Community-embedded Reproductive Health Care for Adolescents in Latin America.

Not Applicable

Completed

• Conditions: Sexual and Reproductive Health Problems
• Interventions: Behavioral: Theory of planned behaviour (TPB) and social cognitive theory (SCT).

• Registration Number: NCT01722084
• Lead Sponsor: University Ghent

Brief Summary

Adolescents in Latin America are at major risk for unwanted pregnancies leading to unsafe abortions and maternal health risks. Mostly, adolescent health programmes tend to focus on unidirectional interventions aiming at a single determinant of adolescents´ sexual and reproductive health. However, evidence exists that a complex health problem should be addressed by an equally nuanced and multipronged response. Knowledge is lacking on how to develop a comprehensive approach to promote adolescents' sexual health.

The CERCA study will conduct an implementation based on the hypothesis that a comprehensive strategy of community-embedded interventions helps to improve the sexual health of adolescents. We will test this hypothesis and describe the development, implementation and testing of interventions in three Latin American cities: Cochabamba (Bolivia), Cuenca (Ecuador) and Managua (Nicaragua).

The research methodology has been designed based on the methodological frameworks of action research, community based participatory research and intervention mapping.

The interventions are complex addressing different target groups (adolescents, parents, authorities and health providers) and focussing on various behaviours that are related to communication about sexuality, information seeking, access to health care and safe sexual intercourse.

For the evaluation of effectiveness a randomised and non-randomised controlled study was developed for respectively Managua and the two other cities. Furthermore a process evaluation is conducted.

This research will result in a framework that will contribute to the planning of interventions that are effective and responsive to adolescents' sexual health needs.

Detailed Description

Not available

Study Timeline

• Study Start: 2011-07
• Study First Submitted: 2012-10-29
• Study First Submitted QC: 2012-11-02
• Study First Posted: 2012-11-06
• Primary Completion: 2013-10
• Study Completion: 2013-12
• Status Verified: 2014-12
• Last Update Submitted: 2014-12-04
• Last Update Posted: 2014-12-05

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 9625

Inclusion Criteria

Nicaragua - adolescents aged 13-18 living in the 33 town districts of Managua with a population number that varies between 1400 and 4500 inhabitants and with more than 50 % poor people.

Bolivia and Ecuador: Students from conveniently selected secondary schools in Cochabamba (Bolivia) and Cuenca (Ecuador).

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Community-eùbedded reproductive health interventions	Theory of planned behaviour (TPB) and social cognitive theory (SCT).	Members of communities that belonged to the intervention arm were exposed to complex interventions addressing different target groups (adolescents, parents, authorities and health providers) and focusing on various behaviours that were related to communication about sexuality, information seeking, access to health care and safe sexual intercourse.

Primary Outcome Measures

Name	Time	Method
Self-reported use of modern contraceptives at 18 months of interventions.	At 18 months of intervention	Self-reported exposure to intervention activities and registered participation at intervention activities.

Secondary Outcome Measures

Name	Time	Method
Self-reported ease to communicate about sexuality with parents, partner, friends.	At 18 months of intervention	Self-reported exposure to intervention activities, registered participation at intervention activities and registered access of adolescents to health services.
Self-reported information seeking behaviour.	At 18 months of intervention	Self-reported exposure to intervention activities, registered participation at intervention activities and registered access of adolescents to health services.
Self-reported pregnancy.	At 18 months of intervention	Self-reported exposure to intervention activities, registered participation at intervention activities and registered access of adolescents to health services.
Self-reported access health services for sexual and reproductive health.	At 18 months of intervention	Self-reported exposure to intervention activities, registered participation at intervention activities and registered access of adolescents to health services.

Trial Locations

Locations (4)

South Group; 🇧🇴 Cochabamba, Bolivia

Centro de investigaciones y estudios de salud; 🇳🇮 Managua, Nicaragua

Instituto Centro Americano de la Salud; 🇳🇮 Managua, Nicaragua

Universidad de Cuenca; 🇪🇨 Cuenca, Ecuador