Browsing by Author "Rotheram-Borus, Mary J."

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Gender-specific HIV and substance abuse prevention strategies for South African men : study protocol for a randomized controlled trial
    (BioMed Central, 2018-08-03) Rotheram-Borus, Mary J.; Tomlinson, Mark; Mayekiso, Andile; Bantjes, Jason; Harris, Danielle M.; Stewart, Jacqueline; Weiss, Robert E.
    Background: Young men in South Africa face concurrent epidemics of HIV, drug and alcohol abuse, and unemployment. Standard HIV prevention programs, located in healthcare settings and/or using counseling models, fail to engage men. Soccer and vocational training are examined as contexts to deliver male-specific, HIV prevention programs. Methods: Young men (n = 1200) are randomly assigned by neighborhood to one of three conditions: 1) soccer league (n = 400; eight neighborhoods); 2) soccer league plus vocational training (n = 400; eight neighborhoods); or 3) a control condition (n = 400; eight neighborhoods). Soccer practices and games occur three times per week and vocational training is delivered by Silulo Ulutho Technologies and Zenzele Training and Development. At baseline, 6 months, 12 months, and 24 months, the relative efficacy of these strategies to increase the number of significant outcomes (NSO) among 15 outcomes which occur (1) or not (0) are summed and compared using binomial logistic regressions. The summary primary outcome reflects recent HIV testing, substance abuse, employment, sexual risk, violence, arrests, and mental health status. Discussion: The failure of men to utilize HIV prevention programs highlights the need for gender-specific intervention strategies. However, men in groups can provoke and encourage greater risk-taking among themselves. The current protocol evaluates a male-specific strategy to influence men’s risk for HIV, as well as to improve their ability to contribute to family income and daily routines. Both interventions are expected to significantly benefit men compared with the control condition.
  • Thumbnail Image
    Item
    To evaluate if increased supervision and support of South African Government health workers’ home visits improves maternal and child outcomes : study protocol for a randomized control trial
    (Biomed Central, 2017-08) Rotheram-Borus, Mary J.; Le Roux, Karl; Le Roux, Ingrid M.; Christodoulou, Joan; Laurenzi, Christina; Mbewu, Nokwanele; Tomlinson, Mark
    Background: Concurrent epidemics of HIV, depression, alcohol abuse, and partner violence threaten maternal and child health (MCH) in South Africa. Although home visiting has been repeatedly demonstrated efficacious in research evaluations, efficacy disappears when programs are scaled broadly. In this cluster randomized controlled trial (RCT), we examine whether the benefits of ongoing accountability and supervision within an existing government funded and implemented community health workers (CHW) home visiting program ensure the effectiveness of home visiting. Methods/Design: In the deeply rural, Eastern Cape of South Africa, CHW will be hired by the government and will be initially trained by the Philani Programme to conduct home visits with all pregnant mothers and their children until the children are 2 years old. Eight clinics will be randomized to receive either (1) the Accountable Care Condition in which additional monitoring and accountability systems that Philani routinely uses are implemented (4 clinics, 16 CHW, 450 households); or (2) a Standard Care Condition of initial Philani training, but with supervision and monitoring being delivered by local government structures and systems (4 clinics, 21 CHW, 450 households). In the Accountable Care Condition areas, the CHW’s mobile phone reports, which are time-location stamped, will be monitored and data-informed supervision will be provided, as well as monitoring growth, medical adherence, mental health, and alcohol use outcomes. Interviewers will independently assess outcomes at pregnancy at 3, 6, 15, and 24 months post-birth. The primary outcome will be a composite score of documenting maternal HIV/TB testing, linkage to care, treatment adherence and retention, as well as child physical growth, cognitive functioning, and child behavior and developmental milestones. Discussion: The proposed cluster RCT will evaluate whether routinely implementing supervision and accountability procedures and monitoring CHWs’ over time will improve MCH outcomes over the first 2 years of life.
  • Thumbnail Image
    Item
    Who can we reach and who can we keep? predictors of intervention engagement and adherence in a cluster randomized controlled trial in South Africa
    (BMC (part of Springer Nature), 2020-02-27) Rabie, Stephan; Bantjes, Jason; Gordon, Sarah; Almirol, Ellen; Stewart, Jackie; Tomlinson, Mark; Rotheram-Borus, Mary J.
    Background: Engaging and retaining young men in community-based interventions is highly challenging. The purpose of this study was to investigate the individual factors that predict intervention engagement and adherence in a sample of at-risk South African men. Methods: Baseline data were collected as a part of a cluster randomised control trial (RCT) situated in Khayelitsha and Mfuleni, two peri-urban settlements situated on the outskirts of Cape Town, South Africa. Neighbourhoods were randomised to one of three intervention conditions. We performed univariate descriptive statistics to report neighbourhood and individual socio-demographic factors, and ran multivariate models, adjusting for entry of study, to determine if high adherence and consistency of engagement with the intervention were associated with sociobehavioural demographics and risk behaviours, such as hazardous substance use, gangsterism, and criminal activity. Results: Total of 729 men were on average 22.5 years old (SD 2.8), with a mean of 10 years of education. More than half of the sample were single (94%), lived with their parents (66%) and had an income below ~$30 (52%). The overall mean of adherence is 0.41 (SD 0.24) and mean of consistency of engagement is 0.61 (SD 0.30). Our data indicated that completing more years of education, living with parents, and having higher socioeconomic status were significantly associated with higher rates of engagement and adherence. Men with a history of gang membership demonstrated higher levels of adherence and consistent engagement with the intervention, compared with other men who were recruited to the intervention. Crucially, our data show that young men with a history of substance use, and young men who report symptoms of depression and high levels of perceived stress are equally likely as other young men to adhere to the intervention and attend intervention sessions consistently. Conclusion: Our results may contribute to a better understanding of young men’s patterns of engagement and adherence to public health interventions. The results may have important implications for policy and practice, as they may be useful in planning more effective interventions and could potentially be used to predict which young men can be reached through community-based interventions.