Effects of a community-based, multi-level family planning intervention on theoretically grounded intermediate outcomes for couples in rural Uganda: Results from a mixed methods pilot evaluation

IF 3.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology Pub Date : 2024-01-19 DOI:10.1111/bjhp.12713

Katelyn M. Sileo, Christine Muhumuza, Rhoda K. Wanyenze, Trace S. Kershaw, Brooke Ellerbe, Suyapa Muñoz, Samuel Sekamatte, Haruna Lule, Susan M. Kiene

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引用次数: 0

Abstract

Objectives

This study tested the theoretically grounded conceptual model of a multi-level intervention, Family Health = Family Wealth (FH = FW), by examining FH = FW's effect on intermediate outcomes among couples in rural Uganda. FH = FW is grounded in the social-ecological model and the social psychological theory of transformative communication.

Design

A pilot quasi-experimental controlled trial.

Methods

Two matched clusters (communities) were randomly allocated to receive the FH = FW intervention or an attention/time-matched water, sanitation and hygiene intervention (N = 140, 35 couples per arm). Quantitative outcomes were collected through interviewer-administered questionnaires at baseline, 7-months and 10-months follow-up. Focus group discussions (n = 39) and semi-structured interviews (n = 27) were conducted with subsets of FH = FW participants after data collection. Generalized estimated equations tested intervention effects on quantitative outcomes, and qualitative data were analysed through thematic analysis—these data were mixed and are presented by level of the social-ecological model.

Results

The findings demonstrated an intervention effect on family planning determinants across social-ecological levels. Improved individual-level family planning knowledge, attitudes and intentions, and reduced inequitable gender attitudes, were observed in intervention versus comparator, corroborated by the qualitative findings. Interpersonal-level changes included improved communication, shared decision-making and equitable relationship dynamics. At the community level, FH = FW increased perceived acceptance of family planning among others (norms), and the qualitative findings highlighted how FH = FW's transformative communication approach reshaped definitions of a successful family to better align with family planning.

Conclusions

This mixed methods pilot evaluation supports FH = FW's theoretically grounded conceptual model and ability to affect multi-level drivers of a high unmet need for family planning.

查看原文本刊更多论文

以社区为基础的多层次计划生育干预措施对乌干达农村地区夫妇基于理论的中间结果的影响：混合方法试点评估结果。

研究目的本研究检验了多层次干预措施 "家庭健康=家庭财富（FH = FW）"的理论基础概念模型，研究了 FH = FW 对乌干达农村夫妇中间结果的影响。FH = FW 以社会生态模式和变革性交流的社会心理学理论为基础：设计：试点准实验对照试验：方法：随机分配两个匹配的群组（社区），接受 FH = FW 干预或注意力/时间匹配的水、环境卫生和个人卫生干预（N = 140，每组 35 对夫妇）。在基线、7 个月和 10 个月的随访中，通过访谈者发放的问卷收集定量结果。在数据收集后，对 FH = FW 参与者的子集进行了焦点小组讨论（39 人）和半结构化访谈（27 人）。广义估计方程测试了定量结果的干预效果，并通过主题分析对定性数据进行了分析--这些数据是混合的，并按社会生态模型的层次进行了展示：结果：研究结果表明，干预措施对各个社会生态层面的计划生育决定因素都有影响。干预措施与参照方案相比，个人层面的计划生育知识、态度和意向都有所改善，不公平的性别态度也有所减少，定性研究结果也证实了这一点。人际层面的变化包括沟通、共同决策和平等关系动态的改善。在社区层面，"家庭健康=家庭幸福 "提高了其他人对计划生育的接受度（规范），定性研究结果强调了 "家庭健康=家庭幸福 "的变革性沟通方法如何重塑成功家庭的定义，使其与计划生育更加一致：这项混合方法试点评估支持 FH = FW 的理论基础概念模型，以及其影响计划生育高需求未得到满足的多层次驱动因素的能力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British Journal of Health Psychology PSYCHOLOGY, CLINICAL-

CiteScore

14.10

自引率

1.30%

发文量

期刊介绍： The focus of the British Journal of Health Psychology is to publish original research on various aspects of psychology that are related to health, health-related behavior, and illness throughout a person's life. The journal specifically seeks articles that are based on health psychology theory or discuss theoretical matters within the field.