Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 W. 168th Street, Room 537, New York, NY, 10032, USA.
Muhumbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
J Prim Prev. 2021 Aug;42(4):363-384. doi: 10.1007/s10935-020-00586-0.
Multiple methodological approaches have been used to explore adolescent alcohol use and related sexual behaviors, ranging from surveys to assessments of alcohol outlet density. Although surveys can capture the extent of alcohol use, they do not allow for a contextualized understanding of young people's voiced experiences with alcohol, including sociocultural, gendered and environmental pressures to consume, and related engagement in sex. The mapping of alcohol outlets provides physical density information, but infrequently from youths' perspectives. Traditional qualitative methods like in-depth interviews and focus group discussions do allow for a more nuanced understanding of adolescents' experiences, but they can be limited by the use of semi-structured guides that may negatively impact the fluidity of discussion. We seek to contribute to the methodological approaches utilized with adolescents by demonstrating how contextualized data were captured from Tanzanian adolescents' experiences of alcohol and sex, which are sensitive topics in many African countries. We collected data in secondary schools and youth centers across four sites in Dar es Salaam, the largest and most diverse city in Tanzania. As a complement to in-depth interviews, archival reviews, and a systematic mapping of alcohol availability, participatory methodologies such as photovoice, story writing, and drawing allowed Tanzanian youth to offer more honest, descriptions of lived experiences with their physical and social environment in relation to alcohol use and related sexual behavior patterns. Through participatory methods, study participants were able to discuss behaviors that are viewed as social transgressions, sensitive topics like violence in relation to sex, and views around their own self-agency. The use of a methodological toolkit including participatory methodologies enabled youth to trust the researchers and share sensitive information in a relatively short period of time, overcoming some of the challenges of traditional qualitative methods.
已经采用了多种方法来探索青少年的饮酒行为和相关性行为，包括调查和评估酒类销售点密度。虽然调查可以捕捉到饮酒的程度，但它们无法深入了解年轻人对饮酒的真实体验，包括社会文化、性别和环境对饮酒的压力，以及相关的性行为。酒类销售点的映射提供了物理密度信息，但很少从年轻人的角度出发。传统的定性方法，如深入访谈和焦点小组讨论，可以更深入地了解青少年的体验，但它们可能受到使用半结构化指南的限制，这可能会对讨论的流畅性产生负面影响。我们旨在通过展示如何从坦桑尼亚青少年的饮酒和性行为经历中获取情境化数据，为青少年使用的方法学方法做出贡献，这些经历在许多非洲国家都是敏感话题。我们在达累斯萨拉姆的四个地点的中学和青年中心收集了数据。作为深入访谈、档案审查和酒类供应系统映射的补充，参与式方法，如摄影、故事写作和绘画，使坦桑尼亚青少年能够更诚实地描述他们与周围物理和社会环境有关的饮酒和相关性行为模式的生活体验。通过参与式方法，研究参与者能够讨论被视为社会越轨行为的行为，如与性有关的暴力等敏感话题，以及围绕他们自身自主意识的观点。使用包括参与式方法在内的方法学工具包使年轻人能够在相对较短的时间内信任研究人员并分享敏感信息，克服了传统定性方法的一些挑战。
