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Grundlingh H, Kyegombe N, Namy S, Nakuti J, Laruni Y, Nanyunja B, Muluusi H, Nakiboneka M, Mukuwa A, Tanton C, Knight L, Naker D, Devries K. Adapting a complex violence prevention intervention: a case study of the Good School Toolkit in Uganda. BMC Public Health 2024; 24:417. [PMID: 38336641 PMCID: PMC10854115 DOI: 10.1186/s12889-024-17676-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 01/04/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Adaptation is a key strategy to extend the reach of evidence-based interventions to prevent violence in new populations, but there is a dearth of practical case examples. The Good School Toolkit was developed by Ugandan NGO Raising Voices for use in primary schools (GST-P). We describe our systematic approach to adapting the GST-P for use in secondary schools in Uganda, and reflect on the utility of the process as well as limitations of existing adaptation frameworks. METHODS We adapted the GST-P in four phases, which included: I) clarifying the logic model and core intervention components using a streamlined process; II) conducting formative research (cross-sectional survey, focus groups, etc.) to understand the new population; III) selecting and preparing new intervention components and modifying existing intervention components; and IV) pretesting new intervention components with teachers and students in Uganda. RESULTS We identified core components using a logic model. Formative research showed results largely in line with our apriori hypotheses. Teacher violence remained highly prevalent in secondary versus primary schools (> 65% of secondary students reported past year exposure), while peer violence significantly increased (secondary = 52% vs. primary girls = 40%, P < 0.001; secondary = 54% vs. primary boys = 44%, P = 0.009) in secondary versus primary schools. Significantly more secondary girls (51%) than secondary boys (45%) reported past year dating/intimate partner violence (P = 0.03). Inequitable, gendered educational practices emerged as a salient theme, perceived to heighten female students' vulnerability to violence. In light of these findings, we made several adjustments to the adapted intervention. We strengthened existing teacher and peer violence intervention components. We also developed, pretested and revised new program components to prevent dating violence and promote 'gender fairness in schools'. Finally, original activities were modified to support engagement with school administration and promote increased student agency in secondary schools. CONCLUSIONS Based on our experience, it was difficult to apply mechanistic models to clarify the intervention logic of the GST-P, a complex multicomponent intervention, and simpler methods may be sufficient. Our team had high levels of contextual knowledge before the adaptation, and formative research to understand the new target population provided only limited additional insight. In similar situations, a simplified approach to mapping the core intervention components, qualitative research to understand the new target population, and pre-testing of new intervention components may be the most informative elements of systematic adaptation processes.
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Affiliation(s)
- Heidi Grundlingh
- Child Protection Research Group, Department of Population Health, London, School of Hygiene and Tropical Medicine, London, UK
| | - Nambusi Kyegombe
- Child Protection Research Group, Department of Population Health, London, School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | | | | | | | | | - Clare Tanton
- Child Protection Research Group, Department of Population Health, London, School of Hygiene and Tropical Medicine, London, UK
| | - Louise Knight
- Child Protection Research Group, Department of Population Health, London, School of Hygiene and Tropical Medicine, London, UK
| | | | - Karen Devries
- Child Protection Research Group, Department of Population Health, London, School of Hygiene and Tropical Medicine, London, UK.
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Schroeder E, Tallarico R, Bakaroudis M. The impact of adolescent initiation rites in East and Southern Africa: Implications for policies and practices. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2022. [DOI: 10.1080/02673843.2022.2052123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
| | - Renata Tallarico
- Regional Coordinator, UNFPA East and Southern Africa Regional Office, Johannesburg, South Africa
| | - Maria Bakaroudis
- Comprehensive Sexuality Education Specialist & Disability Focal Point, UNFPA East and Southern Africa Regional Office, Johannesburg, South Africa
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Seff I, Meinhart M, Harker Roa A, Stark L, Villaveces A. Predicting adolescent boys' and young men's perpetration of youth violence in Colombia. Int J Inj Contr Saf Promot 2021; 29:123-131. [PMID: 34823440 PMCID: PMC10084713 DOI: 10.1080/17457300.2021.2009519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Youth violence poses a substantive public health burden in Latin America, particularly among adolescent boys and young men. Understanding predictors of youth violence perpetration among boys and young men is critical to more effectively target and tailor prevention programs, especially in Colombia, which has endured decades-long internal armed conflict. This study uses Colombia's nationally representative 2018 Violence Against Children and Youth Survey data to examine risk and protective factors associated with violence perpetration among 13- to 24-year-old male. Amongst adolescent boys and young men in Colombia, the prevalence of ever perpetrating violence against someone other than an intimate partner was approximately 23%. Multivariable logistic regression models revealed that physical violence victimization by peers, emotional violence victimization by caregivers, having lost or been separated from a mother during childhood, and witnessing community violence were all associated with lifetime perpetration of youth violence. Programs targeting reduction of youth violence among boys might consider addressing the previously identified predictors earlier in the life course and at the individual, family and community levels.
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Affiliation(s)
- Ilana Seff
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Melissa Meinhart
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Lindsay Stark
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Andrés Villaveces
- Division of Violence Prevention, US Centers for Disease Control and Prevention, Atlanta, GA, USA
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Ryan LM, Irvin N, Miller M, Walter C, Jones V. Characteristics of pediatric emergency department visits for youth 10-15 years old with injuries due to interpersonal violence. Int J Inj Contr Saf Promot 2021; 29:23-28. [PMID: 34724882 DOI: 10.1080/17457300.2021.1993267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This retrospective cohort study at an urban academic pediatric emergency department (ED) in the United States identified all visits for youth 10-15 years of age for injury due to intentional interpersonal violence between January 2019 and December 2020. Demographic and clinical data were abstracted, including circumstances of the event. Data analysis included a comparison of pre-pandemic visits to pandemic visits after a statewide stay-at-home order was issued (March 30, 2020). Of 2780 10-15 year old youth evaluated for any injury, 819 (29.5%) had intentional/violence-related injuries. Most patients were male (53.1%), Black/African-American (84.1%), and were enrolled in a public insurance plan (75.0%). Although peer-violence related injuries comprised a substantial proportion (19.2%), the majority resulted from family violence (54.7%), which may include child maltreatment or physical fighting. Most injuries occurred at home (53.9%). Alcohol, drugs and weapons were significantly more likely to be involved in violent events during the pandemic in comparison to pre-pandemic (12.5 vs 5.0%, 11.4% vs 3.0%, 30.4% vs 8.5%; p < 0.001). Our findings support the need for ED-based efforts to screen and intervene for family and peer violence and other contributory factors (including personal, family and peer alcohol, drug and weapons access) when youth present with intentional injuries, which can be critical to preventing future violence.
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Affiliation(s)
- Leticia Manning Ryan
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nathan Irvin
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mattea Miller
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Creason Walter
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Vanya Jones
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Ashaba S, Cooper-Vince C, Maling S, Satinsky EN, Baguma C, Akena D, Nansera D, Bajunirwe F, Tsai AC. Childhood trauma, major depressive disorder, suicidality, and the modifying role of social support among adolescents living with HIV in rural Uganda. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 4:100094. [PMID: 34841384 PMCID: PMC8623847 DOI: 10.1016/j.jadr.2021.100094] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Childhood trauma is associated with mental health problems among adolescents living with HIV (ALHIV) in sub-Saharan Africa, but little is known about potential moderating factors. METHODS We enrolled 224 ALHIV aged 13-17 years and collected information on childhood trauma, major depressive disorder, and suicidality. We used modified multivariable Poisson regression to estimate the association between the mental health outcome variables and childhood trauma, and to assess for effect modification by social support. RESULTS Major depressive disorder had a statistically significant association with emotional abuse (adjusted relative risk [ARR] 2.57; 95% CI 1.31-5.04; P=0.006) and physical abuse (ARR 2.16; 95% CI 1.19-3.89; P=0.01). The estimated association between any abuse and major depressive disorder was statistically significant among those with a low level of social support (ARR 4.30; 95% CI 1.64-11.25; P=0.003) but not among those with a high level of social support (ARR 1.30; 95% CI 0.57-2.98; P=0.52). Suicidality also had a statistically significant association with emotional abuse (ARR 2.03; 95% CI 1.05-3.920; P=0.03) and physical abuse (ARR 3.17; 95% CI 1.60-6.25.; P=0.001), but no differences by social support were noted. LIMITATIONS Corporal punishment is used widely in schools and homes as a form of discipline in Uganda; this cultural practice could have biased reporting about physical abuse. CONCLUSIONS Childhood trauma is associated with poor mental health among ALHIV, but its effects may be moderated by social support. More research is needed to develop social support interventions for ALHIV with adverse childhood experiences for improved mental health outcomes.
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Affiliation(s)
- Scholastic Ashaba
- Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda
| | | | - Samuel Maling
- Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda
| | - Emily N. Satinsky
- Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda
- Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Charles Baguma
- Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda
| | - Dickens Akena
- Department of Psychiatry, Makerere College of Health Sciences, Makerere, Uganda
| | - Denis Nansera
- Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda
| | - Francis Bajunirwe
- Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda
| | - Alexander C. Tsai
- Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda
- Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Tramontano C, Nocentini A, Palmerio L, Losito B, Menesini E. Mapping community, social, and economic risks to investigate the association with school violence and bullying in Italy. CHILD ABUSE & NEGLECT 2020; 109:104746. [PMID: 33002749 DOI: 10.1016/j.chiabu.2020.104746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 09/02/2020] [Accepted: 09/13/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND School violence and bullying are a pandemic issue. The academic literature underlined the need to investigate social-contextual risk factors. The United Nations called for more comprehensive and disaggregated data to inform prevention strategies. OBJECTIVE The present study comprises a set of secondary analyses on Italian data from the International Civic and Citizenship Study 2016. We adopted an innovative 'bottom-up' approach to identify the level of disaggregation for national data. The researchers focused on community, social, and economic risk indicators at school-level, and investigated whether it was possible to aggregate schools in different classes, depending on their risk profile. PARTICIPANTS AND SETTINGS Analyses were implemented on a nationally representative sample of 170 Principals of lower secondary schools, 2,527 teachers and 3,766 students at grade 8. METHODS AND ANALYSES A Latent Class Analyses was conducted on risk indicators and four classes of risk were identified: No Risk, Community Risk, Socio-economic Risk, Multi-Risk (entropy = .786). No significant differences were found across classes in relation to urban/rural location, school size, and geographical macro-partition. On the contrary, significant differences emerged when considering teachers' perception of bullying, social problem, and students' behavior at school. Furthermore significant differences were found for the quality of relationship with teachers as reported by students. CONCLUSIONS Results a) suggested a potential gradient of increasing risk moving across the classes; b) provided a contribution to address the gap in the investigation of contextual factors and bullying; c) offered a new lens to tailor interventions to prevent school violence and bullying.
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Affiliation(s)
- Carlo Tramontano
- Centre for Global Learning: Education and Attainment, Coventry University, Priory St., Coventry, CV1 5FB, United Kingdom.
| | - Annalaura Nocentini
- Department of Educational Sciences and Psychology, University of Florence, Florence, Italy
| | - Laura Palmerio
- Istituto Nazionale per la Valutazione del Sistema Educativo di Istruzione e Formazione (INVALSI), Rome, Italy
| | - Bruno Losito
- Department of Education, Roma Tre University, Rome, Italy
| | - Ersilia Menesini
- Department of Educational Sciences and Psychology, University of Florence, Florence, Italy
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Rumble L, Febrianto RF, Larasati MN, Hamilton C, Mathews B, Dunne MP. Childhood Sexual Violence in Indonesia: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2020; 21:284-299. [PMID: 29629637 DOI: 10.1177/1524838018767932] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
There has been relatively little research into the prevalence of childhood sexual violence (CSV) as well as the risk and protective factors for CSV in low- and middle-income countries including Indonesia. Systematic searches conducted in English and Bahasa Indonesia in this review identified 594 records published between 2006 and 2016 in peer-reviewed journals and other literature including 299 Indonesian records. Fifteen studies, including nine prevalence studies, met the quality appraisal criteria developed for this review. The review found that CSV research is scarce: Only one study included nationally representative prevalence estimates. Varying definitions for CSV, survey methods, and sample characteristics limited the generalizability of the data. The available evidence points to significant risk of sexual violence affecting both girls and boys across many geographical and institutional settings. Married adolescent girls are vulnerable to sexual violence by partners in their homes. Children in schools are vulnerable to CSV by peers and adults. Victims seldom disclose incidents and rarely seek support. In addition, early childhood experiences of trauma were strongly associated with later perpetration of sexual violence and revictimization. Limited information is available about protective factors. This review synthesizes evidence about what is currently known about CSV in Indonesia and identifies the strengths and weaknesses of the existing research. A more robust evidence base regarding CSV is required to better inform policy and justify investment into prevention programs.
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Affiliation(s)
| | | | | | | | - Ben Mathews
- Queensland University of Technology, Queensland, Brisbane, Australia
| | - Michael P Dunne
- Queensland University of Technology, Queensland, Brisbane, Australia
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9
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Vertamatti MAF, Strufaldi R, Evans DP, Drezett J, Barbosa CP, Abreu LCD. Factors associated with reporting delays and severity of childhood sexual abuse in São Paulo, Brazil. PSYCHOL HEALTH MED 2018; 24:739-748. [PMID: 30539657 DOI: 10.1080/13548506.2018.1556397] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Negative health outcome and its relationship with length and severity of Childhood Sexual Abuse is well established in the literature. Until recently, this literature consisted disproportionately of studies of adults recalling past events. For guidelines for the treatment of childhood survivors, research focused on child victims may be more relevant. We aim to characterize factors related to long-term and severe sexual abuse among children in São Paulo, Brazil. We conducted a cross-sectional study of children up to the age of ten, referred to a specialty program on sexual abuse between 2004 and 2013. Length and severity of the abuse were tested for associations with variables related to the abuse using a Chi-square test, followed by the Poisson regression with robust variance for prevalence ratio. Most children experienced abuse were reliant on relatives or friends for housing (45%). The time between abuse and reporting was longer when the perpetrator lived in the same household as the child and when abuse was reported by a relative or friend. Abuse was more frequent among female children, but longer and more severe in males. A lack of independent housing, parents' education and social stigma facilitated childhood sexual abuse by delaying reporting among our sample.
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Affiliation(s)
- Maria Auxiliadora F Vertamatti
- a Faculdade de Medicina do ABC , Santo Andre , Brazil.,b Hospital Municipal Universitário , São Bernardo do Campo , Brazil.,c Departamento de Saúde Materno-infantil, Faculdade de Saúde Pública , Universidade de São Paulo (USP) , Sao Paulo , Brazil
| | - Rodolfo Strufaldi
- a Faculdade de Medicina do ABC , Santo Andre , Brazil.,b Hospital Municipal Universitário , São Bernardo do Campo , Brazil
| | - Dabney P Evans
- d Hubert Department of Global Health and Department of Behavioral Sciences and Health Education at the Rollins School of Public Health , Emory University , Atlanta , GA , USA
| | - Jefferson Drezett
- a Faculdade de Medicina do ABC , Santo Andre , Brazil.,c Departamento de Saúde Materno-infantil, Faculdade de Saúde Pública , Universidade de São Paulo (USP) , Sao Paulo , Brazil
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Mansueto G, Caselli G, Ruggiero GM, Sassaroli S. Metacognitive beliefs and childhood adversities: an overview of the literature. PSYCHOL HEALTH MED 2018; 24:542-550. [DOI: 10.1080/13548506.2018.1550258] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Giovanni Mansueto
- Department of Psychiatry & Psychology, School for Mental Health & Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Health Sciences, University of Florence, Florence, Italy
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milano, Italy
- Department of Psychology, Sigmund Freud University, Milano, Italy
| | - Gabriele Caselli
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milano, Italy
- Department of Psychology, Sigmund Freud University, Milano, Italy
- School of Applied Sciences, London South Bank University, London, UK
| | - Giovanni Maria Ruggiero
- Department of Psychology, Sigmund Freud University, Milano, Italy
- Psicoterapia Cognitiva e Ricerca, Cognitive Psychotherapy School, Milano, Italy
| | - Sandra Sassaroli
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milano, Italy
- Department of Psychology, Sigmund Freud University, Milano, Italy
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Cluver L, Meinck F, Toska E, Orkin FM, Hodes R, Sherr L. Multitype violence exposures and adolescent antiretroviral nonadherence in South Africa. AIDS 2018; 32:975-983. [PMID: 29547438 PMCID: PMC6037279 DOI: 10.1097/qad.0000000000001795] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 02/11/2018] [Accepted: 02/26/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVES HIV-positive adolescents have low-ART adherence, with consequent increased risks of mortality, morbidity, and viral resistance. Despite high rates of violence against children in the Africa region, no known studies have tested impacts on HIV-positive adolescents. We examine associations of ART adherence with adolescent violence victimization by caregivers, teachers, peers, community members, and healthcare providers. DESIGN AND METHODS HIV-positive adolescents were interviewed (n = 1060), and clinic biomarker data collected. We sampled all 10-19-year olds ever ART-initiated within 53 clinics in 180 South African communities (90.1% reached). Analyses examined associations between nonadherence and nine violence types using sequential multivariate logistic regressions. Interactive and additive effects were tested with regression and marginal effects. RESULTS Past-week self-reported ART nonadherence was 36%. Nonadherence correlated strongly with virologic failure (OR 2.3, CI 1.4-3.8) and symptomatic pulmonary tuberculosis (OR 1.49, CI 1.18-2.05). Four violence types were independently associated with nonadherence: physical abuse by caregivers (OR 1.5, CI 1.1-2.1); witnessing domestic violence (OR 1.8, CI 1.22-2.66); teacher violence (OR 1.51, CI 1.16-1.96,) and verbal victimization by healthcare staff (OR 2.15, CI 1.59-2.93). Past-week nonadherence rose from 25% with no violence to 73.5% with four types of violence exposure. CONCLUSION Violence exposures at home, school, and clinic are major and cumulating risks for adolescent antiretroviral nonadherence. Prevention, mitigation, and protection services may be essential for the health and survival of HIV-positive adolescents.
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Affiliation(s)
- Lucie Cluver
- Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, UK
- Department of Psychiatry and Mental Health, University of Cape Town
| | - Franziska Meinck
- Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, UK
- OPTENTIA Research Focus Group, School of Behavioural Sciences, North-West University, Vanderbeijlpark
| | - Elona Toska
- AIDS and Society Research Unit, Centre for Social Science Research, University of Cape Town
| | - F. Mark Orkin
- Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, UK
- MRC Development Pathways to Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Rebecca Hodes
- AIDS and Society Research Unit, Centre for Social Science Research, University of Cape Town
| | - Lorraine Sherr
- Department of Global Health, University College London, UK
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