Abstract
Multiple methodological approaches have been used to explore adolescent alcohol use and related sexual behaviors, ranging from surveys to assessments of alcohol outlet density. Although surveys can capture the extent of alcohol use, they do not allow for a contextualized understanding of young people’s voiced experiences with alcohol, including sociocultural, gendered and environmental pressures to consume, and related engagement in sex. The mapping of alcohol outlets provides physical density information, but infrequently from youths’ perspectives. Traditional qualitative methods like in-depth interviews and focus group discussions do allow for a more nuanced understanding of adolescents’ experiences, but they can be limited by the use of semi-structured guides that may negatively impact the fluidity of discussion. We seek to contribute to the methodological approaches utilized with adolescents by demonstrating how contextualized data were captured from Tanzanian adolescents’ experiences of alcohol and sex, which are sensitive topics in many African countries. We collected data in secondary schools and youth centers across four sites in Dar es Salaam, the largest and most diverse city in Tanzania. As a complement to in-depth interviews, archival reviews, and a systematic mapping of alcohol availability, participatory methodologies such as photovoice, story writing, and drawing allowed Tanzanian youth to offer more honest, descriptions of lived experiences with their physical and social environment in relation to alcohol use and related sexual behavior patterns. Through participatory methods, study participants were able to discuss behaviors that are viewed as social transgressions, sensitive topics like violence in relation to sex, and views around their own self-agency. The use of a methodological toolkit including participatory methodologies enabled youth to trust the researchers and share sensitive information in a relatively short period of time, overcoming some of the challenges of traditional qualitative methods.
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Acknowledgements
We would like to gratefully acknowledge funding support from the National Institutes on Alcohol Abuse and Alcoholism. We would also like to express our deepest gratitude to our research assistants, our Tanzanian colleagues in the field sites, and to all the Tanzanian young people and adults who kindly provided time and information that made this research possible.
Funding
This work was supported by the National Institutes on Alcohol Abuse and Alcoholism (NIAAA), under Grant #R21 AAA02286801A1.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. IRB approval was sought (and given) to waive parental consent given the sensitivity of the research topics, and the likelihood that the youth would be less likely to share their perceptions about alcohol use and sexual activity if parents were notified about the contents of the study. However careful review was conducted to reasonably assure that the content being explored, most of it anonymous, would not cause harm to any participants. Due to the expected high levels of illiteracy across the participants, verbal consent was obtained. Informed consent was obtained from all individual participants included in the study.
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Sommer, M., Ibitoye, M., Likindikoki, S. et al. Participatory Methodologies With Adolescents: A Research Approach Used to Explore Structural Factors Affecting Alcohol Use and Related Unsafe Sex in Tanzania. J Primary Prevent 42, 363–384 (2021). https://doi.org/10.1007/s10935-020-00586-0
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DOI: https://doi.org/10.1007/s10935-020-00586-0