Intensive Group Learning and On-Site Services to Improve Sexual and Reproductive Health Among Young Adults in Liberia: A Randomized Evaluation of HealthyActions

Rebecca Firestone; Reid Moorsmith; Simon James; Marilyn Urey; Rena Greifinger; Danielle Lloyd; Lisa Hartenberger-Toby; Jewel Gausman; Musa Sanoe

doi:10.9745/GHSP-D-16-00074

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FIGURE.
Flow Diagram of Enrollment, Allocation, and Analysis Process

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TABLE 1 Demographic Profile of Sampled Learners at Baseline (January–March 2014) and Endline (June–July 2014), Selected Counties of Liberia

	Baseline (N = 1,157)			Endline (N = 1,052)
	Control (n = 518)	Treatment (n = 639)	P Value	Control (n = 503)	Treatment (n = 549)	P Value
Female, No. (%)	368 (71.04)	466 (72.93)	.48	327 (65.01)	400 (72.86)	.01
Age, years, mean (SD)	28.41 (5.93)	28.09 (5.81)	.35	28.03 (5.86)	28.86 (6.24)	.41
No. of children, mean (SD)	2.91 (2.08)	2.83 (2.16)	.55	2.73 (2.17)	2.79 (1.93)	.65
No. of children, No. (%)	65 (12.55)	77 (12.05)	.80	75 (14.91)	86 (15.66)	.73
Marital status, No. (%)			.70			.08
Single/never married	187 (36.10)	241 (37.72)		167 (33.2)	180 (32.79)
Married/living together	313 (60.42)	379 (59.31)		320 (63.62)	340 (61.93)
Divorced	14 (2.70)	12 (1.88)		6 (1.19)	20 (3.64)
Widowed	4 (0.77)	7 (1.10)		10 (1.99)	9 (1.64)
Educational level, mean (SD)	1.72 (0.82)	1.65 (0.73)	.12	1.78 (0.81)	1.60 (0.75)	<.01
ABE level 1, No. (%)	268 (51.74)	324 (50.70)		232 (46.12)	306 (55.74)
ABE level 2, No. (%)	127 (24.52)	216 (33.80)		148 (29.42)	156 (28.42)
ABE level 3, No. (%)	123 (23.75)	99 (15.49)		123 (24.45)	87 (15.85)
Income, No. (%)			.10			.08
0	74 (14.29)	127 (19.87)		98 (19.48)	137 (24.95)
LRD 1–100	80 (15.44)	83 (12.99)		52 (10.34)	70 (12.75)
LRD 100–500	234 (45.17)	257 (40.22)		210 (41.75)	237 (43.17)
LRD 600–1,000	68 (13.13)	77 (12.05)		79 (15.71)	57 (10.38)
More than LRD 1,000	58 (11.20)	94 (14.71)		61 (12.13)	47 (8.56)
Don’t know/no answer	4 (0.77)	1 (0.16)		3 (0.60)	1 (0.18)

Abbreviations: ABE, alternative basic education; LRD, Liberian dollars; SD, standard deviation.

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TABLE 2 Self-Reported Condom Use With Regular and Casual Partners Among Sampled Learners at Baseline (January–March 2014) and Endline (June–July 2014), Selected Counties of Liberia

	Baseline			Endline			Average Marginal Effects (95% CI)	P Value
	Control	Treatment	P Value	Control	Treatment	P Value	Average Marginal Effects (95% CI)	P Value
With regular partner			.62			.01
Sample size	356	427		312	304
Never	229 (64.33)	288 (67.45)		199 (63.78)	159 (52.30)		-0.12 (-0.22, -0.02)	.02
Intermittently	102 (28.65)	114 (26.70)		94 (30.13)	113 (37.17)		0.08 (-0.02, 0.17)	.13
Always	25 (7.02)	25 (5.85)		19 (6.09)	32 (10.53)		0.04 (-0.01, 0.09)	.10
With casual partner			.24			.85
Sample size	89	121		80	84
Never	34 (38.20)	56 (46.28)		25 (31.25)	24 (28.57)		-0.05 (-0.18, 0.07)	.41
Intermittently	33 (37.08)	31 (25.62)		24 (30.00)	22 (26.19)		-0.4 (-0.16, 0.08)	.48
Always	20 (22.47)	33 (27.27)		30 (37.50)	37 (44.05)		0.10 (-0.07, 0.28)	.25
Don't know	2 (2.25)	1 (0.83)		1 (1.25)	1 (1.19)		–	–

Abbreviation: CI, confidence interval.
Data reported as No. (%) except when otherwise noted.

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TABLE 3 Current Contraceptive Use Among Non-Pregnant, Non-Breastfeeding Women at Baseline (January–March 2014) and Endline (June–July 2014), Selected Counties of Liberia

	Baseline (N = 546)			Endline (N = 470)			Average Marginal Effects (95% CI)^a	P Value
	Control (n = 232)	Treatment (n = 314)	P Value	Control (n = 215)	Treatment (n = 255)	P Value	Average Marginal Effects (95% CI)^a	P Value
Short-acting methods
Injectable	56 (24.14)	76 (24.20)	.99	65 (30.23)	62 (24.31)	.15	-0.05 (-0.13, 0.04)	0.27
Male condom	19 (8.19)	29 (9.24)	.67	18 (8.37)	28 (10.98)	.34	0.03 (-0.0, 0.93)	.37
Pill	53 (22.84)	53 (16.88)	.08	33 (15.35)	60 (23.53)	.03	0.08 (0.00, 0.17)	.06
Female condom	1 (0.43)	0 (0.00)	.24	0 (0.00)	1 (0.39)	.21	–	–
Long-acting methods
Implant	9 (3.88)	17 (5.41)	.41	16 (7.44)	39 (15.29)	.01	0.09 (0.03, 0.16)	<.01
Female sterilization	1 (0.43)	1 (0.32)	.83	0 (0.00)	0 (0.00)	>.99	–	–
Male sterilization	0 (0.00)	0 (0.00)	>.99	0 (0.00)	0 (0.00)	>.99	–	–
IUD	0 (0.00)	0 (0.00)	>.99	0 (0.00)	0 (0.00)	>.99	–	–
Any long-acting or permanent method	10 (4.31)	18 (5.73)	.63	16 (7.44)	39 (15.29)	.01	0.10 (0.05, 0.16)	<.01
Any modern method	123 (53.02)	159 (50.64)	.58	119 (55.35)	170 (66.67)	.01	0.13 (0.04, 0.22)	<.01
Traditional methods
Rhythm	4 (1.72)	4 (1.27)	.67	8 (3.72)	7 (2.75)	.55	–	–
Other traditional	4 (1.72)	0 (0.00)	.02	1 (0.47)	3 (1.18)	.40	–	–

Abbreviations: CI, confidence interval; IUD, intrauterine device.
Data reported as No. (%) except when otherwise noted.
↵a Estimations for some methods couldnot be calculated because of the small number of users in the sample.

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TABLE 4 HIV Knowledge, Attitudes, and Testing Behaviors Among Sampled Learners at Baseline (January–March 2014) and Endline (June–July 2014), Selected Counties of Liberia

	Baseline (N = 1,157)			Endline (N = 1,052)			Average Marginal Effects (95% CI)
	Control (n = 518)	Treatment (n = 639)	P Value	Control (n = 503)	Treatment (n = 549)	P Value	Average Marginal Effects (95% CI)
Have you heard of HIV or AIDS?	510 (98.46)	629 (98.44)	.99	498 (99.01)	547 (99.64)	.38	0.00 (-0.01, 0.02)
Do you know where to access HIV testing services?	366 (70.66)	423 (66.20)	.07	357 (70.97)	494 (89.98)	<.001	0.19 (0.13, 0.26)^**
Have you ever been tested for HIV and received the result?	237 (45.75)	241 (37.72)	.001	211 (41.95)	482 (87.80)	<.001	0.45 (0.38, 0.53)^**
Do you intend to get an HIV test within the next year?	474 (91.51)	560 (87.64)	.01	457 (90.85)	533 (97.09)	<.001	0.06 (0.03, 0.09)^**