title: Community embedded reproductive health interventions for adolescents in Latin America: development and evaluation of a complex multi-centre intervention.
abstract: BACKGROUND
  Adolescents in Latin America are at high risk for unwanted and unplanned pregnancies, which often result in unsafe abortions or poor maternal health outcomes. Both young men and women in the region face an increased risk of sexually transmitted infections due to inadequate sexual and reproductive health information, services and counselling. To date, many adolescent health programmes have targeted a single determinant of sexual and reproductive health. However, recent evidence suggests that the complexity of sexual and reproductive health issues demands an equally multi-layered and comprehensive approach.
  
  
  METHODS
  This article describes the development, implementation and evaluation design of the community-embedded reproductive health care for adolescents (CERCA) study in three Latin American cities: Cochabamba (Bolivia), Cuenca (Ecuador) and Managua (Nicaragua). Project CERCA's research methodology builds on existing methodological frameworks, namely: action research, community based participatory research and intervention-mapping.The interventions in each country address distinct target groups (adolescents, parents, local authorities and health providers) and seek improvement of the following sexual health behaviours: communication about sexuality, sexual and reproductive health information-seeking, access to sexual and reproductive health care and safe sexual relationships.In Managua, we implemented a randomised controlled study, and in Cochabamba and Cuenca we adopted a non-randomised controlled study to evaluate the effectiveness of Project CERCA interventions, in addition to a process evaluation.
  
  
  CONCLUSIONS
  This research will result in a methodological framework that will contribute to the improved design and implementation of future adolescent sexual and reproductive health interventions.
  
  
  BACKGROUND
  ClinicalTrials.gov (NCT01722084).
authors: International Centre for Reproductive Health, Ghent University, De Pintelaan 185 UZP 114, Gent 9000, Belgium. peter.decat@ugent.be
authors: Peter
authors: P
authors: Decat
authors: Erica
authors: E
authors: Nelson
authors: Sarah
authors: S
authors: De Meyer
authors: Lina
authors: L
authors: Jaruseviciene
authors: Miguel
authors: M
authors: Orozco
authors: Zoyla
authors: Z
authors: Segura
authors: Anna
authors: A
authors: Gorter
authors: Bernardo
authors: B
authors: Vega
authors: Kathya
authors: K
authors: Cordova
authors: Lea
authors: L
authors: Maes
authors: Marleen
authors: M
authors: Temmerman
authors: Els
authors: E
authors: Leye
authors: Olivier
authors: O
authors: Degomme
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration*; D003153:Community Health Services / Q000458:organization & administration*; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007843:Latin America; D008297:Male; D016730:Program Development; D015397:Program Evaluation; D034121:Reproductive Health Services / Q000458:organization & administration*; D012107:Research Design