Dataset Information

Fostering gender equality and reproductive and sexual health among adolescents: results from a quasi-experimental study in Northern Uganda.

ABSTRACT:

Objective

To assess the impact of the Gender Roles, Equality and Transformations (GREAT) intervention: a narrative-based, resource-light, life-stage tailored intervention package designed to promote gender-equitable attitudes and behaviours, and improve sexual and reproductive health (SRH) and gender-based violence (GBV) outcomes among adolescents and their communities.

Design

Repeated cross-sectional evaluation study, using propensity score matching combined with difference-in-difference estimation.

Setting

Two postconflict communities in Lira and Amuru districts in Northern Uganda.

Participants

Male and female unmarried adolescents (10-14 years, 15-19 years), married adolescents (15-19 years) and adults (over the age of 19 years) were selected using a stratified, two-stage cluster sample of primary and secondary schools and households (baseline: n=2464, endline: n=2449).

Primary outcome measures

Inequitable gender attitudes and behaviours; GBV; and SRH knowledge and behaviours.

Results

Statistically significant intervention effects were seen across all three outcomes-gender equity, GBV and SRH-among older and newly married adolescents and adults. Among older adolescents, intervention effects include shifts on: inequitable gender attitudes scale score: -4.2 points ((95% CI -7.1 to -1.4), p<0.05); Inequitable household roles scale score: -11.8 ((95% CI -15.6to -7.9), p<0.05); Inequitable attitudes towards GBV scale: -1.9 ((95% CI -5.0 to -0.2), p<0.05); per cent of boys who sexually assaulted a girl in past 3 months: -7.7 ((95% CI -13.1 to -2.3), p<0.05); inequitable SRH attitudes scale: -10.1 ((95% CI -12.9 to -7.3), p<0.05). Among married adolescents, intervention effects include shifts on: Inequitable household roles scale score: -6.5 ((95% CI -10.8 to -2.2), p<0.05); inequitable attitudes towards GBV scale: -4.7 ((95% CI -9.8 to -0.3), p<0.05); per cent who reacted violently to their partner: -15.7 ((95% CI -27.1 to -4.4), p<0.05); inequitable SRH attitudes scale: -12.9 ((95% CI -17.3 to -8.5), p<0.05).

Conclusion

The GREAT intervention model demonstrates the promise of a resource-light, life-stage tailored programme that employs culturally appropriate, participatory and narrative-based techniques to advance gender equity and adolescent health. This type of programming contributes towards reductions in GBV and improved adolescent SRH outcomes.

SUBMITTER: Dagadu NA

PROVIDER: S-EPMC8943764 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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Publications

Fostering gender equality and reproductive and sexual health among adolescents: results from a quasi-experimental study in Northern Uganda.

Dagadu Nana Apenem NA Barker Kathryn M KM Okello Sam B T SBT Kerner Brad B Simon Callie C Nabembezi Dennis D Lundgren Rebecka Inga RI

BMJ open 20220322 3

<h4>Objective</h4>To assess the impact of the Gender Roles, Equality and Transformations (GREAT) intervention: a narrative-based, resource-light, life-stage tailored intervention package designed to promote gender-equitable attitudes and behaviours, and improve sexual and reproductive health (SRH) and gender-based violence (GBV) outcomes among adolescents and their communities.<h4>Design</h4>Repeated cross-sectional evaluation study, using propensity score matching combined with difference-in-di ...[more]

PMID: 35318230

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Project description:BackgroundSexual education has become increasingly important as unhealthy sexual practices and subsequent health risks become more prevalent during adolescence. Traditional sex education teaching methodologies are limiting for digital natives exposed to various digital technologies. Harnessing the power of technology applications attractive to the younger generation may be a useful approach for teaching sex education.ObjectiveThe aim of this study was to improve sexual health knowledge and understanding of the problems associated with unhealthy sexual practices and address sexual and reproductive health challenges experienced in a low-tech setting.MethodsA participatory design approach was used to develop the digital gamified methodology. A sample of 120 secondary school students aged 11-15 were randomly assigned to either experimental or control group for each of the 3 teaching approaches: (1) gamified instruction (actual serious games [SG] in teaching); (2) gamification (GM; making nongames, such as game-like learning); and (3) traditional teaching (TT) methods.ResultsThe SG and GM approaches were more effective than TT methods in teaching sexual health education. Specifically, the average scores across groups demonstrated an increase of mean scores from the pre- to posttest (25.10 [SD 5.50] versus 75.86 [SD 13.16]; t119=41.252; P<.001 [2 tailed]). Analysis of variance indicated no significant differences across groups for pretest scores (F2,117=1.048, P=.35). Significant differences across groups were evident in the posttest scores. Students in the SG and GM groups had higher average scores than the TT group (F2,117=83.98; P<.001). Students reported increased learning motivation, attitude, know-how, and participation in learning (P<.001) when using SG and GM approaches.ConclusionsDigital health technologies (particularly teaching and learning through gamified instruction and other novel approaches) may improve sexual health education. These findings may also be applied by practitioners in health care settings and by researchers wishing to further the development of sex education.

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Dataset Information

Fostering gender equality and reproductive and sexual health among adolescents: results from a quasi-experimental study in Northern Uganda.

Objective

Design

Setting

Participants

Primary outcome measures

Results

Conclusion

Publications

Fostering gender equality and reproductive and sexual health among adolescents: results from a quasi-experimental study in Northern Uganda.

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