Who can we reach and who can we keep? predictors of intervention engagement and adherence in a cluster randomized controlled trial in South Africa
Date
2020-02-27
Journal Title
Journal ISSN
Volume Title
Publisher
BMC (part of Springer Nature)
Abstract
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.
Description
CITATION: Rabie, S., et al. 2020. 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 Public Health, 20:275, doi:10.1186/s12889-020-8357-x.
The original publication is available at https://bmcemergmed.biomedcentral.com
The original publication is available at https://bmcemergmed.biomedcentral.com
Keywords
HIV-positive youth, Risk-taking (Psychology), HIV-positive youth -- Substance abuse -- Risk factors, Patient compliance
Citation
Rabie, S., et al. 2020. 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 Public Health, 20:275, doi:10.1186/s12889-020-8357-x