Decade of research into the acceptability of interventions aimed at improving adolescent and youth health and social outcomes in Africa: a systematic review and evidence map

ObjectiveInterventions aimed at improving adolescent health and social outcomes are more likely to be successful if the young people they target find them acceptable. However, no standard definitions or indicators exist to assess acceptability. Acceptability research with adolescents in low-and-middle-income countries (LMICs) is still limited and no known reviews systhesise the evidence from Africa. This paper maps and qualitatively synthesises the scope, characteristics and findings of these studies, including definitions of acceptability, methods used, the type and objectives of interventions assessed, and overall findings on adolescent acceptability.DesignWe conducted a systematic review of peer-reviewed studies assessing intervention acceptability with young adults (aged 10–24) in Africa, published between January 2010 and June 2020.Data sourcesWeb of Science, Medline, PsycINFO, SociIndex, CINAHL, Africa-wide, Academic Search Complete and PubMed were searched through July 2020.Eligibility criteria for selecting studiesPapers were selected based on the following inclusion criteria: if they (1) reported primary research assessing acceptability (based on the authors’ definition of the study or findings) of one or more intervention(s) with adolescents and young adults 10–24; (2) assessed acceptability of intervention(s) aimed at positively influencing one or more development outcome(s), as defined by sustainable development goal (SDG) indicators; (3) reported on research conducted in Africa; (4) were in the English Language; (5) were peer-reviewed and and (6) were published between 1 January 2010 and 30 June 2020.Data extraction and synthesisAbstracts were reviewed independently by the two first authors to determine relevance. Full text of potentially eligible studies were retrieved and independently examined by the same two authors; areas of disagreement or lack of clarity were resolved through discussion by the two authors and—where necessary—the assessment of a third author.Results55 studies were considered eligible for inclusion in the review. Most studies were conducted in Southern Africa, of which 32 jointly in South Africa and Uganda. The majority of interventions assessed for acceptability could be classified as HIV or HPV vaccine interventions (10), E-health (10), HIV testing interventions (8), support group interventions (7) and contraceptive interventions (6). The objectives of most interventions were linked to SDG3, specifically to HIV and sexual and reproductive health. Acceptability was overall high among these published studies. 22 studies provided reasons for acceptability or lack thereof, some specific to particular types of interventions and others common across intervention types.ConclusionsOur review exposes considerable scope for future acceptability research and review work. This should include extending acceptability research beyond the health (and particularly HIV) sector and to regions in Africa where this type of research is still scarce; including adolescents earlier, and potentially throughout the intervention process; further conceptualising the construct of acceptability among adolescents and beyond; and examining the relationship between acceptability and uptake.

Moments of Uncertainty: Exploring How an App-Based Oral HIV Self-Testing Strategy Fits in Communities ‘Living Under’ HIV Risk

Feasibility and acceptability research for HIV self-testing (HIVST) often emphasises the importance of good test conduct and correct test interpretation for knowing one’s HIV result while overlooking the ways in which different uncertainties and meanings emerge around testing. Using empirical examples from a quantitative study assessing an app-based strategy in Cape Town, South Africa, this research article explores the practice of HIVST and how people deal with uncertainties while using the app in question, named ‘HIVSmart!’. We use the concept of ‘living under’ to explore the practices of HIV testing for those who fit the definition of being ‘at risk’ of HIV (note that an individual’s HIV status must be unknown in order for them to fit this definition) and to understand how an app-based HIVST strategy fits within these practices. We show how the app and oral self-test—as well as knowledge around HIV risk behaviours, comparisons between different testing methods, and the guidance and presence of healthcare staff—alleviate as well as generate uncertainty and constitute HIV status as an ongoing process. The effective implementation of new strategies for HIVST requires consideration of multiple aspects of the testing process, including local understandings of HIV risk, access to healthcare staff, and the meaning of certain test methods within a particular context.

A decade of Acceptability Research with Adolescents in Africa: Systematic review and evidence map

Interventions aimed at improving adolescent developmental outcomes are more likely to be successful if the young people they target find them acceptable. However, no standard definitions or indicators exist to assess acceptability, acceptability research with adolescents in LMICs is still limited, and no known reviews synthesise the evidence from Africa. We conducted a systematic review of peer-reviewed studies assessing intervention acceptability with young adults (aged 10-24) in Africa, published between January 2010 and June 2020. This paper maps and qualitatively synthesizes the scope, characteristics, and findings of these studies, including definitions of acceptability, methods used, the type and objectives of interventions assessed, and overall findings on adolescent acceptability. The review was carried out in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Key word searches generated 4692 unique records and 55 final eligible studies, assessing 60 interventions. Most studies were conducted in Southern Africa, of which 32 jointly in South Africa and Uganda. The majority of interventions assessed for acceptability could be classified as HIV or HPV vaccine interventions (10), E-health (10), HIV testing interventions (8), support group interventions (7) and contraceptive interventions (6). The objectives of most interventions were linked to SDG3, specifically to HIV and sexual and reproductive health. Acceptability was overall high among these published studies. 22 studies provided reasons for acceptability or lack thereof, some specific to particular types of interventions and others common across intervention types. Our review exposes considerable scope for future acceptability research and review work. This should include: extending acceptability research beyond the health (and particularly HIV) sector and to regions in Africa where this type of research is still scarce; including adolescents earlier, and potentially throughout the intervention process; further conceptualising the construct of acceptability among adolescents and beyond, and examining the relationship between acceptability and uptake.

Inspected by systems for control of minimal efforts with reductions of ecological characteristics

Relevance of work. The work is devoted to the improvement of the quality control system of detergents with improved ecological characteristics and the presentation of innovative formulations with its compliance with modern environmental standards. This meets the needs of the modern market of eco-products and the scientific need to develop and evaluate a new generation of detergents. The purpose of the work is to test a number of methods for validity for diagnosing washing powders for their environmental and functional acceptability. Research methods - theoretical and modeling (development of a scheme of complex analysis of washing powders), representative (presentation of innovative recipes) and diagnostic. Within the framework of the latter, the possibilities of correlation-regression and imitation methods in the assessment of detergents with improved environmental characteristics, as well as the method of component-functional analysis of detergents were tested. Results. The validity of the method of ecological labeling for research and quality control of detergents on the basis of the maximum allowable ecological concentration, which limits or prohibits the use of harmful and dangerous substances, is proved. The innovative recipe of detergents on the example of washing powders of the DeLaMark trademark is presented and on the basis of the developed standards its check is carried out. Its ecological and functional acceptability is proved. Perspectives. Detergents' evaluation indicators and methods of their determination established on the basis of experimental researches allow to improve the procedure of control of products of this type, which is important for satisfaction of consumer needs. This makes it possible to develop recommendations for improving the domestic regulatory framework for the production of detergents with improved environmental performance through the use of OSU OEM 08.002.12.065:2016 "Detergents and cleaners. Environmental criteria for life cycle assessment ". The alternative methods used in the work to assess the quality of detergents allow you to effectively choose the most correct method of determining them.

The Social Validity of “Acceptability of Behavioral Interventions Used in Classrooms”: Inferences From Longitudinal Evidence

In this retrospective commentary on “Acceptability of Behavioral Interventions Used in Classrooms: The Influence of Amount of Teacher Time, Severity of Behavior Problem, and Type of Intervention,” I first examine the concept of social validity and related measurement challenges per Wolf’s concerns about consumers’ subjective reactions to behavior intervention procedures. I claim the genesis of the treatment acceptability research that others and I have completed was primarily motivated to advance the measurement of a subjective and fundamental construct in the process of selecting and implementing interventions in classrooms with teachers and children. With this background, I briefly describe the featured school-focused treatment acceptability study, followed by inferences about its (a) impact on subsequent intervention research and (b) relationship with common behavioral consultation and health care practices. I conclude with some speculations about future acceptability research and the importance of psychologists and educators caring about the social validity of their services.

Australian medical students have fewer opportunities to do physical examination of peers of the opposite gender

Purpose: Peer physical examination (PPE), by which junior medical students learn physical examination skills before practicing on patients, is a widely implemented and accepted part of medical curricula. However, the ethical implications of PPE have been debated, since issues including student gender impact on its acceptability. Research has previously demonstrated the phenomenon of ‘attitude-behavior inconsistency’ showing that students’ predictions about their participation in PPE differ from what they actually do in practice. This study asks whether gender and student self-ratings of outlook affect engagement in PPE. Methods: This study gathered data from students who had completed PPE with the objective of determining what factors have the greatest impact on the actual practice of PPE by students. Data were used to derive the number of opportunities students had to examine a peer, for various body parts. Respondent gender and self-ratings of outlook were recorded. Results: Responses from 130 students were analysed: 74 female (57%) and 56 male (43%). Students have fewer opportunities to examine peers of the opposite gender; this is statistically significant for all body parts when male students examine female peers. Conclusion: Gender is the factor of overriding importance on whether these peer interactions actually occur, such that students have fewer opportunities to examine peers of the opposite gender, particularly male students examining female peers. Student outlook has little impact. We speculate that the more acceptable PPE is to participants, paradoxically, the more complicated these interactions become, possibly with implications for future practice.

HIV pre-exposure prophylaxis and treatment as prevention: a review of awareness and acceptability among men who have sex with men in the Asia-Pacific region and the Americas

This review assesses acceptability research for HIV pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP) among men who have sex with men (MSM) in the Asia-Pacific region and the Americas, evaluating awareness and attitudes. There has been limited research on the acceptability of PrEP outside the United States and no research to date evaluating the acceptability of TasP since the findings of the HIV Prevention Trials Network 052 trial were released. Existing research suggests that PrEP is reasonably acceptable to MSM, but few men are likely to perceive the need for it. Studies of HIV treatment optimism suggest that MSM are likely to be sceptical of TasP.