Enhancing adolescent self-efficacy and collective efficacy through public engagement around HIV/AIDS competence: A multilevel, cluster randomized-controlled trial
Enhancing adolescent self-efficacy and collective efficacy through public engagement around HIV/AIDS competence: A multilevel, cluster randomized-controlled trial
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DOI：
10.1016/j.socscimed.2012.04.035
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发表时间：
2012-09-01
影响因子：
5.4
通讯作者：
Earls, Felton
中科院分区：
文献类型：
--
作者：
Carlson, Mary;Brennan, Robert T.;Earls, Felton
很少考虑到儿童对抗艾滋病毒/艾滋病流行病的潜在能力。为消除这一流行病对儿童和青少年的影响而采取的干预措施通常只针对他们的脆弱性。我们评估了青年公民计划，一个以社区为中心的健康促进课程，旨在提高自我和集体的效能，通过公共教育和社区动员在坦桑尼亚的基利曼哈罗地区的一个城市。该计划的理论框架整合了人的能力，沟通行动，社会生态和社会认知等方面。本研究设计为整群随机对照试验（CRCT）。15对地缘政治定义的大约2000-4000居民的匹配社区被随机分配到治疗组和对照组。在每个社区组中，随机选择24名9至14岁的青少年，讨论社会生态、公民身份、社区健康和艾滋病毒/艾滋病能力等主题。他们在已获得的理解和信心的基础上，在28周的时间里，生动地介绍了其社区艾滋病毒感染、检测和治疗的科学基础和社会背景。该课程包括5个模块：团体形成，了解我们的社区，健康和我们的社区，在我们的社区进行评估和采取行动，在我们的社区互动。青少年参与者和成年居民代表他们的社区进行了调查之前和之后的干预，数据进行了分析，使用多层次模型。在治疗社区，青少年增加了他们的审议和沟通效能和成人表现出更高的集体效能的儿童。在CRCT评估之后，对照组接受相同的课程。在基利曼哈罗地区，青年公民方案正被视为一种结构性的促进健康的办法，通过这种办法，在民间社会和地方政府的范围内培养青少年的自我效能和儿童的集体效能。(c)2012爱思唯尔有限公司版权所有。
The potential capacity of children to confront the HIV/AIDS pandemic is rarely considered. Interventions to address the impact of the pandemic on children and adolescents commonly target only their vulnerabilities. We evaluated the Young Citizens Program, an adolescent-centered health promotion curriculum designed to increase self- and collective efficacy through public education and community mobilization across a municipality in the Kilimanjaro Region of Tanzania. The theoretical framework for the program integrates aspects of human capability, communicative action, social ecology and social cognition. The design consists of a cluster randomized-controlled trial (CRCT). Fifteen pairs of matched geopolitically defined neighborhoods of roughly 2000-4000 residents were randomly allocated to treatment and control arms. Within each neighborhood cluster, 24 randomly selected adolescents, ages 9-14, deliberated on topics of social ecology, citizenship, community health and HIV/AIDS competence. Building on their acquired understanding and confidence, they dramatized the scientific basis and social context of HIV infection, testing and treatment in their communities over a 28-week period. The curriculum comprised 5 modules: Group Formation, Understanding our Community, Health and our Community, Making Assessments and Taking Action in our Community and Inter-Acting in our Community. Adolescent participants and adult residents representative of their neighborhoods were surveyed before and after the intervention; data were analyzed using multilevel modeling. In treatment neighborhoods, adolescents increased their deliberative and communicative efficacy and adults showed higher collective efficacy for children. Following the CRCT assessments, the control group received the same curriculum. In the Kilimanjaro Region, the Young Citizens Program is becoming recognized as a structural, health promotion approach through which adolescent self-efficacy and child collective efficacy are generated in the context of civil society and local government. (c) 2012 Elsevier Ltd. All rights reserved.