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Presented at Mixed Methods in Research Association conference in August 2018


Design and implementation of a mixed methods study:

Evaluation of a comprehensive sexuality education program in Mexico City

S. Makleff, J. Garduño, I. Zavala, P. Rivera, J. Valades, F. Barindelli, C. Marston

Evidence about effective intimate partner violence (IPV) prevention strategies is limited, particularly in low- and middle-income countries (LMICs). Some studies suggest that a ‘gender-transformative’ approach is key to successful IPV prevention programs, and it is plausible that gender-transformative comprehensive sexuality education (CSE) can prevent IPV. However, few CSE evaluations have measured IPV-related outcomes. 

The International Planned Parenthood Federation/Western Hemisphere Region (IPPF/WHR), Fundación Mexicana para la Planeación Familiar (Mexfam), and the London School of Hygiene and Tropical Medicine (LSHTM) collaborated on a study evaluating the school-based comprehensive sexuality education intervention developed by Mexfam and implemented by the organization’s “Gente Joven” (‘Young People’) program in Mexico City. The study examines whether and how CSE contributes to the prevention of dating violence and to more equitable relationships among 14- to 17-year-old public school students. The CSE intervention, piloted and evaluated in 2017, comprises approximately 20 total hours of curriculum delivered weekly over a semester by trained health educators. 

The mixed methods process evaluation was collaboratively designed and implemented by project partners in 2016 and 2017. Between January and June 2018, the research team will be analyzing data and writing evaluation reports for internal dissemination. In this presentation, I will describe the collaborative study design process, explain why we chose a mixed methods approach, and share the implementation experience and challenges of using a wide range of data collection methods. 

We began the study design process by developing a theory of change to articulate the hypothesized pathways through which CSE might lead to more equitable and less violent relationships. We then designed a mixed methods process evaluation to examine the diverse pathways articulated in the theory of change. The evaluation uses a longitudinal quasi-experimental design in one intervention and one control group. Data collection methods include a pre-post survey in the intervention and control groups; longitudinal qualitative interviews with a subset of intervention participants; endline focus groups in both intervention and control groups; endline in-depth interviews with a subset of intervention participants; and endline focus groups with the teachers in the school and the “Gente Joven” health educators.

In our experience, the collaborative approach to study design, in a team comprising academics, programmatic staff and youth health educators, ensured that local expertise influenced the development of research questions that are locally meaningful, a feasible study design, and would produce utilizable findings. A mixed method design was a key strategy we identified to achieve these aims. The presentation will include a discussion of the benefits and challenges of this approach, describing the mixed methods analysis process, sharing key findings, and reflecting on the reception of the mixed methods results by the project partners.

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