A Pilot Study of an Evidence-Based Prevention Intervention (keepin' it REAL) for Early Adolescents in Kenyan Schools.

CONCLUSIONS: Although larger trials with a more representative sample of schools are needed, the study suggests the potential for kiR as an effective approach for substance use prevention in Kenya. METHOD: A convenience sample of primary schools in metropolitan Nairobi was randomized into an intervention or control group. Teachers in intervention schools were trained to deliver the kiR curriculum with fidelity. Students in seventh and eighth grades in the intervention and control schools (N = 533) completed pretest and posttest questionnaires assessing substance use behaviors, attitudes, and drug resistance strategies. OBJECTIVE: Although many primary school students in Kenya report use of alcohol and other drugs, evidence-based prevention interventions for schools are generally unavailable. Globally, there are growing opportunities to conduct research that assesses whether efficacious interventions from elsewhere can be adopted for new settings and populations. This small pilot study implemented and evaluated a linguistically adapted version of the school-based keepin' it REAL (kiR) universal substance use prevention program from the United States in Kenyan primary schools to assess its effectiveness and estimate potential effect sizes. RESULTS: Relative to the control group, kiR students reported several desired changes in behaviors and attitudes: less recent alcohol use and heavy (binge) alcohol drinking, and continuing or increased adherence to certain anti-drug norms. There was partial evidence that kiR helped students rely less on conflictual drug resistance strategies, such as reacting to substance offers angrily or with violence. Effect sizes for these outcomes compare favorably to those obtained in other school-based prevention interventions.

Does Capacity Development Increase Demand for Health Services and Rights Among Key Populations Affected by HIV? A Systematic Review of Evidence from Low and Middle-Income Countries.

Capacity development is a process by which individuals, organizations and societies develop abilities to perform functions, solve problems and achieve objectives. This systematic review sought to document capacity development interventions, the associated outcomes and its effectiveness in increasing demand for rights and health services among key populations (KP) in low and middle-income countries. Twenty papers met our review's selection criteria. Significant improvements in health service utilization were achieved in most community mobilization and peer-led interventions. Whilst we found ample evidence linking capacity development to uptake of services, there was a striking dearth of research examining the impact of capacity development on demand for rights among KP. There was inadequate contextual data to explain variations in intervention effectiveness across different projects. More evidence is needed on the impact of capacity development on demand for health services and rights among KP. Consensus on parameters of capacity development and priority outcomes is required.