ideas42, 80 Broad St 30Fl, New York, NY 10004, United States of America (USA).
MSI Reproductive Choices, London, England.
Bull World Health Organ. 2021 Nov 1;99(11):795-804. doi: 10.2471/BLT.20.285339. Epub 2021 Sep 29.
To evaluate the impact of a peer-referral and clinic welcome programme for reducing barriers to adolescents' uptake of family planning services in Uganda.
We developed an intervention using behavioural design and carried out a stratified, randomized controlled evaluation of the intervention in girls aged 15-19 years. Sexual and reproductive health clinics were randomized into control (56 clinics) and intervention groups (60 clinics). All intervention clinics received the core intervention (materials to create an adolescent-friendly environment and referral cards to give to friends), while a subset of clinics additionally received training in youth-friendly service provision. We collected clinics' routine data on monthly numbers of visits by adults and adolescents over a 15-month baseline and 6-month intervention period, 2018-2020.
In multivariate regression analysis we found significant effects of the intervention on primary outcomes in the pooled intervention group compared with control. Mean monthly visits by adolescents increased by 45% (incidence rate ratio, IRR: 1.45; 95% confidence interval, CI: 1.14-1.85), or over five additional adolescent clients per clinic per month. The mean adolescent proportion of total clients improved by 5.3 percentage points (95% CI: 0.02-0.09). Within treatment arms, clinics receiving the training in youth-friendly service provision showed the strongest effects: a 62% increase (IRR: 1.62; 95% CI: 1.21-2.17) in adolescent clients, or over seven additional adolescents per clinic per month, relative to the control group.
A behavioural change intervention designed to target identified barriers can increase adolescents' uptake of family planning counselling and services.
评估同伴推荐和诊所欢迎计划对减少乌干达青少年获得计划生育服务障碍的影响。
我们使用行为设计开发了一项干预措施，并对 15-19 岁女孩进行了分层随机对照评估。性健康和生殖健康诊所被随机分为对照组（56 家诊所）和干预组（60 家诊所）。所有干预诊所都收到了核心干预措施（创建青少年友好环境的材料和推荐给朋友的转诊卡），而部分诊所还接受了青年友好服务提供方面的培训。我们收集了诊所 15 个月基线和 6 个月干预期间每月成年和青少年就诊次数的常规数据，时间为 2018-2020 年。
在多变量回归分析中，我们发现与对照组相比，干预组在汇总干预组中的主要结果有显著影响。青少年每月就诊次数增加了 45%（发病率比，IRR：1.45；95%置信区间，CI：1.14-1.85），即每个诊所每月增加了 5 名以上的青少年患者。青少年在总就诊者中的平均比例提高了 5.3 个百分点（95%CI：0.02-0.09）。在治疗组内，接受青年友好服务提供培训的诊所显示出最强的效果：青少年就诊者增加了 62%（IRR：1.62；95%CI：1.21-2.17），即每个诊所每月增加了 7 名以上的青少年患者，与对照组相比。
一项旨在针对已确定障碍的行为改变干预措施可以增加青少年对计划生育咨询和服务的接受度。
