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Denison JA, Willis K, DeLong SM, Sievwright KM, Agwu AL, Arrington-Sanders R, Kaufman MR, Prabhu S, Williams AM, Fields EL, Alexander KA, Lee L, Yang C. Advancing Adolescent and Young Adult HIV Prevention and Care and Treatment Through Use of Multi-level Theories and Frameworks: A Scoping Review and Adapted HIV Ecological Framework. AIDS Behav 2024; 28:1694-1707. [PMID: 38351279 PMCID: PMC11069483 DOI: 10.1007/s10461-023-04255-1] [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] [Accepted: 12/12/2023] [Indexed: 05/05/2024]
Abstract
While multi-level theories and frameworks have become a cornerstone in broader efforts to address HIV inequities, little is known regarding their application in adolescent and young adult (AYA) HIV research. To address this gap, we conducted a scoping review to assess the use and application of multi-level theories and frameworks in AYA HIV prevention and care and treatment empirical research. We systematically searched five databases for articles published between 2010 and May 2020, screened abstracts, and reviewed eligible full-text articles for inclusion. Of the 5890 citations identified, 1706 underwent full-text review and 88 met the inclusion criteria: 70 focused on HIV prevention, with only 14 on care and treatment, 2 on both HIV prevention and care and treatment, and 2 on HIV-affected AYA. Most authors described the theory-based multi-level framework as informing their data analysis, with only 12 describing it as informing/guiding an intervention. More than seventy different multi-level theories were described, with 38% utilizing socio-ecological models or the eco-developmental theory. Findings were used to inform the adaptation of an AYA World Health Organization multi-level framework specifically to guide AYA HIV research.
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Affiliation(s)
- Julie A Denison
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street. Room E5546, Baltimore, MD, 21205, USA.
| | - Kalai Willis
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Stephanie M DeLong
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kirsty M Sievwright
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street. Room E5546, Baltimore, MD, 21205, USA
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, US
| | - Allison L Agwu
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Michelle R Kaufman
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sandeep Prabhu
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street. Room E5546, Baltimore, MD, 21205, USA
| | - Ashlie M Williams
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street. Room E5546, Baltimore, MD, 21205, USA
| | - Errol L Fields
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Lana Lee
- Adult Clinical Branch, Office of HIV/AIDS, United States Agency for International Development, Washington, DC, USA
| | - Cui Yang
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Cini KI, Wulan NR, Dumuid D, Nurjannah Triputri A, Abbsar I, Li L, Priambodo DA, Sameve GE, Camellia A, Francis KL, Sawyer SM, Patton GC, Ansariadi A, Azzopardi PS. Towards responsive policy and actions to address non-communicable disease risks amongst adolescents in Indonesia: insights from key stakeholders. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 18:100260. [PMID: 38028160 PMCID: PMC10667299 DOI: 10.1016/j.lansea.2023.100260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 07/02/2023] [Accepted: 07/21/2023] [Indexed: 12/01/2023]
Abstract
Background Non-communicable diseases (NCDs) such as cancer, diabetes, heart disease, mental disorder and chronic lung conditions are the leading cause of death and disability in Indonesia. Adolescence is when risks for NCDs emerge and it is also an important life stage for intervention, yet young people are often at the margins of NCD policy and actions. This study aimed to understand how policies and actions should address NCD risks (tobacco smoking, inadequate physical activity, and diet) for adolescents in Indonesia, and how young people can be meaningfully involved. Methods Qualitative in-depth interviews over videoconference (n = 21) were conducted in English or Bahasa with stakeholders in Indonesia. Participants included policymakers, implementation partners, and advocates who were focused on adolescent health or NCDs. Interviews were recorded, transcribed, translated, and thematically analysed using NVivo12. Findings were disseminated to participants for validation and feedback. Youth participants (n = 7) attended an additional workshop and considered recommendations and actions arising from this research. Findings Participants identified that government and non-government organisations are acting on NCDs in Indonesia, but few of the existing initiatives target adolescents, and adolescent services rarely addressed NCD risks. Participants also felt that policies to protect adolescents from NCD risks (i.e., smoke-free areas in public) were not always enforced. For programs or initiatives focused on adolescent health, those that had engaged adolescents as co-creators and leaders were perceived to be more successful. As such, participants recommended more meaningful engagement of young people, including young people's leadership of initiatives. Additional recommendations included the need for intersectoral engagement and a 'whole-of-government' approach to prevention given the complex determinants of NCD risks, and the need for evidence-based actions that are underpinned by quality data to enable monitoring of progress. Interpretation There is a recognised need to strengthen policies and actions to address NCD risks amongst adolescents in Indonesia. Meaningful youth engagement that allows young people to take the lead, intersectoral actions, and evidence-based data driven responses were key strategies identified. Funding UNICEF East Asia and Pacific Regional Office.
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Affiliation(s)
- Karly I. Cini
- Global Adolescent Health Group, Maternal Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Nisaa R. Wulan
- Global Adolescent Health Group, Maternal Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | - Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Australia
| | - Alifah Nurjannah Triputri
- Centre for Epidemiology and Population Health Studies, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Iffat Abbsar
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Luo Li
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Diandra A. Priambodo
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | | | | | - Kate L. Francis
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Susan M. Sawyer
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Australia
| | - George C. Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Ansariadi Ansariadi
- Centre for Epidemiology and Population Health Studies, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Peter S. Azzopardi
- Global Adolescent Health Group, Maternal Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Australia
- Adolescent Health and Wellbeing Program, Telethon Kids Institute, Adelaide, South Australia, Australia
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Hendricks LA, Young T, Van Wyk SS, Matheï C, Hannes K. Storyboarding HIV Infected Young People's Adherence to Antiretroviral Therapy in Lower- to Upper Middle-Income Countries: A New-Materialist Qualitative Evidence Synthesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11317. [PMID: 36141589 PMCID: PMC9517626 DOI: 10.3390/ijerph191811317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 06/16/2023]
Abstract
Young people living with perinatal infections of Human Immunodeficiency Virus (YLPHIV) face a chronic disease, with treatment including adherence to lifelong antiretroviral treatment (ART). The aim of this QES was to explore adherence to ART for YLPHIV as an assemblage within the framework of the biopsychosocial model with a new materialist perspective. We searched up to November 2021 and followed the ENTREQ and Cochrane guidelines for QES. All screening, data extraction, and critical appraisal were done in duplicate. We analysed and interpreted the findings innovatively by creating images of meaning, a storyboard, and storylines. We then reported the findings in a first-person narrative story. We included 47 studies and identified 9 storylines. We found that treatment adherence has less to do with humans' preferences, motivations, needs, and dispositions and more to do with how bodies, viruses, things, ideas, institutions, environments, social processes, and social structures assemble. This QES highlights that adherence to ART for YLPHIV is a multisensorial experience in a multi-agentic world. Future research into rethinking the linear and casual inferences we are accustomed to in evidence-based health care is needed if we are to adopt multidisciplinary approaches to address pressing issues such as adherence to ART.
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Affiliation(s)
- Lynn A. Hendricks
- Centre for Evidence Based Health Care, Division of Epidemiology and Biostatistics, Stellenbosch University, Cape Town 3000, South Africa
- Research Group SoMeTHin’K (Social, Methodological and Theoretical Innovation/Kreative), Faculty of Social Sciences, Katholieke Universiteit, 3000 Leuven, Belgium
| | - Taryn Young
- Centre for Evidence Based Health Care, Division of Epidemiology and Biostatistics, Stellenbosch University, Cape Town 3000, South Africa
| | - Susanna S. Van Wyk
- Centre for Evidence Based Health Care, Division of Epidemiology and Biostatistics, Stellenbosch University, Cape Town 3000, South Africa
| | - Catharina Matheï
- Department of Public Health and Primary Care, Katholieke Universiteit, 3000 Leuven, Belgium
| | - Karin Hannes
- Research Group SoMeTHin’K (Social, Methodological and Theoretical Innovation/Kreative), Faculty of Social Sciences, Katholieke Universiteit, 3000 Leuven, Belgium
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Shulock K, Beima-Sofie K, Apriyanto H, Njuguna I, Mburu C, Mugo C, Itindi J, Onyango A, Wamalwa D, John-Stewart G, O'Malley G. "It's about making adolescents in charge of their health": policy-makers' perspectives on optimizing the health care transition among adolescents living with HIV in Kenya. AIDS Care 2022; 34:1127-1134. [PMID: 34482776 DOI: 10.1080/09540121.2021.1971606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
ABSTRACTThe health care transition (HCT) from pediatric to adult care is a potential contributor to poor clinical outcomes among adolescents living with HIV (ALHIV). In sub-Saharan Africa (SSA), there is limited information on effective tools and processes to prepare and support ALHIV through this transition. This study elicited perspectives of policy-makers regarding barriers and facilitators to successful HCT among ALHIV in Kenya. Twenty in-depth interviews (IDIs) were conducted with policy-makers using a semi-structured guide. Using the socio-ecological model (SEM) as an organizing framework, directed content and thematic network analyses methods were used to characterize themes related to key influences on HCT processes and to describe actionable recommendations for improved tools and resources. Policy-makers identified multilevel support, including the development of a triadic relationship between the caregiver, healthcare worker (HCW) and adolescent, as an essential strategy for improved HCT success. Across the SEM, policy-makers described the importance of actively engaging adolescents in their care to promote increased ownership and autonomy over health decisions. At the structural level, the need for more comprehensive HCT guidelines and improved HCW training was highlighted. Expanded HCT tools and guidelines, that emphasize supportive relationships and intensified adolescent engagement, may improve HCT processes and outcomes.
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Affiliation(s)
- Katherine Shulock
- Department of Global Health, University of Washington, Seattle, WA, USA
| | | | - Haris Apriyanto
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Irene Njuguna
- Department of Global Health, University of Washington, Seattle, WA, USA
- Kenyatta National Hospital, Research and Programs, Nairobi, Kenya
| | - Caren Mburu
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Cyrus Mugo
- Kenyatta National Hospital, Research and Programs, Nairobi, Kenya
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | | | - Alvin Onyango
- Department of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - Dalton Wamalwa
- Department of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - Grace John-Stewart
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
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Sellars E, Pavarini G, Michelson D, Creswell C, Fazel M. Young people's advisory groups in health research: scoping review and mapping of practices. Arch Dis Child 2021; 106:698-704. [PMID: 33208398 DOI: 10.1136/archdischild-2020-320452] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/21/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND Young people's advisory groups (YPAGs) for research are comprised of children or adolescents who work with researchers to shape different stages of the research process. Their involvement is expected to ensure studies better reflect the preferences and needs of targeted youth populations. However, despite their increasing use in health research, there is little systematic evidence on the methods and impacts associated with YPAGs. METHOD To address this gap, we conducted a scoping review of YPAGs in youth-focused health studies. We systematically searched MEDLINE for empirical studies in populations between 12 years and 18 years of age published in 2019. If a potential YPAG was identified, authors were contacted for additional information about the activities and level of involvement of the YPAG. FINDINGS Of all studies that collected primary data from persons aged 12-18 years, only 21 studies reported using youth advice during their research. This represents less than 1% of all published empirical child and adolescent studies. There was variation in the type of research activity undertaken by YPAGs and their level of involvement. Most studies involved YPAGs in co-production of research design and/or in dissemination activities. The majority of authors that responded were positive about the impact of YPAGs. INTERPRETATION Recommendations for consistent reporting of YPAG involvement in empirical studies include reporting on the match between YPAG and study populations, frequency/format of meetings, and the nature and level of involvement.
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Affiliation(s)
- Elise Sellars
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | | | - Cathy Creswell
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Mina Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
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