Abstract
BackgroundStrengthening pre-adolescents knowledge and skills through an age- and culturally-appropriate intervention could prevent health issues later in life. Early interventions could influence the trajectory of future risky behaviour, and may influence health behaviour amongst their parents. The CIrCLE of Life Initiative was developed to address HIV and obesity. We evaluated whether the combined intervention increased knowledge, enhanced skills, and/or promoted healthy behaviour among students (9–12 years old) and their parents.MethodsThe study was conducted from May to December 2018. Trained educators delivered 30-min lessons over ten consecutive weeks with 537 Grade 6 students at five government-run schools, in a district, in South Africa. Schools were purposively selected based on socioeconomic status and urban-rural classification. Students communicated with parents through shared homework activities. A pretest-posttest study design was used, with a 3-month follow up. Both groups completed self-administered paper-based questionnaires. A score of subscales was used in analysis. The pretest and posttest scores were compared for students and parents using a dependent t-test. Differences in outcomes by school quintile were compared using one-way ANOVA.ResultsResponse rates were high for both students (80.6%) and their parents (83.4%). Statistically significant differences were observed in HIV knowledge in students pretest (mean 8.04, SD 3.10) and posttest scores (mean 10.1, SD 2.70; p < 0.01), and their parents (mean 10.32, SD 2.80 vs 11.0, SD 2.50; p < 0.01). For both students and parents, pre- and post-test obesity awareness mean scores were similar, 1.93, SD 0.92 and 2.78, SD 0.57; p < 0.01, for students; and 2.47, SD 0.82 and 2.81, SD 0.54; p < 0.01, for parents. In the posttest, statistically significant changes were also observed in both groups, enhancing skills in measuring body mass index and pulse rate, and interpreting food labels. Students had a high intention to share gained knowledge with parents who had a high intention to receive it (89.4 and 89.5%, respectively).ConclusionThe intervention increased knowledge about HIV and obesity-related awareness, and it enhanced skills in selected outcomes among pre-adolescents and parents. Accurate messages and enhanced communication skills could support inter-generational knowledge transfer.Trial registrationClinicalTrials.gov Identifier: NCT04307966 retrospectively registered on 12 March 2020.
Highlights
Strengthening pre-adolescents knowledge and skills through an age- and culturally-appropriate intervention could prevent health issues later in life
South Africa, like other developing countries, is in the midst of a health transition that is characterised by the double burden of communicable disease, such as human immunodeficiency virus (HIV) [1], and non-communicable disease (NCD) such as cardiovascular disease [2]
The Child Influencing paRent Communication for Life Education (CIrCLE) of Life Initiative, aimed to increase knowledge, improve perceptions and attitudes, shift behaviours related to HIV and obesity among Grade 6 students, and transfer HIV- and obesity-related information from students to parents through shared activities
Summary
Strengthening pre-adolescents knowledge and skills through an age- and culturally-appropriate intervention could prevent health issues later in life. South Africa, like other developing countries, is in the midst of a health transition that is characterised by the double burden of communicable disease, such as human immunodeficiency virus (HIV) [1], and non-communicable disease (NCD) such as cardiovascular disease [2]. Obesity is a key contributor to the rise in the prevalence of NCDs [3, 4] and, together with HIV/AIDS, is a cause of early mortality [1]. The burden of obesity and HIV affects both adults and children. Based on weightfor-height measures, 13% of children under the age of 5 years are overweight; a prevalence of more than twice the global average of 6.1% [5]. It is estimated that 340,000 children (0 to 14 years) are HIV infected [6]
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