Mixed methods evaluation of Peace Corps SKILLZ Girl among adolescent girls in Lesotho and Botswana

DETAILED SUMMARY

Importance

• PC SKILLZ Girl was designed to contribute to decreased HIV incidence, pregnancy rates, and gender-based violence by building adolescent girls’ sexual and reproductive health (SRH) knowledge and confidence, and by offering access to HIV testing services in a youth-friendly environment. 
• This evaluation was conducted to fulfill the aims of the 2016–2020 Cooperative Agreement between Grassroot Soccer and Peace Corps, which sought to document and share lessons learned and ensure the sustainability of SKILLZ programs at Peace Corps posts.

Objective

• To assess the knowledge, attitudes, and beliefs related to SRH, HIV, gender equity, and positive identity formation among PC SKILLZ Girl participants; to describe key stakeholders’ perspectives on the program and its effects; and to identify critical components of implementation fidelity among Peace Corps Volunteers and their Counterparts, in Lesotho and Botswana.

Study details

• Study design: Mixed methods study (no control group)
• Data collection: Pre- and post-intervention quantitative surveys assessing SRH knowledge/attitudes, gender-equitable attitudes, and positive identity formation; focus group discussions with participants, teachers and community adults, and Peace Corps Volunteers (PCVs) and Counterparts trained in the curriculum
• Participants: Adolescent girl participants, Peace Corps Volunteers, Counterparts, teachers, and community adults (age range not specified in source)
• Implementation setting: Peace Corps posts and surrounding communities in Lesotho and Botswana
• Study period: 2017 to 2020 (evaluation initially planned for three countries; teacher strikes in Lesotho and the COVID-19 pandemic in Botswana constrained data collection)

Intervention

• PC SKILLZ Girl: The first gender-specific program developed by Grassroot Soccer and adapted for Peace Corps posts, delivered by trained PCVs alongside a local “Counterpart” head Coach who leads practices and helps bridge language and socio-cultural differences with participants.

Results

• PC SKILLZ Girl was highly acceptable to participants, PCVs, and Counterparts.
• Results demonstrate statistically significant gains in HIV-related knowledge and attitudes, including knowledge that HIV cannot be transmitted by sharing food (Lesotho, p=.017) and positive attitudes toward friendship with someone with HIV (Botswana, p<.05).
• Smaller gains were observed in contraceptive knowledge and gender-equitable attitudes in both countries.
• Implementation was shaped by challenges retaining trained Counterparts, language barriers that played out differently by country, and requests for more ongoing support from Peace Corps posts and GRS after training.
• Quote: “I don’t see myself different from people living with HIV because there is a saying that if you are not infected you are rather affected. If you don’t have HIV, your relatives or friends might have HIV and that affects you.” (PC SKILLZ Girl participant, Botswana)

Conclusions and Implications

• PC SKILLZ Girl shows promising, modest effects on SRH knowledge, HIV-related attitudes, and gender-equitable beliefs among adolescent girls in Lesotho and Botswana.
• Recommendations for future programming include earlier and joint PCV/Counterpart training, more paced (non-camp) delivery, stronger Counterpart recruitment and ongoing support, and greater investment in language translation and field-testing.
• GRS and Peace Corps are currently revising the program to reflect updated evidence and meet OGAC and DREAMS criteria.