SKILLZ Girl ‘Dosage’ Pilot among adolescent girls in South Africa

DETAILED SUMMARY

Importance

• Grassroot Soccer programs use soccer language, metaphors, and activities to start conversations and convey critical health information to participants.
• Program implementation timelines may affect participant results, cost, and resource availability.

Objective

• To evaluate whether an abbreviated model of SKILLZ girl is effective in comparison to the standard model in improving participant knowledge, attitude, and behavioral outcomes, including mental health knowledge, utilization of coping skills, HIV and sexual and productive health and rights (SRHR) knowledge, self-concept, and future orientation.
• To evaluate whether the abbreviated model shows promise in facilitating the intervention’s implementation in the areas of acceptability, feasibility, fidelity, and cost.

Study details

• Study design: Mixed methods study (control group: standard of care)
• Data collection tools: pre/post questionnaires (abbreviated n=202, standard n=157); a brief acceptability questionnaire (abbreviated only n=179); a qualitative focus group discussion and interviews with participants (abbreviated n=1, standard n=1), Coaches (n=1), and one Master Coach supervisor; financial analysis of cost per participant
• Participants: Adolescent girls aged 15–19 years, Coaches
• Implementation setting: Alexandra, South Africa
• Study period: 2023–2025

Intervention

• SKILLZ Girl: a single-gender program for girls aged 15-19 years implemented by trained female, near-peer mentor Coaches from the same communities as participants. Program sessions use soccer language, metaphors, and activities to start conversations and convey critical health information to participants. Two versions were tested:
  • Standard: 12 sessions
  • Abbreviated: 6 sessions plus graduation and a comic book-style magazine as a supplementary resource

Results

• Pre/post results for standard and abbreviated interventions were similar: overall change of 10% for standard (n=157) and 8% for abbreviated (n=202)
• Nearly all participants in both groups attended ≥70% of sessions (eligible to graduate)
• Cost per participant: $43 for standard, $30 for abbreviated
• Positive quantitative acceptability results for standard and abbreviated
• Negative feedback on magazine in abbreviated program; participants did not like completing activities on their own or had difficulty with the language used
• Coaches generally preferred the standard intervention but recognized potential value in the abbreviated version to reach more participants efficiently

Conclusions and implications

• Initial evaluation presents early evidence that the abbreviated intervention can achieve similar results to the standard version, but participants prefer in-person sessions to the magazine and Coaches prefer the standard program with more contact time.
• Future programming decisions must balance preferences, cost, and resource availability.