Mary (Maya ) CarlsonCo-Principal Investigator

CHASE: Child Health and Social Ecology

1.Objectives of the community-based child-centered Young Citizen Program2. Design of the community-based child-centered HIV intervention3. Research design for evaluation of a community-based child-centered HIV program4. Post-intervention assessments of deliberative and communication self-efficacy in Intervention and Control Young Citizens 5. Results of Young Citizen (February-May 2007) and Presidential (August—November 2007) community-mobilization for universal HIV testing

1. Objectives of the community-based child-centered Young Citizen Program

AIMS:

To increase the self-efficacy of children in the domains of deliberation and health

To increase the willingness of adults to protect children affected by HIV/AIDS (collective-efficacy)

To develop collaboration between children and adults to increase the HIV/AIDS competence of local community areas

CONTEXT:

To understand the administrative organization and ecological processes of communities in Moshi Municipality in Northern in Tanzania ( population of 143,799 in 2002 census)

To mount a community-based health promotion trial with children

(ages 10-14 years) in a setting with a HIV/AIDS seroprevalence estimated at 10%

2. Research design for evaluation of the community-based child-centered HIV intervention

The intervention is designed as a scripted series of progressive modules that permit sufficient structure to guide Young Citizens in taking on community-based health promotion activities, yet provide the opportunities for participation and preference-ranking.

The 15 groups met once a week, for 2-3 hours sessions for a total of 28 weeks, and were facilitated by a team of young adults trained in participatory learning approach. The mtaa leaders were invited to the M2 sessions and remained active in the YCs community activities.

There initial 12 sessions of Modules 1-3 were held in classrooms (after class and on Saturdays) whereas the remaining 16 sessions were held at different locations throughout their communities.

M4 represents an extended period of interface with the community. During this period, the children become increasing skilled in representing health concerns to community residents and in dialogue with community members about the content of their skits.(14 sessions)

3. Research design for evaluation of a community-based child-centered HIV program

Community surveys of demographic characteristics, collective efficacy, and HIV-related knowledge and stigma in 2000+ adults across all 60 Moshi Urban neighborhoods (street-mtaa areas), prior to and following behavioral intervention

Health and behavior assessments of 720 young adolescents (10-14 years) and their primary caregivers, 24 randomly selected from each of 30 experimental mtaa areas prior to and following behavioral intervention.

Random assignment of non-adjacent demographically matched pairs of 30 neighborhoods to treatment and control (delayed treatment) arms of child-centered health promotion trial

4. Post-intervention assessments of deliberative and communication self-efficacy

in Intervention and Control Young Citizens

Deliberative Efficacy (5 items) reliability= .78 p.<.004 to express my opinions to other children my age to make my ideas understood when other children disagree with

me to use talking and reasoning to solve problems I have with other

children that others will value me even if they disagree with my opinions to express my opinions to adults

Communication with adults (4 items) reliability =.80 p.<. 002 to make adults listen to me to ask assistance from adults about how to solve any problems to ask adults for advice about sexually transmitted diseases to talk with others on any issue that troubles me

5. Results of Young Citizen (February-May 2007) and Presidential (August—November 2007) community-

mobilization for universal HIV testing

YC Survey of Pasua communities

0%

10%

20%

30%

40%

50%

60%

1 2 3 4

HIV Testing Questions

Res

po

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ing

"ye

s" PM

PR

PBM

PS

KAL

1. Ever tested for HIV ; 2.Tested during YC Heath Fair; 3. Tested during President campaign; 4..Tested both Heath fair and President campaign;