Participatory Action Research for Adolescent Sexual and Reproductive Health: A Scoping Review
|Study Name||Country/Setting||Study Design||Participants and Sample Size||Other Stakeholders||Co-Designing Activities|
|Assifi 2020 ||Urban/community, NSW, Australia||Mixed-methods study||16–19 years |
Stage 2-N = 384
Stage 3-N = 5–10
Stage 4-N = 6
|Research advisory group.|
Participants from diverse professional backgrounds n = 5–10.
Health professionals with abortion expertise.
|Facilitated co-design workshop, create a framework and recommendations to inform adolescent friendly abortion service delivery in New South Wales.|
|Aventin 2021 ||Rural- Khayelitsha, South Africa, and Maseru, Lesetho. Community||Mixed methods||Advisory group:|
adolescents- 9 (5F/4M)
Community 18+ 8 (4F/FM)
Expert 18+ 13 (8F/5M)
Adolescents- 8 (5F/3M)
Community 18+ 7 (5F/2M)
Experts 18+ 8 (5F/3M)
Adolescents- 28 (15F/13M)
Adults- 12 (6F/6M)
Adolescents- 27 (14F/13M)
Adults- 10 (8F/2M)
NGOs (8), health workers (2), teachers (3), principle (1), caregiver (2), community leader (2), ministry of education and training (6), ministry of health (2), UNICEF (1), social workers (2), department of health (1), western cape education department (5).
Caregivers (5), councillors (2), pastors (2), teachers (4), police officer (1), health worker (1), community leader (1), nurses (2), NGO (1), social worker (1).
|Systematic and collaborative process|
ADVISORY GROUPS Collected primary data from 12 focus group discussions (6 in each country), eight with 55 adolescents and four with 22 adult participants.
|Cense 2020 ||Dutch high school |
|Mixed methods||Adolescents aged 12–18 |
N = 300
|17 young peer researchers.||Short semi-structured interviews to explore the range of issues connected to how pupils experienced sexuality education at school.|
Focus group discussions to explore these issues.
Photovoice sessions used to create a more open space for pupils to reflect on how sexuality education could be.
|Cook 2021 ||Wollongong (NSW, Australia) |
|Mixed methods||15–25 years|
n = not mentioned
|Workshop leaders.||Condom-mapping workshops were held, and 11 ‘perfect’ condom maps were generated.|
Groups of young people ranged from two to five people per map.
Participants sat around a large paper outline of a condom. Participants were asked to imagine their ‘perfect’ condom and to illustrate their ideas on the condom map, using both written and visual elements.
|Cordova 2020 ||Michigan, USA||Mixed methods||13 and 21 years |
N = 50
|Youth leadership council involved in:
|Decker 2020 ||Community, rural, Fresno County, California, USA||cluster randomized controlled trial||1260 youth ages 13–19 years||None stated.||October 2017 and ended in March 2020|
|Fongkaew 2006 ||Public and Private schools |
Chaing Mai Province, Thailand
|Mixed methods||42 youth leader trainers or senior youth leaders (SYLs), 16 males and 26 females;|
104 junior youth leaders (JYLs), including 38 males and 66 females, studying in Grade 7 at 12 schools;
2300 students in Grades 5–7 at 12 schools.
1159 males and 1141 females.
|Youth leader trainers or senior youth leaders (n = 42), 16 males and 26 females;|
Junior youth leaders (n = 104), including 38 males and 66 females, studying in Grade 7 at 12 schools.
Teacher (n = 46) from 12 schools, 11 males and 35 females;
Other stakeholders including school administrators, school committee members, parent representatives and public health personnel.
|Youth-adult partnership with schools.|
Youth leader trainers developed three curricula for SRH education and HIV/AIDS prevention on (1) leadership; (2) rights, duties, and responsibilities; and (3) HIV/SRH.
YLTs attended skill training camps, rehearsed, and practiced being YLTs and served as trainers and mentors for YYLs.
|Garwick 2008 ||Minneapolis and St. Paul, Minnesota, USA |
|Mixed methods||148 Native youth|
13–15 and 16–18 years
|Native community leaders and project consultants |
NTV research team included two faculty, a project coordinator from the University of Minnesota, and seven community consultants
The project coordinator and community consultants (four adults; three youth, 18 –21 years).
|Group discussion and questionnaires that took about 2 h.|
Focus group discussions co-led by an adult and youth native project consultant of the same gender as the participants in community-based organizations.
The adult facilitator guided the focus group discussion using an interview guide containing core and probe questions.
The youth facilitator captured participant ideas on a poster-sized flip chart and asked clarifying questions.
|Gilbert 2021 ||Darwin, Australia||mixed methods||Youth working group (YWG): |
4 Aboriginal and Torres Strait Islander and 3 non-Indigenous youth aged 18–25 years.
Students working in the field of Aboriginal and Torres Strait Islander health and/ or sexual reproductive health.
|Four 90 min consultations with YWG, 5 to 10 participants, with one researcher. |
YWG members shared their current understandings of preconception health, experiences of preconception care and how they currently obtain related health information.
YWG members identified components of preconception health identified in q1 they would like to know more about and which components they felt were most important.
YWG members asked what they believe are the strengths and weaknesses of current resources, what were the most useful sources of information and what resource features or functions would best suit their needs. Preferences for graphic design and illustrations were also discussed.
|Gill 2016 ||Local youth outreach centre |
The Ottawa Hospital and St Mary’s
|Prospective qualitative community-based participatory research |
Nine-step validated qualitative participatory approach that combined documentary photography with focus groups
|Ages 15–25 years||Key stakeholders at outreach centre.||Stage 1: Reviewing the objectives of the study and the photovoice method; brainstorming with the participants on the various structural and biological factors that affect reproductive and sexual health; training on the use of the disposable camera; and the ethics and safety of photography and the use of a third-party release form for individuals captured in photographs|
Stage 2: Occurred approximately 6–8 weeks later. This was to provide an opportunity for the participants to return their completed package, as well as for the researchers to print the photographs for the subsequent session.
Participants had an opportunity to select approximately 10–15 pictures that they believed illustrated their perspective on reproductive and sexual health issues.
The selected photographs were transferred to a laptop and each photograph was an interpretation by each participant, as it related to the key objectives of this study.
Participants discussed each other’s photographs as a group and identified common key themes and how to best use their pictures to develop interventions to promote reproductive and sexual health among their peers.
|Guerrero 2020 ||Peru (Lima, Ayacucho, and Loreto) rural community||Content development||STAGE 1: 68 13–24-year-old|
Aged 13–17 (22F/10M)
Aged 13–24 (23F/13M)
STAGE 2: No adolescents involved
STAGE 3: 104 adolescents (52% F/48% M)
|Adult advisers.||Six community consultations in the three study sites, with two meetings at each site with the following structure: one meeting with 13–17-year-old females and males and an adult adviser; and one meeting with 18–24-year-old females and males and an adult adviser.|
Development of short message services—no adolescent involvement.
A total of 12 focus groups to validate SMS content each group of participants evaluated 36–37 SMS (146 SMS in total), each adolescent received a form to rate each SMS, ranging from very bad (1 point) to very good (4 points).
|Haruna 2019 ||Three secondary schools from Dar es Salaam, Tanzania||Quasi-experimental |
andomized controlled trial research design
|348 secondary school participants (students) between 11 and 15 years of age|
There were 193 boys (55.5 per cent) and 155 girls (44.5 per cent)
|Paediatricians, sexual and reproductive health specialists, sexual health teachers from participating schools, computer, information science specialists (including the game designer, who is a computer engineer), and the targeted end-users themselves (secondary school students in Dar es Salaam).||The evaluation of the effectiveness of iterations of the game was done using adolescent sexual health literacy tests and the validated Motivation, Attitude, Knowledge and Engagement framework. |
The whole process of game design, testing, evaluation, and refinement were underpinned by the activity theory and participatory design (PD) research.
|Holiday 2020 ||Community, American southern states||Mixed methods||Research phase:|
recruited 431 teens and enrolled 246 (57%) into the project. Among them, 178 (72%) completed all sessions.
|Six adults in the focus groups|
Parents / guardians
|Six focus groups were held with both teens and parents/guardians of teens.|
A total of 48 months (4 years).
|Hong 2010 ||China |
Public middle school/rural
|Mixed methods||10–14 years |
Males & females
N = 102
|Teachers = 15|
Parents = 12
|Hubert 2021 ||Urban communities in the states of Mexico and Morelos,||Mixed methods||45 participants (23 women and girls and 22 men and boys) aged 12 to 19||E-learning: three exploratory workshops, no exact number of participants.|
Online chat: 21 including thematic and academic experts, public officials, members of civil society, and health personnel involved in SRH for adolescents.
|Four focus groups (FGs) two FGs comprised adolescents aged 12 to 14 and two comprised adolescents 15- to 19-years old; each age group was divided by sex.|
|Ivanova 2016 ||Latin America (Bolivia, Ecuador, and Nicaragua) rural/community||Mixed methods||9 adolescents 10–19 years||10 parents |
3 heath care providers
3 friends of youth/health promoters
6 community leaders
3 country implementers
3 project leaders
3 consortium management
|18 in-depth interviews and 21 focus group discussions with stakeholders and beneficiaries.|
Data were collected through key informant interviews (KIIs) and focus group discussions (FGDs) with the key stakeholders of CERCA–adolescents, parents, teachers, community leaders, peer educators, health care providers, project leaders at the country level, implementers at the country level and the international consortium management team
|Jaworsky 2013 ||Ontario, Canada||Mixed methods||18 youth (aged 16–28 years) sexual health peer educators||None stated|
|Jones 2012 ||School rural, Kabarole District, western Uganda||Mixed methods||51 students (25F/26M)|
(age 13 to 18, average 15.6 years), 24 from School A and 27 from School B
|School administrators and staff||Focus group discussions including students and teachers from two secondary schools in a rural district of western Uganda.|
Semi-structured focus groups and interviews and through meeting artefacts, including notes, flip charts, lesson plans and observations.
A total of almost 25 h were recorded and transcribed.
|Lofton 2020 ||Community, sub-Saharan Africa||Mixed methods||24 youth, ages 13–17 (12 males and 12 females)||Two adult facilitators per photovoice session, 12 in total||Youth used a systematic action planning process to develop action plans.|
Finally, the youth codified their ideas through the pile sorting activity, which allowed them to identify themes and rank these in terms of priorities. They then used a systematic action planning process, described in Results section, to develop an action plan for each prioritized theme.
Youth also had to identify the target for their solution, specifically which stakeholders in the community will help them carry out the plan.
|Marinkovich 2014 ||Kisumu, Kenya||Mixed methods||40 adolescents (13–17 years)|
Living with HIV
|Co-researchers/peer leaders||Participant-generated data was collected in the form of interviews and focus groups. Interviews and focus groups were voice-recorded, transcribed and when necessary, translated. The research team interviewed 40 participants through three individual interviews and seven focus groups.|
|Markus 2012 ||Wind River|
Wind River UNITY group
|Mixed methods||6 co-researchers 18- and 19-year-old AI/IN||Wyoming Health Council||Designing the content and activity of the program.|
In the photovoice project, the model provided a way for the participants to think about their project in terms of its potential to empower them, as individuals, to help them develop and sustain healthy relationships, and, in turn, to advocate for themselves in their communities, institutions, and even in society at large.
Aided in analysis of each co-researchers photovoice stories.
|Newby 2017 ||UK|
|Mixed methods||10 young people aged 11 to 16 years (making the YPPB)|
13- to 19-year-old
N = 24
|Two health psychologists:|
A public health consultant
A project manager
12 professionals from a variety of services
|Nolan 2020 ||Community, urban Kigali, peri-urban Ruhango, and peri-urban Butare|
|Cluster randomized controlled trial||Design aspect |
N = 600
100 students per school, for a total of 6000 students in the study.
Community leaders, including some religious leaders
Health care providers
60 schools in 8 districts in Rwanda
|The first phase, conducted from 2016 to 2019. |
Prototyping: Youth Having users (adolescents) react to a tangible idea in the form of a prototype, rather than abstract concept.
|Patchen 2020 ||District of Columbia (DC) and Birmingham, Alabama (AL)||Mixed methods||African American|
Males and females aged 15–21 N = 86
6 individuals, 3 males and 3 females
26 youths participated in usability testing,
23 from AL and 31 from DC participated in focus groups
|Gaming experts with graduate and undergraduate degrees programmed the game with assistance from graphic artists, script writers, and audio/visual specialists.||Initial design and features of the game were driven by four meetings with the youth advisory board, where the initial game prototype—an initial version of the game—was developed and refined based on feedback obtained after each meeting. The advisory board then played the prototype for at least an hour and provided feedback on content, artwork, and design, minigames, dialogue, and entertainment value.|
All participants tested the game prototype and completed the system usability scale (SUS). Possible scores range from 0 (not usable) to 100 (perfectly usable).
Focus groups with participants to guide additional development, to the game.
|Pensak 2020 ||USA (Connecticut) urban/school||Mixed methods||Phase 1: 15 adolescents |
Phase 2: 24 participants of 15- to 17-year-old
|Parents (of adolescents involved)||Phase 1: Focus group sessions to identify key themes and specific domains of impact|
|Shahmanesh 2021 ||Community, rural south Africa |
uMkhanyakude district of KZN
|Mixed methods||18–30 years||Two teams of four social science researchers||Between March 2018 and September 2019|
|Shegog 2017 ||USA (American Indian/Alaska Native (AI/AN))|
|Mixed methods||Phase 1:|
AI/AN Youth (n = 80) ages 9–16 years
AI/AN Youth (n = 45) ages 11–15 years
Health care providers
adult stakeholders (n = 27)
|Phase 1: Gain their perspectives on needed adaptations of of IYG-Tech.|
Phase 3: Usability testing of NATIVE-IYG tech.
|Simuyaba 2021 ||Community rural, Zambia||Mixed methods||230 adolescents and young people|
community gate keepers and health committee members
|Data were collected through focus group discussions, in-depth interviews, and observations.|
Between November 2018 and March 2019:
|Wood 2016 ||Schools, south Africa||Mixed methods||24–11 graders (14F/10M)||Researcher from community||Data were generated through two purposive discussions with the participants.|
Discussions with the participants, led by a young researcher from their community rather than by (researchers), to encourage openness and honesty.
The peer educator participants also decided to gather data from other youth in the school by means of short open-ended questionnaires.
Individual interviews were taped and transcribed verbatim, and the peer educators synthesised the data they gathered by means of the questionnaires into narratives.
|Zaleski 2015 ||USA (Illinois)|
|Mixed-methods||Twenty youth leaders|
84 interviewees, 16–22 years
|not mentioned||Conducted four one-on-one interviews with their Chicago peers for a total of 80 individual interviews.|
Youth leaders created and disseminated surveys of their personal networks, including schools and colleges, and ICAH disseminated to national networks, including partnering organizations, movement building organizations, and school systems across the country that ICAH works with (convenience sample).
Youth leaders participated in 1 in person focus group, facilitated by the youth education coordinator, which focused on connecting the online comfort-assessment survey to positive sexual decision-making among youths.
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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Lassi, Z.S.; Neideck, E.G.; Aylward, B.M.; Andraweera, P.H.; Meherali, S. Participatory Action Research for Adolescent Sexual and Reproductive Health: A Scoping Review. Sexes 2022, 3, 189-208. https://doi.org/10.3390/sexes3010015
Lassi ZS, Neideck EG, Aylward BM, Andraweera PH, Meherali S. Participatory Action Research for Adolescent Sexual and Reproductive Health: A Scoping Review. Sexes. 2022; 3(1):189-208. https://doi.org/10.3390/sexes3010015Chicago/Turabian Style
Lassi, Zohra S, Ebony Grace Neideck, Bridget Mary Aylward, Prabha H. Andraweera, and Salima Meherali. 2022. "Participatory Action Research for Adolescent Sexual and Reproductive Health: A Scoping Review" Sexes 3, no. 1: 189-208. https://doi.org/10.3390/sexes3010015