Nursing and Midwifery

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Browsing Nursing and Midwifery by Author "Chipeta, Effie"

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    Implementation research on the appropriateness, feasibility, acceptability, and effectiveness of delivery of comprehensive sexuality education to Young people with disabilities and young people living with HIV out-of-school.
    (Kamuzu University of Health Sciences, 2021-03-04) Chipeta, Effie
    Type of study: This is an implementation science research study that will employ different methods to test the appropriateness, feasibility, acceptability and effectiveness of approaches to train and support facilitators to deliver CSE in out-of-school settings to young people with disabilities (YPWDs) and young people living with HIV (YPLHIV) in Malawi. Background and rationale: In January 2018, six UN agencies launched a revised edition of the International technical guidance on sexuality education, which provides guidance on designing and delivering comprehensive sexuality education (CSE) to support young people’s (10-24 years) health and well-being. Through UNFPA HQ and regional offices, the 3-year initiative titled “Reaching those most left behind through CSE for out-of-school young people,” is being implemented in Malawi and other four countries. The program in Malawi focuses on delivering CSE in out-of-school contexts to young people with disabilities and young people living with HIV. Objectives: The overall objective of the implementation research is to determine whether the activities used to train and support the facilitators are feasible, appropriate, acceptable, and effective in enabling the facilitators to engage YPWD and YPLHIV, deliver CSE to them in the out-of-school context, and assist them in obtaining relevant services. The specific objectives of the implementation research are: 1. To determine whether the activities used to train and support facilitators were appropriate for the delivery of comprehensive sexuality education to young people with disabilities and young people living with HIV. 2. To determine whether the plan for training and supporting the facilitators was feasible and whether it was implemented with fidelity. 3. To determine whether the training and support provided to the facilitators was effective in improving their competencies and attitudes. 4. To determine whether the facilitators: a. perceived that the training and support they received adequately enabled them to carry out their roles and responsibilities. b. effectively carried out their roles and responsibilities. 5. To determine whether the YPWD and YPLHIV: a. perceived the CSE as accessible, relevant, interesting, and useful. b. gained in terms of knowledge, attitudes, values, and skills related to sexuality and reproduction, and in terms of the use of relevant services. Methods: This is an implementation science research study that will employ different methods to test the appropriateness, feasibility, acceptability and effectiveness of training and supporting facilitators to deliver CSE in out-of-school settings to young people with disabilities and young people living with HIV in Malawi. Data will be collected at different time periods to measure and assess the implementation process and outcomes throughout the course of the intervention. We will use qualitative methods such as focus group discussions and in depth interviews and records review to measure the implementation processes and outcomes. Data management and analysis: The data will be secured. To ensure that the identities of participants are kept confidential, data will be anonymised and random identifiers will be generated for each file. The investigators will also go through audio files and transcripts to ensure quality. Quantitative data will also be cleaned. Qualitative data will be analysed using thematic content analysis approach while we will generate descriptive statistics with quantitative data. The qualitative and quantitative findings will be triangulated. By using various research methods (i.e. records review, qualitative interviews and quantitative data), we will eliminate some biases and shortcomings that may arise with using one method. Where necessary, qualitative data will provide explanations, justifications and validations to the findings from the quantitative data. Possible constraints: We anticipate no major constraints. However, due to the COVID-19 pandemic, study activities may be delayed or paused depending on the status of the pandemic. We will also adhere to all COVID-19 guidelines in conducting our research to ensure the safety of both researchers and study participants. Results To ensure that the research findings support efforts to improve CSE more generally, research findings will be disseminated through key stakeholders, peer reviewed journals, conferences and a copy will be sent to approving ethics committees (e.g. COMREC). Implications of the study: We anticipate that facilitators will become more competent in and more comfortable with delivering CSE in out-of-school settings to the targeted populations, that is, young people with disabilities and young people living with HIV. We anticipate that the facilitators will be acceptable to the young people and that delivery of the CSE will be feasible and more effective.