Background Many young, South African men use alcohol and drugs and have multiple partners, but avoid health care settings – the primary site for delivery of HIV intervention activities. Objectives To identify the feasibility of engaging men in HIV testing and reducing substance use with soccer and vocational training programs. Methods In two Cape Town neighborhoods, all unemployed men aged 18–25 years were recruited and randomized by neighborhood to: 1) an immediate intervention condition with access to a soccer program, random rapid diagnostic tests (RDT) for alcohol and drug use, and an opportunity to enter a vocational training program (n=72); or 2) a delayed control condition (n=70). Young men were assessed at baseline and six months later by an independent team. Results Almost all young men in the two neighborhoods participated (98%); 85% attended at least one practice (M = 42.3, SD= 34.4); 71% typically attended practice. Access to job training was provided to the 35 young men with the most on-time arrivals at practice, drug-free RDT, and no red cards for violence. The percentage of young men agreeing to complete RDT at soccer increased significantly over time; RDTs with evidence of alcohol and drug use decreased over time. At the pre-post assessments, the frequency of substance use decreased; and employment and income increased in the immediate condition compared to the delayed condition. HIV testing rates, health care contacts, sexual behaviors, HIV knowledge, condom use and attitudes towards women were similar over time. Discussion Alternative engagement strategies are critical pathways to prevent HIV among young men. This feasibility study shows that soccer and job training offer such an alternative, and suggest that a more robust evaluation of this intervention strategy be pursued.
Baseline data were collected on 263 general hospital patients screened as problem drinkers, who were randomly allocated to one of two groups. In one group an attempt was made to refer patients for treatment while no action was taken for the other. Both groups were followed up at 12 and 18 months. At 12 months the referred group had improved significantly more than the control group in terms of self-reported alcohol problems, personal happiness, period since last drinking and work performance. However, these effects had diminished at 18 months, largely because of improvements in the control group afier the 12-months follow-up, which appeared to function as an intervention. These results suggest that intervention following screening is of benefit, and that such a strategy could usefully be incorporated into normal hospital routine.
This paper was published in British Joumal of Addiction (1987) 82, 83-89.The following acknowledgements were omitted: AcknowledgementsWe thank the patients and staff of Christchurch Hospital for their co-operation; the Canterbury Hospital Board and its Alcohol Advisory Committee; the Alcoholic Liquor Advisory Council for providing funds; and Brenda Jermyn and Jennifer Benecke for their efforts in interviewing and follow-up.
BackgroundVolunteer home visiting is a widely adopted community-based approach to support families by linking isolated or vulnerable families with community volunteers who visit their homes weekly over approximately 12 months. This study seeks to robustly evaluate the effectiveness of this model of support for families with young children.ObjectiveThis paper reports the intention-to-treat analysis of primary and secondary outcomes for a pragmatic randomized controlled trial (RCT) of the Volunteer Family Connect intervention, a volunteer home-visiting program designed to support families with young children who experience social isolation or a lack of parenting confidence and skills.MethodsThe RCT was conducted across seven sites in Australia. Overall, 341 families were recruited: 169 intervention (services as usual+volunteer home visits) and 172 control (services as usual) families. Intervention families received the program for 3-12 months. Participants were invited to complete six data collection points over a 15-month period. Primary outcomes were community connectedness and parenting competence. Secondary outcomes included parent physical and mental health, general parent wellbeing, parent empowerment, the sustainability of family routines, and the parent-child relationship. According to the protocol, the program would be judged to be effective if at least one of the primary outcomes was significantly positive and the other was neutral (ie, intervention families did not demonstrate positive or negative outcomes compared to the control group).ResultsThe intervention group demonstrated significant improvement in the primary outcome variable parenting sense of competence as compared to the control group. Overall, there was no significant difference between the intervention and control groups with regard to the primary outcome variable community connectedness, other than on the “Guidance” subscale of the Social Provisions Scale. Because there were statistically significant findings for the total score of one primary outcome variable “parenting sense of competence” and largely neutral findings for the primary outcome variable “community connectedness,” the program met the previously defined criteria for program effectiveness. In relation to secondary outcomes, intervention families reported significantly higher wellbeing and were significantly more likely to feel that life was improving.ConclusionsThe Volunteer Family Connect intervention was considered an effective intervention, with a role to play on the landscape of services available to support vulnerable families with young children.Trial RegistrationAustralian New Zealand Clinical Trial Registry ACTRN12616000396426; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370304
This paper presents a scoping review of the literature on child participatory research in Australia published in academic journals between 2000 and 2018. The review focused on research designed to engage with children and young people in the development, implementation and evaluation of services. A total of 207 papers were identified and distributed across eight service sectors: child protection and family law, community, disability, education, health, housing and homelessness, juvenile justice and mental health. The papers were reviewed against Shier’s participation matrix, demonstrating that almost all of the identified papers included children only as participants who contributed data to adult researchers. Only a small number of papers involved children and young people in the other phases of research, such as designing research questions, analysis and dissemination. There is a clear interest in the engagement of children and young people in service design and decision-making in Australia. This paper is intended to serve as a catalyst for discussion on where there are gaps and where further Australian research is needed.
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