Cross-sectional study to understand diffusion of SKILLZ among adolescents in Botswana

DETAILED SUMMARY

Importance

• Grassroot Soccer is premised on the Social Learning Theory, where participants are encouraged to talk openly about HIV knowledge/attitudes, as well as share that information with their peers.
• An evaluation of the Grassroot Soccer pilot showed HIV knowledge among a control group of students “caught up” to intervention participants. This shows potential evidence of the diffusion of HIV knowledge among students.

Objective

• To assess whether Grassroot Soccer compared with no supplementary programming increases the number and expands the profile of people whom adolescents educate about HIV/AIDS over a five- to six-week period in three primary schools in Botswana.

Study details

• Study design: Cross-sectional survey
• Data collection tools: Post-program surveys only
• Participants: 342 Grassroot Soccer participants (balanced by gender, ages 10-15 years)
• Implementation setting: 3 primary schools – Ben Thema (urban, standard 6), Lesedi (urban, standard 7), Oodi (rural, standard 7).
• Study period: The intervention was delivered over a period of 3 months, from May – August 2006.

Intervention

• SKILLZ Core (formerly called “Grassroot Soccer program”): A games-based HIV/AIDS and life skills curriculum for youth ages 10-18 years. Coaches included professional soccer players.

Results

• Participants reported high participation in soccer (¾ of study participants), playing with either a team or friends
• Median response about how many people the participants educated was 3-5 people
• Positively skewed distribution with 44 participants who reported educating more than 10 people
• Results estimate that participants collectively reached 1,503 to 2,375 people, with a per-capita diffusion rate of 4.4–6.9 individuals educated per participant
• Results show variation by school, age, gender, and soccer participation, with girls educating more people than boys and older students educating more than younger students
• Participants usually educated mothers, siblings, friends at school, and friends outside school, with notable differences between urban and rural schools
• Focus group discussions suggest that participants actively share Grassroot Soccer messages and games with friends, family, and classmates
  • “We shared the games with family and other kids at the school.” (adolescent)
  • “I played HIV Dodge with my cousins and neighbors at home.” (adolescent)

Conclusions and implications

• Findings demonstrate the power of peer-led, sports-based interventions to normalize conversations about HIV amongst peers and communities through knowledge diffusion, therefore reducing stigma and increasing program impact.