Linking at-risk South African girls to sexual violence and reproductive health services: A mixed-methods assessment of a soccer-based HIV prevention program and pilot SMS campaign

Katherine G Merrill; Jamison C Merrill; Rebecca B Hershow; Chris Barkley; Boitumelo Rakosa; Jeff DeCelles; Abigail Harrison

doi:10.1016/j.evalprogplan.2018.04.010

Linking at-risk South African girls to sexual violence and reproductive health services: A mixed-methods assessment of a soccer-based HIV prevention program and pilot SMS campaign

Eval Program Plann. 2018 Oct:70:12-24. doi: 10.1016/j.evalprogplan.2018.04.010. Epub 2018 Apr 30.

Authors

Katherine G Merrill¹, Jamison C Merrill², Rebecca B Hershow³, Chris Barkley⁴, Boitumelo Rakosa⁵, Jeff DeCelles⁶, Abigail Harrison⁷

Affiliations

¹ Grassroot Soccer, Cape Town, 38 Hout Street, Cape Town, 8001, South Africa. Electronic address: [email protected].
² Grassroot Soccer, Cape Town, 38 Hout Street, Cape Town, 8001, South Africa. Electronic address: [email protected].
³ Grassroot Soccer, Cape Town, 38 Hout Street, Cape Town, 8001, South Africa. Electronic address: [email protected].
⁴ Grassroot Soccer, Cape Town, 38 Hout Street, Cape Town, 8001, South Africa. Electronic address: [email protected].
⁵ Grassroot Soccer, Soweto, Nike Football Training Center, 1096 Chris Hani Road, Soweto, Gauteng, 1809, South Africa. Electronic address: [email protected].
⁶ Grassroot Soccer, Cape Town, 38 Hout Street, Cape Town, 8001, South Africa. Electronic address: [email protected].
⁷ Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 S. Main Street, Providence, RI, 02903, United States. Electronic address: [email protected].

Abstract

Grassroot Soccer developed SKILLZ Street-a soccer-based life skills program with a supplementary SMS platform-to support adolescent girls at risk for HIV, violence, and sexual and reproductive health challenges. We conducted a mixed-methods assessment of preliminary outcomes and implementation processes in three primary schools in Soweto, South Africa, from August to December 2013. Quantitative methods included participant attendance and SMS platform usage tracking, pre/post questionnaires, and structured observation. Qualitative data were collected from program participants, parents, teachers, and a social worker during 6 focus group discussions and 4 in-depth interviews. Of 394 participants enrolled, 97% (n = 382) graduated, and 217 unique users accessed the SMS platform. Questionnaires completed by 213 participants (mean age: 11.9, SD: 3.02 years) alongside qualitative findings showed modest improvements in participants' perceptions of power in relationships and gender equity, self-esteem, self-efficacy to avoid unwanted sex, communication with others about HIV and sex, and HIV-related knowledge and stigma. The coach-participant relationship, safe space, and integration of soccer were raised as key intervention components. Implementation challenges were faced around delivery of soccer-based activities. Findings highlight the relevance and importance of programs like SKILLZ Street in addressing challenges facing adolescent girls in South African townships. Recommendations for future programs are provided.

Keywords: Adolescent girls; Gender violence; HIV; Sexual & reproductive health; Soccer-based intervention.

Publication types

Evaluation Study
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
Female
HIV Infections / prevention & control*
Health Knowledge, Attitudes, Practice*
Health Promotion / methods*
Humans
Interviews as Topic
Parent-Child Relations
Pilot Projects
Power, Psychological*
Program Evaluation
Reproductive Health Services
Schools
Self Efficacy*
Sex Offenses / prevention & control*
Soccer
South Africa
Surveys and Questionnaires

Grants and funding

P2C HD041020/HD/NICHD NIH HHS/United States