Evaluating the Effects of Reproductive Health Training on Provider Behavior

NCT06428058 | Active Not Recruiting

• 1 other identifier: R01HD092655
• Study Type: interventional
• Target: 310
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this randomized, controlled, single blinded trial is to evaluate the medium to long-term effects of an Afrocentric sexual health curriculum on health professional students' knowledge, attitudes, and clinical skills in providing sexual health in Tanzania.

Conditions

Health Knowledge, Attitudes, Practice; Training

Outcome Measures

Primary Outcomes (6)

• Change in Sexual Health Knowledge Score

  Sexual health knowledge was assessed using 16 multichoice items created by the research team. The items covered female sexual health concerns (2 items), sexual development and masturbation (3 items), sexual orientation (3 items), sexual violence (3 items), sexuality in middle age (3 items), sexual history taking and sexual counseling (2 items). Total scores were used for analysis (maximum total score of 16). Participants get one point for every item answer correctly. Because there are 16 items in this section, participants can have a minimum total score of 0 and a maximum total score of 16. A higher score signifies better sexual health knowledge.

  Baseline, 6-month follow-up, 12-month follow-up, and 24-month follow-up.

• Change in Sexual Health Attitudes: Confidence in Ability to Discuss

  Confidence in their ability to discuss the sexual health of patients, and confidence in their ability to discuss their patients' sexual health concerns were assessed using the Sexual Health Education for Professionals Scale (SHEPS). This section consists of 37 items where participants rate their confidence from (1) very unconfident to (5) confident. Because there are 37 items in this section, participants can have a minimum total score of 37 and a maximum total score of 185. A higher value signifies better confidence in the ability to discuss sexual health topics.

  Baseline, 6-month follow-up, 12-month follow-up, and 24-month follow-up.

• Change in Sexual Health Attitudes: Confidence in Having Knowledge

  Confidence in their knowledge to assess the sexual health of patients, and confidence in their ability to discuss their patient's sexual health concerns were assessed using the Sexual Health Education for Professionals Scale (SHEPS). This section consists of 37 items where participants rate their confidence from (1) very unconfident to (5) confident. Because there are 37 items in this section, participants can have a minimum total score of 37 and a maximum total score of 185. A higher value signifies better confidence in having knowledge of sexual health topics.

  Baseline, 6-month follow-up, 12-month follow-up, and 24-month follow-up.

• Change in Sexual Counseling Skills: Interpersonal Communications

  Skills were assessed by faculty raters assessing two videos (per each time point) of student counseling blind to whether the participant was in the intervention or control group and whether the assessment was at baseline or follow-up. Each participant was rated on 10 items assessing their interpersonal communication (IC) abilities. Each item was on a 3-point scale (0=not done; 1=partially done; 2=done). The scale has a minimum score of 0 and a maximum score of 20 per video. The investigators aggregated scores for each time point by summing the two videos at each time point. Therefore, the minimum total score is 0 and the maximum total score is 40. A higher score value signifies better interpersonal communication skills.

  Baseline, 6-month follow-up, 12-month follow-up, and 24-month follow-up.

• Change in Sexual Counseling Skills: Medical History Taking

  Skills were assessed by faculty raters assessing the two videos (per time point) of student counseling blind to whether the participant was in the intervention or control group and whether the assessment was at baseline or follow-up. Medical history taking (MHT) was rated by six key pieces of information on a 2-point scale, where 0=not obtained information and 1=obtained information. The scale has a minimum score of 0 and a maximum score or 6 per video. The investigators aggregated scores for each time point by summing the two videos at each time point. Therefore, the minimum total score is 0 and the maximum total score is 12.

  Baseline, 6-month follow-up, 12-month follow-up, and 24-month follow-up.

• Change in Sexual Health Beliefs

  The SHEPS Attitudes section comprises 27 items. Participants rate their level of agreement (1=strongly agree; 5=strongly disagree), with 13 items being reverse coded. Because there are 27 items in this section, participants can have a minimum total score of 27 and a maximum total score of 135. Low scores correspond to "liberal" views and high scores correspond to "conservative" views.

  Baseline, 6-month follow-up, 12-month follow-up, and 24-month follow-up.

Study Arms (2)

Comprehensive Sexual Health Curriculum

EXPERIMENTAL

Participants received a four-day comprehensive sexual health curriculum tailored for Africa.

Behavioral: Comprehensive sexual health curriculum

Waitlist Control

NO INTERVENTION

Participants in this arm completed a follow-up survey and scheduled to receive the intervention after the end of the trial.

Interventions

Comprehensive sexual health curriculum BEHAVIORAL

This is a randomized, controlled, single blinded, trial, stratified by health profession, of the intervention versus waitlist control assessing the effects on sexual health knowledge, attitudes, and sexual history and counseling skills at medium (6-) and long-term (12 and 24 months) follow-up. At the end of the intervention as compared with waitlist controls. The intervention was a 4-day, Afrocentric, comprehensive sexual health curriculum. Tanzanian faculty wrote the curriculum in English and Kiswahili to address the most common sexual health challenges clinicians experience in Tanzania. The 4-day curriculum covers sexual health across the lifespan, lesbian, gay, bisexual, and transgender (LGBT) and sexual violence, clinical skills training, ethics, and community resources and cultural considerations.

Comprehensive Sexual Health Curriculum

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• A health student studying at MUHAS and verified by being registered as a pre-final year midwifery, nursing or medical student (or its equivalent).
• "Pre-final" year is defined as a student who is just about to enter year 3 of nursing, or year 4 of midwifery or medicine.
• Living or studying in Tanzania
• Experienced, operationalized as having worked at least 100 hours as a health worker in a clinic, hospital or community setting so students can discuss what happens in the clinical setting
• Able to speak English and Kiswahili.

You may not qualify if:

• Students who will not be able to attend all days of the seminar at their health institution or be on their campus for the follow-up.
• Students who express any reservations about attending (e.g., due to religious objections)
• Students who express a fear of violence due to attending (e.g., from a spouse or relative).
• Students who attended the sexual health seminar (e.g., during THP-1 or at another site). This is to prevent a student participating more than once.

Sponsors & Collaborators

• Muhimbili University of Health and Allied Sciences: collaborator
• Johns Hopkins University: collaborator
• University of Minnesota: lead

Study Sites (1)

Muhimbili University of Health and Allied Sciences

Dar es Salaam, Tanzania

Location

MeSH Terms

Conditions

Behavior

Study Officials

• B.R. Simon Rosser, PhD

  University of Minnesota

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: A randomized, controlled, single blinded trial, stratified by health profession, of the intervention vs waitlist control.
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Testing of an Afrocentric sexual health curriculum for Midwifery, Nursing and Medical Students.

Study Record Dates

• First Submitted: May 20, 2024
• First Posted: May 24, 2024
• Study Start: June 28, 2024
• Primary Completion: August 2, 2025
• Study Completion (Estimated): October 1, 2026
• Last Updated: February 24, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

TA (1)