Evaluating the Effects of Reproductive Health Training on Provider Behavior - Aim 3

Training for Health Professionals 2 Aim 3 is designed to evaluate the real-world effectiveness and feasibility of disseminating an Afrocentric sexual and reproductive health curriculum for health professional students in Tanzania. The study builds on prior Training for Health Professionals work, including a previous randomized controlled trial that showed improvements in sexual and reproductive health knowledge, attitudes, and clinical skills among health care students.

This Phase IV implementation study will be conducted at three institutions in Tanzania: the State University of Zanzibar, Kilimanjaro Christian University, and the University of Dodoma. The study will enroll medical, nursing, and midwifery students who are current pre-final year students at one of the participating institutions.

Participants will receive a four-day Afrocentric comprehensive sexual and reproductive health curriculum. The curriculum covers sexual health across the lifespan and male and female sexual dysfunctions on Day 1; key populations, including LGBT persons and sex workers, and sexual violence on Day 2; clinical skills training, ethics, and policy writing on Day 3; and community resources and cultural considerations on Day 4.

Participants will complete study surveys at baseline, immediately after the intervention, and at 3-month and 12-month follow-up. The surveys will assess sexual health knowledge, attitudes, and sexual history and counseling skills. Faculty involved in delivering the curriculum will also complete post-training evaluations assessing their knowledge, comfort, and skills in teaching the curriculum.

The study will evaluate whether participants increase and retain sexual health knowledge, attitudes, and skills after participating in the curriculum in a real-world educational setting. The study will also assess implementation fidelity and faculty training outcomes to inform future dissemination of the curriculum.

• Afrocentric Sexual and Reproductive Health Curriculum (Behavioral), also known as Training for Health Professionals Curriculum: The intervention is a four-day Afrocentric comprehensive sexual and reproductive health curriculum. It covers sexual health across the lifespan, male and female sexual dysfunctions, key populations including LGBT persons and sex workers, sexual violence, clinical skills training, ethics, policy writing, community resources, and cultural considerations.

Primary outcomes

• Change in Sexual and Reproductive Health Knowledge [Baseline, immediately post-intervention, 3 months, and 12 months]: Change in sexual and reproductive health knowledge will be assessed using participant survey responses collected before the curriculum, immediately after the curriculum, and at 3-month and 12-month follow-up.
• Change in Sexual and Reproductive Health Attitudes [Baseline, immediately post-intervention, 3 months, and 12 months]: Change in attitudes related to sexual and reproductive health care will be assessed using participant survey responses collected before the curriculum, immediately after the curriculum, and at 3-month and 12-month follow-up.
• Change in Sexual History Taking and Counseling Skills [Baseline, immediately post-intervention, 3 months, and 12 months]: Change in sexual history taking and counseling skills will be assessed using participant survey responses collected before the curriculum, immediately after the curriculum, and at 3-month and 12-month follow-up.

Sex: All, ages: 18 Years to any, accepts healthy volunteers

Inclusion Criteria:

* Current pre-final year student at the State University of Zanzibar, Kilimanjaro Christian University, or the University of Dodoma in midwifery, nursing, or medicine
* Able to attend the full 4-day training
* Fluent in English and Kiswahili
* Willing to volunteer to complete all evaluation procedures

Exclusion Criteria:

* Unable to attend all days of the seminar at SUZA, KCMC, or UDOM
* Unable to be on the SUZA, KCMC, or UDOM campus for the follow-up dates
* Expresses reservations about attending, including religious objections
* Expresses fear of violence due to attending, including fear from a spouse or relative
* Prior exposure to the Training for Health Professionals curriculum or either of the previous pilots
* Younger than 18 years of age
* Non-English speaker
* Unable to read
* Employee of the researcher
* Prisoner
* Adult lacking capacity to consent or with diminished capacity to consent
* Active member of the military or DoD personnel

• B. R. Simon Rosser, PhD, Principal investigator, University of Minnesota

NIH grants: R01HD092655