Hewett Paul C, Austrian Karen, Soler-Hampejsek Erica, Behrman Jere R, Bozzani Fiammetta, Jackson-Hachonda Natalie A
Population Council, 4301 Connecticut Avenue, Washington, D.C., 2008, USA.
Population Council, P.O. Box 17643-00500, Nairobi, Kenya.
BMC Public Health. 2017 May 5;17(1):386. doi: 10.1186/s12889-017-4280-1.
Adolescents in less developed countries such as Zambia often face multi-faceted challenges for achieving successful transitions through adolescence to early adulthood. The literature has noted the need to introduce interventions during this period, particularly for adolescent girls, with the perspective that such investments have significant economic, social and health returns to society. The Adolescent Girls Empowerment Programme (AGEP) was an intervention designed as a catalyst for change for adolescent girls through themselves, to their family and community.
METHODS/DESIGN: AGEP was a multi-sectoral intervention targeting over 10,000 vulnerable adolescent girls ages 10-19 in rural and urban areas, in four of the ten provinces of Zambia. At the core of AGEP were mentor-led, weekly girls' group meetings of 20 to 30 adolescent girls participating over two years. Three curricula - sexual and reproductive health and lifeskills, financial literacy, and nutrition - guided the meetings. An engaging and participatory pedagogical approach was used. Two additional program components, a health voucher and a bank account, were offered to some girls to provide direct mechanisms to improve access to health and financial services. Embedded within AGEP was a rigorous multi-arm randomised cluster trial with randomization to different combinations of programme arms. The study was powered to assess the impact across a set of key longer-term outcomes, including early marriage and first birth, contraceptive use, educational attainment and acquisition of HIV and HSV-2. Baseline behavioural surveys and biological specimen collection were initiated in 2013. Impact was evaluated immediately after the program ended in 2015 and will be evaluated again after two additional years of follow-up in 2017. The primary analysis is intent-to-treat. Qualitative data are being collected in 2013, 2015 and 2017 to inform the programme implementation and the quantitative findings. An economic evaluation will evaluate the incremental cost-effectiveness of each component of the intervention.
The AGEP program and embedded evaluation will provide detailed information regarding interventions for adolescent girls in developing country settings. It will provide a rich information and data source on adolescent girls and its related findings will inform policy-makers, health professionals, donors and other stakeholders.
ISRCTN29322231 . March 04 2016; retrospectively registered.
在赞比亚等欠发达国家，青少年在从青春期成功过渡到成年早期的过程中往往面临多方面挑战。文献指出，在此期间需要引入干预措施，特别是针对少女，因为此类投资对社会具有重大的经济、社会和健康回报。少女赋权计划（AGEP）是一项干预措施，旨在通过少女自身、家庭和社区推动变革。
方法/设计：AGEP是一项多部门干预措施，目标是赞比亚十个省份中四个省份城乡地区的10000多名10至19岁弱势少女。AGEP的核心是由导师主导、为期两年、每周一次的少女小组会议，每次有20至30名少女参加。三次课程——性与生殖健康及生活技能、金融知识和营养——指导会议。采用了引人入胜且参与性强的教学方法。还为部分少女提供了另外两个项目组成部分，即健康代金券和银行账户，以提供直接机制来改善获得健康和金融服务的机会。AGEP内部有一项严格的多组随机整群试验，随机分配到不同的项目组组合。该研究旨在评估一系列关键长期结果的影响，包括早婚和初育、避孕措施使用、教育程度以及艾滋病毒和单纯疱疹病毒2型感染情况。2013年开始进行基线行为调查和生物样本采集。在2015年项目结束后立即评估影响，并将在2017年再进行两年随访后再次评估。主要分析采用意向性分析。2013年、2015年和2017年收集定性数据，为项目实施和定量研究结果提供参考。一项经济评估将评估干预措施各组成部分的增量成本效益。
AGEP项目及相关评估将提供有关发展中国家背景下少女干预措施的详细信息。它将为少女提供丰富的信息和数据来源，其相关研究结果将为政策制定者、卫生专业人员、捐助者及其他利益相关者提供参考。
ISRCTN29322231。2016年3月4日；追溯注册。
