A mixed-methods, exploratory, quasi-experimental evaluation of a radio drama intervention to prevent age-disparate transactional sex in Tanzania

IntroductionAge-disparate transactional sex (ADTS) is associated with HIV, unintended pregnancy, school dropout and violence, yet few interventions have successfully prevented it, and none have set ADTS prevention as their primary outcome. This exploratory evaluation aimed to assess indications of c...

Full description

Bibliographic Details
Main Authors: Marjorie Pichon, Daniel J Carter, Lottie Howard-Merrill, Revocatus Sono, Veronicah Gimunta, Oscar Rutenge, Yandé Thiaw, Kirsten Stoebenau, Nancy Perrin, Ana Maria Buller
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-12-01
Series:Frontiers in Reproductive Health
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/frph.2022.1000853/full
_version_ 1811311237795938304
author Marjorie Pichon
Daniel J Carter
Lottie Howard-Merrill
Revocatus Sono
Veronicah Gimunta
Oscar Rutenge
Yandé Thiaw
Kirsten Stoebenau
Nancy Perrin
Ana Maria Buller
author_facet Marjorie Pichon
Daniel J Carter
Lottie Howard-Merrill
Revocatus Sono
Veronicah Gimunta
Oscar Rutenge
Yandé Thiaw
Kirsten Stoebenau
Nancy Perrin
Ana Maria Buller
author_sort Marjorie Pichon
collection DOAJ
description IntroductionAge-disparate transactional sex (ADTS) is associated with HIV, unintended pregnancy, school dropout and violence, yet few interventions have successfully prevented it, and none have set ADTS prevention as their primary outcome. This exploratory evaluation aimed to assess indications of change after exposure to the Learning Initiative on Norms, Exploitation and Abuse (LINEA) intervention, a mass-media, gender-transformative social norms intervention aimed at preventing ADTS in Tanzania.MethodsIn a condensed implementation 331 participants were instructed to listen to the LINEA radio drama over seven weeks, and 60 were randomly allocated to household discussion sessions about content. In-depth interviews (n = 81) from girls aged 12–16 years, and women and men caregivers were collected at baseline (September 2021), midline (November) and endline (December 2021). Surveys were conducted (n = 120) at baseline and endline using the Norms and Attitudes on ADTS Scale (NAATSS) and the Gender Roles and Male Provision Expectations (GRMPE) scale. Interviews were thematically analyzed using a framework approach. Age-stratified linear regression models adjusted for baseline scores were used to measure association between the intervention and endline scale scores.ResultsLongitudinal data were available from 59 qualitative (73%) and 95 quantitative participants (79%). Qualitative evidence revealed the drama facilitated family conversations about adolescent challenges, allowing caregivers to advise daughters. Some girls gained confidence to refuse men's gifts, learning that accepting them could necessitate sexual reciprocation. Some caregivers felt increased responsibility for supporting girls in the community to avoid ADTS. Blame for ADTS shifted for some from girls to men, suggesting increased understanding of inequitable power dynamics and reductions in victim blaming. Marginal quantitative evidence revealed that highly exposed girls had improved gender equitable beliefs on the GRMPE (β = −6.26; 95% CI: −12.94, 0.42). Moderately exposed men had increased gender inequitable norms on the NAATSS subscale (β = 0.42 95% CI: 0.05, 0.79), but there was no effect in highly exposed men.ConclusionsGiven the small sample results should be interpreted cautiously. Our initial findings indicate high engagement with the LINEA intervention shows promise in shifting knowledge, behaviors, and attitudes, beliefs and social norms driving ADTS in Shinyanga, Tanzania, supporting a robust impact evaluation.
first_indexed 2024-04-13T10:15:24Z
format Article
id doaj.art-779255acc2134b29a6db83c00b5e6d49
institution Directory Open Access Journal
issn 2673-3153
language English
last_indexed 2024-04-13T10:15:24Z
publishDate 2022-12-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Reproductive Health
spelling doaj.art-779255acc2134b29a6db83c00b5e6d492022-12-22T02:50:46ZengFrontiers Media S.A.Frontiers in Reproductive Health2673-31532022-12-01410.3389/frph.2022.10008531000853A mixed-methods, exploratory, quasi-experimental evaluation of a radio drama intervention to prevent age-disparate transactional sex in TanzaniaMarjorie Pichon0Daniel J Carter1Lottie Howard-Merrill2Revocatus Sono3Veronicah Gimunta4Oscar Rutenge5Yandé Thiaw6Kirsten Stoebenau7Nancy Perrin8Ana Maria Buller9Gender Violence & Health Centre, Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, United KingdomGender Violence & Health Centre, Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, United KingdomDepartment of Education, Practice and Society, Institute of Education, University College London, London, United KingdomAdolescent Girls and Young Women Department, Amani Girls Home, Mwanza, United Republic of TanzaniaAdolescent Girls and Young Women Department, Amani Girls Home, Mwanza, United Republic of TanzaniaTanganyika Christian Refugee Service, Shinyanga Unit, United Republic of TanzaniaGender Violence & Health Centre, Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, United KingdomDepartment of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, United StatesDepartment of Behavioral and Community Health, Johns Hopkins School of Nursing, Baltimore, MD, United StatesGender Violence & Health Centre, Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, United KingdomIntroductionAge-disparate transactional sex (ADTS) is associated with HIV, unintended pregnancy, school dropout and violence, yet few interventions have successfully prevented it, and none have set ADTS prevention as their primary outcome. This exploratory evaluation aimed to assess indications of change after exposure to the Learning Initiative on Norms, Exploitation and Abuse (LINEA) intervention, a mass-media, gender-transformative social norms intervention aimed at preventing ADTS in Tanzania.MethodsIn a condensed implementation 331 participants were instructed to listen to the LINEA radio drama over seven weeks, and 60 were randomly allocated to household discussion sessions about content. In-depth interviews (n = 81) from girls aged 12–16 years, and women and men caregivers were collected at baseline (September 2021), midline (November) and endline (December 2021). Surveys were conducted (n = 120) at baseline and endline using the Norms and Attitudes on ADTS Scale (NAATSS) and the Gender Roles and Male Provision Expectations (GRMPE) scale. Interviews were thematically analyzed using a framework approach. Age-stratified linear regression models adjusted for baseline scores were used to measure association between the intervention and endline scale scores.ResultsLongitudinal data were available from 59 qualitative (73%) and 95 quantitative participants (79%). Qualitative evidence revealed the drama facilitated family conversations about adolescent challenges, allowing caregivers to advise daughters. Some girls gained confidence to refuse men's gifts, learning that accepting them could necessitate sexual reciprocation. Some caregivers felt increased responsibility for supporting girls in the community to avoid ADTS. Blame for ADTS shifted for some from girls to men, suggesting increased understanding of inequitable power dynamics and reductions in victim blaming. Marginal quantitative evidence revealed that highly exposed girls had improved gender equitable beliefs on the GRMPE (β = −6.26; 95% CI: −12.94, 0.42). Moderately exposed men had increased gender inequitable norms on the NAATSS subscale (β = 0.42 95% CI: 0.05, 0.79), but there was no effect in highly exposed men.ConclusionsGiven the small sample results should be interpreted cautiously. Our initial findings indicate high engagement with the LINEA intervention shows promise in shifting knowledge, behaviors, and attitudes, beliefs and social norms driving ADTS in Shinyanga, Tanzania, supporting a robust impact evaluation.https://www.frontiersin.org/articles/10.3389/frph.2022.1000853/fulltransactional sexage-disparate sexgender-based violence (GBV)social norms interventionmass media interventionsevaluation
spellingShingle Marjorie Pichon
Daniel J Carter
Lottie Howard-Merrill
Revocatus Sono
Veronicah Gimunta
Oscar Rutenge
Yandé Thiaw
Kirsten Stoebenau
Nancy Perrin
Ana Maria Buller
A mixed-methods, exploratory, quasi-experimental evaluation of a radio drama intervention to prevent age-disparate transactional sex in Tanzania
Frontiers in Reproductive Health
transactional sex
age-disparate sex
gender-based violence (GBV)
social norms intervention
mass media interventions
evaluation
title A mixed-methods, exploratory, quasi-experimental evaluation of a radio drama intervention to prevent age-disparate transactional sex in Tanzania
title_full A mixed-methods, exploratory, quasi-experimental evaluation of a radio drama intervention to prevent age-disparate transactional sex in Tanzania
title_fullStr A mixed-methods, exploratory, quasi-experimental evaluation of a radio drama intervention to prevent age-disparate transactional sex in Tanzania
title_full_unstemmed A mixed-methods, exploratory, quasi-experimental evaluation of a radio drama intervention to prevent age-disparate transactional sex in Tanzania
title_short A mixed-methods, exploratory, quasi-experimental evaluation of a radio drama intervention to prevent age-disparate transactional sex in Tanzania
title_sort mixed methods exploratory quasi experimental evaluation of a radio drama intervention to prevent age disparate transactional sex in tanzania
topic transactional sex
age-disparate sex
gender-based violence (GBV)
social norms intervention
mass media interventions
evaluation
url https://www.frontiersin.org/articles/10.3389/frph.2022.1000853/full
work_keys_str_mv AT marjoriepichon amixedmethodsexploratoryquasiexperimentalevaluationofaradiodramainterventiontopreventagedisparatetransactionalsexintanzania
AT danieljcarter amixedmethodsexploratoryquasiexperimentalevaluationofaradiodramainterventiontopreventagedisparatetransactionalsexintanzania
AT lottiehowardmerrill amixedmethodsexploratoryquasiexperimentalevaluationofaradiodramainterventiontopreventagedisparatetransactionalsexintanzania
AT revocatussono amixedmethodsexploratoryquasiexperimentalevaluationofaradiodramainterventiontopreventagedisparatetransactionalsexintanzania
AT veronicahgimunta amixedmethodsexploratoryquasiexperimentalevaluationofaradiodramainterventiontopreventagedisparatetransactionalsexintanzania
AT oscarrutenge amixedmethodsexploratoryquasiexperimentalevaluationofaradiodramainterventiontopreventagedisparatetransactionalsexintanzania
AT yandethiaw amixedmethodsexploratoryquasiexperimentalevaluationofaradiodramainterventiontopreventagedisparatetransactionalsexintanzania
AT kirstenstoebenau amixedmethodsexploratoryquasiexperimentalevaluationofaradiodramainterventiontopreventagedisparatetransactionalsexintanzania
AT nancyperrin amixedmethodsexploratoryquasiexperimentalevaluationofaradiodramainterventiontopreventagedisparatetransactionalsexintanzania
AT anamariabuller amixedmethodsexploratoryquasiexperimentalevaluationofaradiodramainterventiontopreventagedisparatetransactionalsexintanzania
AT marjoriepichon mixedmethodsexploratoryquasiexperimentalevaluationofaradiodramainterventiontopreventagedisparatetransactionalsexintanzania
AT danieljcarter mixedmethodsexploratoryquasiexperimentalevaluationofaradiodramainterventiontopreventagedisparatetransactionalsexintanzania
AT lottiehowardmerrill mixedmethodsexploratoryquasiexperimentalevaluationofaradiodramainterventiontopreventagedisparatetransactionalsexintanzania
AT revocatussono mixedmethodsexploratoryquasiexperimentalevaluationofaradiodramainterventiontopreventagedisparatetransactionalsexintanzania
AT veronicahgimunta mixedmethodsexploratoryquasiexperimentalevaluationofaradiodramainterventiontopreventagedisparatetransactionalsexintanzania
AT oscarrutenge mixedmethodsexploratoryquasiexperimentalevaluationofaradiodramainterventiontopreventagedisparatetransactionalsexintanzania
AT yandethiaw mixedmethodsexploratoryquasiexperimentalevaluationofaradiodramainterventiontopreventagedisparatetransactionalsexintanzania
AT kirstenstoebenau mixedmethodsexploratoryquasiexperimentalevaluationofaradiodramainterventiontopreventagedisparatetransactionalsexintanzania
AT nancyperrin mixedmethodsexploratoryquasiexperimentalevaluationofaradiodramainterventiontopreventagedisparatetransactionalsexintanzania
AT anamariabuller mixedmethodsexploratoryquasiexperimentalevaluationofaradiodramainterventiontopreventagedisparatetransactionalsexintanzania