Flavia Namuwonge, MBA, Doctoral Student, Washington University in St. Louis, MO
Samuel Kizito, MD, MS, Research fellow, Washington University in St. Louis, St Louis, MO
Vicent Ssentumbwe, BA,, Student, Washington University in St. Louis, St. Louis, MO
Portia Nartey, MSW, MSP, Research Study Coordinator, Washington University in Saint Louis, St. Louis, MO
Anita Kabarambi, Msc., Dr., Washington University in Saint Louis, St. Louis, MO
Proscovia Nabunya, MSW, PhD, Assistant Professor, Washington University in Saint Louis, St. Louis, MO
Rashida Namirembe, MSW, Research Study Coordinator, Washington University in Saint Louis, Saint Louis, MO
Fred Ssewamala, PhD, William E. Gordon Distinguished Professor, Washington University in Saint Louis, St. Louis, MO
Josephine Nabayinda, Msc, Doctoral student, Washington University in Saint Louis, Saint Louis, MO
Joshua Kiyingi, MSTAT, Doctoral Student, Washington University in St. Louis, St. Louis, MO
Jennifer Nattabi, MSW, Doctoral Student, Washington University in Saint Louis, St. Louis, MO
Background: As children transition through adolescence, they are susceptible to peer social pressures and tend to mirror the behaviors of their peers. Using data from a National Institutes of Health-funded 3-arm Cluster Randomized Control Trial, Suubi4Her (N=1260; 14–17-year-old school-going girls), and applying social learning and Asset theory, we address two key questions regarding peer pressure and adolescent girls’ risk-taking behaviors. Specifically, we 1) assess the relationship between peer pressure and adolescent risk-taking behaviors; and 2) test the mediating effect of peer pressure on the Suubi4Her intervention and adolescent risk-taking behaviors.
Methods: School-going adolescent girls from 47 public secondary schools in southwestern Uganda were assigned to three study arms: control (n=16 schools, n= 408 students) receiving usual care comprising of sexual and reproductive health curriculum; and two active treatment arms: Treatment 1 (n=16 schools, n=471 students) receiving everything the control arm received plus a savings led intervention; Treatment 2 (n=15 schools, n=381 students) receiving everything the control and treatment arm 1 received, plus a family-strengthening intervention. We used multilevel models to assess the relationship between peer pressure and risk-taking behaviors. We ran structural equation models for mediation analysis.
Results: Overall baseline demographic characteristics indicate no statistically significant difference across the three study arms. At 12 months post-intervention initiation, however, participants in the control arm reported worse scores on risk-taking behaviors, including sexual risk and use of alcohol. We also locate a statistically significant effect of the intervention on acquiring STIs through the mediating effect of peer pressure (β = -0.059 [95% CI: -0.106, -0.012], p=0.014). Overall, the study points to the role of peer pressure on adolescent girls' risk-taking behaviors; and a need to address peer pressure at an early stage. We know that the behaviors adolescents exhibit early in life may impact them during their adult life.
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