A process evaluation of the Communication for Healthy Communities adolescent health program in Uganda

Abstract

This study is a process evaluation of an adolescent-focused intervention of the USAID Communication for Healthy Communities program, in Uganda. We used mixed methods including observation, consultations and review of program documents to collect data on program coverage, reach and factors influencing implementation. Findings show that program activities were successfully implemented through collaborative partnerships with service partners and the community. Interpersonal communication complemented by mass-media messaging was effective in reaching and empowering adolescents with health information to make informed choices for behavior change. The program used theoretical frameworks to guide targeted interventions through audience segmentation and community empowerment. Targeted mass-media messaging and placement was found to be pertinent for program reach. Working through existing community structures is important for an effective reach of health promotion programs. Lessons identified for scaling-up adolescent health programs include the need to harmonize training and deployment of community champions by development partners, recruit audience-specific influential champions and link income-generating activities to health education interventions. There is thus need to collaboratively develop and institutionalize effective monitoring and evaluation strategies during program inception and design phases for appropriate accountability, ownership and a continuation of gains.

Implementation Science for the Prevention and Treatment of HIV among Adolescents and Young Adults in Sub-Saharan Africa: A Scoping Review

“…The intervention focused on older adolescents (15 to 24 years) living with HIV, and the study documented adaptation of the intervention within a low-resource context. Nalukwago et al [ 47 ] conducted a process evaluation using the Diffusion of Innovations framework to collect data on HIV program reach and factors influencing implementation of a health-communication intervention to reduce HIV infections among adolescents 15 to 19 years old in Uganda. Nacken et al [ 28 ] structured a needs assessment using the PRECEDE component of the PRECEDE– PROCEED model to understand the needs of students and teachers in Tanzania regarding an HIV prevention intervention in primary schools.…”

“…While data from 2021 shows greater geographic diversity, Western and Central Africa were generally underrepresented in the overall group of studies reviewed. This has been the prevailing geographic Diffusion of Innovations [47], PRECEDE-PROCEED [28], and EPIS [32]. Neither the Consolidated Framework for Implementation Research (CFIR) nor the RE-AIM framework, two of the mostly widely used implementation science frameworks, were cited [64][65][66].…”

“…Only four of included articles referenced a specific implementation science framework, specifically, ADAPT [ 18 ], Diffusion of Innovations [ 47 ], PRECEDE– PROCEED [ 28 ], and EPIS [ 32 ]. Neither the Consolidated Framework for Implementation Research (CFIR) nor the RE-AIM framework, two of the mostly widely used implementation science frameworks, were cited [ 64 – 66 ].…”