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Urrutia MT, Araya AX, Gajardo M, Chepo M, Torres R, Schilling A. Acceptability of HPV Vaccines: A Qualitative Systematic Review and Meta-Summary. Vaccines (Basel) 2023; 11:1486. [PMID: 37766161 PMCID: PMC10536942 DOI: 10.3390/vaccines11091486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/14/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
In 2006, the human papillomavirus (HPV) vaccine was approved for use as an effective intervention for reducing the risk of developing cervical cancer; however, its successful implementation is dependent on acceptability. This study aims to provide a comprehensive understanding of the reasons that favor or do not favor the acceptability of HPV vaccines. METHODS We conducted a systematic review and meta-summary of qualitative research on 16 databases. A total of 32 articles that considered the perspectives of vaccine users, their parents, and the professionals who care for them were reviewed. Synthesis was conducted as described by Sandelowski and Barroso. RESULTS We used inductive and deductive methods to obtain a total of 22 dimensions, out of which three issues stood out that should be considered to improve acceptability and are formed by three groups of study, namely, information about the vaccine, fears and side effects, and sexuality associated with the vaccine. CONCLUSIONS Acceptability, as well as adherence to HPV vaccination, is a complex concept. This review highlights the perspectives of the three sets of actors involved in the process (i.e., users, parents, and professionals) and views these factors in relation to acceptability as a guide for new interventions.
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Affiliation(s)
- María-Teresa Urrutia
- School of Nursing, Universidad Andrés Bello, Santiago 8370134, Chile; (A.-X.A.); (M.C.)
| | | | - Macarena Gajardo
- School of Medicine, Universidad de Chile, Santiago 9170022, Chile;
| | - Macarena Chepo
- School of Nursing, Universidad Andrés Bello, Santiago 8370134, Chile; (A.-X.A.); (M.C.)
| | - Romina Torres
- Sistema de Bibliotecas UC, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile;
| | - Andrea Schilling
- Clinical Research Center, Institute of Science and Innovation in Medicine, Facultad de Medicina, Clinica Alemana Universidad del Desarrollo, Santiago 7610315, Chile;
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Nardell MF, Sindelo S, Rousseau E, Siko N, Fuzile P, Julies R, Bassett IV, Mellins CA, Bekker LG, Butler LM, Katz IT. Development of "Yima Nkqo," a community-based, peer group intervention to support treatment initiation for young adults with HIV in South Africa. PLoS One 2023; 18:e0280895. [PMID: 37319250 PMCID: PMC10270624 DOI: 10.1371/journal.pone.0280895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 01/11/2023] [Indexed: 06/17/2023] Open
Abstract
AIMS Half of young adults diagnosed with HIV in South Africa start antiretroviral therapy (ART). We developed and field tested a facilitator-guided peer support group called Yima Nkqo ("Standing Tall" in isiXhosa) to promote treatment initiation for young adults newly diagnosed with HIV in communities around Cape Town. METHODS Following an adapted version of the UK Medical Research Council's framework for developing complex interventions, we 1) identified evidence on previous interventions to improve ART uptake in sub-Saharan Africa; 2) collected and analyzed qualitative data on the acceptability of our proposed intervention; 3) proposed a theoretical understanding of the process of behavior change; and 4) developed an intervention manual and feedback tools. During field-testing, participant feedback on intervention acceptability, and team feedback on consistency of content delivery and facilitation quality, were analyzed using an iterative, rapid-feedback evaluation approach. In-depth written and verbal summaries were shared in weekly team meetings. Team members interpreted feedback, identified areas for improvement, and proposed suggestions for intervention modifications. RESULTS Based on our formative research, we developed three, 90-minute sessions with content including HIV and ART education, reflection on personal resources and strengths, practice disclosing one's status, strategies to overcome stressors, and goal setting to start treatment. A lay facilitator was trained to deliver intervention content. Two field testing groups (five and four participants, respectively) completed the intervention. Participants highlighted that strengths of Yima Nkqo included peer support, motivation, and education about HIV and ART. Team feedback to the facilitator ensured optimal consistency of intervention content delivery. CONCLUSIONS Iteratively developed in collaboration with youth and healthcare providers, Yima Nkqo is a promising new intervention to improve treatment uptake among young adults with HIV in South Africa. The next phase will be a pilot randomized controlled trial of Yima Nkqo (ClinicalTrials.gov Identifier: NCT04568460).
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Affiliation(s)
- Maria F. Nardell
- Division of Global Health Equity, Brigham and Women’s Hospital, Boston, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA, United States of America
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
| | - Siyaxolisa Sindelo
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
| | - Elzette Rousseau
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
| | - Nomakaziwe Siko
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
| | - Pamela Fuzile
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
| | - Robin Julies
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
| | - Ingrid V. Bassett
- Harvard Medical School, Boston, MA, United States of America
- Center for Global Health, Massachusetts General Hospital, Boston, MA, United States of America
| | - Claude A. Mellins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY, United States of America
| | - Linda-Gail Bekker
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
- Department of Medicine, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, Republic of South Africa
- Governing Council, International AIDS Society, Geneva, Switzerland
| | - Lisa M. Butler
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT, United States of America
| | - Ingrid T. Katz
- Harvard Medical School, Boston, MA, United States of America
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA, United States of America
- Harvard Global Health Institute, Harvard University, Cambridge, MA, United States of America
- Division of Women’s Health, Brigham and Women’s Hospital, Boston, MA, United States of America
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Casale M, Somefun O, Haupt Ronnie G, Desmond C, Sherr L, Cluver L. A conceptual framework and exploratory model for health and social intervention acceptability among African adolescents and youth. Soc Sci Med 2023; 326:115899. [PMID: 37087974 DOI: 10.1016/j.socscimed.2023.115899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 04/05/2023] [Accepted: 04/08/2023] [Indexed: 04/25/2023]
Abstract
Intervention acceptability has become an increasingly key consideration in the development, evaluation and implementation of health and social interventions. However, to date this area of investigation has been constrained by the absence of a consistent definition of acceptability, comprehensive conceptual frameworks disaggregating its components, and few reliable assessment measures. This paper aims to contribute to this gap, by proposing a conceptual framework and exploratory model for acceptability with a specific priority population for health and developmental interventions: adolescents and youth in Africa. We document our multi-staged approach to model development, comprising both inductive and deductive components, and both systematic and interpretative review methods. This included thematic analyses of respective acceptability definitions and findings, from 55 studies assessing acceptability of 60 interventions conducted with young people aged 10-24 in (mainly Southern and Eastern) Africa over a decade; a consideration of these findings in relation to Sekhon et al.'s Theoretical Framework of Acceptability (TFA); a cross-disciplinary review of acceptability definitions and models; a review of key health behavioural change models; and expert consultation with interdisciplinary researchers. Our proposed framework incorporates nine component constructs: affective attitude, intervention understanding, perceived positive effects, relevance, perceived social acceptability, burden, ethicality, perceived negative effects and self-efficacy. We discuss the rationale for the inclusion and definition of each component, highlighting key behavioural models that adopt similar constructs. We then extend this framework to develop an exploratory model for acceptability with young people, that links the framework components to each other and to intervention engagement. Acceptability is represented as an emergent property of a complex, adaptive system of interacting components, which can influence user engagement directly and indirectly, and in turn be influenced by user engagement. We discuss opportunities for applying and further refining or developing these models, and their value as a point of reference for the development of acceptability assessment tools.
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Affiliation(s)
- Marisa Casale
- School of Public Health, University of the Western Cape, Cape Town, South Africa; Department of Social Policy and Intervention, University of Oxford, Barnett House, Oxford, United Kingdom.
| | - Oluwaseyi Somefun
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | | | - Chris Desmond
- Centre for Rural Health, University of KwaZulu-Natal, South Africa
| | | | - Lucie Cluver
- Department of Social Policy and Intervention, University of Oxford, Barnett House, Oxford, United Kingdom; Dept of Psychiatry and Mental Health, University of Cape Town, South Africa
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Sensoy Bahar O, Nabunya P, Namuwonge F, Samtani S, Ssentumbwe V, Namuli F, Magorokosho N, Ssewamala FM. "It gives you a road map of what to do to solve your problems": acceptability of a combination HIV prevention intervention among adolescent girls in Uganda. BMC Public Health 2023; 23:249. [PMID: 36747149 PMCID: PMC9901100 DOI: 10.1186/s12889-023-15083-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/18/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The HIV burden remains a critical public health concern and adolescent girls are at significantly higher risk compared to the general adult population. Similar to other sub-Saharan African countries, Uganda reports high HIV prevalence among adolescent girls and young women. Yet, both evidence-based HIV prevention interventions and their acceptability among adolescent girls have not been widely studied. In this study, we examined the acceptability of the Suubi4Her intervention, an evidence-based combination intervention aimed at reducing HIV risk among adolescent girls in Uganda. METHODS We conducted semi-structured in-depth interviews with 25 adolescent girls upon intervention completion to explore their experiences with the Suubi4Her intervention that was tested in a clinical trial in Uganda (2017-2023). Specifically, we explored their decision-making process for participating in the intervention, experiences with program attendance, and their feedback on specific intervention characteristics. Informed by the Theoretical Framework of Acceptability, the data were analyzed using thematic analysis. RESULTS The main motivation for participation was access to health-related information, including information on STIs, HIV, and pregnancy as well as information on banking, saving, and income-generating activities. Though many participants did not have any initial concerns, mistrust of programs, initial paperwork, caregiver's ability to commit time, concerns about ability to save, and HIV/STI and pregnancy testing were raised by some participants. Facilitators to session attendance included motivation to learn information, caregiver commitment, reminder calls, and incentives received for participation. The main challenges included household responsibilities and obligations, difficulty raising transport money, and weather challenges. Adolescent girls appreciated the group format and found the location and times of the sessions convenient. They also found the content relevant to their needs and noted positive changes in their families. CONCLUSIONS The results showed high intervention acceptability among adolescent girls. These findings have important programmatic and policy implications in Uganda, especially given the higher HIV prevalence among adolescent girls in the country. TRIAL REGISTRATION NCT03307226 (Registered: 10/11/17).
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Affiliation(s)
- Ozge Sensoy Bahar
- Brown School, Washington University in St. Louis, St. Louis, MO, USA. .,International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, MO, USA.
| | - Proscovia Nabunya
- grid.4367.60000 0001 2355 7002Brown School, Washington University in St. Louis, St. Louis, MO USA ,grid.4367.60000 0001 2355 7002International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, MO USA
| | - Flavia Namuwonge
- grid.4367.60000 0001 2355 7002Brown School, Washington University in St. Louis, St. Louis, MO USA ,grid.4367.60000 0001 2355 7002International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, MO USA
| | - Satabdi Samtani
- grid.4367.60000 0001 2355 7002International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, MO USA
| | - Vicent Ssentumbwe
- grid.4367.60000 0001 2355 7002Brown School, Washington University in St. Louis, St. Louis, MO USA ,grid.4367.60000 0001 2355 7002International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, MO USA
| | - Florence Namuli
- International Center for Child Health and Development Field Office, Masaka, Uganda
| | - Natasja Magorokosho
- grid.4367.60000 0001 2355 7002International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, MO USA
| | - Fred M. Ssewamala
- grid.4367.60000 0001 2355 7002Brown School, Washington University in St. Louis, St. Louis, MO USA ,grid.4367.60000 0001 2355 7002International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, MO USA
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Ortblad KF, Sekhon M, Wang L, Roth S, van der Straten A, Simoni JM, Velloza J. Acceptability Assessment in HIV Prevention and Treatment Intervention and Service Delivery Research: A Systematic Review and Qualitative Analysis. AIDS Behav 2023; 27:600-617. [PMID: 35870025 PMCID: PMC9868192 DOI: 10.1007/s10461-022-03796-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2022] [Indexed: 01/26/2023]
Abstract
We reviewed the literature on the assessment of acceptability of HIV prevention and treatment interventions and service delivery strategies. Following PRISMA guidelines, we screened 601 studies published from 2015 to 2020 and included 217 in our review. Of 384 excluded studies, 21% were excluded because they relied on retention as the sole acceptability indicator. Of 217 included studies, only 16% were rated at our highest tier of methodological rigor. Operational definitions of acceptability varied widely and failed to comprehensively represent the suggested constructs in current acceptability frameworks. Overall, 25 studies used formal quantitative assessments (including four adapted measures used in prior studies) and six incorporated frameworks of acceptability. Findings suggest acceptability assessment in recent HIV intervention and service delivery research lacks harmonization and rigor. We offer guidelines for best practices and future research, which are timely and critical in this era of informed choice and novel options for HIV prevention and treatment.
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Affiliation(s)
- Katrina F Ortblad
- Public Health Science Division, Fred Hutchinson Cancer Center, 1100 Fairview Ave N, Seattle, WA, 98109, USA.
| | - Mandeep Sekhon
- Centre for Applied Health and Social Care Research, Kingston University and St Georges University of London, London, UK
- Department of Population Health Sciences, School of Population Health and Environmental Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Liying Wang
- Department of Psychology, University of Washington, Seattle, USA
| | | | - Ariane van der Straten
- Center for AIDS Prevention Studies, Department of Medicine, University of California San Francisco, San Francisco, USA
- ASTRA Consulting, Kensington, USA
| | - Jane M Simoni
- Department of Psychology, University of Washington, Seattle, USA
- Department of Global Health, University of Washington, Seattle, USA
| | - Jennifer Velloza
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, USA
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Sensoy Bahar O, Boateng A, Nartey PB, Ibrahim A, Kumbelim K, Nabunya P, Ssewamala FM, McKay MM. " ANZANSI Program Taught Me Many Things in Life": Families' Experiences with a Combination Intervention to Prevent Adolescent Girls' Unaccompanied Migration for Labor. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13168. [PMID: 36293748 PMCID: PMC9603225 DOI: 10.3390/ijerph192013168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Approximately 160 million children work as child laborers globally, 39% of whom are female. Ghana is one of the countries with the highest rates of child labor. Child labor has serious health, mental health, and educational consequences, and those who migrate independently for child labor are even at higher risk. Yet, evidence-based efforts to prevent unaccompanied child migration are limited. In this study, we examined the acceptability of a family-level intervention, called ANZANSI (resilience in local language) combining two evidence-based interventions, a family economic empowerment intervention and a multiple family group family strengthening intervention, to reduce the risk factors associated with the independent migration of adolescent girls from the Northern region to big cities in Ghana. We conducted semi-structured interviews separately with 20 adolescent girls and their caregivers who participated in ANZANSI. Interviews were conducted in the local language and transcribed and translated verbatim. Informed by the theoretical framework of acceptability, the data were analyzed using thematic analysis. The results showed high intervention acceptability among both adolescent girls and their caregivers, including low burden, positive affective attitude, high perceived effectiveness, low opportunity costs, and high self-efficacy. The study findings underline the high need for such interventions in low-resource contexts in Ghana and provide the foundation for testing this intervention in a larger randomized trial.
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Affiliation(s)
- Ozge Sensoy Bahar
- Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO 63130, USA
| | - Alice Boateng
- Department of Social Work, University of Ghana, Accra P.O. Box LG419, Ghana
| | - Portia B. Nartey
- Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO 63130, USA
| | - Abdallah Ibrahim
- School of Public Health, University of Ghana, Accra P.O. Box LG419, Ghana
| | | | - Proscovia Nabunya
- Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO 63130, USA
| | - Fred M. Ssewamala
- Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO 63130, USA
| | - Mary M. McKay
- Vice Provost Office, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA
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Zanoni B, Archary M, Sibaya T, Ramos T, Donenberg G, Shahmanesh M, Celum C, Pettifor A, Bekker LG, Haberer J. Interventions addressing the adolescent HIV continuum of care in South Africa: a systematic review and modified Delphi analysis. BMJ Open 2022; 12:e057797. [PMID: 35487726 PMCID: PMC9058810 DOI: 10.1136/bmjopen-2021-057797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Compared with adults, adolescents in South Africa have larger gaps at each step of the HIV continuum of care resulting in low levels of viral suppression. METHODS We conducted a systematic review and modified Delphi analysis of interventions addressing the HIV continuum of care for adolescents in South Africa. We searched PubMed, Science Direct, and Google Scholar and online conference proceedings from the International AIDS Society, the International AIDS Conference, and the Conference on Retrovirology and Opportunistic Infections from 1 January 2010 to 30 September 2020. We then conducted a modified Delphi analysis with 29 researchers involved in the National Institutes of Health's Fogarty International-supported Adolescent HIV Implementation Science Alliance-South Africa to evaluate interventions for efficacy, feasibility and potential for scale-up. RESULTS We identified nine initial published articles containing interventions addressing the adolescent HIV continuum of care in South Africa, including five interventions focused on HIV diagnosis, two on antiretroviral therapy adherence and two on retention in care. No studies addressed linkage to care or transition from paediatric to adult care. Two studies discussed intervention costs. In-home and HIV self-testing, community-based adherence support, and provision of adolescent-friendly services were the most impactful and scalable interventions addressing the adolescent HIV continuum of care. CONCLUSION Future interventions should work comprehensively across the adolescent HIV continuum of care and be tailored to the specific needs of adolescents.
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Affiliation(s)
- Brian Zanoni
- Pediatric Infectious Diseases, Emory University, Atlanta, Georgia, USA
- Global Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
- Pediatric Infectious Diseases, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Moherndran Archary
- Pediatric Infectious Disease, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
- Pediatrics, University of KwaZulu-Natal Nelson R Mandela School of Medicine, Durban, South Africa
| | - Thobekile Sibaya
- Pediatrics, University of KwaZulu-Natal Nelson R Mandela School of Medicine, Durban, South Africa
| | | | - Geri Donenberg
- Institute for Juvenile Research, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Maryam Shahmanesh
- Institute for Global Health, University College London, London, UK
- Clinical Science, Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa
| | - Connie Celum
- Epidemiology, University of Washington, Seattle, Washington, USA
| | - Audrey Pettifor
- Epidemiology, University of North Carolina System, Chapel Hill, North Carolina, USA
| | - Linda Gail Bekker
- Desmond Tutu HIV Center, University of Cape Town, Cape Town, South Africa
| | - Jessica Haberer
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA
- Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Sherr L, Cluver L, Desmond C, Dhaliwal M, Webb D, Aber JL. Accelerating achievement for Africa's adolescents - an innovative initiative. PSYCHOL HEALTH MED 2022; 27:1-13. [PMID: 36471485 DOI: 10.1080/13548506.2022.2147962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Lorraine Sherr
- Institute for Global Health, University College London, London, UK
| | - Lucie Cluver
- Department of Social Policy & Intervention, University of Oxford, Oxford, UK.,Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Chris Desmond
- Centre for Rural Health, University of Kwa-Zulu Natal, Durban, South Africa
| | - Mandeep Dhaliwal
- HIV and Health Group, United Nations Development Programme (UNDP), New York, USA
| | - Douglas Webb
- Health and Innovative Financing, HIV and Health Group, United Nations Development Programme (UNDP), New York, USA
| | - J Lawrence Aber
- Steinhardt School of Culture, Education, and Human Development, New York University New York, NY, United States
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Casale M, Yates R, Gittings L, Haupt Ronnie G, Somefun O, Desmond C. Consolidate, conceptualize, contextualise: key learnings for future intervention acceptability research with young people in Africa. PSYCHOL HEALTH MED 2022; 27:181-192. [PMID: 35938622 PMCID: PMC10029093 DOI: 10.1080/13548506.2022.2108078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Acceptability has become a key consideration in the development, evaluation and implementation of health and social interventions. This commentary paper advances key learnings and recommendations for future intervention acceptability research with young people in Africa, aimed at supporting the achievement of developmental goals. It relates findings of the adolescent acceptability work conducted within the Accelerate Hub, since mid 2020, to broader inter-disciplinary literatures and current regional health and social priorities. We argue that, in order to strengthen the quality and applied value of future acceptability work with young people, we need to do three things better. First, we need to consolidate prior findings on acceptability, within and across intervention types, to inform responses to current public health and social challenges and further the conceptual work in this area. Second, we need to better conceptualise acceptability research with young people, by developing stronger conceptual frameworks that define acceptability and its constructs, and predict its relationship with intervention engagement. Third, we need to better contextualise findings by considering acceptability data within a broader social and political context, which in turn can be supported by better conceptualisation. In this paper we describe contributions of our work to each of these three inter-connected objectives, and suggest ways in which they may be taken forward by researchers and practitioners. These include aggregating evidence from past interventions to highlight potential barriers and enablers to current responses in priority areas; involving key actors earlier and more meaningfully in acceptability research; further developing and testing behavioural models for youth acceptability; and working collaboratively across sectors towards programmatic guidance for better contextualisation of acceptability research. Progress in this field will require an inter-disciplinary approach that draws from various literatures such as socio-ecological theory, political economy analysis, health behaviour models and literature on participatory research approaches.
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Affiliation(s)
- Marisa Casale
- School of Public Health,University of the Western Cape, Cape Town, South Africa
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Rachel Yates
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Lesley Gittings
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
- Faculty of Social Work, University of Toronto, Canada
| | | | - Oluwaseyi Somefun
- School of Public Health,University of the Western Cape, Cape Town, South Africa
| | - Chris Desmond
- Centre for Rural Health, University of KwaZulu-Natal
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