Effect of the PREPARE intervention on sexual initiation and condom use among adolescents aged 12–14: a cluster randomised controlled trial in Dar es Salaam, Tanzania

BMC Public Health

Research Article

Elia John Mmbaga¹  Sander Matthijs Eggers²  Hein de Vries²  Annegreet Gera Wubs³  Leif Edvard Aarø⁴  Mrema Kilonzo⁵  Lusajo Kajula⁵  Sylvia Kaaya⁵ 

[1] Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, PO Box 65015, Dar es Salaam, Tanzania;Department of Health Education and Health Promotion, Maastricht University, Maastricht, The Netherlands;Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway;Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway;Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway;Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania;

关键词: Sexual Debut;    Generalize Estimate Equation;    Sexual Initiation;    Intervention School;    Control School;   

DOI  :  10.1186/s12889-017-4245-4

 received in 2015-10-30, accepted in 2017-04-07,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundUnsafe sexual practices continue to put adolescents at risk for a number of negative health outcomes in Tanzania. While there are some effective theory-based intervention packages with positive impact on important mediators of sexual behaviours, a context specific and tested intervention is urgently needed in Tanzania.PurposeTo develop and evaluate an intervention that will have a significant effect in reducing sexual initiation and promoting condom use among adolescents aged 12–14 in Dar es Salaam, Tanzania.DesignA school-based Cluster Randomised Controlled Trial was conducted during 2011–2014 in Kinondoni Municipality.MethodsA total of 38 public primary schools were randomly selected, of which half were assigned to the intervention and half to the control group based on their size and geographic location. Participants were interviewed using a self-administered questionnaire at baseline before the PREPARE intervention and then, 6 and 12 months following intervention. The primary outcomes were self-reported sex initiation and condom use during the past 6 months. Data analysis was done using Generalized Estimating Equation (GEE) modelling controlling for repeated measures and clustering of students within schools.ResultsA total of 5091 students were recruited at baseline, and interviewed again at 6 (n = 4783) and 12 months (n = 4370). Mean age of participants at baseline was 12.4 years. Baseline sociodemographic, psychometric and behavioural characteristics did not significantly differ between the two study arms. The GEE analysis indicated that the intervention had a significant effect on sexual initiation in both sexes after controlling for clustering and correlated repeated measures. A significantly higher level of action planning to use condoms was reported among female adolescent in the intervention arm than those in the control arm (p = 0.042). An effect on condom use behaviour was observed among male adolescent (p = 0.004), but not among female (p = 0.463).ConclusionsThe PREPARE intervention had an effect in delaying self-reported sexual initiation among adolescents aged 12–14 in Dar es Salaam Tanzania. The intervention positively influenced action planning to use condoms for both sexes and increased actual condom use among male adolescents only. Future interventions addressing adolescent sexual and reproductive health should focus on impacting mediators of behaviour change.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12613000900718, registered on 13 August, 2013.

【 授权许可】

CC BY   
© The Author(s). 2017