南非女孩的基于赋权的自卫计划的有效性:在学校进行的集群随机对照试验的结果
Miriam Hartmann1,2, Shepherd Mutangabende3, Stephen Nash4
1Women's Global Health Imperative, RTI International, Berkeley, CA, USA. Miriam.hartmann@ki.se.
BMC women's health
|March 15, 2025
概括
这项研究评估了一项基于赋权的自卫计划,以预防南非女孩的性暴力 (SV). 干预措施并没有显著降低 SV 暴露,突出了实施挑战和未来预防工作需要改进的领域.
科学领域:
- 公共卫生 公共卫生
- 全球健康 全球健康
- 青少年健康 青少年健康
背景情况:
- 基于赋权的自卫 (ESD) 计划是有效的预防性暴力 (SV) 在女孩.
- 南非的ESD计划的有效性,特别是适应COVID-19的"不意味着不"干预措施,以前没有被探索过.
- 这项研究旨在评估这种适应的ESD计划在南非Gqeberha的影响和实施.
研究的目的:
- 评估适应COVID的"不意味着不"基于赋权的自卫 (ESD) 干预措施对南非10-19岁女孩预防性暴力 (SV) 的影响.
- 评估实施过程,并确定COVID后学校环境中的障碍和促进者.
- 探索包括强奸,线下和在线性骚扰在内的二次结果,以及与SV相关的知识和态度等中间结果.
主要方法:
- 一个混合型1集群随机对照试验,涉及南非Gqeberha的15所学校,分配比例为1:1:1的三个部门:仅对女孩进行干预,单独对女孩和男孩进行干预,以及对照.
- 在基线,3个月,6个月和12个月进行调查,以测量过去一年的SV暴露 (主要结果),并使用通用估计方程模型进行分析.
- 通过出席日志,季度报告和利益相关者访谈收集实施数据.
主要成果:
- 该研究招募了1,540名参与者 (1,250名具有主要结果数据),平均年龄为13岁;83%的人被确定为黑人.
- 与对照组相比,干预组没有观察到过去一年性暴力 (SV) 暴露的显著减少 (adjRR 1.24,95%CI 0.96,1.69;p=0.08).
- 与对照组相比,干预组的自我防御知识显著增加 (系数0.42,95% CI 0.16,0.68;p=0.007).
结论:
- 适应COVID的"不意味着不"ESD干预措施并没有显著减少南非Gqeberha的青少年女孩的性暴力 (SV).
- 实施障碍,包括时间限制和整个学校在COVID后缺乏购买,可能影响了结果.
- 未来的研究应该整合实施科学方法以优化ESD计划的交付和评估,专注于披露和承认SV预防的复杂性.
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