Training for Health Professionals In Tanzania (THP)

July 11, 2024 updated by: University of Minnesota

Training for Health Professionals in Tanzania

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.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

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.

Study Type

Interventional

Enrollment (Actual)

412

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Tanzania
      • Dar Es Salaam, Tanzania
        • Muhimbili University of Health and Allied Sciences (MUHAS)
  • United States
    • Minnesota
      • Minneapolis, Minnesota, United States, 55455
        • University of Minnesota

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

14 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  1. current student at MUHAS in midwifery, nursing, or medicine.
  2. 3rd or 4th year for medical students or 2nd or 3rd year for nursing and midwifery students.
  3. able to attend the full 4-day training during the first week of student vacation.
  4. fluent in English (the language of instruction at MUHAS) and Kiswahili (the lingua franca in Tanzania).
  5. willing to volunteer and complete all evaluation procedures.

Exclusion Criteria:

  1. 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.
  2. students who express severe reservations about attending (e.g., due to religious objections).
  3. Students who express fear of violence due to attending (e.g., from a spouse or relative).

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Intervention Arm
A four-day comprehensive sexual health curriculum tailored for Africa.
Behavioral: Comprehensive sexual health curriculum

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.
No Intervention: Waitlist control
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?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Sexual Health Knowledge Score From Baseline to Follow-up
Time Frame: At Baseline and 3-4 months Follow-up
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 they 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. A single value was calculated for the intervention arm and waitlist control from difference scores (calculated as follow-up minus baseline scores).
At Baseline and 3-4 months Follow-up
Change in Sexual Health Attitudes: Confidence in Ability to Discuss From Baseline to Follow-up
Time Frame: At Baseline and 3-4 months Follow-up
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. A single value was calculated for the intervention arm and waitlist control from difference scores (calculated as follow-up minus baseline scores).
At Baseline and 3-4 months Follow-up
Change in Sexual Health Attitudes: Confidence in Having Knowledge From Baseline to Follow-up
Time Frame: At Baseline and 3-4 months Follow-up
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. A single value was calculated for the intervention arm and waitlist control from difference scores (calculated as follow-up minus baseline scores).
At Baseline and 3-4 months Follow-up
Change in Sexual Counseling Skills: Interpersonal Communications From Baseline to Follow-up
Time Frame: At Baseline and 3-4 months Follow-up
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. We 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. A single value was calculated for the intervention arm and waitlist control from difference scores based on the sum of the scores at baseline and the sum of the scores at followup.
At Baseline and 3-4 months Follow-up
Change in Sexual Counseling Skills: Medical History Taking From Baseline to Follow-up
Time Frame: At Baseline and 3-4 months Follow-up
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. We 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. A higher score value signifies better medical history taking skills. A single value was calculated for the intervention arm and waitlist control from difference scores based on the sum of the scores at baseline and the sum of the scores at followup.
At Baseline and 3-4 months Follow-up
Change in Sexual Health Beliefs From Baseline to Follow-up
Time Frame: At Baseline and 3-4 months Follow-up
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. A single value was calculated for the intervention arm and waitlist control from difference scores (calculated as follow-up minus baseline scores).
At Baseline and 3-4 months Follow-up

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Evaluate the effectiveness of the curriculum - Demographics and knowledge
Time Frame: Month 36
As part of the RCT, health professionals' knowledge, attitude change, and skills will be assessed first. Demographics, professional specifications, and sex knowledge will be measured using pen and paper surveys. Responses will be measured on the Likert scale. These pen and paper surveys will be entered onto the U of M site using double data entry.
Month 36
Evaluate the effectiveness of the curriculum - Communication, confidence, and attitudes
Time Frame: Month 36
Communication abilities, content confidence, and attitudes will be recorded using pen and paper surveys and measured by the Sexual health Education of Professionals Scale (SHEPS). These pen and paper surveys will be entered onto the U of M site using double data entry.
Month 36
Evaluate the effectiveness of the curriculum - Skills
Time Frame: Month 36
The primary behavioral changes that will be measured is the student's ability to ask appropriate sexual questions, take a sexual history and counsel sexual problems. These skills will be measured by videotaping participants at pretest and a 3-month follow-up. Videos of participants will be rated by co-investigators to assess the students' performance over time. Videos will be randomized so raters are blind to whether video is a pre-test or follow-up. Two raters will assess each video clip and rate the students' performance as: 1=harmful; 2=poor; 3=neutral; 4=good; and 5=excellent.
Month 36

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Minnesota

Collaborators

Johns Hopkins University
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Muhimbili University of Health and Allied Sciences

Investigators

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

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 1, 2021

Primary Completion (Actual)

September 7, 2021

Study Completion (Actual)

September 20, 2022

Study Registration Dates

First Submitted

August 1, 2018

First Submitted That Met QC Criteria

April 18, 2019

First Posted (Actual)

April 22, 2019

Study Record Updates

Last Update Posted (Actual)

August 7, 2024

Last Update Submitted That Met QC Criteria

July 11, 2024

Last Verified

July 1, 2024

More Information

Terms related to this study

Other Study ID Numbers

  • STUDY00006904
  • R01HD092655 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Only group data will be analyzed.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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