Implementation research on the appropriateness, feasibility, acceptability, and effectiveness of delivery of comprehensive sexuality education to Young people with disabilities and young people living with HIV out-of-school.
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Date
2021-03-04
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Kamuzu University of Health Sciences
Abstract
Type of study: This is an implementation science research study that will employ different methods to test the
appropriateness, feasibility, acceptability and effectiveness of approaches to train and support
facilitators to deliver CSE in out-of-school settings to young people with disabilities (YPWDs) and young
people living with HIV (YPLHIV) in Malawi.
Background and rationale:
In January 2018, six UN agencies launched a revised edition of the International technical guidance on
sexuality education, which provides guidance on designing and delivering comprehensive sexuality
education (CSE) to support young people’s (10-24 years) health and well-being. Through UNFPA HQ and
regional offices, the 3-year initiative titled “Reaching those most left behind through CSE for out-of-school
young people,” is being implemented in Malawi and other four countries. The program in Malawi focuses
on delivering CSE in out-of-school contexts to young people with disabilities and young people living with
HIV.
Objectives:
The overall objective of the implementation research is to determine whether the activities used to train
and support the facilitators are feasible, appropriate, acceptable, and effective in enabling the facilitators
to engage YPWD and YPLHIV, deliver CSE to them in the out-of-school context, and assist them in obtaining
relevant services.
The specific objectives of the implementation research are:
1. To determine whether the activities used to train and support facilitators were appropriate
for the delivery of comprehensive sexuality education to young people with disabilities and
young people living with HIV.
2. To determine whether the plan for training and supporting the facilitators was feasible and
whether it was implemented with fidelity.
3. To determine whether the training and support provided to the facilitators was effective in
improving their competencies and attitudes.
4. To determine whether the facilitators:
a. perceived that the training and support they received adequately enabled them to
carry out their roles and responsibilities.
b. effectively carried out their roles and responsibilities.
5. To determine whether the YPWD and YPLHIV:
a. perceived the CSE as accessible, relevant, interesting, and useful.
b. gained in terms of knowledge, attitudes, values, and skills related to sexuality and
reproduction, and in terms of the use of relevant services.
Methods:
This is an implementation science research study that will employ different methods to test the
appropriateness, feasibility, acceptability and effectiveness of training and supporting facilitators to
deliver CSE in out-of-school settings to young people with disabilities and young people living with HIV in Malawi. Data will be collected at different time periods to measure and assess the implementation
process and outcomes throughout the course of the intervention. We will use qualitative methods such
as focus group discussions and in depth interviews and records review to measure the implementation
processes and outcomes.
Data management and analysis: The data will be secured. To ensure that the identities of participants are kept confidential, data will be
anonymised and random identifiers will be generated for each file. The investigators will also go through
audio files and transcripts to ensure quality. Quantitative data will also be cleaned.
Qualitative data will be analysed using thematic content analysis approach while we will generate
descriptive statistics with quantitative data. The qualitative and quantitative findings will be triangulated.
By using various research methods (i.e. records review, qualitative interviews and quantitative data), we
will eliminate some biases and shortcomings that may arise with using one method. Where necessary,
qualitative data will provide explanations, justifications and validations to the findings from the
quantitative data.
Possible constraints:
We anticipate no major constraints. However, due to the COVID-19 pandemic, study activities may be
delayed or paused depending on the status of the pandemic. We will also adhere to all COVID-19
guidelines in conducting our research to ensure the safety of both researchers and study participants.
Results
To ensure that the research findings support efforts to improve CSE more generally, research findings will
be disseminated through key stakeholders, peer reviewed journals, conferences and a copy will be sent
to approving ethics committees (e.g. COMREC).
Implications of the study: We anticipate that facilitators will become more competent in and more comfortable with delivering
CSE in out-of-school settings to the targeted populations, that is, young people with disabilities and young
people living with HIV. We anticipate that the facilitators will be acceptable to the young people and that
delivery of the CSE will be feasible and more effective.
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Keywords
Research Subject Categories::MEDICINE