• 220 likes • 521 Views
PREPARE PROJECT. Feedback Cape Town Nov 27 2013 Dar Es Salaam Site – Sylvia Kaaya. Introduction. 38 Schools randomized into 19 intervention and 19 delayed intervention arms Two streams in each class 5 & 6 were randomly selected for intervention implementation (4 classes) Intervention:
E N D
PREPARE PROJECT Feedback Cape Town Nov 27 2013 Dar Es Salaam Site – Sylvia Kaaya
Introduction • 38 Schools randomized into 19 intervention and 19 delayed intervention arms • Two streams in each class 5 & 6 were randomly selected for intervention implementation (4 classes) • Intervention: • All learners in implementing classes 5 and 6 in the 19 intervention schools • Evaluation: • All learners in implementing classes 5 & 6 aged 12-14 years in the 19 intervention and delayed intervention schools
Introduction Three Programs components developed and implemented • A Classroom-based • A Peer-led • Youth friendly services • Aimed to facilitate sustainable relationships between intervention schools and youth friendly services
Introduction Program objectives Behaviour change • Delay sex initiation/ abstinence if sexually active • Consistent condom use Proximal predictors • Increased knowledge on HIV & protection • Change attitudes& norms about delayed sex initiation and condom use • Increased self-efficacy to delay sex initiation & use condoms
Objectives • Implementation • Were planned activities correctly implemented? • What challenges existed in implementation? • Quality • Were instructional methods and materials well received? • Were teachers having any difficulties in preparing lesson plans? • Were peer educators confident and prepared? • Exposure/Involvement • Are students being exposed to each session/activity? • Are students participating during the sessions/activities? • Are students comfortable talking about sexuality and reproductive health with peers? • Changed beliefs • Did the program have an impact on the way learners think about sexuality?
Data Sources • Workbooks – key sections work done by learner and graded • Program fidelity and learners acceptability of the program • Analysis from random sample of 10% workbooks from each school Progress: Data entry SPSS • Observation Forms • Assesses quality of implementation and involvement of learners • Planned at least 2 of each session observed; Have classroom (n=32), Peer sessions (n=16) and YFS (n=8) • Progress: Analysis matrices • Interview Guides – narrative data • KII (Education Municipal officeand Health workers) • FGD (exposed learners, Peer educators , teachers, head teachers, academic coordinators and Parents) Progress: Code book development and narrative entry to Nvivo Ver10 • Teacher’s lesson plan forms and Peer leaders’ Diaries Progress: Analysis • Weekly feed-back calls from implementing teachers – challenges and solutions
Performance Tools: Peer and Classroom Observation tools and Weekly call tool. Results: 0 poor school, 9 (47%) Excellent schools and 10 (53%) Average schools Excellent schools: • Team teaching • Self innovation • Sense of ownership among the teachers and students as well • Cooperation and support from the head teachers office • Morale of the teachers and the learners in implementing the program high • Good peer educators who led well the peer sessions Average schools: • No team teaching • Low morale of the teachers and peer educators in implementation • Little self innovation on how best to implement the program • Low ability of the peer educators facilitation of the peer sessions • Cooperation and support from the head teachers office • Sense of ownership among the teachers and students as well CAPE TOWN NOVEMBER 2013
Follow Up 1 (90.7% capture) • Baseline Vs FU1: 473 (9.3%)
Follow Up 2 (84.6% capture) • Baseline Vs FU2: 784 (15%) Lost to follow up • FU1 Vs FU2: 311 (6.7%) Lost to follow up
Booster • One-day in school activities developed by students • Show cased a number of activities to other students, parents and community leaders • Some of the activities included:- • Drama • Songs • Poem • Picture competition • Reproductive health talks from nurses
Delayed Intervention • Delayed intervention is planned to start in January 2014 • Formation of planning committee (n=8) • Pairing of schools (Intervention and delayed intervention) • Sharing of students, teachers and peer-educator manuals during implementation in the delayed intervention schools.
Acknowledgements • Bergen Team • Leif and Annegreet • Maastricht University • Hein De Vries • Matthijs Eggers
Dar Team Site PI: Sylvia Kaaya Co- PIs: Gad Kilonzo, Elia Mmbagaand Khalifa Mrumbi Coordinator & Research Fellow: LusajoKajula Intervention: Juliana Joachim Evaluation: Mrema Noel MSc. Applied Epidemiology: Dr. Prosper Njau