CLA and Research to Change with Adolescents in Zambia

Grassroot Soccer Zambia (GRSZ), an adolescent health organization, developed a comic book-style magazine as a resource to support the mental health of youth living with HIV (YLHIV) in Chipata and Lusaka Districts. As part of the USAID-funded Youth Excel “Our Knowledge, Leading Change” program, GRSZ applied a Collaborating, Learning, and Adapting (CLA) approach through the research to change (R2C) approach championed by the project, conducting research to explore the effectiveness and relevance of the magazine as a mental health resource; and understand implementation, as the magazine was distributed to reach 2,328 YLHIV in 2022. GRSZ used the "monitoring and evaluation for learning" and "adaptive management" CLA sub-components, to ensure that research insights were used to improve the project during implementation, and to pause and reflect throughout the course of the project. GRSZ teams met weekly to discuss and adjust implementation strategies. Meanwhile, milestone reports, which were prepared for submission to Youth Excel, allowed for the consolidation of insights and the opportunity to adapt. An additional learning goal was added to the R2C activities to gain a deeper understanding of YLHIV participants' engagement with written activities in the magazine.

By using the CLA approach, the GRSZ team supported the successful completion of the R2C activities, which showed early signs of the magazine’s effectiveness; including a 9% overall improvement in pre/post survey scores examining mental health knowledge, attitudes, and behaviors. The magazine was found to be highly acceptable and relevant to participants and adult stakeholders, and YLHIV participants shared numerous examples of how they used the magazine in their daily lives. Application of the CLA framework through the R2C activities also yielded recommendations for phase two of the project, including the expansion of the magazine distribution model to include teachers and health-facility staff, and the distribution of the magazines to broader groups of adolescents, not only YLHIV.