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PREPARE PROJECT

Feedback Cape Town Nov 27 2013Dar 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 schools2

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

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IntroductionProgram objectivesBehaviour 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

condoms4

Introduction: Manuals

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PROCESS EVALUATION

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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 schoolProgress: 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 office and 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

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Performance

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

Tools: Peer and Classroom Observation tools and Weekly call tool. Results: 0 poor school, 9 (47%) Excellent schools and 10 (53%) Average schools

CAPE TOWN NOVEMBER 2013

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OUTCOME EVALUATION

Sum

mar

y of

the

impa

ct

eval

uatio

n st

udy

desi

gn I O1 X1 O2 Y O3

C O1 O2 O3 X2

Pair-wise matching and randomization (schools)

I – Intervention groupC – Comparison groupO1 – Baseline data collectionO2 – First follow up data collectionO3 – 2nd follow up data collection x1 – Interventiony – Booster sessions X2 – Delayed intervention (January, 2014)

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BaselineInvited 6,090

Recruited 5,573

388 Unable to participate Interviewed 5,185

72 Discarded Entry 5,113

8 Double ID; 3 ID missing 3 less than 20%

entered

Final 5,099

121 (2%) Did not assent312 (5%) Parents declined

105 (1.7%) Unable to read and write

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Follow Up 1 (90.7% capture)Baseline 5099

Collected 4,653

12 Discarded during baseline Entered 4,641

12 Not in Baseline3 Wrong ID

Final 4,626

• Baseline Vs FU1: 473 (9.3%)

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Follow Up 2 (84.6% capture)Baseline 5099

Collected 4,325

3 Discarded (Error in completion) Entered 4,322

7 Duplicate ID

Final 4,315

• Baseline Vs FU2: 784 (15%) Lost to follow up

• FU1 Vs FU2: 311 (6.7%) Lost to follow up

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INTERVENTION BOOSTER

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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

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DELAYED INTERVENTION

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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

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Dar Team

Site PI: Sylvia Kaaya

Co- PIs: Gad Kilonzo, Elia Mmbaga and

Khalifa Mrumbi

Coordinator & Research Fellow: Lusajo Kajula

Intervention: Juliana Joachim

Evaluation: Mrema Noel

MSc. Applied Epidemiology: Dr. Prosper Njau

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Ahsante Sana!

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