Analysis of Article about HIV Risk-Reduction Intervention for South African Adolescents by Jemmott - Research Paper Example

? PAPER CRITIC FOR PROGRAM EVALUATION Introduction South Africa is leading nation in the world in terms of the number of people living with human immunodeficiency virus/sexually transmitted disease according to American Medical Association (2010). About 18.8% of South African individuals aged 15-49 are infected by HIV. It also estimated that more than half of the South Africans who attained the age 15 by 2006 will not live to see their 60th birthday. The article “School-Based Randomized Controlled Trial of an HIV/STD Risk-Reduction Intervention for South African Adolescents” by John B. Jemmott III, PhD; Loretta S. Jemmott, PhD, RN; Ann O’Leary, PhD; Zolani Ngwane, PhD;Larry D. Icard, PhD; Scarlett L. Bellamy, ScD; Shasta F. Jones, PhD; J. Richard Landis, PhD;G. Anita Heeren, MD, PhD; Joanne C. Tyler, DSc; Monde B. Makiwane, PhD, tries to give a clear perceptive of what are factors behind this worrying trend in South Africa. This paper will critically analyze the article in various ways such as the methodologies used, settings, aims and objectives, theoretical and empirical perspectives and much more. Background Setting- the study focused on the primary schools in a large, black township and rural settlement found near Cape Province. The setting of the study seems to focus mainly on the rural and poor families. But the reality is that HIV is a pandemic affecting every member of the society-either directly or indirectly-despite or his/her economic or social status. In this regard, there is some biasness as far as the setting of the study is concerned. Participants- random sampling method was used to select nine of 17 matched pairs of schools. The selected students were mainly in their sixth grade. However, the researcher had the consent of the parents or guardians before interviewing the students. This is a rather good move as far as the study is concerned. The aim of the study was to test the efficacy of school-based HIV/AIDS risk-reduction intervention for South African teenagers/adolescents. Therefore, choosing sixth grade students was perfect for the study as they fall within the adolescent age. That makes the results obtained in evaluation with a pretest viable to be obtained when there is application of a pretest. Stakeholders-stakeholders are different types of people who have direct or indirect interest on the outcome of the study results. Stakeholders regularly hold competing and occasionally combative perceptions on the appropriateness of the study. The interests of the stakeholders are affected by the outcome of the result. There is no clear identification of the concerned parties throughout the study. This is because of unclear definition of the significance of the study. Program theory The results of the study represent a theory based, contextually appropriate methods for HIV/AIDS reduction among the South African adolescents. The meta-analyses indicates that results from the school level were almost similar to the results obtained from individual level, although slightly more significant statistically. While logic models and program theory are frequently used interchangeably, the more accurate definition of a logic model is the graphical theory. The importance of logic models in this type of study cannot be ignored. This is because logic models are used as tools to plan, develop, manage, communicate and evaluate program or study. The logic models are effectively used in this study. For example, tables 1, 2, 3 and 4 give description of logic models as used in the study. Table 1 shows the number of students used in the study. 558 girls and 449 boys participated in the study. Linking this to the logic model, then Table represents the input section of the model. Table 2 presents descriptive statistics for sexual behaviors through intrusion condition and assessment period. This is the activity section of logic model. Table 3 is a representation of the estimated intervention effects during the follow-up period, intra-class correlation coefficients and corresponding significance level. This is like the output section of the logic model. Overall, the study utilizes appropriately the theoretical concepts in arriving at the conclusions. When you evaluate the study results, it is easier to develop short-term, intermediate and long-term solutions that will help reduce HIV/AIDS among South African adolescents. Overview of evaluation It is always important to define the outcome or the objective of the study. Each study objective will require a specific strategy although sometimes these strategies may be measured together. It is also worth noting that proxy objectives are often used to undertake long-term changes that are not practicable to the study. The logic model tells us the aims and objectives of the study and how those objectives will be achieved. It is therefore important to understand this essential evaluation question. The most likely evaluation question that can arise from this study is: did the study helped in achieving measure that could help in testing the efficacy of school-based HIV/AIDS risk-reduction intervention for South African teenagers/adolescents. The approach of incorporating behavior-change theories with qualitative information from the population of the study yielded a more efficacious, contextual appropriate intervention during the study. According to the study, anal intercourse exposes one to higher risks HIV transmission as compared to the vaginal intercourse. Although, the results showed that anal intercourse only approached statistical significance in the individual-level analysis, the school based analysis showed that HIV intervention will results to a rather significant reduction in anal intercourse contrasted to the control intervention. However, there was no clear indication of the outcome of interest from the study. This might have risen because of inadequate time and resources for assessment and sufficient program experience to offer conclusive evidence of the result. Research design and related threats to validity As indicated above, the settings of the study does not apply to different settings. Therefore it is difficult to generalize the results to the past or future periods. Additionally, the result of the study cannot have the similar impact in other settings. This makes the results to fade with time if the participant and implementers are not observed. Results The results of the study showed that the risk of acquiring HIV/AIDS among adolescent can be reduced by effective shaping of sexual behavior of young children before they attain the active sexual age. On average, there was a 50% reduction on adolescents who embraced unprotected vaginal intercourse as compared to a health-promotion attention intervention. On the other hand, vaginal intercourse with several partners was reduced by roughly 50% by the intervention compared with the control intervention. From the results, it is clear that there were challenges in obtaining adequate statistical power due to the low rates of sexuality among the sample group. Hence, there were no clear criteria in how the study produced significant effects on important sexual behavior results. The study was conducted in Africa therefore there was need to apply theories that relate to Africa and their cultures. However, the application of the Western theories on behavioral change in sub-Saharan African could not produce anything better than weak intervention effects. The study has several methodological strengths. First, the application of both behavior-change and extensive formative research ensured that errors and biasness are limited. Secondly, the main focus of the study was young people in the context of a generalized HIV epidemic. Those who participated in the study blind to the conditions of the intervention, hence ensuring differential self-selection bias. The analysis was also adjusted for clustering among the respondents in school was longitudinally assessed. The greatest limitation of the study however, is the reliance on self-reports of behavior. Another limitation is that the study does not give clear results that can be used to generalize to all South African adolescents. Work cited Kellaghan, Thomas, George F. Madaus, and Daniel L. Stufflebeam. Evaluation Models: Viewpoints on Educational and Human Services Evaluation. Boston [u.a.: Kluwer, 2000. Print. Royse, David D, Bruce A. Thyer, and Deborah Padgett. Program Evaluation: An Introduction. Australia: Wadsworth Cengage Learning, 2010. Print. Read More