Quasi-experimental study of a SKILLZ adaptation among adolescents in the Dominican Republic

DETAILED SUMMARY

Importance

• Although previous research showed that sports can be an effective tool for engaging youth in HIV prevention, these studies were conducted exclusively within the African continent.
• This study explores the implementation of a sports-based HIV education intervention in a Caribbean context.

Objective

• To assess whether an adaptation of SKILLZ, in comparison with a control group, is effective in improving HIV-related knowledge, communication habits and behavioral intentions over a 4 month time period among youth aged 10–20 years living in six predominantly Haitian communities in the Puerto Plata province of the Dominican Republic

Study details

• Study design: Quasi-experimental design with qualitative methods
• Data collection tools: 397 total structured interviews were completed. 164 interviews were conducted pre-intervention. 140 interviews were conducted post-interview (n=99 intervention group; n=41 control group). 93 interviews were conducted at the 4 month follow up period (n=75 intervention group; n=18 control group).
• Participants: 164 mixed gender adolescents aged 10-20 years old residing in predominantly Haitian communities (four bateyas and two barrios) in the northern Dominican Republic; mean ages were 13.5 years in the intervention group and 14.4 years in the control group 
• Implementation setting: Programming delivered after school at community centers
• Study period: 4 months

Intervention

• Adaptation of SKILLZ: Utilized community role models – local soccer players – to deliver programming centered on adolescent HIV education. The intervention was provided in a 5 day camp format with roughly 10 hours of total programming. The camp was divided into 13 interactive activities that emphasized discovery-based learning.

Results

• Immediately post-intervention, participants in the intervention group scored higher than the control group on all 15 indicators with significant differences noted in 12 indicators after the Bonferroni adjustment (p < 0.0003).
• At 4 month follow up, intervention group participants scored higher than their control group counterparts on all 15 indicators, but statistically significant differences were only noted in 3 indicators (1 knowledge indicator, 2 attitude indicators).
• The intervention group regressed in their correct response rate to knowledge questions at 4 month follow up. At 4 month follow up, the intervention group provided 78% correct responses compared to 83% immediately post-intervention.

Conclusions and implications

• The findings support prior research performed in sub-Saharan African settings which demonstrated the potential effectiveness of sports-based HIV prevention.
• Results demonstrate that a sports-based intervention can retain its effect on knowledge, attitudes and communication when adapted to a Caribbean context.