Mixed methods study of SKILLZ Girl and supplementary SMS platform among adolescent girls in South Africa

DETAILED SUMMARY

Importance

• South African adolescent girls face numerous sexual and reproductive health challenges. This study sought to build on an earlier evaluation of SKILLZ Girl (Hershow et al., 2015).

Objective

• To assess preliminary outcomes and processes of SKILLZ Girl (formerly SKILLZ Street) and a supplementary SMS platform among adolescent primary school girls over a five-week period.

Study details

• Study design: Mixed methods design (convergent parallel); no comparison group.
• Data collection tools: Attendance registers; mobile phone platform tracking; pre- and post-questionnaires; 6 focus group discussions; 4 in-depth interviews; structured observation
• Participants: Adolescent girls ages 11 to 16 years, parents, teachers, social worker
• Implementation setting: 3 primary schools in Soweto, South Africa (urban setting)
• Study period: Five months for attendance, mobile phone platform tracking, and structured observation; five weeks for pre/post questionnaires; data collected in 2013

Intervention

• SKILLZ Girl (called SKILLZ Street at the time): 10 two-hour sessions taking place on school grounds after school hours twice-a-week for five weeks, plus an SMS platform

Results

• Sample & graduation rate: 394 enrolled, 217 accessed the SMS platform, 213 completed questionnaires. 97% graduation rate.
• Quantitative: Modest increases observed in participants’ attitudes towards the balance of power in relationships (Cohen’s d: 0.48), gender equitable attitudes (Cohen’s d: 0.43), self-efficacy to avoid unwanted sex (Cohen’s d: 0.46), communication about HIV and sex (Cohen’s d: 0.39), HIV stigma (Cohen’s d: 0.33), self-esteem (Cohen’s d: 0.25), and knowledge of HIV (Cohen’s d: 0.19). Increases also observed in understanding of where to get services for rape (14% increase in percentage points from pre to post).
• Qualitative: Highlighted the coach-participant relationship, safe space, and integration of soccer as key program components. Challenges emerged around delivering soccer-based activities.
• Quotes from two participants:
  • “SKILLZ Street gives you the confidence, like strong body language. Not only will I use it to say no to sex, but for other things as well. If you don’t want it, ‘No.'”
  • “I liked Sex and Gender [the 2nd session in the curriculum] because previously I could not go play, as I had to do all the cleaning and house chores. But now we share the work between me and my brother. He cleans Monday and I take Tuesday and so forth.”

Conclusions and implications

• Programs like SKILLZ Street are relevant and important for addressing challenges facing adolescent girls in South African townships.
• Provided support for generating Grassroot Soccer’s boys-only program, SKILLZ Guyz.