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Objective To refine a standard questionnaire on sexual practices, experiences and health-related outcomes to improve its cross-cultural applicability and interpretability. We aimed to explore participants' willingness and ability to answer the draft questionnaire items, and determine whether items were interpreted as intended across diverse geographic and cultural environments. Methods We conducted cognitive interviews (n = 645) in three iterative waves of data collection across 19 countries during March 2022-March 2023, with participants of diverse sex, gender, age and geography. Interviewers used a semi-structured field guide to elicit narratives from participants about their questionnaire item interpretation and response processes. Local study teams completed data analysis frameworks, and we conducted joint analysis meetings between data collection waves to identify question failures. Findings Overall, we observed that participants were willing to respond to even the most sensitive questionnaire items on sexual biography and practices. We identified issues with the original questionnaire that (i) affected the willingness (acceptability) and ability (knowledge barriers) of participants to respond fully; and/or (ii) prevented participants from interpreting the questions as intended, including poor wording (source question error), cultural portability and very rarely translation error. Our revisions included adjusting item order and wording, adding preambles and implementation guidance, and removing items with limited cultural portability. Conclusion We have demonstrated that a questionnaire exploring sexual practices, experiences and health-related outcomes can be comprehensible and acceptable by the general population in diverse global contexts, and have highlighted the importance of rigorous processes for the translation and cognitive testing of such a questionnaire. [phrase omitted] [phrase omitted] Objectif Adapter un questionnaire standard sur les pratiques et experiences sexuelles ainsi que les resultats lies a la sante sexuelle, afin d'ameliorer son intelligibilite et son applicabilite transculturelle. Nous souhaitions analyser la volonte des participants et leur capacite a repondre aux differentes thematiques abordees dans le projet de questionnaire, puis determiner si certaines questions avaient ete interpretees comme prevu selon les environnements geographiques et culturels. Methodes Nous avons mene des entretiens cognitifs (n = 645) repartis en trois periodes iteratives de collecte de donnees dans 19 pays entre mars 2022 et mars 2023, avec des participants de sexes, genres, ages et origines differents. Les personnes chargees de l'entretien ont utilise un guide pratique semi-structure pour interroger les participants sur la maniere dont ils ont interprete les questions et entrepris d'y repondre. Des equipes locales impliquees dans cette etude ont rempli des cadres d'analyse de donnees, puis nous avons organise des reunions de reflexion conjointes entre les periodes de collecte de donnees afin de recenser les questions qui se sont soldees par un echec. Resultats De maniere generale, nous avons constate que les participants etaient disposes a repondre au questionnaire, y compris aux thematiques les plus sensibles sur leur historique et leurs pratiques sexuelles. Nous avons identifie, dans le questionnaire initial, des problemes qui (i) ont eu un impact sur la volonte (acceptabilite) et la capacite (connaissances insuffisantes) des participants a y repondre pleinement; et/ou (ii) ont empeche les participants d'interpreter les questions comme prevu, notamment en raison d'une mauvaise formulation (erreur dans la question source), d'une absence de transposition culturelle et, dans de tres rares cas, d'une erreur de traduction. Dans le cadre de nos revisions, nous avons modifie l'ordre et la formulation des questions, ajoute des notes explicatives et un guide de mise en reuvre, mais aussi supprime les questions difficiles a transposer dans d'autres contextes culturels. Conclusion Nous avons montre qu'un questionnaire explorant les pratiques et experiences sexuelles ainsi que les resultats lies a la sante pouvait etre comprehensible et acceptable pour l'ensemble de la population dans divers contextes a travers le monde. Nous avons egalement souligne l'importance d'etablir des processus rigoureux de traduction et devaluation cognitive pour ce type de questionnaire. [phrase omitted] Objetivo Ajustar un cuestionario estandar sobre las practicas, las experiencias y los resultados relacionados con la salud sexual para mejorar su aplicabilidad e interpretabilidad transcultural. El objetivo consistia en explorar la disposicion y la capacidad de los participantes para responder al borrador del cuestionario y determinar si las preguntas se interpretaban segun lo previsto en diferentes entornos geograficos y culturales. Metodos Se realizaron entrevistas cognitivas (n = 645) en tres rondas iterativas de recopilacion de datos en 19 paises durante marzo de 2022 y marzo de 2023, con participantes de diversos sexos, generos, edades y regiones geograficas. Los entrevistadores utilizaron una guia de campo semiestructurada para obtener relatos de los participantes sobre sus procesos de interpretacion y respuesta a las preguntas del cuestionario. Los equipos de estudio locales completaron los marcos de analisis de datos y se celebraron reuniones conjuntas de analisis entre las rondas de recopilacion de datos para identificar fallos en las preguntas. Resultados En general, se observo que los participantes estaban dispuestos a responder incluso a las preguntas mas delicadas del cuestionario sobre biografia y practicas en materia sexual. Se identificaron problemas con el cuestionario original que (i) afectaban a la disposicion (aceptabilidad) y la capacidad (barreras de conocimiento) de los participantes para responder plenamente; o (ii) evitaban que los participantes interpretaran las preguntas segun lo previsto, incluida una redaccion deficiente (error en la pregunta original), portabilidad cultural y, muy raramente, error de traduccion. Las revisiones incluyeron el ajuste del orden y la redaccion de las preguntas, la adicion de preambulos y orientaciones de implementacion, y la eliminacion de preguntas con una portabilidad cultural limitada. Conclusion Se ha demostrado que un cuestionario que explora las practicas, las experiencias y los resultados relacionados con la salud sexual puede ser comprensible y aceptable para la poblacion general en diversos contextos mundiales. Ademas, se ha destacado la importancia de contar con procesos rigurosos para la traduccion y las pruebas cognitivas de un cuestionario de este tipo., Introduction Despite decades of research, programming and investment into improving sexual and reproductive health and rights outcomes, there has been inadequate attention paid to sexual activity. (1,2) Information, education and [...]

In Indonesia, knowledge of parents' experiences of their daughters' HPV vaccination in school settings is limited. As Indonesia seeks to scale up its HPV vaccination program nationwide, parents' perspectives hold important insights into how elements of the vaccination model can be sustained and improved. This study explored mothers' experiences of their daughters' HPV vaccination experiences, their knowledge of HPV risks and prevention, and factors associated with willingness to recommend HPV vaccination for girls. A cross-sectional online survey was conducted with 143 mothers of schoolgirls who had received HPV vaccination at schools in Yogyakarta and Jakarta. Multivariate logistic regression was used to assess factors associated with willingness to recommend HPV vaccination. Chi-square and independent t-tests were performed to assess relationships between variables. One-way ANOVA was used to test mean differences in knowledge scores among mothers with different education levels. Many respondents (62.4%) received key health information before their daughters' HPV vaccination. Mothers' average knowledge score was 6.07/10 (SD 2.35). Receiving satisfactory information was significantly associated with willingness to recommend HPV vaccination for girls to others. A significant association was found between mothers' willingness to recommend HPV vaccination and having ever participated in cervical cancer screening themselves. Providing consistent health information that addresses the knowledge gaps and affirms the benefits and safety of HPV vaccines can improve the likelihood of mothers recommending HPV vaccination to others. The benefit of a synchronized approach to promoting primary and secondary prevention was supported by the findings. [ABSTRACT FROM AUTHOR]

Iron deficiency is widespread throughout the developing world. We provide new evidence on the effect of iron deficiency on economic and social prosperity of older adults drawing on data from a random assignment treatment-control design intervention. The Work and Iron Status Evaluation is an on-going study following over 17,000 individuals in Central Java, Indonesia. Half the respondents receive a treatment of 120 mg of iron every week for a year; the controls receive a placebo. Compliance is monitored carefully. Results from the first six months of the intervention are presented for adults age 30 through 70 years. Males who were iron deficient prior to the intervention and who are assigned to the treatment are better off in terms of physical health, psycho-social health and economic success. These men are more likely to be working, sleep less, lose less work time to illness, are more energetic, more able to conduct physically arduous activities and their psycho-social health is better. There is evidence that economic productivity of these males also increased. Among iron-deficient males assigned to the treatment who were also self-employed prior to the baseline, hourly earnings rose substantially and so they earned more on a monthly basis. Benefits for women are in the same direction but the effects are more muted. The results provide unambiguous evidence in support of the hypothesis that health has a causal effect on economic prosperity of males during middle and older ages.

Early adolescents (ages 10–14) living in low- and middle-income countries have heightened vulnerability to psychosocial risks, but available evidence from these settings is limited. This study used data from the Global Early Adolescent Study to characterize prototypical patterns of emotional and behavioral problems among 10,437 early adolescents (51% female) living in the Democratic Republic of Congo (DRC), Malawi, Indonesia, and China, and explore the extent to which these patterns varied by country and sex. LCA was used to identify and classify patterns of emotional and behavioral problems separately by country. Within each country, measurement invariance by sex was evaluated. LCA supported a four-class solution in DRC, Malawi, and Indonesia, and a three-class solution in China. Across countries, early adolescents fell into the following subgroups: Well-Adjusted (40–62%), Emotional Problems (14–29%), Behavioral Problems (15–22%; not present in China), and Maladjusted (4–15%). Despite the consistency of these patterns, there were notable contextual differences. Further, tests of measurement invariance indicated that the prevalence and nature of these classes differed by sex. Findings can be used to support the tailoring of interventions targeting psychosocial adjustment, and suggest that such programs may have utility across diverse cross-national settings. [ABSTRACT FROM AUTHOR]

Bullying is a major public health concern for Indonesian adolescents, with well-documented links to a range of emotional and behavioral problems. Despite such evidence, few investigations have employed qualitative methods to illuminate youth's own perceptions of bullying and its psychosocial correlates in this context. The current study aimed to address this gap through an exploration of Indonesian adolescents' motivations, perceptions, and beliefs regarding bullying. Building on prior quantitative findings, an explanatory sequential mixed methods approach was used to better understand the myriad ways in which bullying ties into other psychosocial challenges. Qualitative interviews were conducted with a total of 45 adolescents ages 13 to 14 (25 girls and 20 boys) in two junior high schools in Semarang between October and December 2019. Interviews were audio-recorded, transcribed verbatim, and translated into English for analysis. Qualitative data were then coded using an inductive thematic analysis approach. Interviews yielded contextual insights into adolescents' definitions of bullying including the distinction between "normal" and "serious" bullying; related risk behaviors; key drivers; social and emotional consequences; and coping strategies. Across these thematic categories, a number of noteworthy gender differences emerged, highlighting the role that underlying gender norms can play in driving bullying involvement. Further, findings emphasize the need to develop a locally valid definition of bullying which takes into account the ways in which emotional distress may be both a criterion and a consequence of bullying. Findings can be used to inform bullying prevention programs targeting Indonesian youth. [ABSTRACT FROM AUTHOR]

Rotavirus remains the most common cause of severe, dehydrating diarrhea among children worldwide. Several rotavirus vaccines are under development. Decisions about new vaccine introduction will require reliable data on disease [...]