title: Involvement of stakeholders in determining health priorities of adolescents in rural South Africa.
abstract: BACKGROUND
  When developing intervention research, it is important to explore issues from the community perspective. Interventions that promote adolescent health in South Africa are urgently needed, and Project Ntshembo ('hope') aims to improve the health of young women and their offspring in the Agincourt sub-district of rural northeast South Africa, actively using stakeholder involvement throughout the research process.
  
  
  OBJECTIVE
  This study aimed to determine adolescent health priorities according to key stakeholders, to align stakeholder and researcher priorities, and to form a stakeholder forum, which would be active throughout the intervention.
  
  
  METHODS
  Thirty-two stakeholders were purposefully identified as community members interested in the health of adolescents. An adapted Delphi incorporating face-to-face discussions, as well as participatory visualisation, was used in a series of three workshops. Consensus was determined through non-parametric analysis.
  
  
  RESULTS
  Stakeholders and researchers agreed that peer pressure and lack of information, or having information but not acting on it, were the root causes of adolescent health problems. Pregnancy, HIV, school dropout, alcohol and drug abuse, not accessing health services, and unhealthy lifestyle (leading to obesity) were identified as priority adolescent health issues. A diagram was developed showing how these eight priorities relate to one another, which was useful in the development of the intervention. A stakeholder forum was founded, comprising 12 of the stakeholders involved in the stakeholder involvement process.
  
  
  CONCLUSIONS
  The process brought researchers and stakeholders to consensus on the most important health issues facing adolescents, and a stakeholder forum was developed within which to address the issues. Stakeholder involvement as part of a research engagement strategy can be of mutual benefit to the researchers and the community in which the research is taking place.
authors.affiliation: MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Rhian.Twine@wits.ac.za.
authors.forename: Rhian
authors.initials: R
authors.lastname: Twine
authors.affiliation: MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.|Umeå Centre for Global Health Research, Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.|INDEPTH Network, Accra, Ghana.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Kahn
authors.affiliation: MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.|F. Hoffmann-La Roche AG, Basel, Switzerland.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Scholtz
authors.affiliation: MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Shane A
authors.initials: SA
authors.lastname: Norris
mesh_terms: D000293:Adolescent; D000067697:Adolescent Health; D000328:Adult; D055812:Community-Based Participatory Research / Q000379:methods*; D003697:Delphi Technique; D005260:Female; D006292:Health Priorities / Q000458:organization & administration*; D006297:Health Services Accessibility; D006302:Health Services Research / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008427:Maternal Health Services; D011247:Pregnancy; D012424:Rural Population; D013019:South Africa; D055815:Young Adult
keywords: Delphi; adolescents; health priorities; stakeholder; stakeholder involvement