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Participatory Action Research Approach to improve Adolescent Girls' Reproductive Health.

ABSTRACT: OBJECTIVE:School-based reproductive health education programs (RHEP) motivate adolescent girls to maintain and improve their health, and prevent diseases. The purpose of this PAR was to design, implement and evaluate RHEP to strengthen adolescent girl's reproductive health. METHODS:The PAR process was selected as an RHEP strategy, and it has four main phases, including: 1) assessment to explore the reproductive health education needs (RHEN) of adolescent girls. We collected data through in-depth individual interviews with 11 adolescent girls (12-18 years) in high school, 2 focus group discussions (FGD), and 4 interviews with the key informants. 2) Intervention design involved a Delphi approach to design an intervention that would address each need using 7 expert participants with a background in primary health, health promotion and other youth-focused professions. 3) In the action plan phase, the workshops, lecture meetings, counseling, and FGD were organized by the research team. 4) The impact of the intervention was evaluated through a mixed evaluation methodology, a semi-structured interviews with stakeholders and key informant, quasi-experimental assessment and FGD. RESULTS:There were three themes we extracted from the data: (a) the need for RHP for adolescent girls, (b) sources of information about RH, and (c) the need to empower teachers to provide RHEP to their students. a) Workshops, (b Counseling, c) Lecture Meetings, d) Focus Group. The study showed that the level of knowledge about RH in more than half of the participants was poor and only in nearly half of them it was moderate. CONCLUSION:Results suggest that Iranian adolescents do not have adequate education regarding RH, and RHEP by PAR can be effective in improving the knowledge and behavior of female students.

SUBMITTER: Khalesi ZB

PROVIDER: S-EPMC7558900 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Participatory Action Research Approach to improve Adolescent Girls' Reproductive Health.

Khalesi Zahra Bostani ZB Sigaroudi Abdolhosein Emami AE Farmanbar Rabiollah R

JBRA assisted reproduction 20201006 4

<h4>Objective</h4>School-based reproductive health education programs (RHEP) motivate adolescent girls to maintain and improve their health, and prevent diseases. The purpose of this PAR was to design, implement and evaluate RHEP to strengthen adolescent girl's reproductive health.<h4>Methods</h4>The PAR process was selected as an RHEP strategy, and it has four main phases, including: 1) assessment to explore the reproductive health education needs (RHEN) of adolescent girls. We collected data t ...[more]

PMID: 32469192

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Project description:To evaluate and determine the value of monitoring models developed by the Mahidol Oxford Tropical Research Unit and the East African Consortium for Clinical Research, consider how this can be measured and explore monitors' and investigators' experiences of and views about the nature, purpose and practice of monitoring.A case study approach was used within the context of participatory action research because one of the aims was to guide and improve practice. 34 interviews, five focus groups and observations of monitoring practice were conducted.Fieldwork occurred in the places where the monitoring models are coordinated and applied in Thailand, Cambodia, Uganda and Kenya. Participants included those coordinating the monitoring schemes, monitors, senior investigators and research staff.Transcribed textual data from field notes, interviews and focus groups was imported into a qualitative data software program (NVIVO V. 10) and analysed inductively and thematically by a qualitative researcher. The initial coding framework was reviewed internally and two main categories emerged from the subsequent interrogation of the data.The categories that were identified related to the conceptual framing and nature of monitoring, and the practice of monitoring, including relational factors. Particular emphasis was given to the value of a scientific and cooperative style of monitoring as a means of enhancing data quality, trust and transparency. In terms of practice the primary purpose of monitoring was defined as improving the conduct of health research and increasing the capacity of researchers and trial sites.The models studied utilise internal and network wide expertise to improve the ethics and quality of clinical research. They demonstrate how monitoring can be a scientific and constructive exercise rather than a threatening process. The value of cooperative relations needs to be given more emphasis in monitoring activities, which seek to ensure that research protects human rights and produces reliable data.

Project description:BACKGROUND AND OBJECTIVES:Despite the widespread acknowledgement of the importance of childhood oral health, little progress has been made in preventing early childhood caries. Limited information exists regarding specific daily-life and community-related factors that impede optimal oral hygiene, diet, care, and ultimately oral health for children. We sought to understand what parents of young children consider important and potentially modifiable factors and resources influencing their children's oral health, within the contexts of the family and the community. METHODS:This qualitative study employed Photovoice among 10 English-speaking parents of infants and toddlers who were clients of an urban WIC clinic in North Carolina. The primary research question was: "What do you consider as important behaviors, as well as family and community resources to prevent cavities among young children?" Five group sessions were conducted and they were recorded, transcribed verbatim and analyzed using qualitative research methodology. Inductive analyses were based on analytical summaries, double-coding, and summary matrices and were done using Atlas.ti.7.5.9 software. FINDINGS:Good oral health was associated with avoidance of problems or restorations for the participants. Financial constraints affected healthy food and beverage choices, as well as access to oral health care. Time constraints and occasional frustration related to children's oral hygiene emerged as additional barriers. Establishment of rules/routines and commitment to them was a successful strategy to promote their children's oral health, as well as modeling of older siblings, cooperation among caregivers and peer support. Community programs and organizations, social hubs including playgrounds, grocery stores and social media emerged as promising avenues for gaining support and sharing resources. CONCLUSIONS:Low-income parents of young children are faced with daily life struggles that interfere with oral health and care. Financial constraints are pervasive, but parents identified several strategies involving home care and community agents that can be helpful. Future interventions aimed to improve children's oral health must take into consideration the role of families and the communities in which they live.

Project description:IntroductionSocial accountability is important for improving the delivery of health services and empowering citizens. The government of Tanzania has transferred authority to plan, budget and manage financial resources to the lower health facilities since 2017. Health facility governing committees (HFGCs) therefore play a pivotal role in ensuring social accountability. While HFGCs serve as bridges between health facilities and their communities, efforts need to be made to reinforce their capacity. This project therefore aims to understand whether, how and under what conditions informed and competent HFGCs improve social accountability.Methods and analysisThis study adopts a participatory approach to realist evaluation, engaging members of the HFGCs, health managers and providers and community leaders to: (1) map the challenges and opportunities of the current reform, (2) develop an initial programme theory that proposes a plan to strengthen the role of the HFGCs, (3) test the programme theory by developing a plan of action, (4) refine the programme theory through multiple cycles of participatory learning and (5) propose a set of recommendations to guide processes to strengthen social accountability in the Tanzanian health system. This project is part of an ongoing strong collaboration between the University of Dar es Saalam (Tanzania), and Umeå University (Sweden), providing opportunities for action learning and close interactions between researchers, decision-makers and practitioners.Ethics and disseminationEthical approval to conduct the study was obtained from the National Ethical Review Committee in Tanzania- National Institute for Medical Research (NIMR/HQ/R.8a/Vol.IX/3928). Permissions to conduct the study in the health facilities were given by the President's Office Regional Administration and Local Government and relevant regional and district authorities. The results will be published in open-access, peer-reviewed journals and presented at scientific conferences.

Project description:ObjectivesTo systematically review interventions that include an element of menstrual education delivered to young adolescent girls.DesignThis was a systematic review and meta-analysis. Selected articles were quality assessed using the Mixed Methods Appraisal Tool quality appraisal checklist. A meta-analysis was conducted on a subset of articles, and the effect size of the intervention was calculated using Cohen's d. A logic model was constructed to frame the effect of menstrual education interventions on menstrual health.SettingPapers reporting on interventions in high-income and low-income and middle-income countries were sought.Information sourcesSeven electronic databases were searched for English-language entries that were published between January 2014 and May 2020.ParticipantsThe interventions were aimed at younger adolescent girls aged 10-14 years old.InterventionsThe interventions were designed to improve the menstrual health of the recipients, by addressing one or more elements of menstrual knowledge, attitude or practices (KAP).Eligibility criteriaInterventions that had not been evaluated were excluded.Primary and secondary outcomesThe most common type of output was a difference in knowledge or skill score ascertained from a pre and post test. Some studies measured additional outcomes, such as attitude or confidence.ResultsTwenty-four eligible studies were identified. The number of participants varied from 1 to 2564. All studies reported improvements in menstrual KAP. The meta-analysis indicates that larger effect sizes were attained by those that encouraged discussion than those that distributed pamphlets.ConclusionsEducation interventions are effective in increasing the menstrual knowledge of young adolescent girls and skills training improves competency to manage menstruation more hygienically and comfortably. Interactive interventions are more motivating than didactic or written. Sharing concerns gives girls confidence and helps them to gain agency on the path to menstrual health.Trial registration numberFor this review, a protocol was not prepared or registered.

Project description:BACKGROUND:There is a global trend towards providing training for health professions students outside of tertiary academic complexes. In many countries, this shift places pressure on available sites and the resources at their disposal, specifically within the public health sector. Introducing an educational remit into a complex health system is challenging, requiring commitment from a range of stakeholders, including national authorities. To facilitate the effective implementation of distributed training, we developed a guiding framework through an extensive, national consultative process with a view to informing both practice and policy. METHODS:We adopted a participatory action research approach over a four year period across three phases, which included seven local, provincial and national consultative workshops, reflective work sessions by the research team, and expert reviews. Approximately 240 people participated in these activities. Engagement with the national department of health and health professions council further informed the development of the Framework. RESULTS:Each successive 'feedback loop' contributed to the development of the Framework which comprised a set of guiding principles, as well as the components essential to the effective implementation of distributed training. Analysis further pointed to the centrality of relationships, while emphasising the importance of involving all sectors relevant to the training of health professionals. A tool to facilitate the implementation of the Framework was also developed, incorporating a set of 'Simple Rules for Effective distributed health professions training'. A national consensus statement was adopted. CONCLUSIONS:In this project, we drew on the thinking and practices of key stakeholders to enable a synthesis between their embodied and inscribed knowledge, and the prevailing literature, this with a view to further enaction as the knowledge generators become knowledge users. The Framework and its subsequent implementation has not only assisted us to apply the evidence to our educational practice, but also to begin to influence policy at a national level.

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Participatory Action Research Approach to improve Adolescent Girls' Reproductive Health.

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Participatory Action Research Approach to improve Adolescent Girls' Reproductive Health.

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