Perspectives of Adolescents, Parents, Service Providers, and Teachers on Mobile Phone Use for Sexual Reproductive Health Education

Mobile health (mHealth) programs offer opportunities to improve the sexual and reproductive health (SRH) of adolescents by providing information. This paper reports the findings of a study carried out in Homabay County, Kenya, to assess stakeholders’ perspectives on access to and use of mobile phones by adolescents for SRH education. We aimed to establish whether mobile phones could facilitate access to SRH information by adolescents and the barriers to be addressed. This was a qualitative exploratory study involving adolescents, parents, teachers, health care workers, and community health volunteers. Data were collected through focus group discussions (FGDs) and key informant interviews (KIIs), and were analyzed through thematic and content analysis. Respondents lauded mHealth as an effective and efficient approach to adolescent SRH education with a potential to promote the learning of useful SRH information to influence their behavior formation. Respondents pointed out bottlenecks such as the limited ownership of and inequitable access to phones among adolescents, logistical barriers such as lack of electricity, internet connectivity, and the impact of phones on school performance, which must be addressed. The usefulness of mHealth in adolescent SRH education can be enhanced through inclusive program formulation and co-creation, imple-mented through safe spaces where adolescents would access information in groups, and supported by trained counselors

Perspectives of Adolescents, Parents, Service Providers, and Teachers on Mobile Phone Use for Sexual Reproductive Health Education

Mobile health (mHealth) programs offer opportunities to improve the sexual and reproductive health (SRH) of adolescents by providing information. This paper reports the findings of a study carried out in Homabay County, Kenya, to assess stakeholders’ perspectives on access to and use of mobile phones by adolescents for SRH education. We aimed to establish whether mobile phones could facilitate access to SRH information by adolescents and the barriers to be addressed. This was a qualitative exploratory study involving adolescents, parents, teachers, health care workers, and community health volunteers. Data were collected through focus group discussions (FGDs) and key informant interviews (KIIs), and were analyzed through thematic and content analysis. Respondents lauded mHealth as an effective and efficient approach to adolescent SRH education with a potential to promote the learning of useful SRH information to influence their behavior formation. Respondents pointed out bottlenecks such as the limited ownership of and inequitable access to phones among adolescents, logistical barriers such as lack of electricity, internet connectivity, and the impact of phones on school performance, which must be addressed. The usefulness of mHealth in adolescent SRH education can be enhanced through inclusive program formulation and co-creation, imple-mented through safe spaces where adolescents would access information in groups, and supported by trained counselors

Schools health promotion among adolescents in Northern Nigeria

Background: Jigawa and Kano States, Northern Nigeria have some of the worst human development outcomes globally for adolescents across a wide range of health indicators. Our aim was to understand health awareness, beliefs, and behaviours of adolescents in school in Jigawa and Kano States, to inform prioritization and development of health promotion interventions in the region. Methods: We carried out a cross-sectional survey followed by focus group discussions (FGDs) with adolescents aged 15 to 20 years from four schools in Jigawa and Kano States (July-August 2019). Adolescents (274 per school) were randomly selected stratified by class-year (SS1 and SS2); 64 participated in FGDs (8 groups of 8). Trained researchers administered a questionnaire face-to-face via smart phones. Topics included: mental health; tobacco use; substance misuse; violence and unintentional injury; physical and dietary behaviours; and hygiene. FGDs investigated topics in greater depth. Here we report prevalence and predictors of mental health calculated from survey responses, and thematic analysis of interview findings. Results: One thousand and seventy-nine students completed the survey (98%);∼50% girls. Preliminary analysis showed prevalence of moderate-severe anxiety was higher in girls than boys (6.8% girls, 0.8% boys, p \u3c 0.001); and moderate-severe depression (10.3% girls, 0.5% boys, p \u3c 0.001). Up to 50% boys and girls experienced violence or abuse in school, and 16% used a prescription drug without a prescription in past 30 days. Multivariable logistic regression showed female gender (aOR =4.0, 95% CI; 2.7,6.0); 30-day off-prescription drug use - aOR=2.3 (1.5,3.8); and being hit or slapped by a teacher - aOR=1.7, (1.1, 2.6) were predictors of moderate to severe anxiety. Results were similar for moderate to severe depression. Qualitative findings supported and contextualized these results. Conclusions: Results will inform school-based interventions to improve health of adolescents in the region. Key messages: Administering a health questionnaire to gather health information of adolescents in school in Kano and Jigawa states, Nigeria was feasible. Health questionnaire and focus group data will be shared with school and community leaders to shape school-based interventions to improve health outcomes amongst adolescents

Reflections of maternity service users and midwives on the co-creation of interventions to support midwives addressing alcohol during antenatal care

Background: There are divergent perspectives between midwives and pregnant women on how alcohol consumption during pregnancy could be addressed. Cocreation is an approach where lay people and professionals work together as equal partners, offering the opportunity to bridge the gap. Objectives: Our aim was to evaluate how well we carried out authentic co-creation of an intervention to support midwives have a dialogue about alcohol consumption with pregnant women. Patient involvement: Recent maternity service users including women with experience of harm due to alcohol during pregnancy provided feedback on the design, conduct and dissemination of the study. Methods: An iterative co-creation approach rooted in participatory research methods was used. Five online workshops were carried out with thirteen midwives and six maternity service users via Zoom July-August 2021. Data were analysed using the core values of co-create as a framework: equality, inclusivity, holistic, resource, positivity, transparency, iterative, and sustainability. Results: The co-creation process was productive and rewarding to midwives and maternity service users. There were positive experiences across the co-creation framework with some unintended positive consequences for maternity-service users. Discussion: This evaluation provides new knowledge on how well the co-creation process worked in relation to research involving a sensitive topic that can invite stigma. Co-creation projects require generous time and financial resources to ensure a high quality process and robust outcome for all. Practical value: Co-creation of strategies involving both service providers and service users have potential to facilitate evidence-based practice