Abstract
BackgroundDespite the availability of a range of contraceptive methods, young people around the world still face barriers in accessing and using them. The use of digital technology for the delivery of health interventions has expanded rapidly. Intervention delivery by mobile phone can be a useful way to address young people’s needs with regard to sexual and reproductive health, because the information can be digested at a time of the recipients’ choosing. This study reports the adaptation of an evidence-based contraceptive behavioural intervention for young people in Zimbabwe.MethodsFocus group discussions and in depth interviews were used to evaluate the ‘fit’ of the existing intervention among young people in Harare, Zimbabwe. This involved determining how aligned the content of the existing intervention was to the knowledge and beliefs of young Zimbabweans plus identifying the most appropriate intervention deliver mode. The verbatim transcripts were analysed using a thematic analysis. The existing intervention was then adapted, tested and refined in subsequent focus group discussions and interviews with young people in Harare and Bulawayo.ResultsEleven key themes resulted from the discussions evaluating the fit of the intervention. While there were many similarities to the original study population, key differences were that young people in Zimbabwe had lower levels of personal and smart mobile phone ownership and lower literacy levels. Young people were enthusiastic about receiving information about side effects/side benefits of the methods. The iterative testing and refinement resulted in adapted intervention consisting of 97 messages for female recipients (94 for male), delivered over three months and offered in English, Shona and Ndebele.ConclusionsYoung people in Zimbabwe provided essential information for adapting the existing intervention. There was great support for the adapted intervention among the young people who took part in this study. The adapted intervention is now being implemented within an integrated community-based sexual and reproductive health service in Zimbabwe.
Highlights
Despite the availability of a range of contraceptive methods, young people around the world still face barriers in accessing and using them
Adapting evidence-base interventions for different contexts is a financially and time efficient way to expediate the delivery of effective interventions to the people that need them. This intervention adaptation study demonstrates that intervention adaptation can be done rigorously and in a relatively short amount of time, despite unanticipated disruptions caused by the COVID-19 pandemic
The rationale for adding a mobile phone components to the CHIEDZA package was to enhance the integration of its reproductive health and Human immunodeficiency virus (HIV) services, by offering young people the opportunity to receive information about contraception in their own space, extending the CHIEDZA package beyond its face to face offering
Summary
Despite the availability of a range of contraceptive methods, young people around the world still face barriers in accessing and using them. The use of digital technology for the delivery of health interventions has expanded rapidly. Intervention delivery by mobile phone can be a useful way to address young people’s needs with regard to sexual and reproductive health, because the information can be digested at a time of the recipients’ choosing. Young people face numerous barriers to accessing and using contraception- for which effective interventions are needed [2]. The global expansion of use of personal digital technology has offered new routes in which to deliver health interventions [3]. Mobile phones interventions can be advantageous for addressing young people’s sexual and reproductive health (SRH) as they can be received in private, allowing the recipient to digest the information in their own time. The support can be non-judgemental, can reach many people and is often more convenient and cheaper to deliver than face-to-face support
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