Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, P O Box 241, Cape Town, 8000, South Africa.
Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa.
BMC Public Health. 2020 Feb 27;20(1):275. doi: 10.1186/s12889-020-8357-x.
Engaging and retaining young men in community-based interventions is highly challenging. The purpose of this study was to investigate the individual factors that predict intervention engagement and adherence in a sample of at-risk South African men.
Baseline data were collected as a part of a cluster randomised control trial (RCT) situated in Khayelitsha and Mfuleni, two peri-urban settlements situated on the outskirts of Cape Town, South Africa. Neighbourhoods were randomised to one of three intervention conditions. We performed univariate descriptive statistics to report neighbourhood and individual socio-demographic factors, and ran multivariate models, adjusting for entry of study, to determine if high adherence and consistency of engagement with the intervention were associated with socio-behavioural demographics and risk behaviours, such as hazardous substance use, gangsterism, and criminal activity.
Total of 729 men were on average 22.5 years old (SD 2.8), with a mean of 10 years of education. More than half of the sample were single (94%), lived with their parents (66%) and had an income below ~$30 (52%). The overall mean of adherence is 0.41 (SD 0.24) and mean of consistency of engagement is 0.61 (SD 0.30). Our data indicated that completing more years of education, living with parents, and having higher socioeconomic status were significantly associated with higher rates of engagement and adherence. Men with a history of gang membership demonstrated higher levels of adherence and consistent engagement with the intervention, compared with other men who were recruited to the intervention. Crucially, our data show that young men with a history of substance use, and young men who report symptoms of depression and high levels of perceived stress are equally likely as other young men to adhere to the intervention and attend intervention sessions consistently.
Our results may contribute to a better understanding of young men's patterns of engagement and adherence to public health interventions. The results may have important implications for policy and practice, as they may be useful in planning more effective interventions and could potentially be used to predict which young men can be reached through community-based interventions.
ClinicalTrials.gov registration, NCT02358226. Prospectively registered 24 November 2014.
吸引和留住社区参与的年轻男性极具挑战性。本研究的目的是调查高危南非男性样本中预测干预参与和依从性的个体因素。
作为位于南非开普敦郊区的两个郊区城镇科伊特沙和姆富利尼的一项集群随机对照试验（RCT）的一部分，收集了基线数据。社区被随机分配到三种干预条件之一。我们进行了单变量描述性统计，以报告社区和个体社会人口统计学因素，并进行了多变量模型，以调整研究的进入，以确定高依从性和一致性与社会行为人口统计学和风险行为（如危险物质使用、帮派活动和犯罪活动）相关。
共有 729 名男性平均年龄为 22.5 岁（SD 2.8），平均受教育年限为 10 年。样本中超过一半是单身（94%），与父母同住（66%），收入低于~$30（52%）。整体依从性平均值为 0.41（SD 0.24），一致性参与平均值为 0.61（SD 0.30）。我们的数据表明，完成更多年的教育、与父母同住以及拥有更高的社会经济地位与更高的参与率和依从率显著相关。有帮派成员史的男性与干预的依从性和一致性参与度较高，而其他被招募参与干预的男性则较低。至关重要的是，我们的数据表明，有物质使用史的年轻男性和报告抑郁症状和高感知压力水平的年轻男性与其他年轻男性一样，同样有可能坚持干预并定期参加干预课程。
我们的结果可能有助于更好地理解年轻男性参与公共卫生干预措施的模式和依从性。这些结果可能对政策和实践具有重要意义，因为它们可能有助于规划更有效的干预措施，并有可能用于预测哪些年轻男性可以通过社区为基础的干预措施接触到。
ClinicalTrials.gov 注册，NCT02358226。2014 年 11 月 24 日前瞻性注册。
