Health Training for Health Professionals In Tanzania

Study Overview
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Brief Summary
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The goal of this randomized, controlled, single blinded trial is to evaluate the effectiveness of an Afrocentric sexual health curriculum on health professional students' knowledge, attitudes, and clinical skills in providing sexual health care in Tanzania.

Detailed Description
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There were 563 students recruited for the study that met the eligibility requirement. A total of 412 students gave consent and were randomized into intervention and control groups. At baseline, participants took a survey covering demographic information, educational background, sexual health knowledge, and attitudes toward sexual health topics. After completing the survey, participants participated in two standardized patient interviews involving actors role playing sexual health-related patient scenarios. Those who were in the intervention arm participated in a 4-day sexual health curriculum followed by a post-test survey measuring sexual health knowledge, attitudes, and evaluation of sexual health training. Three to four months later, intervention and waitlist control participants completed a follow-up survey assessing sexual health knowledge and attitudes toward sexual health topics and standardized patients scenarios. Multiple linear regression was used to assess the overall effectiveness of the sexual health curriculum on the attitudes, knowledge, and skills of health professionals after it has been implemented.

Official Title
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Training for Health Professionals in Tanzania

Conditions
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Training, Health Knowledge, Attitudes, Practice

Intervention / Treatment
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* Behavioral: Comprehensive sexual health curriculum


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: current student at MUHAS in midwifery, nursing, or medicine. 3rd or 4th year for medical students or 2nd or 3rd year for nursing and midwifery students. able to attend the full 4-day training during the first week of student vacation. fluent in English (the language of instruction at MUHAS) and Kiswahili (the lingua franca in Tanzania). willing to volunteer and complete all evaluation procedures. Exclusion Criteria: students who will not be able to attend MUHAS all days of the seminar or be on the MUHAS campus for the follow-up dates. students who express severe reservations about attending (e.g., due to religious objections). Students who express fear of violence due to attending (e.g., from a spouse or relative).

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Development and testing of a sexual health curriculum for Midwifery, Nursing and Medical Students.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention Arm<br>A four-day comprehensive sexual health curriculum tailored for Africa. | Behavioral: Comprehensive sexual health curriculum<br>* This is a randomized, controlled, single blinded, trial, stratified by health profession, of the intervention versus waitlist control assessing knowledge, attitude change and skill development. 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, LGBT and sexual violence, clinical skills training, ethics and policy writing, and community resources and cultural considerations.<br>|
| No Intervention: Waitlist control<br>Participants in this arm completed a follow-up survey and were scheduled to receive the intervention after the end of the trial. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sexual Health Knowledge | 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). | At Baseline and 3-4 months Follow-up | 
| Sexual Health Attitudes | 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). Each section consists of 37 items where participants rate their confidence from (1) very unconfident to (5) confident. | At Baseline and 3-4 months Follow-up | 
| Sexual Health Counseling Skills | Skills were assessed by faculty raters assessing the video 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. Medical history taking (MHT) was rated by six key pieces of information. | At Baseline and 3-4 months Follow-up | 
| 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. | At Baseline and 3-4 months Follow-up |