Search Results (15)

Background/Objectives: Low- and middle-income countries (LMICs) have the highest global burden of cervical cancer deaths. Human papillomavirus (HPV) vaccination is a key strategy for cervical cancer elimination, and in LMICs, global recommendations to vaccinate girls aged 9–14 years against HPV are generally implemented through school-based immunization platforms. Unfortunately, this strategy risks missing out-of-school (OOS) girls (i.e., girls not enrolled in formal schools). This narrative review maps the literature and synthesizes existing evidence on service delivery strategies for reaching OOS girls with HPV vaccination in LMICs. Methods: Using relevant databases, we conducted a narrative review of published, peer-reviewed literature to map and synthesize the existing evidence on effective service delivery strategies for reaching OOS girls with HPV vaccination in LMICs. Results: The 21 articles identified presented findings on strategies to reach OOS girls, with the most frequently cited strategies being facility-based and community outreach approaches. Authors also described community-based strategies used to identify and enumerate OOS girls, including peer tracing, church outreach initiatives, as well as partnerships with local groups (e.g., civil service organizations) and individuals (e.g., healthcare workers, teachers). The articles discussed barriers at the individual (e.g., lack of parental consent), facility/program delivery (e.g., lack of transportation for vaccines), and community (e.g., distance from homes to vaccination services) levels to HPV vaccine delivery, as well as solutions at the facility/program delivery (e.g., pilot programs) and community (e.g., multi-level partnerships) levels. Conclusions: Additional research is needed to evaluate implementation strategies targeting OOS girls with HPV vaccination. A better understanding of these strategies can provide valuable insights for HPV vaccine policymakers, healthcare providers, and program implementers. Full article

This research study was conducted to pilot an out-of-school family science program for fifth- and sixth-grade Latina girls and their parents. Program goals included encouraging parents in supporting their Latina daughters in science, increasing the girls’ interest in science and increasing the families’ participation in science experiences together. The 41 families participated in a 7-week Saturday program on either rocketry or gardening. Each week, the parent–daughter dyads engaged in hands-on Family Problem-Based Learning activities together and then the parents and daughters met separately in Conversation Groups. To measure the impact of the program, surveys were administered to the parents and daughters separately at four points: pre-, mid-, post- and delayed-post (three months after the program). Parents reported increases over time for several aspects of their support for their daughters in science and also increases in frequency of science experiences with their daughters. The daughters reported increases over time in their science identity and their discussions with their parents about jobs in science. In addition, the examination of video-recordings of a subset of the parent–daughter interactions during the activities revealed that parental and daughter behaviors evolved over the course of the program. Implications for engaging parents in science education are discussed. Full article

Cervical cancer (CC) is the second most common cancer in Western Africa, accounting for 12,000 cases and 6000 deaths annually. While vaccination against human papilloma virus (HPV) and CC screenings reduce the incidence and mortality of CC in many developed countries, 90% of CC deaths are in low-income countries. Lack of knowledge about the connection between HPV and CC, lack of access to vaccines and screenings, weak healthcare infrastructure, and stigma related to sexually transmitted diseases are among the factors that contribute to this disparity. Previously, we evaluated the knowledge of HPV and CC in Bamako, Mali, showing that knowledge of the link between HPV and CC was very low (less than 8% of participants) and that less than 3% of women were screened for CC. Subsequent implementation of a community-based education program and support for local clinics resulted in a five-fold increase in CC screening at the five participating clinics in 2015. In this study, we paired CC screenings of mothers with HPV vaccination of their daughters to target out-of-school (OOS) girls whom school-based vaccination campaigns would not reach. Our campaign resulted in a 10.7% increase in HPV vaccination. Full article

Informal science education researchers have become increasingly interested in how out-of-school spaces that offer STEM (science, technology, engineering, and math) programs inform learners’ STEM achievement, interests, and affective outcomes. Studies have found that these spaces can offer critical learning and developmental opportunities for underrepresented racially minoritized (URM) students (Black, Latinx, low socioeconomic status) in STEM subjects. Shifting away from the leaky STEM pipeline analogy, researchers have posited contemporary understandings to explain why the minoritization of URM girls persists. Informal learning environments such as STEM summer camps are being studied to assess how URM girls experience and interact with STEM in novel ways. These environments can inform the research field about how URM girls’ perceptions of their STEM identities, abilities, efficacy, and belonging in STEM develop as they engage in those spaces. This mixed-method study used a multiple-case-study approach to examine how aspects of URM middle school girls’ STEM identities positively changed after participating in a one-week, sleep-away, single-gender STEM summer camp held at a university in the Southwestern U.S. Drawing on intersectionality and STEM identity, we used ecological systems theory to design our research study, examining how URM middle school girls narrate their STEM identities in this informal learning environment. Using quantitative analyses and deductive coding methods, we explored how elements of girls’ STEM identities were shaped during and after their participation in the STEM summer camp. Findings from our study highlight (1) quantitative changes in girl participants’ STEM identities, sense of belonging in STEM, and perceived STEM ability belief, (2) qualitative results supporting our quantitative findings, and (3) how the intersectionality of participants’ race and gender played a role in their STEM identities. This study points to the potential of STEM informal learning camps as a way of developing and fostering URM girls’ STEM identities. Full article

Eighty one percent of adolescents aged 11–17 years are inadequately physically active worldwide. Physical activity (PA) recommendations for high school children have not been studied previously in schools in the Qatar region. The objectives of the study were: (i) to assess the level of compliance of the recommended PA and to assess if there are any gender differences; and (ii) to analyze the recommended step count compliance during school and non-school days. An observational cross-sectional study was conducted. Twenty-nine children (12 boys and 17 girls) aged 13–17 years (15.24 ± 1.46) took part in this study. Participants wore Fitbit Charge 5 wrist bands for three weeks to collect various digital biomarkers including moderate-to-vigorous physical activity (MVPA) and step counts (tracking during out-of-school time and school time). Based on this study, high school children in the two Qatar region schools did not meet the MVPA and steps/day recommendation by the established agencies: 38% of the total study group met the recommended 60 min/day of activity (50% boys, 29% girls). Gender differences were also observed in PA levels and steps per day: for non-school days, 17% met the recommended 10,000 steps/day (25% boys, 12% girls). There was a pattern of greater PA performance and steps during the weekdays as opposed to the weekend, but these values showed no robust evidence in favor of H1 or statistical significance for step counts. However, the evidence was robust in favor of H1 (difference between weekend and weekday) due to a statistically significant difference for meeting the 60 min/day activity. While further studies are required to establish if this is a general trend in Qatari schools, this pilot study does highlight the need to design more effective programs and messaging strategies to improve PA levels in the high school population. Full article

The levels of physical activity (PA) in the population have decreased, especially at an early age. The aims of the study were: to evaluate the percentage of children meeting PA recommendations for both genders, and to measure steps and PA level at different time intervals during the week. This was an observational cross-sectional study. Seventy-three schoolchildren (36 boys and 37 girls), aged two years (2.12 ± 0.46), were selected to participate in this study. Participants wore an “Actigraph GT3X” accelerometer for seven days to measure the minutes engaged in moderate-to-vigorous physical activity (MVPA) and step volume. The results show 100% of the children studied met the recommended 60 min/day of MVPA, and 50% achieved 120 min/day MVPA and 13,000 steps per day. No gender differences were found. The results of the analysis show a propensity for higher step volumes and PA values from Monday to Friday. In addition, subjects achieved higher step volumes and PA values during “School Time” than “Out-of-School Time”. Given that during “School Time” children showed higher PA and step values, schools represent an important place to help facilitate PA milestones. This study shows the need for further studies and interventions aimed at understanding and improving children’s PA levels at an early age. Full article

Physical literacy (PL) is one of the main concepts related to lifelong physical activity (PA) and physical fitness (PF), but there is a lack of information on factors that might be associated with PL in adolescents from southeastern Europe. This study aimed to evaluate the associations between PF, participation and achievement in physical education (PE), out-of-school participation in sports, and PL in high school adolescents from Croatia. Participants were 298 high school students aged 14–18 years (191 females). Variables included school age, PE grade, sports participation, anthropometric indices, four PF tests, and PL (evidenced by CAPL-2-knowledge and understanding questionnaire (CAPL-2-KU) and PLAYself questionnaire). Gender-stratified analyses of differences were conducted using the t-test for independent samples or the Mann-Whitney test. Associations between variables were calculated with Pearson’s product moment correlation or Spearman’s rank order correlation. PF was positively correlated CAPL-2-KU in both genders. PE grade was significantly associated with PLAYself score (Pearson’s correlation = 0.36 and 0.38, p < 0.001 for boys and girls, respectively) but not with the CAPL-2-KU score. School age was not correlated with PL among boys, but there was a significant but negligible correlation between CAPL-2-KU and school age in girls (<2% of the common variance). Adolescents involved in sports had better PL and PF compared with adolescents not involved in sports. In conclusion, participation in out-of-school sports offers a good base for developing PL. Although this study took part over the COVID-19 pandemic period when the regular PE curriculum was significantly altered, the poor associations between school age and PL could lead to the assumption that the current PE curriculum does not allow for improvement of PL in later high school age, which warrants further investigation. Full article

Physical activity recommendations for early childhood are gradually being met to a lesser extent today. The objectives of the study were: (i) to assess the degree of compliance with physical activity (PA) recommendations by gender; and (ii) to analyze the level of PA and steps in different periods over a week. This study was an observational cross-sectional study. Sixty-three young children (33 boys and 30 girls) aged two years (2.15 ± 0.35) were recruited for this study. Participants wore a “Garmin vivofit^® jr.” activity tracker for seven days, collecting minutes of moderate-to-vigorous physical activity (MVPA) and step volume (Out-of-School Time and School Time). The results show a 50% compliance of the 120 min/day MVPA and 13,000 steps per day. No gender differences were detected. The findings in the analysis indicated a trend towards higher PA and steps at the Weekend. Moreover, participants reached higher PA and steps values “Out-of-School Time” than “School Time” (MVPA) (min/day). This study can provide strategies and motivational PA guidelines at school to enhance well-being at an early age. These activity trackers could stimulate more sustainable forms of urban mobility, such as walking, as the environment would accompany the child to meet daily PA recommendations. Full article

Although physical and sexual abuse exposure is a well-established risk for poor health, the dimensions of abuse associated with health among socially vulnerable adolescent girls and young women (AGYW) remain underexamined. This article describes associations between combinations of abuse type and timing with mental health, substance use, and sexual risk outcomes among a sample of 499 AGYW (aged 16 to 19) who had left school early and were recruited for a cluster randomized trial in Cape Town, South Africa. Approximately one-third (33.5%; 95% CI: 28.7, 38.6) of participants reported lifetime abuse. Exposure to more than one type of abuse was associated with increased risk of depression (β = 3.92; 95% CI: 2.25, 5.59) and anxiety (β = 3.70; 95% CI: 2.11, 5.28), and greater odds of polydrug use (OR = 2.10; 95% CI: 1.02, 4.34) and substance-impaired sex (OR = 2.17; 95% CI: 1.31, 3.86). Exposure to multiple types of abuse during childhood/early adolescence and again in late adolescence was associated with increased risk of depression (β = 4.65; 95% CI: 3.15, 6.14), anxiety (β = 4.35; 95% CI: 2.70, 6.02), and polydrug use (OR = 2.37; 95% CI: 1.03, 5.73). Findings underscore the need for trauma-informed interventions that reduce mental health, substance use, and sexual risks among AGYW who have experienced multiple forms of abuse and recurrent abuse. Full article

This study aimed to evaluate the relationship between psychosocial variables (peer support, parental support, autonomous motivation, and controlled motivation), availability of physical activity resources in a neighborhood environment, and out-of-school moderate to vigorous physical activity (MVPA) among Chinese adolescents. The questionnaire of Family Life, Activity, Sun, Health, and Eating (FLASHE) Study was used to collect information on demographics, socioeconomic status, psychosocial variables, available physical activity resources in the neighborhood environment, and minutes of out-of-school MVPA. ANOVA analysis and multiple regression analysis were performed. The mean age of the 3833 adolescents included in our analysis was 14.7 years old (SD = 1.7). Peer support (b = 9.35, 95% CI: 7.55–11.15), autonomous motivation (b = 6.46, 95% CI: 4.09–8.82), parental support (b = 3.90, 95% CI: 1.75–6.07), and availability of physical activity resources in neighborhood environment (b = 3.18, 95% CI: 1.99–4.36) were significantly associated with out-of-school MVPA (p < 0.05). Controlled motivation was insignificantly related to minutes of out-of-school MVPA. Boys spent more time on out-of-school MVPA than girls (p < 0.001) and had a high level of peer support, parental support, and motivation (p < 0.05). Our findings suggest that interventions targeting the out-of-school MVPA among Chinese adolescents should focus on the psychosocial variables and neighborhood environment. Full article

This study aimed to evaluate the effects of an alcohol-related harm prevention program on out-of-school adolescent girls. This was a quasi-experimental study employing a randomized controlled non-synchronized design. There were 23 and 22 participants in the experimental and control groups, respectively. The program comprised three sessions aiming to motivate voluntary changes and promote autonomous decision-making. The experimental group showed significantly higher alcohol-related knowledge and substantially lower alcohol outcome expectancy than the control group. No significant differences emerged from drinking refusal, self-efficacy, or alcohol abstinence intention. This program could improve alcohol-related knowledge and reduce out-of-school adolescent girls’ positive alcohol outcome expectancy. Full article

Background: Some studies have reported a positive parent–child association between physical activity (PA), but few have examined the difference in these associations concerning both genders. The objective of this study was to establish the association between moderate to vigorous physical activity (MVPA) and mode of commuting (MC) of the parents with their children by gender and age group. Methods: This cross-sectional study included 686 mothers and fathers (43.4 ± 6.5 years old) and their children (children 9.7 ± 1.7 y. and adolescents 14.0 ± 1.7 y.). Each participant completed a questionnaire on PA and MC. Chi-square test, odds ratio for categorical variables, and lineal regressions for continuous variables were used to examine the parent–child associations. Results: An inverse association was found between fathers–children in the weekend MVPA in children and between mothers–adolescents in out-of-school and weekend MVPA. An inverse association was found in MVPA between mothers-girls, and the different parents’ MC to work was positively associated with the MC to school in children and adolescents except for the association AC parents–adolescents. The AC was mainly associated between mothers and girls and boys. Conclusions: A weak association in parent–child MVPA but a strong association in MC between parent–child was found. Full article

Despite the benefits of engaging in physical activity during their leisure time, children do not meet the recommendations on physical activity. Following the socio-ecological model as a theoretical framework, the aim of this study was to determine the barriers and facilitators that influence physical activity participation in children’s leisure time. Data collection was conducted through focus groups and individual drawings in a sample of 98 eight- to eleven-year-olds from six schools in Cuenca (Spain). Following the socio-ecological model, individual characteristics (age and sex), as well as the microsystem (parents and friends), mesosystem (timing and out-of-school schedule) and exosystem (safety and weather) influence physical activity participation. The relationships between these levels of the socio-ecological model reveal that opportunities for leisure physical activity are determined by children’s schedules. This schedule is negotiated by the family and is influenced by parents’ worries and necessities. This is the main barrier to physical activity participation due to the creation of more restrictive, sedentary schedules, especially for girls. Our results show the elements required to develop successful strategies to increase physical activity opportunities, namely, focusing on giving children the opportunity to choose activities, raising parents’ awareness of the importance of physical activity and improving the perceived safety of parks, taking into consideration the gender perspective. Full article

Cervical cancer is a critical public health issue in sub-Saharan Africa (SSA), where it is the second leading cause of cancer among women and the leading cause of female cancer deaths. Incidence and mortality rates are substantially higher than in high-income countries with population-based screening programs, yet implementing screening programs in SSA has so far proven to be challenging due to financial, logistical, and sociocultural factors. Human Papillomavirus (HPV) vaccination is an effective approach for primary prevention of cervical cancer and presents an opportunity to reduce the burden from cervical cancer in SSA. With a number of SSA countries now eligible for Global Alliance for Vaccines and Immunization (GAVI) support for vaccine introduction, it is timely to consider the factors that impede and facilitate implementation of vaccine programs in SSA. This article describes epidemiological features of cervical cancer in SSA and the current status of HPV vaccine implementation in SSA countries. Rwanda’s experience of achieving high vaccination coverage in their national HPV immunization program is used as a case study to explore effective approaches to the design and implementation of HPV vaccination programs in SSA. Key factors in Rwanda’s successful implementation included government ownership and support for the program, school-based delivery, social mobilization, and strategies for reaching out-of-school girls. These findings might usefully be applied to other SSA countries planning for HPV vaccination. Full article

This study describes age, sex, and season patterns in children’s physical activity behaviors during discrete time periods, both in school and at home. Participants were 135 elementary, 67 middle, and 89 high-school students (128 boys and 163 girls) involved in a larger school activity monitoring project. We examined time spent in moderate-to-vigorous physical activity (MVPA) at recess, physical education (PE), lunch, commuting to/from school, before-school, after-school, evening, and weekend segments. Differences in MVPA by age, sex, and season were examined using a three-way analysis of variance and separately for each individual segment. Moderate-to-vigorous physical activity levels varied by context and were higher during recess (15.4 ± 8.5 min) while at school, and on Saturdays (97.4 ± 89.5 min) when youth were out-of-school. Elementary children were more active than their older counterparts only during lunch time, after-school, and Sunday (p < 0.05). Boys were consistently more active than girls at all segments. Participants were only more active during non-winter than winter months during PE (p = 0.006), after-school (p < 0.001), and Sunday (p = 0.008) segments. These findings showed that activity levels in youth vary during the day and season. The segments reflect discrete time periods that can potentially be targeted and evaluated to promote physical activity in this population. Full article