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Using the Web to Survey and Inform Urban Adolescents about Health

A Longitudinal Feasiblity Study in Kenya and Brazil

This project was a collaborative research-practice conducted jointly by Ipas, headquartered in Chapel Hill, and the Carolina Population Center at the University of North Carolina at Chapel Hill. The principal investigators were Ellen Mitchell at Ipas and Carolyn Tucker Halpern at UNC-CH.

There were four primary objectives for the collaboration:

  1. to collect information, through a school-based, longitudinal research survey design, on the reproductive health and socioeconomic welfare of urban adolescents living in Kenya and Brazil;
  2. to test the feasibility of the World Wide Web as a secure and reliable mechanism by which to conduct repeated survey measurements, as indicated by relative attrition, missing data, and cost effectiveness;
  3. to assess the attractiveness and utility of the web to disseminate information and improve knowledge about health, especially reproductive health, to adolescents;
  4. to disseminate information about adolescent health needs that will inform and improve public health policy and practice.

The study design involved collecting data over a one-year period from 1500 students in three experimental and two control schools in Nairobi. All students completed one paper module. The students in the three experimental schools completed five modules using the web. Knowledge of key reproductive health topics was assessed at three points (modules 1, 4, and 6). Modules 4 - 6 directed students to web-based information: all students were directed to general information (e.g., what is emergency contraception), and students who reported specific experiences (e.g., sexual violence) were directed to community resources for those experiences. As an incentive to participate, all students at the experimental schools were given time to surf the web or do email after completing each module. Students in the control schools completed a second paper module at about the time that students in experimental schools were completing their final web-based module. Data collection started in Nairobi in April 2002 and ended in September 2003.

A similar study was conducted in Rio de Janeiro. It involved four experimental schools and one control school. Results from the two projects are available in the dissemination reports linked on this page. In addition, the following papers have been published from these data:

Halpern CT, Mitchell EMH, Farhat T, Bardsley P. Effectiveness of web-based education on Kenyan and Brazilian adolescents' knowledge about HIV/AIDS, abortion law, and emergency contraception: Findings from TeenWeb. Soc Sci Med, 2008;67: 628-637.

Mitchell EMH, Halpern CT, Kamathi EM, Owino S. Social scripts and stark realities: Kenyan adolescents' abortion discourse. Cult Health Sex, 2006;8: 515-528.

Yotebieng M, Halpern CT, Mitchell EMH, Adimora AA. Correlates of condom use among secondary-school male students in Nairobi, Kenya. SAHARA J, 2009;6(1): 9-16.