitive theory. Psychol Health 1998;13:623-49.[CrossRef][Web of Science]
- Bandura A. Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall, 1986.
- Bandura A. Social cognitive theory and exercise of control over HIV infection. New York: Plenum, 1994. pp. 25-59.
- Buston K., Wight D., Hart G., Scott S. Implementation of a teacher-delivered sex education programme: Obstacles and facilitating factors. Health Education Research: Theory and Practice 2002;17(1):59-72.[Abstract/Free Full Text]
- Boscarino JA, DiClemente RJ AIDS knowledge, teaching comfort, and support for AIDS education among school teachers: a statewide survey. AIDS Educ Prev 1996; 8(3):267-77.[Web of Science][Medline]
[Order article via Infotrieve]
- Wight D., Abraham C. From psychosocial theory to sustainable classroom practice: developing a teacher-delivered sex education programme. Health Educ Res 2000;15:25-38.[Abstract/Free Full Text]
- Kirby D., Short L., Collins J., Rugg D., Kolbe L., Howard M., et al. School-based programmes to reduce sexual risk behaviors: a review of effectiveness. Public Health Reports 1994;109(3):339-61.[Web of Science][Medline]
[Order article via Infotrieve]
Scandinavian Journal of Public Health, Vol. 37, No. 2 Suppl,
37-47 (2009)
DOI: 10.1177/1403494808090631
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