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description Publicationkeyboard_double_arrow_right Article , Other literature type 2022 United KingdomOxford University Press (OUP) SSHRC, EC | HEY BABY, NIH | Undetectable and Untransm...SSHRC ,EC| HEY BABY ,NIH| Undetectable and Untransmittable: reducing HIV transmission among young women living with HIV, their partners and children in South AfricaLesley Gittings; Sally Medley; Carmen H Logie; Nokubonga Ralayo; Lucie Cluver; Nabeel Petersen; Jenny Chen-Charles; Elona Toska;Summary This paper presents empirical and methodological findings from an art-based, participatory process with a group (n = 16) of adolescent and young advisors in the Western Cape Province of South Africa. In a weekend workshop, participants reflected on their participation in 12 years of health and development-related research through theatre, song, visual methodologies and semi-structured interviews. Empirical findings suggest that participants interpreted the group research encounter as a site of empowerment, social support and as a socio-political endeavour. Through song, theatre and a mural illustration, they demonstrated that they value ‘unity’ in research, with the aim of ameliorating the conditions of adolescents and young people in other parts of South Africa and the continent. Methodological findings document how participants deployed art-based approaches from South Africa’s powerful history of activism, including the struggle against apartheid, the fight for anti-retroviral therapy and more recent social movements towards decolonization.
Oxford University Re... arrow_drop_down Oxford University Research ArchiveOther literature type . 2022License: CC BY NCData sources: Oxford University Research Archiveadd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
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For further information contact us at helpdesk@openaire.eu3 citations 3 popularity Top 10% influence Average impulse Average Powered by BIP!visibility 38visibility views 38 download downloads 11 Powered bymore_vert Oxford University Re... arrow_drop_down Oxford University Research ArchiveOther literature type . 2022License: CC BY NCData sources: Oxford University Research Archiveadd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
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For further information contact us at helpdesk@openaire.eudescription Publicationkeyboard_double_arrow_right Other literature type 2023 United Kingdom English EC | HEY BABY, SSHRC, EC | CAPITA +1 projectsEC| HEY BABY ,SSHRC ,EC| CAPITA ,UKRI| Relationships and HealthAuthors: Martin, M;Martin, M;Background: Implementation fidelity is a critical component of intervention science research, which aims to understand how interventions unfold in practice to improve their outcomes. A key element of fidelity is facilitator competent adherence - the extent to which a programme is delivered as prescribed with the specified level of quality. The dissertation endeavoured to better understand how to measure facilitator competent adherence and the role facilitator competent adherence plays in achieving intended parent/caregiver (parent) and child outcomes in the parenting programme literature and, specifically, within Parenting for Lifelong Health for Parents and Adolescents (PLH-Teens). PLH-Teens is a parenting programme designed to reduce violence against children and child behavioural and emotional problems in low- and middle-income countries (LMICs). The dissertation is composed of three studies – one which synthesised data from the parenting programme literature and two which analysed data from the 2020-2021 scale-up of PLH-Teens in Tanzania to 75,061 participants by community facilitators (school teachers and community health workers; N=444). Objectives: The dissertation had three objectives with each corresponding to an individual paper. The first objective was to synthesise the evidence on the relationship between observational measures of facilitator competent adherence and parent and child outcomes in the parenting programme literature. The second objective was to examine whether the observational measure of facilitator competent adherence used in the large-scale implementation of PLH-Teens in Tanzania is reliable and valid for use in research and practice and to determine the level of competent adherence with which community facilitators delivered PLH-Teens in Tanzania. The third objective was to determine the predictive validity of the observational measure of competent adherence used in PLH-Teens by examining whether competence adherence is associated with parent and adolescent outcomes. Methods: Paper 1 synthesised the results of a systematic review of studies on parenting programmes aiming to reduce violence against children and child behavioural and emotional problems to examine the associations between observational measures of facilitator competent adherence and parent and child outcomes. Due to study heterogeneity and poor reporting, Synthesis Without Meta-Analysis (SWiM) guidelines were followed. Paper 2 used 95 facilitator assessments collected by implementing partners during the 2020-2021 delivery of PLH-Teens in Tanzania. The paper evaluated the reliability and validity of the measure used to assess facilitator competent adherence in PLH-Teens - the Facilitator Assessment Tool (PLH-FAT-T). Reliability was assessed by conducting intra-rater reliability, inter-rater reliability, and internal consistency analyses using percentage agreements, intra-class correlations, Cronbach’s alphas, and omegas. Validity was assessed via consultations with stakeholders (content validity) and exploratory factor analyses (construct validity). This paper also estimated the level of competent adherence with which community facilitators delivered PLH-Teens by calculating the average PLH-FAT-T score achieved by facilitators. Paper 3 investigated the relationship between facilitator competent adherence and the pre-post outcomes of PLH-Teens participants. Analyses used 24 PLH-FAT-T assessments that could be linked to the pre-post surveys of 3,057 families. This analysis was conducted using multi-level Poisson regressions with fixed and random effects. Results: Paper 1 found 18 studies reporting on the relationship between observational measures of facilitator competent adherence and parent and child outcomes. The review found that most studies (n=13) reported a statistically significant positive relationship with at least one of the parent or child outcomes reported. However, eight studies reported inconsistent findings across outcomes. Four studies found no significant association with outcomes. Paper 2 found that the PLH-FAT-T showed strong content validity, poor to moderate intra- and inter-rater reliability, strong internal consistency, and moderate construct validity. Iterative exploratory factor analyses produced a shortened PLH-FAT-T, the PLH-FAT-T Short Form, comprised of 19 fewer items which had stronger psychometric properties. Analyses of the PLH-FAT-T Short Form found that community facilitators delivered PLH-Teens at scale in Tanzania to a high-level of competent adherence (82.3% average). Using the PLH-FAT-T Short Form, Paper 3 found that the relationship between facilitator competent adherence and outcomes was mixed with some positive, some insignificant, and some negative associations. A positive association was found between competent adherence and the primary outcome of interest, child maltreatment, as reported by adolescents. The analysis found that increased competent adherence had a positive association with two of the 12 parent-reported outcomes and seven of the 10 adolescent-reported outcomes (including child maltreatment). Yet, increased competent adherence also had a negative association with five parent-reported outcomes, as well as insignificant associations with five parent-reported outcomes and three adolescent-reported outcomes. Discussion: Paper 1 suggests that better facilitator competent adherence is generally associated with positive parent and child outcomes. However, this finding is weakened by the methodological heterogeneity of included studies and due to the wide variety of ways in which studies conceptualised competent adherence-outcome relationships. As a result, the paper reveals that there is substantial methodological work to be done in the broader parenting programme community to improve the rigour of and reporting on investigations regarding this relationship. As the amount of literature on the measurement and role of facilitator competent adherence grows in the behavioural intervention literature, the recommendations made in Paper 1 have relevance for other implementation scientists conducting and sharing studies on competent adherence. Paper 2 reports on the first psychometric evaluation of the PLH-FAT-T and is the first study of its kind to report on the fidelity achieved by facilitators during routine parenting programme delivery at scale in a low-income country. Findings suggest that the PLH-FAT-T had poor to moderate reliability and sufficient validity and that the PLH-FAT-T Short Form had stronger psychometric properties. Although the tool was stronger following iterative exploratory factor analyses, the findings indicate that further work is needed to strengthen the reliability and validity of the PLH-FAT-T Short Form. Findings also suggest that community facilitators with minimal background in and training on parenting programmes delivered PLH-Teens to a high level of quality at scale in a low-income community setting despite significant barriers. Thus, the findings of Paper 2 suggest that it may be possible for community facilitators to deliver behavioural interventions to a high level of competent adherence in low-income routine delivery settings at scale. The findings of Paper 3 are similar to the findings of Paper 1 in that Paper 3 does not provide a clear answer as to whether, and to what extent, facilitator competent adherence impacts participant outcomes. Potential explanations of the findings include the PLH-FAT-T Short Form has poor predictive validity; the PLH-FAT-T Short Form assessments were not reliable; a variety of methodological challenges may have prevented an examination of the true relationship between competent adherence and outcomes; competent adherence does not relate to outcomes in the manner theorised; competent adherence plays a less important role in the achievement of outcomes than anticipated or, at some point, plays a negative role; and only certain programme components are achieving outcomes so the PLH-FAT-T Short Form is not capturing the important aspects of programme delivery. The alignment of the findings of Papers 1 and 3 with some other systematic reviews and meta-analyses in the broader implementation science literature suggests that the role facilitator competent adherence plays in participant outcomes is not fully understood. Thus, there is reason to further investigate the theorised relationship between facilitator competent adherence and outcomes outlined in seminal implementation science theories and models to fully illuminate the inner workings of the ‘black box’ of interventions. A fuller understanding of the role that facilitator competent adherence plays in participant outcomes is essential to maximise the benefits to be reaped from evidence-based behavioural interventions. Conclusion: The dissertation provides important evidence regarding the measurement and role of facilitator competent adherence in the parenting programme literature and in Parenting for Lifelong Health. As a result, the dissertation provides a series of recommendations for the future of competent adherence monitoring in research and practice that are relevant to both the parenting programme literature and the broader implementation science literature. As parenting programmes continue to be delivered and scaled worldwide, it is intended that the findings and recommendations herein will be used to benefit both Parenting for Lifelong Health and the broader parenting programme community in the quest to maximise opportunity for vulnerable children and families globally to benefit from evidence-based parenting programmes.
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For further information contact us at helpdesk@openaire.eu0 citations 0 popularity Average influence Average impulse Average Powered by BIP!visibility 46visibility views 46 download downloads 38 Powered bymore_vert Oxford University Re... arrow_drop_down Oxford University Research ArchiveOther literature type . 2023Data sources: Oxford University Research ArchiveAll Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=od______1064::6966cefdbc7f2cd1fc872dc476966a12&type=result"></script>'); --> </script>
For further information contact us at helpdesk@openaire.eudescription Publicationkeyboard_double_arrow_right Article 2021Informa UK Limited EC | PACCASA, NIH | Building Research in Inte..., NIH | Partnerships for the Next... +5 projectsEC| PACCASA ,NIH| Building Research in Inter-Disciplinary Gender and HIV through the Social Sciences (The BRIDGES Programme) ,NIH| Partnerships for the Next Generation of HIV Social Science in South Africa ,SSHRC ,EC| HEY BABY ,UKRI| GCRF Accelerating Achievement for Africa's Adolescents Hub ,NIH| Using Information to Align Services and Link and Retain Men in the HIV Cascade ,EC| CAPITAL. Gittings; Rebecca Hodes; C. Colvin; S. Mbula; P. Kom;ABSTRACT This paper explores how HIV-positive abakhwetha (young male initiates) undergoing ulwaluko (traditional Xhosa initiation and circumcision) engage with HIV-related biomedical care and treatment. Health-focused life history narratives (n = 36), semi-structured interviews (n = 32) and analysis of health facility files (n = 41) with adolescent boys and young men (ages 13–24) living with HIV, and semi-structured interviews with traditional and biomedical health practitioners (n = 14) were conducted in 2017 and 2018. This research was part of the Mzantsi Wakho study, a longitudinal, mixed methods study of adolescents living with HIV (n = 1060). Findings demonstrate that ulwaluko rules of not engaging with biomedical care and treatment pose a challenge for initiates who are taking chronic medicine. Fears of inadvertent disclosure of their HIV-positive status collide with the pressure to successfully complete ulwaluko in order to be legitimised as men. In response to this dilemma, they engage a variety of strategies – including taking medicine in secret by hiding them, having a trusted person deliver them discretely, and stopping medicine-taking altogether. The three months following ulwaluko also pose a challenge in accessing biomedical treatment and care. In this time of high surveillance, amakrwala (new men) do not present at health facilities for fear of being thought to have had a botched circumcision or to have contravened ‘manhood rules’ and left ulwaluko before having healed properly. To get around this, those who continued taking medicine engaged caregiver pick-ups. Beyond suggesting that ulwaluko is a high-risk time for disengagement from biomedical treatment and care, this paper builds on a robust scholarship on the importance of locality and context in gender and health research. It documents the creativity, agency and resilience of initiates and their families as they subvert and re-signify health-related masculine norms.
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For further information contact us at helpdesk@openaire.eu1 citations 1 popularity Average influence Average impulse Average Powered by BIP!more_vert Europe PubMed Centra... arrow_drop_down add ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
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For further information contact us at helpdesk@openaire.eudescription Publicationkeyboard_double_arrow_right Article , Other literature type 2022Informa UK Limited SSHRC, EC | HEY BABY, NIH | Undetectable and Untransm... +1 projectsSSHRC ,EC| HEY BABY ,NIH| Undetectable and Untransmittable: reducing HIV transmission among young women living with HIV, their partners and children in South Africa ,UKRI| GCRF Accelerating Achievement for Africa's Adolescents HubMarisa Casale; Rachel Yates; Lesley Gittings; Genevieve Haupt Ronnie; Oluwaseyi Somefun; Chris Desmond;Acceptability has become a key consideration in the development, evaluation and implementation of health and social interventions. This commentary paper advances key learnings and recommendations for future intervention acceptability research with young people in Africa, aimed at supporting the achievement of developmental goals. It relates findings of the adolescent acceptability work conducted within the Accelerate Hub, since mid 2020, to broader inter-disciplinary literatures and to current regional health and social priorities. We argue that, in order to strengthen the quality and applied value of future acceptability work with young people, we need to do three things better. First, we need to consolidate prior findings on acceptability, within and across intervention types, to inform responses to current public health and social challenges and further the conceptual work in this area. Second, we need to better conceptualise acceptability research with young people, by developing stronger conceptual frameworks that define acceptability and its constructs, and predict its relationship with intervention engagement. Third, we need to better contextualise findings by considering acceptability data within a broader social and political context, which in turn can be supported by better conceptualisation. In this paper we describe contributions of our work to each of these three inter-connected objectives, and suggest ways in which they may be taken forward by researchers and practitioners in the future. These include aggregating evidence from past interventions to highlight potential barriers and enablers to current responses in priority areas; involving key actors earlier and more meaningfully in acceptability research; further developing and testing behavioural models for youth acceptability; and working collaboratively across sectors towards programmatic guidance for better contextualisation of acceptability research. Progress in this field will require an inter-disciplinary approach that draws from various literatures such as socio-ecological theory, political economy analysis, health behaviour models and literature on participatory research approaches.
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For further information contact us at helpdesk@openaire.eu3 citations 3 popularity Top 10% influence Average impulse Average Powered by BIP!more_vert add ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
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For further information contact us at helpdesk@openaire.eudescription Publicationkeyboard_double_arrow_right Article 2021Informa UK Limited SSHRC, EC | HEY BABY, UKRI | GCRF Accelerating Achieve...SSHRC ,EC| HEY BABY ,UKRI| GCRF Accelerating Achievement for Africa's Adolescents HubLesley Gittings; Elona Toska; Sally Medley; Lucie Cluver; Carmen H. Logie; Nokubonga Ralayo; Jenny J. Chen; Jane Mbithi-Dikgole;Consequences of COVID-19 pandemic responses have included exacerbated poverty, food insecurity and state and domestic violence. Such effects may be particularly pronounced amongst adolescents and young people living in contexts of precarity and constraint, including in South Africa. However, there are evidence gaps on the lived experiences of this group. We conducted telephonic semi-structured interviews with adolescents and young people in two South African provinces (n = 12, ages 18-25) in April 2020 to explore and document their experiences, challenges and coping strategies during strict COVID-19 lockdown. Participants described indirect effects of COVID-19 including food insecurity, lost livelihoods and changes to social service provisions such as municipal electricity services and sanitation. Psychosocial stressors related to uncertainty over education and work futures were also discussed. The aforementioned challenges were particularly present with young parents, 'working poor' participants, and those with pre-existing mental health challenges. Participants demonstrated excellent COVID-19 transmission and prevention knowledge, showing that they had received and correctly interpreted public health messaging. Despite this, many simultaneously held non-scientific COVID-19 beliefs. Engaging a socio ecological framework, findings demonstrate how the indirect effects of COVID-19 may exacerbate underlying multi-layered vulnerabilities for adolescents and young people living in contexts of precarity and constraint.
Global Public Health arrow_drop_down add ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
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For further information contact us at helpdesk@openaire.eu60 citations 60 popularity Top 1% influence Top 10% impulse Top 1% Powered by BIP!more_vert Global Public Health arrow_drop_down add ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
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description Publicationkeyboard_double_arrow_right Article , Other literature type 2022 United KingdomOxford University Press (OUP) SSHRC, EC | HEY BABY, NIH | Undetectable and Untransm...SSHRC ,EC| HEY BABY ,NIH| Undetectable and Untransmittable: reducing HIV transmission among young women living with HIV, their partners and children in South AfricaLesley Gittings; Sally Medley; Carmen H Logie; Nokubonga Ralayo; Lucie Cluver; Nabeel Petersen; Jenny Chen-Charles; Elona Toska;Summary This paper presents empirical and methodological findings from an art-based, participatory process with a group (n = 16) of adolescent and young advisors in the Western Cape Province of South Africa. In a weekend workshop, participants reflected on their participation in 12 years of health and development-related research through theatre, song, visual methodologies and semi-structured interviews. Empirical findings suggest that participants interpreted the group research encounter as a site of empowerment, social support and as a socio-political endeavour. Through song, theatre and a mural illustration, they demonstrated that they value ‘unity’ in research, with the aim of ameliorating the conditions of adolescents and young people in other parts of South Africa and the continent. Methodological findings document how participants deployed art-based approaches from South Africa’s powerful history of activism, including the struggle against apartheid, the fight for anti-retroviral therapy and more recent social movements towards decolonization.
Oxford University Re... arrow_drop_down Oxford University Research ArchiveOther literature type . 2022License: CC BY NCData sources: Oxford University Research Archiveadd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
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For further information contact us at helpdesk@openaire.eu3 citations 3 popularity Top 10% influence Average impulse Average Powered by BIP!visibility 38visibility views 38 download downloads 11 Powered bymore_vert Oxford University Re... arrow_drop_down Oxford University Research ArchiveOther literature type . 2022License: CC BY NCData sources: Oxford University Research Archiveadd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.All Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=10.1093/heapro/daac020&type=result"></script>'); --> </script>
For further information contact us at helpdesk@openaire.eudescription Publicationkeyboard_double_arrow_right Other literature type 2023 United Kingdom English EC | HEY BABY, SSHRC, EC | CAPITA +1 projectsEC| HEY BABY ,SSHRC ,EC| CAPITA ,UKRI| Relationships and HealthAuthors: Martin, M;Martin, M;Background: Implementation fidelity is a critical component of intervention science research, which aims to understand how interventions unfold in practice to improve their outcomes. A key element of fidelity is facilitator competent adherence - the extent to which a programme is delivered as prescribed with the specified level of quality. The dissertation endeavoured to better understand how to measure facilitator competent adherence and the role facilitator competent adherence plays in achieving intended parent/caregiver (parent) and child outcomes in the parenting programme literature and, specifically, within Parenting for Lifelong Health for Parents and Adolescents (PLH-Teens). PLH-Teens is a parenting programme designed to reduce violence against children and child behavioural and emotional problems in low- and middle-income countries (LMICs). The dissertation is composed of three studies – one which synthesised data from the parenting programme literature and two which analysed data from the 2020-2021 scale-up of PLH-Teens in Tanzania to 75,061 participants by community facilitators (school teachers and community health workers; N=444). Objectives: The dissertation had three objectives with each corresponding to an individual paper. The first objective was to synthesise the evidence on the relationship between observational measures of facilitator competent adherence and parent and child outcomes in the parenting programme literature. The second objective was to examine whether the observational measure of facilitator competent adherence used in the large-scale implementation of PLH-Teens in Tanzania is reliable and valid for use in research and practice and to determine the level of competent adherence with which community facilitators delivered PLH-Teens in Tanzania. The third objective was to determine the predictive validity of the observational measure of competent adherence used in PLH-Teens by examining whether competence adherence is associated with parent and adolescent outcomes. Methods: Paper 1 synthesised the results of a systematic review of studies on parenting programmes aiming to reduce violence against children and child behavioural and emotional problems to examine the associations between observational measures of facilitator competent adherence and parent and child outcomes. Due to study heterogeneity and poor reporting, Synthesis Without Meta-Analysis (SWiM) guidelines were followed. Paper 2 used 95 facilitator assessments collected by implementing partners during the 2020-2021 delivery of PLH-Teens in Tanzania. The paper evaluated the reliability and validity of the measure used to assess facilitator competent adherence in PLH-Teens - the Facilitator Assessment Tool (PLH-FAT-T). Reliability was assessed by conducting intra-rater reliability, inter-rater reliability, and internal consistency analyses using percentage agreements, intra-class correlations, Cronbach’s alphas, and omegas. Validity was assessed via consultations with stakeholders (content validity) and exploratory factor analyses (construct validity). This paper also estimated the level of competent adherence with which community facilitators delivered PLH-Teens by calculating the average PLH-FAT-T score achieved by facilitators. Paper 3 investigated the relationship between facilitator competent adherence and the pre-post outcomes of PLH-Teens participants. Analyses used 24 PLH-FAT-T assessments that could be linked to the pre-post surveys of 3,057 families. This analysis was conducted using multi-level Poisson regressions with fixed and random effects. Results: Paper 1 found 18 studies reporting on the relationship between observational measures of facilitator competent adherence and parent and child outcomes. The review found that most studies (n=13) reported a statistically significant positive relationship with at least one of the parent or child outcomes reported. However, eight studies reported inconsistent findings across outcomes. Four studies found no significant association with outcomes. Paper 2 found that the PLH-FAT-T showed strong content validity, poor to moderate intra- and inter-rater reliability, strong internal consistency, and moderate construct validity. Iterative exploratory factor analyses produced a shortened PLH-FAT-T, the PLH-FAT-T Short Form, comprised of 19 fewer items which had stronger psychometric properties. Analyses of the PLH-FAT-T Short Form found that community facilitators delivered PLH-Teens at scale in Tanzania to a high-level of competent adherence (82.3% average). Using the PLH-FAT-T Short Form, Paper 3 found that the relationship between facilitator competent adherence and outcomes was mixed with some positive, some insignificant, and some negative associations. A positive association was found between competent adherence and the primary outcome of interest, child maltreatment, as reported by adolescents. The analysis found that increased competent adherence had a positive association with two of the 12 parent-reported outcomes and seven of the 10 adolescent-reported outcomes (including child maltreatment). Yet, increased competent adherence also had a negative association with five parent-reported outcomes, as well as insignificant associations with five parent-reported outcomes and three adolescent-reported outcomes. Discussion: Paper 1 suggests that better facilitator competent adherence is generally associated with positive parent and child outcomes. However, this finding is weakened by the methodological heterogeneity of included studies and due to the wide variety of ways in which studies conceptualised competent adherence-outcome relationships. As a result, the paper reveals that there is substantial methodological work to be done in the broader parenting programme community to improve the rigour of and reporting on investigations regarding this relationship. As the amount of literature on the measurement and role of facilitator competent adherence grows in the behavioural intervention literature, the recommendations made in Paper 1 have relevance for other implementation scientists conducting and sharing studies on competent adherence. Paper 2 reports on the first psychometric evaluation of the PLH-FAT-T and is the first study of its kind to report on the fidelity achieved by facilitators during routine parenting programme delivery at scale in a low-income country. Findings suggest that the PLH-FAT-T had poor to moderate reliability and sufficient validity and that the PLH-FAT-T Short Form had stronger psychometric properties. Although the tool was stronger following iterative exploratory factor analyses, the findings indicate that further work is needed to strengthen the reliability and validity of the PLH-FAT-T Short Form. Findings also suggest that community facilitators with minimal background in and training on parenting programmes delivered PLH-Teens to a high level of quality at scale in a low-income community setting despite significant barriers. Thus, the findings of Paper 2 suggest that it may be possible for community facilitators to deliver behavioural interventions to a high level of competent adherence in low-income routine delivery settings at scale. The findings of Paper 3 are similar to the findings of Paper 1 in that Paper 3 does not provide a clear answer as to whether, and to what extent, facilitator competent adherence impacts participant outcomes. Potential explanations of the findings include the PLH-FAT-T Short Form has poor predictive validity; the PLH-FAT-T Short Form assessments were not reliable; a variety of methodological challenges may have prevented an examination of the true relationship between competent adherence and outcomes; competent adherence does not relate to outcomes in the manner theorised; competent adherence plays a less important role in the achievement of outcomes than anticipated or, at some point, plays a negative role; and only certain programme components are achieving outcomes so the PLH-FAT-T Short Form is not capturing the important aspects of programme delivery. The alignment of the findings of Papers 1 and 3 with some other systematic reviews and meta-analyses in the broader implementation science literature suggests that the role facilitator competent adherence plays in participant outcomes is not fully understood. Thus, there is reason to further investigate the theorised relationship between facilitator competent adherence and outcomes outlined in seminal implementation science theories and models to fully illuminate the inner workings of the ‘black box’ of interventions. A fuller understanding of the role that facilitator competent adherence plays in participant outcomes is essential to maximise the benefits to be reaped from evidence-based behavioural interventions. Conclusion: The dissertation provides important evidence regarding the measurement and role of facilitator competent adherence in the parenting programme literature and in Parenting for Lifelong Health. As a result, the dissertation provides a series of recommendations for the future of competent adherence monitoring in research and practice that are relevant to both the parenting programme literature and the broader implementation science literature. As parenting programmes continue to be delivered and scaled worldwide, it is intended that the findings and recommendations herein will be used to benefit both Parenting for Lifelong Health and the broader parenting programme community in the quest to maximise opportunity for vulnerable children and families globally to benefit from evidence-based parenting programmes.
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For further information contact us at helpdesk@openaire.eu0 citations 0 popularity Average influence Average impulse Average Powered by BIP!visibility 46visibility views 46 download downloads 38 Powered bymore_vert Oxford University Re... arrow_drop_down Oxford University Research ArchiveOther literature type . 2023Data sources: Oxford University Research ArchiveAll Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=od______1064::6966cefdbc7f2cd1fc872dc476966a12&type=result"></script>'); --> </script>
For further information contact us at helpdesk@openaire.eudescription Publicationkeyboard_double_arrow_right Article 2021Informa UK Limited EC | PACCASA, NIH | Building Research in Inte..., NIH | Partnerships for the Next... +5 projectsEC| PACCASA ,NIH| Building Research in Inter-Disciplinary Gender and HIV through the Social Sciences (The BRIDGES Programme) ,NIH| Partnerships for the Next Generation of HIV Social Science in South Africa ,SSHRC ,EC| HEY BABY ,UKRI| GCRF Accelerating Achievement for Africa's Adolescents Hub ,NIH| Using Information to Align Services and Link and Retain Men in the HIV Cascade ,EC| CAPITAL. Gittings; Rebecca Hodes; C. Colvin; S. Mbula; P. Kom;ABSTRACT This paper explores how HIV-positive abakhwetha (young male initiates) undergoing ulwaluko (traditional Xhosa initiation and circumcision) engage with HIV-related biomedical care and treatment. Health-focused life history narratives (n = 36), semi-structured interviews (n = 32) and analysis of health facility files (n = 41) with adolescent boys and young men (ages 13–24) living with HIV, and semi-structured interviews with traditional and biomedical health practitioners (n = 14) were conducted in 2017 and 2018. This research was part of the Mzantsi Wakho study, a longitudinal, mixed methods study of adolescents living with HIV (n = 1060). Findings demonstrate that ulwaluko rules of not engaging with biomedical care and treatment pose a challenge for initiates who are taking chronic medicine. Fears of inadvertent disclosure of their HIV-positive status collide with the pressure to successfully complete ulwaluko in order to be legitimised as men. In response to this dilemma, they engage a variety of strategies – including taking medicine in secret by hiding them, having a trusted person deliver them discretely, and stopping medicine-taking altogether. The three months following ulwaluko also pose a challenge in accessing biomedical treatment and care. In this time of high surveillance, amakrwala (new men) do not present at health facilities for fear of being thought to have had a botched circumcision or to have contravened ‘manhood rules’ and left ulwaluko before having healed properly. To get around this, those who continued taking medicine engaged caregiver pick-ups. Beyond suggesting that ulwaluko is a high-risk time for disengagement from biomedical treatment and care, this paper builds on a robust scholarship on the importance of locality and context in gender and health research. It documents the creativity, agency and resilience of initiates and their families as they subvert and re-signify health-related masculine norms.
Europe PubMed Centra... arrow_drop_down add ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
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For further information contact us at helpdesk@openaire.eu1 citations 1 popularity Average influence Average impulse Average Powered by BIP!more_vert Europe PubMed Centra... arrow_drop_down add ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
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For further information contact us at helpdesk@openaire.eudescription Publicationkeyboard_double_arrow_right Article , Other literature type 2022Informa UK Limited SSHRC, EC | HEY BABY, NIH | Undetectable and Untransm... +1 projectsSSHRC ,EC| HEY BABY ,NIH| Undetectable and Untransmittable: reducing HIV transmission among young women living with HIV, their partners and children in South Africa ,UKRI| GCRF Accelerating Achievement for Africa's Adolescents HubMarisa Casale; Rachel Yates; Lesley Gittings; Genevieve Haupt Ronnie; Oluwaseyi Somefun; Chris Desmond;Acceptability has become a key consideration in the development, evaluation and implementation of health and social interventions. This commentary paper advances key learnings and recommendations for future intervention acceptability research with young people in Africa, aimed at supporting the achievement of developmental goals. It relates findings of the adolescent acceptability work conducted within the Accelerate Hub, since mid 2020, to broader inter-disciplinary literatures and to current regional health and social priorities. We argue that, in order to strengthen the quality and applied value of future acceptability work with young people, we need to do three things better. First, we need to consolidate prior findings on acceptability, within and across intervention types, to inform responses to current public health and social challenges and further the conceptual work in this area. Second, we need to better conceptualise acceptability research with young people, by developing stronger conceptual frameworks that define acceptability and its constructs, and predict its relationship with intervention engagement. Third, we need to better contextualise findings by considering acceptability data within a broader social and political context, which in turn can be supported by better conceptualisation. In this paper we describe contributions of our work to each of these three inter-connected objectives, and suggest ways in which they may be taken forward by researchers and practitioners in the future. These include aggregating evidence from past interventions to highlight potential barriers and enablers to current responses in priority areas; involving key actors earlier and more meaningfully in acceptability research; further developing and testing behavioural models for youth acceptability; and working collaboratively across sectors towards programmatic guidance for better contextualisation of acceptability research. Progress in this field will require an inter-disciplinary approach that draws from various literatures such as socio-ecological theory, political economy analysis, health behaviour models and literature on participatory research approaches.
add ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
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For further information contact us at helpdesk@openaire.eu3 citations 3 popularity Top 10% influence Average impulse Average Powered by BIP!more_vert add ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
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You have already added works in your ORCID record related to the merged Research product.All Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=10.1080/13548506.2022.2108078&type=result"></script>'); --> </script>
For further information contact us at helpdesk@openaire.eudescription Publicationkeyboard_double_arrow_right Article 2021Informa UK Limited SSHRC, EC | HEY BABY, UKRI | GCRF Accelerating Achieve...SSHRC ,EC| HEY BABY ,UKRI| GCRF Accelerating Achievement for Africa's Adolescents HubLesley Gittings; Elona Toska; Sally Medley; Lucie Cluver; Carmen H. Logie; Nokubonga Ralayo; Jenny J. Chen; Jane Mbithi-Dikgole;Consequences of COVID-19 pandemic responses have included exacerbated poverty, food insecurity and state and domestic violence. Such effects may be particularly pronounced amongst adolescents and young people living in contexts of precarity and constraint, including in South Africa. However, there are evidence gaps on the lived experiences of this group. We conducted telephonic semi-structured interviews with adolescents and young people in two South African provinces (n = 12, ages 18-25) in April 2020 to explore and document their experiences, challenges and coping strategies during strict COVID-19 lockdown. Participants described indirect effects of COVID-19 including food insecurity, lost livelihoods and changes to social service provisions such as municipal electricity services and sanitation. Psychosocial stressors related to uncertainty over education and work futures were also discussed. The aforementioned challenges were particularly present with young parents, 'working poor' participants, and those with pre-existing mental health challenges. Participants demonstrated excellent COVID-19 transmission and prevention knowledge, showing that they had received and correctly interpreted public health messaging. Despite this, many simultaneously held non-scientific COVID-19 beliefs. Engaging a socio ecological framework, findings demonstrate how the indirect effects of COVID-19 may exacerbate underlying multi-layered vulnerabilities for adolescents and young people living in contexts of precarity and constraint.
Global Public Health arrow_drop_down add ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
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For further information contact us at helpdesk@openaire.eu60 citations 60 popularity Top 1% influence Top 10% impulse Top 1% Powered by BIP!more_vert Global Public Health arrow_drop_down add ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
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