Plummer Mary L, Wight D, Obasi A I N, Wamoyi J, Mshana G, Todd J, Mazige B C, Makokha M, Hayes R J, Ross D A
Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Health Educ Res. 2007 Aug;22(4):500-12. doi: 10.1093/her/cyl103. Epub 2006 Oct 3.
This study is a process evaluation of the school component of the adolescent sexual health programme MEMA kwa Vijana (MkV), which was implemented in 62 primary schools in rural Mwanza, Tanzania from 1999 to 2001. The MkV curriculum was a teacher-led and peer-assisted programme based on the Social Learning Theory. Process evaluation included observation of training sessions, monitoring and supervision, annual surveys of implementers, group discussions and 158 person-weeks of participant observation. Most teachers taught curriculum content well, but sometimes had difficulty adopting new teaching styles. Peer educators performed scripted dramas well, but were limited as informal educators and behavioural models. The intervention appeared successful in addressing some cognitions, e.g. knowledge of risks and benefits of behaviours, but not others, e.g. perceived susceptibility to risk. MkV shared the characteristics of other African school-based programmes found to be successful, and similarly found significant improvements in self-reported behaviour in surveys. However, a substantial proportion of MkV survey self-reports were inconsistent, there was no consistent impact on biological markers and extensive process evaluation found little impact on several key theoretical determinants of behaviour. Improvements in self-reported survey data alone may provide only a very limited-and perhaps invalid-indication of adolescent sexual health programme success.
本研究是对青少年性健康项目“MEMA kwa Vijana”（MkV）学校部分的过程评估，该项目于1999年至2001年在坦桑尼亚姆万扎农村的62所小学实施。MkV课程是一个基于社会学习理论、由教师主导并由同伴协助的项目。过程评估包括对培训课程的观察、监测与监督、对实施者的年度调查、小组讨论以及158人周的参与观察。大多数教师能很好地教授课程内容，但有时在采用新的教学方式方面存在困难。同伴教育者能很好地表演脚本剧，但作为非正式教育者和行为榜样存在局限性。该干预措施在解决一些认知方面似乎是成功的，例如对行为风险和益处的了解，但在其他方面则不然，例如对风险易感性的认知。MkV具有其他成功的非洲校本项目的特点，同样在调查中发现自我报告行为有显著改善。然而，MkV调查中相当一部分自我报告不一致，对生物学指标没有持续影响，广泛的过程评估发现对行为的几个关键理论决定因素几乎没有影响。仅自我报告调查数据的改善可能只能提供对青少年性健康项目成功非常有限且可能无效的指示。
