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Evaluating the Impact of a School-Based Youth-Led Health Education Program for Adolescent Females in Mumbai, India.

ABSTRACT: Background:India's 120 million adolescent girls often have limited opportunities to receive health education, as health-related content in school curricula can be minimal, and the few existing external interventions for this demographic rarely cover multiple topics. Objectives:This study conducted a program evaluation of Girls Health Champions, a school-based peer education intervention in Mumbai, India that educates girls about leading causes of adolescent morbidity and mortality, including nutrition, mental health, and sexual & reproductive health. Methods:Female participants ages 12 to 16 in the eighth, ninth, and tenth standards were recruited at five participating schools in Mumbai, India to learn a multi-topic health curriculum from their peers, with a subset of ninth standard participants in each school trained as the peer educators. Using a quasi-experimental design, participant survey data was collected three times during the 2016-2017 academic year: at baseline, immediately following the peer-led education sessions, and five months following these sessions. Outcomes of interest included change in knowledge levels and health attitudes following the intervention, as well as retention at mid-year. An additional outcome was the change in self-reported leadership skills of peer educators before and after participating. Findings:Compared to baseline, participants demonstrated statistically significant increases in knowledge levels (+48%, p < 0.001) and positive shifts in health-related attitudes (+42%, p < 0.001). These changes were maintained at mid-year (+29% for knowledge levels, p < 0.001; +37% for attitudes, p < 0.001). Findings were consistent when data was stratified by standard and peer educator status (peer educators versus non-peer educators). Peer educators also demonstrated a statistically significant increase in their interest in health promotion. Conclusions:This study demonstrates the effectiveness of the peer education delivery model and finds school-based, peer-led programs covering a range of adolescent health topics can significantly increase knowledge and shift attitudes of program participants. Such benefits can accrue to both peer educators and non-peer educator program participants.

SUBMITTER: Shankar P

PROVIDER: S-EPMC7292104 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Evaluating the Impact of a School-Based Youth-Led Health Education Program for Adolescent Females in Mumbai, India.

Shankar Priya P Sievers Dana D Sharma Ricky R

Annals of global health 20200610 1

<h4>Background</h4>India's 120 million adolescent girls often have limited opportunities to receive health education, as health-related content in school curricula can be minimal, and the few existing external interventions for this demographic rarely cover multiple topics.<h4>Objectives</h4>This study conducted a program evaluation of Girls Health Champions, a school-based peer education intervention in Mumbai, India that educates girls about leading causes of adolescent morbidity and mortality ...[more]

PMID: 32566485

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Project description:IntroductionThere is a critical need for interventions that can be feasibly implemented and are effective in successfully engaging adolescent females in physical activity (PA). A theory-based, peer-led, after-school PA intervention, the Girls Active Project (GAP), was codesigned with adolescent females. This study aimed to assess the feasibility of implementing and evaluating the GAP programme.SettingOne single-sex, female-only, designated disadvantaged postprimary school (students aged 12-18) in Dublin, Ireland.MethodsMixed methods were applied with multiple stakeholders over a 12-week trial (March to May 2021). A single-arm study design was used to examine intervention: reach, dose, fidelity, acceptability, compatibility and context. Feasibility of using proposed self-reported outcome measures (moderate-to-vigorous PA levels, self-rated health, life satisfaction, PA self-efficacy and PA enjoyment) was also explored. Due to school closure resulting from the COVID-19 pandemic, the intervention was delivered both online and in person in the school setting.ResultsEight exercise classes were peer delivered by project leaders (n = 6, students aged 15-17) to intervention recipients (students aged 13-14). Recruitment was low (n = 8, 10% of eligible students, mean age: 13.3 SD: 0.46), yet retention was high (n = 7/8, 88%). Attendance rates were satisfactory (68%), and the intervention was implemented with high fidelity (87%). Data completion rates suggested proposed self-reported outcome measures were deemed appropriate (≥ 95%), except for weight (50%) and height data (80%). Despite COVID-19 hindering intervention implementation, both quantitative and qualitative data suggested that stakeholders were satisfied and perceived the in-person delivered intervention to be compatible with the school setting. Recommended refinements included extending class duration, introducing different rewards, and boosting programme awareness.ConclusionsFurther thought must be given on how to increase recruitment. Overall, the in-person delivered after-school PA programme was well-received by stakeholders and shows promise as an intervention that can be feasibly implemented and evaluated. Suggested improvements to the GAP intervention programme are recommended, before continuing to a more robust evaluation.Trial registration10.17605/OSF.IO/75HWJ (prospectively registered, date of registration: 9th December 2020).

Project description:BackgroundThe Sustainable Development Goals (SDGs) highlight the importance of investments in early childhood care and education (ECCE) and youth development. Given Pakistan's large young population, and gender and urban-rural inequalities in access to education, training, and employment, such investments offer opportunities. LEAPS is a youth-led ECCE program that trains female youth, 18-24 years, as Community Youth Leaders (CYLs) to deliver high-quality ECCE for children, 3.5-5.5 years, in rural Sindh, Pakistan.MethodsWe use a stepped wedge cluster-randomized trial to evaluate implementation of LEAPS. Ninety-nine clusters will be randomized to receive the intervention in one of three 7-month steps (33 clusters/step). The primary outcome is children's school readiness (indexed by the total score on the International Development and Early Learning Assessment (IDELA)). Secondary child outcomes are children's IDELA domain scores and executive functions. Data are collected in cross-sectional surveys of 1089 children (11 children/cluster from 99 clusters) aged 4.5-5.5 years at four timepoints (baseline and at the end of each step). Additionally, we will enroll three non-randomized youth participant open cohorts, one per step (33 CYLs: 66 comparison youth per cohort; 99:198 in total). Youth cohorts will be assessed at enrollment and every 7 months thereafter to measure secondary outcomes of youth personal and professional development, depressive symptoms, and executive functions. A non-randomized school cohort of 330 LEAPS students (10 students/cluster from 33 clusters) will also be enrolled and assessed during Step 1 after intervention rollout and at endline. The quality of the learning environment will be assessed in each LEAPS ECCE center and in a comparison center at two timepoints midway following rollout and at endline. A concurrent mixed-methods implementation evaluation will assess program fidelity and quality, and the extent to which a technical support strategy is successful in strengthening systems for program expansion. A cost evaluation will assess cost per beneficiary. Data collection for implementation and cost evaluations will occur in Step 3.DiscussionYouth-led models for ECCE offer a promising approach to support young children and youth. This study will contribute to the evidence as a means to promote sustainable human development across multiple SDG targets.Trial registrationClinicalTrials.gov NCT03764436 . Registered on December 5, 2018.

Dataset Information

Evaluating the Impact of a School-Based Youth-Led Health Education Program for Adolescent Females in Mumbai, India.

Publications

Evaluating the Impact of a School-Based Youth-Led Health Education Program for Adolescent Females in Mumbai, India.

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