scholarly journals Young people’s experiences using an on-demand mHealth sexual and reproductive health text message intervention in Kenya: A qualitative study (Preprint)

2020 ◽  
Author(s):  
Jefferson Mwaisaka ◽  
Lianne Gonsalves ◽  
Mary Thiongo ◽  
Michael Waithaka ◽  
Hellen Sidha ◽  
...  
Keyword(s):  
Young People ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Digital Health ◽  
Intervention Development ◽  
Ease Of Use ◽  
Clinical Trial Registration ◽  
On Demand ◽  
Wide Range ◽  
Depth Interviews

BACKGROUND Digital health usability assessments can help explain how mHealth applications targeting young people with sexual and reproductive health information performed and whether or not the intended purpose was achieved. Few digital health assessments have however been conducted to evaluate young people’s perceptions regarding mHealth system interactions and content relevance on a wide range of sexual and reproductive health (SRH) topics. Additionally, majority of randomized control trials (RCTs) have focused on push messaging platforms; the mHealth field therefore lacks enough RCTs investigating on-demand mHealth SRH platforms. OBJECTIVE The objective of our study was to explore young people’s experiences using an on-demand SRH mHealth platform in Kenya. METHODS We used qualitative data related to usability of an mHealth (ARMADILLO) platform collected at the end of the intervention period. Thirty (15 females & 15 males) in-depth interviews were held with the intervention participants to elicit their experiences, opinions and perspectives on the ARMADILLO’s design and platform’s content. Study participants were randomly selected from a list of intervention arm participants to participate in the in-depth interviews. Interviews were later transcribed verbatim, translated into English, coded and analyzed thematically using NVivo version 12. RESULTS Respondents reported varied user experiences and levels of satisfaction ranging from ease of use by majority of the respondents to systematic frustrations preventing some participants from progressing to other stages. Interesting mHealth platform’s features included immediate response participants received when requesting messages, weekly remunerated quizzes, educative and informative contents’ and messages’ perceived ‘ability’ to change behaviors. Proposed platform’s enhancements included revising some concepts and words for easy understanding; make the platform interactive where young people can seek clarity when they come across difficult terms or had additional questions about the information received. CONCLUSIONS The importance of understanding the range of health literacy and technological variations when dealing with young people cannot be overemphasized. Young people as mHealth end users must be considered throughout intervention development in order to achieve optimum functionality. Additionally, young people targeted with mHealth SRH interventions need to be sensitized on mHealth platform’s interactions or any other digital health applications if implemented in a non-research setting for optimal use by the targeted audience. CLINICALTRIAL Clinical trial registration: ISRCTN85156148

Sexual and Reproductive Health Information and Experiences Among Syrian Refugee Adolescent Girls in Lebanon

2021 ◽  
Vol 31 (5) ◽  
pp. 983-998
Author(s):  
L’Emira Lama El Ayoubi ◽  
Sawsan Abdulrahim ◽  
Maia Sieverding
Keyword(s):  
Reproductive Health ◽  
Adolescent Girls ◽  
Sexual And Reproductive Health ◽  
Well Being ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Syrian Refugee ◽  
Entry Points ◽  
Depth Interviews ◽  
Source Of Information

Providing adolescent girls with sexual and reproductive health (SRH) information protects them from risks and improves their well-being. This qualitative study, conducted in Lebanon, examined Syrian refugee adolescent girls’ access to SRH information about and experiences with puberty and menarche, sex, marriage, contraception, and pregnancy. We gathered data through three focus group discussions (FGDs) with unmarried adolescent girls, 11 in-depth interviews with early-married adolescents, and two FGDs with mothers. Our findings highlighted that adolescent participants received inadequate SRH information shortly before or at the time of menarche and sexual initiation, resulting in experiences characterized by anxiety and fear. They also revealed discordance between girls’ views of mothers as a preferred source of information and mothers’ reluctance to communicate with their daughters about SRH. We advance that mothers are important entry points for future interventions in this refugee population and offer recommendations aimed to improve adolescent girls’ SRH and rights.

scholarly journals A qualitative study to identify critical attributes and attribute-levels for a discrete choice experiment on oral pre-exposure prophylaxis (PrEP) delivery among young people in Cape Town and Johannesburg, South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Janan J. Dietrich ◽  
Millicent Atujuna ◽  
Gugulethu Tshabalala ◽  
Stefanie Hornschuh ◽  
Mamakiri Mulaudzi ◽  
...  
Keyword(s):  
South Africa ◽  
Young People ◽  
User Preferences ◽  
Dosing Regimen ◽  
Group Discussions ◽  
On Demand ◽  
Study Team ◽  
Attribute Levels ◽  
Depth Interviews ◽  
Oral Prep

Abstract Background The uptake and adherence of daily oral PrEP has been poor in high-risk populations in South Africa including young people. We used qualitative research methods to explore user preferences for daily and on-demand oral PrEP use among young South Africans, and to inform the identification of critical attributes and attribute-levels for quantitative analysis of user preferences, i.e. a discrete choice experiment (DCE). Methods Data were collected between September and November 2018 from eight group discussions and 20 in-depth interviews with young people 13 to 24 years in Cape Town and Johannesburg. Using a convenience sampling strategy, participants were stratified by sex and age. Interviewers used a semi-structured interview guide to discuss several attributes (dosing regimen, location, costs, side effects, and protection period) for PrEP access and use. Group discussions and in-depth interviews were audio-recorded, transcribed verbatim and translated to English. We used framework analysis to explore context-specific attributes and attribute-levels for delivering oral PrEP in South Africa. The adolescent community advisory board, expert and study team opinions were consulted for the final DCE attributes and levels. Results We enrolled 74 participants who were 51% (n = 38/74) male, had a median age of 18.5 [Interquartile range = 16–21.25] years, 91% (n = 67/74) identified as heterosexual and 49% (n = 36/74) had not completed 12th grade education. Using the qualitative data, we identified five candidate attributes including (1) dosing regimen, (2) location to get PrEP, (3) cost, (4) route of administration and (5) frequency. After discussions with experts and the study team, we revised the DCE to include the following five attributes and levels: dosing regime: daily, and on-demand PrEP; location: private pharmacy, public clinic, mobile clinic, ATM); cost: free-of-charge, R50 (~2GBP), R265 (~12GBP); side effects: nausea, headache, rash; and duration of protection: fulltime protection versus when PrEP is used). Conclusions There is limited literature on qualitative research methods describing the step-by-step process of developing a DCE for PrEP in adolescents, especially in resource-constrained countries. We provide the process followed for the DCE technique to understand user preferences for daily and on-demand oral PrEP among young people in South Africa.

An application of Systematic Anomalous Case Analysis to improve models predicting contraceptive use in the Philippines

2021 ◽  
pp. 1-14
Author(s):  
Subasri Narasimhan ◽  
Jessica D. Gipson
Keyword(s):  
Reproductive Health ◽  
Health Outcomes ◽  
Sexual And Reproductive Health ◽  
Contraceptive Use ◽  
Sexual Debut ◽  
Case Analysis ◽  
Reproductive Behaviour ◽  
The Philippines ◽  
Health And Nutrition ◽  
Depth Interviews

Abstract Amidst persistently high unintended pregnancy rates and lags in contraceptive use, novel methodological approaches may prove useful in investigating sexual and reproductive health outcomes in the Philippines. Systematic Anomalous Case Analysis (SACA) – a mixed-methods technique – was employed to examine predictors of women’s lifetime contraceptive use. First, multivariable, longitudinal Poisson regression models predicted fertility and sexual debut using the 1998–2009 Cebu Longitudinal Health and Nutrition Surveys (CLHNS), then regression outliers and normative cases were used to identify 48 participants for in-depth interviews (2013–2014) for further examination. Qualitative findings from 24 women highlighted ‘control over life circumstances’ was critical, prompting the addition of two items to the original quantitative models predicting any contraceptive use (n=532). Each of the items, ‘what happens to [them] is their own doing’ and ‘[I] do not [have] enough control over direction life is taking [me]’, significantly and independently predicted any contraceptive use (aOR: 2.37 (CI: 1.24–4.55) and aOR: 0.46 (CI: 0.28–0.77), respectively). The findings demonstrate the utility of SACA to improve the understanding and measurement of sexual and reproductive health outcomes and underscore the importance of integrating psychosocial constructs into existing models of fertility and reproductive behaviour in the Philippines to improve sexual and reproductive health outcomes.

Sexual and Reproductive Justice for LGBTQI Youth in Policy Responses Across Eastern and Southern Africa

2021 ◽  
Author(s):  
Ingrid Lynch ◽  
Finn Reygan
Keyword(s):  
Young People ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Gender Diversity ◽  
Minority Youth ◽  
Reproductive Justice ◽  
Policy Narratives ◽  
Sexual And Gender Minority ◽  
Eastern And Southern Africa ◽  
And Gender

Both significant progress and profound backlash have occurred in the inclusion of sexual and gender diversity across eastern and southern Africa. This includes the decriminalization of homosexuality in Mozambique in 2015 and the introduction of the Anti-Homosexuality Act (later annulled) in Uganda in the preceding year. Simultaneously there is increased pressure on Ministries of Education to engage more robustly with sexual and reproductive health and rights (SRHR) education in education systems across the region. Emerging regional research points to a narrow, heteronormative focus in comprehensive sexuality education; access barriers to sexual and reproductive health services; and pervasive school-related gender-based violence, including homophobic and transphobic violence. Civil society organizations (CSOs) play a key role in developing best practice in advancing the SRHR of sexual and gender minority youth and are therefore a valuable resource for government SRHR policies and programmatic responses. The regional SRHR education policy landscape is underpinned by two policy narratives: that of young people’s SRHR as a public health concern and a focus on young people’s human rights. These policy narratives not only underpin SRHR policy in the region but also in many instances are drawn on in CSO advocacy when positioning the SRHR of lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) young people as an important policy concern. These two dominant policy narratives, however, have a narrow focus on young people’s risks and vulnerabilities, may inadvertently perpetuate stigma and marginalization of LGBTQI youth, and may limit youth voice and agency. These narratives also do not sufficiently engage local sociocultural and structural conditions that drive negative SRHR outcomes for young people in the region. Research, advocacy, and policy development toward the full realization of the SRHR of sexual and gender minority youth can address some of the limitations of health and rights-based policy narratives by drawing on a sexual and reproductive justice framework. Such a framework expands the policy focus on health risks and individual rights to include engagement with sociocultural and structural constraints on young people’s ability to exercise their rights. A sexual and reproductive justice framework provides a more robust toolkit when working toward full inclusion of sexual and gender diversity in regional school-based SRHR policy and programs.

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