Browsing by Author "Maes, Lea"

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Community embedded reproductive health interventions for adolescents in Latin America: development and evaluation of a complex multi-centre intervention
(2013) Decat, Peter; Nelson, Erica; De Meyer, Sara; Jaruseviciene, Lina; Orozco, Miguel Angel; Segura, Zoyla Esmerada; Gorter, Anna Cornelia; Vega Crespo, Bernardo José; Córdova, Kathya; Maes, Lea; Temmerman,, Marleen; Leye,, Els; Degomme, Olivier
Background: Adolescents in Latin America are at high risk for unwanted and unplanned pregnancies, which often result in unsafe abortions or poor maternal health outcomes. Both young men and women in the region face an increased risk of sexually transmitted infections due to inadequate sexual and reproductive health information, services and counselling. To date, many adolescent health programmes have targeted a single determinant of sexual and reproductive health. However, recent evidence suggests that the complexity of sexual and reproductive health issues demands an equally multi-layered and comprehensive approach. Methods. This article describes the development, implementation and evaluation design of the community-embedded reproductive health care for adolescents (CERCA) study in three Latin American cities: Cochabamba (Bolivia), Cuenca (Ecuador) and Managua (Nicaragua). Project CERCA's research methodology builds on existing methodological frameworks, namely: action research, community based participatory research and intervention-mapping.The interventions in each country address distinct target groups (adolescents, parents, local authorities and health providers) and seek improvement of the following sexual health behaviours: communication about sexuality, sexual and reproductive health information-seeking, access to sexual and reproductive health care and safe sexual relationships.In Managua, we implemented a randomised controlled study, and in Cochabamba and Cuenca we adopted a non-randomised controlled study to evaluate the effectiveness of Project CERCA interventions, in addition to a process evaluation. Discussion. This research will result in a methodological framework that will contribute to the improved design and implementation of future adolescent sexual and reproductive health interventions. Trial registration. ClinicalTrials.gov (NCT01722084). © 2013 Decat et al; licensee BioMed Central Ltd.
Factors affecting physical activity in ecuadorian adolescents: a focus group study
(2015) Van Royen, Kathleen; Verstraeten, Roosmarijn; Andrade Tenesaca, Dolores Susana; Ochoa Avilés, Angélica María; Donoso Moscoso, Silvana Patricia; Maes, Lea; Kolsteren, Patrick
Background: Physical inactivity levels are increasingly prevalent among Ecuadorian adolescents. School-based interventions can be potentially effective in promoting physical activity but must be informed by cultural-specific factors. Methods: Twelve focus groups were carried out with adolescents (n = 80) in rural and urban Ecuador to identify factors influencing physical activity. In addition, 4 focus group discussions with parents (n = 32) and 4 with school staff (n = 32) were conducted. Individual and environmental factors were questioned using the ‘Attitude, Social influences and Self-efficacy’ model and the socioecological model as theoretical frameworks. Results: Factors influencing physical activity varied between groups. In the rural area farming and norms for girls impeded leisure-time physical activity, whereas urban groups emphasized traffic and crime concerns. Groups from a low socioeconomic status more frequently mentioned a fear of injuries and financial constraints. Several factors were common for all groups including preferences for sedentary activities, poor knowledge, time constraints and laziness, as well as a lack of opportunities at home and school, unsupportive parental rules and lack of role models. Conclusion: A conceptual framework including the identified factors emerged to inform the design of a cultural-sensitive school-based intervention to improve physical activity among Ecuadorian adolescents. Future interventions should be tailored to each setting.
Factors affecting physical activity in ecuadorian adolescents: a focus group study
(2015-03) Van Royen, Kathleen; Verstraeten, Roosmarijn; Andrade, Susana; Ochoa Avilés, Angélica María; Donoso, Silvana; Maes, Lea; Kolsteren, Patrick
Individual and environmental factors influencing adolescents’ dietary behavior in low- and middle-income settings
(2016) Verstraeten, Roosmarijn; Jef L., Leroy; Pieniak, Zuzanna; Ochoa Avilés, Angélica María; Holdsworth, Michelle; Verbek, Wim; Maes, Lea; Kolsteren, Patrick
Objective Given the public health importance of improving dietary behavior in chronic disease preven-tion in low- and middle-income countries it is crucial to understand the factors influencingdietary behavior in these settings. This study tested the validity of a conceptual frameworklinking individual and environmental factors to dietary behavior among Ecuadorian adoles-cents aged 10–16 years. Methods A cross-sectional survey was conducted in 784 school-going Ecuadorian adolescents inurban and rural Southern Ecuador. Participants provided data on socio-economic status,anthropometry, dietary behavior and its determining factors. The relationships between indi-vidual (perceived benefits and barriers, self-efficacy, habit strength, and a better under-standing of healthy food) and environmental factors (physical environment: accessibility tohealthy food; social environment: parental permissiveness and school support), and theirassociation with key components of dietary behavior (fruit and vegetables, sugary drinks,breakfast, and unhealthy snack intake) were assessed using structural equation modeling. Results The conceptual model performed well for each component of eating behavior, indicatingacceptable goodness-of-fit for both the measurement and structural models. Models forvegetable intake and unhealthy snacking showed significant and direct effects of individual. factors (perceived benefits). For breakfast and sugary drink consumption, there was a direct and positive association with socio-environmental factors (school support and parental permissiveness). Access to healthy food was associated indirectly with all eating behaviors (except for sugary drink intake) and this effect operated through socio-environmental (parental permissiveness and school support) and individual factors (perceived benefits). Conclusion Our study demonstrated that key components of adolescents’ dietary behaviors are influenced by a complex interplay of individual and environmental factors. The findings indicate that the influence of these factors varied by type of dietary behavior
Predictors of validity and reliability of a physical activity record in adolescents
(2013) Verstraeten, Roosmarijn; Lachat, Carl; Ochoa Avilés, Angélica María; Hagstromer, Maria; Huybregts, Lieven Fernand; Andrade Tenesaca, Dolores Susana; Donoso Moscoso, Silvana Patricia; Van Camp, John; Maes, Lea; Kolsteren, Patrick
Background: Poor to moderate validity of self-reported physical activity instruments is commonly observed in young people in low- and middle-income countries. However, the reasons for such low validity have not been examined in detail. We tested the validity of a self-administered daily physical activity record in adolescents and assessed if personal characteristics or the convenience level of reporting physical activity modified the validity estimates. Methods: The study comprised a total of 302 adolescents from an urban and rural area in Ecuador. Validity was evaluated by comparing the record with accelerometer recordings for seven consecutive days. Test-retest reliability was examined by comparing registrations from two records administered three weeks apart. Time spent on sedentary (SED), low (LPA), moderate (MPA) and vigorous (VPA) intensity physical activity was estimated. Bland Altman plots were used to evaluate measurement agreement. We assessed if age, sex, urban or rural setting, anthropometry and convenience of completing the record explained differences in validity estimates using a linear mixed model. Results: Although the record provided higher estimates for SED and VPA and lower estimates for LPA and MPA compared to the accelerometer, it showed an overall fair measurement agreement for validity. There was modest reliability for assessing physical activity in each intensity level. Validity was associated with adolescents’ personal characteristics: sex (SED: P = 0.007; LPA: P = 0.001; VPA: P = 0.009) and setting (LPA: P = 0.000; MPA: P = 0.047). Reliability was associated with the convenience of completing the physical activity record for LPA (low convenience: P = 0.014; high convenience: P = 0.045). Conclusions: The physical activity record provided acceptable estimates for reliability and validity on a group level. Sex and setting were associated with validity estimates, whereas convenience to fill out the record was associated with better reliability estimates for LPA. This tendency of improved reliability estimates for adolescents reporting higher convenience merits further consideration.