{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:19:11Z","timestamp":1777508351300,"version":"3.51.4"},"reference-count":52,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"content-version":"vor","delay-in-days":38,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes for Health Research","doi-asserted-by":"publisher","award":["PJT-162310"],"award-info":[{"award-number":["PJT-162310"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>HIV stigma among youth in Uganda remains prevalent and impedes efforts to advance HIV prevention. A community-based participatory approach and arts-based population health intervention were undertaken to reduce HIV stigma among young people in northern Uganda. A mixed-method process evaluation aimed to examine successes and barriers to intervention implementation, contextual circumstances that may have influenced intervention outcomes, and acceptability and subjective evaluations among participants. The process evaluation drew data from daily lesson logs and classroom observation notes from Research Assistants (RAs), minutes from research team and school meetings, exit interviews with participants, and a focus group discussion with RAs. Data were collected during the 2023 school year (January to December 2023) in 12 schools in Omoro District, northern Uganda. Key summaries were made from data sources and organized into tables. The use of Linnan and Steckler\u2019s (Process evaluation and public health interventions: an overview. In: Process Evaluation in Public Health Interventions and Research. San Francisco, CA: Jossey-Bass Publishers, 2002, 1\u201313.) comprehensive framework and components of process evaluation, such as context, fidelity, reach, and dose received and delivered, guided this process evaluation. Findings highlighted that although implementation faced time constraints and contextual challenges, including monetary and material compensation, the intervention was delivered as planned and increased awareness of HIV stigma and cultural knowledge for students, teachers, Elders, and communities in Omoro District. Participants also reported that the intervention enhanced cultural understanding by integrating local traditions, proverbs, and storytelling into the educational process, leading to a reduction in HIV stigma among students. Future research should consider contextual and cultural relevancy of interventions as instrumental to an intervention\u2019s acceptability and adoption among target populations.<\/jats:p>","DOI":"10.1093\/heapro\/daaf083","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T23:11:16Z","timestamp":1751065876000},"source":"Crossref","is-referenced-by-count":3,"title":["Process evaluation of an HIV stigma reduction intervention among young people in northern Uganda"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9065-9770","authenticated-orcid":false,"given":"Bonnie","family":"Fournier","sequence":"first","affiliation":[{"name":"School of Nursing, Thompson Rivers University , 805 Tru Way, Kamloops, British Columbia , V2C 0C8","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abukari","family":"Kwame","sequence":"additional","affiliation":[{"name":"College of Nursing, University of Saskatchewan , 1061 Central Avenue, Prince Albert, Saskatchewan , S6V 4E4","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"St\u00e9phanie","family":"Caron-Roy","sequence":"additional","affiliation":[{"name":"School of Nursing, Thompson Rivers University , 805 Tru Way, Kamloops, British Columbia , V2C 0C8","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geoffrey","family":"Maina","sequence":"additional","affiliation":[{"name":"College of Nursing, University of Saskatchewan , 1061 Central Avenue, Prince Albert, Saskatchewan , S6V 4E4","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua B","family":"Mendelsohn","sequence":"additional","affiliation":[{"name":"College of Health Professions, Pace University , 161 William Street, New York, NY 10038 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Sommerfeldt","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, University of Alberta , 11405-87 Ave, Edmonton, Alberta , T6G 1C9","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8035-433X","authenticated-orcid":false,"given":"Carmen H","family":"Logie","sequence":"additional","affiliation":[{"name":"Factor-Inwentash Faculty of Social Work, University of Toronto , 246 Bloor Street W, Toronto, Ontario , M5S 1V4","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1017-5475","authenticated-orcid":false,"given":"Candace I J","family":"Nykiforuk","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Alberta , 11405-87 Ave, Edmonton, Alberta , T6G 1C9","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gillian","family":"Strudwick","sequence":"additional","affiliation":[{"name":"Centre for Addiction and Mental Health , Krembil Centre for Neuroinformatics, 1001 Queen Street West, Toronto, Ontario , M6J 1H1","place":["Canada"]},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto , 4th Floor, 155 College Street, Toronto, Ontario , M5T 3M6","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santo","family":"Ojok","sequence":"additional","affiliation":[{"name":"Tochi Youth Resource Centre , PO Box 416, Gulu ,","place":["Uganda"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,6,20]]},"reference":[{"key":"2025062719111163100_daaf083-B1","doi-asserted-by":"publisher","first-page":"46","DOI":"10.15212\/FMCH.2016.0106","article-title":"Traditional knowledge in HIV treatment and prevention program in northern Uganda","volume":"4","author":"Akena","year":"2016","journal-title":"Fam Med Community Health"},{"key":"2025062719111163100_daaf083-B2","doi-asserted-by":"publisher","first-page":"169","DOI":"10.2989\/16085906.2019.1637912","article-title":"Community beliefs, HIV stigma, and depression among adolescents living with HIV in rural Uganda","volume":"18","author":"Ashaba","year":"2019","journal-title":"Afr J AIDS Res"},{"key":"2025062719111163100_daaf083-B3","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1080\/10810730490271575","article-title":"Diffusion of innovations and HIV\/AIDS","volume":"9","author":"Bertrand","year":"2004","journal-title":"J Health Commun"},{"key":"2025062719111163100_daaf083-B4","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1080\/09540121.2012.699668","article-title":"Validation of a brief stigma-by-association scale for use with HIV\/AIDS-affected youth in South Africa","volume":"25","author":"Boyes","year":"2013","journal-title":"AIDS Care"},{"key":"2025062719111163100_daaf083-B5","volume-title":"Taking Account of Context in Population Health Intervention Research: Guidance for Producers, Users and Funders of Research","author":"Craig","year":"2018"},{"key":"2025062719111163100_daaf083-B6","doi-asserted-by":"publisher","first-page":"j5011","DOI":"10.1136\/bmj.j5011","article-title":"Recent advances in pre-exposure prophylaxis for HIV","volume":"359","author":"Desai","year":"2017","journal-title":"BMJ"},{"key":"2025062719111163100_daaf083-B7","author":"Deserranno"},{"key":"2025062719111163100_daaf083-B8","doi-asserted-by":"publisher","first-page":"2074131","DOI":"10.1080\/16549716.2022.2074131","article-title":"Community engagement in health systems interventions and research in conflict-affected countries: a scoping review of approaches","volume":"15","author":"Durrance-Bagale","year":"2022","journal-title":"Glob Health Action"},{"key":"2025062719111163100_daaf083-B9","doi-asserted-by":"publisher","first-page":"3892","DOI":"10.1007\/s10461-018-2201-7","article-title":"Stigma, depression, and substance use problems among perinatally HIV-infected youth in South Africa","volume":"22","author":"Earnshaw","year":"2018","journal-title":"AIDS Behav"},{"key":"2025062719111163100_daaf083-B10","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1186\/s12874-022-01767-7","article-title":"What do we want to get out of this? A critical interpretive synthesis of the value of process evaluations, with a practical planning framework","volume":"22","author":"French","year":"2022","journal-title":"BMC Med Res Methodol"},{"key":"2025062719111163100_daaf083-B11","author":"Frontline AIDS"},{"key":"2025062719111163100_daaf083-B12","volume-title":"Stigma: Notes on the Management of Spoiled Identity","author":"Goffman","year":"1963"},{"key":"2025062719111163100_daaf083-B13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/09540121.2018.1556384","article-title":"Toward an enhanced understanding of psychological resilience for HIV youth populations","volume":"30","author":"Harrison","year":"2018","journal-title":"AIDS Care"},{"key":"2025062719111163100_daaf083-B14","doi-asserted-by":"publisher","first-page":"112749","DOI":"10.1016\/j.socscimed.2019.112749","article-title":"Stigma reduction interventions for children and adolescents in low- and middle-income countries: systematic review of intervention strategies","volume":"246","author":"Hartog","year":"2020","journal-title":"Soc Sci Med"},{"key":"2025062719111163100_daaf083-B15","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1136\/medhum-2022-012477","article-title":"\u201cI am not alone with tears\u201d: embodying stigma and longing among youth living with perinatally acquired HIV in Tanzania through a collaborative arts-based approach","volume":"49","author":"Hosaka","year":"2023","journal-title":"Med Humanit"},{"key":"2025062719111163100_daaf083-B16","author":"Initiative for Social and Economic Rights"},{"key":"2025062719111163100_daaf083-B17","author":"International HIV\/AIDS Alliance"},{"key":"2025062719111163100_daaf083-B18","author":"International HIV\/AIDS Alliance"},{"key":"2025062719111163100_daaf083-B19","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1177\/14034948211014104","article-title":"Diffusion of innovations: a guiding framework for public health","volume":"50","author":"Iqbal","year":"2022","journal-title":"Scand J Public Health"},{"key":"2025062719111163100_daaf083-B20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/2325958219900713","article-title":"\u201cMy friend with HIV remains a friend\u201d: HIV\/AIDS stigma reduction through education in secondary schools-a pilot project in Buea, Cameroon","volume":"19","author":"Jacobi","year":"2020","journal-title":"J Int Assoc Provid AIDS Care"},{"key":"2025062719111163100_daaf083-B21","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/s12916-018-1237-x","article-title":"Implementation science and stigma reduction interventions in low- and middle-income countries: a systematic review","volume":"17","author":"Kemp","year":"2019","journal-title":"BMC Med"},{"key":"2025062719111163100_daaf083-B22","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1186\/s12889-020-8198-7","article-title":"Experiences and perceptions of youth living with HIV in western Uganda on school attendance: barriers and facilitators","volume":"20","author":"Kimera","year":"2020","journal-title":"BMC Public Health"},{"key":"2025062719111163100_daaf083-B23","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1080\/10508421003595927","article-title":"Payments and direct benefits in HIV\/AIDS related research projects in Uganda","volume":"20","author":"Kwagala","year":"2010","journal-title":"Ethics Behav"},{"key":"2025062719111163100_daaf083-B24","doi-asserted-by":"publisher","first-page":"1986250","DOI":"10.1080\/22423982.2021.1986250","article-title":"\u201cDo something with them!\u201d: developing \u201ccomfortable\u201d engagement with elders participating in an arts-based sexual health promotion and STBBI prevention workshop for Indigenous Youth in Labrador, Canada","volume":"80","author":"Landy","year":"2021","journal-title":"Int J Circumpolar Health"},{"key":"2025062719111163100_daaf083-B25","first-page":"1","volume-title":"Process Evaluation in Public Health Interventions and Research","author":"Linnan","year":"2002"},{"key":"2025062719111163100_daaf083-B26","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1177\/1049732317750862","article-title":"Body mapping as a youth sexual health intervention and data collection tool","volume":"28","author":"Lys","year":"2018","journal-title":"Qual Health Res"},{"key":"2025062719111163100_daaf083-B27","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1007\/s10461-018-2304-1","article-title":"Self-stigma reduction interventions for people living with HIV\/AIDS and their families: a systematic review","volume":"23","author":"Ma","year":"2019","journal-title":"AIDS Behav"},{"key":"2025062719111163100_daaf083-B28","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/j.cell.2020.03.005","article-title":"Curing HIV: seeking to target and clear persistent infection","volume":"181","author":"Margolis","year":"2020","journal-title":"Cell"},{"key":"2025062719111163100_daaf083-B29","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1093\/pubmed\/fdx117","article-title":"Evaluating a community-based public health intervention using a complex systems approach","volume":"40","author":"Matheson","year":"2018","journal-title":"J Public Health"},{"key":"2025062719111163100_daaf083-B30","doi-asserted-by":"publisher","first-page":"e0236141","DOI":"10.1371\/journal.pone.0236141","article-title":"Feasibility and acceptability of a pilot, peer-led HIV self-testing intervention in a hyperendemic fishing community in rural Uganda","volume":"15","author":"Matovu","year":"2020","journal-title":"PLoS One"},{"key":"2025062719111163100_daaf083-B31","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1186\/s13063-022-06643-9","article-title":"Reducing HIV-related stigma among young people attending school in northern Uganda: study protocol for a participatory arts-based population health intervention and stepped-wedge cluster-randomized trial","volume":"23","author":"Mendelsohn","year":"2022","journal-title":"Trials"},{"key":"2025062719111163100_daaf083-B32","author":"Ministry of Health"},{"key":"2025062719111163100_daaf083-B33","author":"Ministry of Health"},{"key":"2025062719111163100_daaf083-B34","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1136\/jech-2013-202869","article-title":"Process evaluation in complex public health intervention studies: the need for guidance","volume":"68","author":"Moore","year":"2014","journal-title":"J Epidemiol Community Health"},{"key":"2025062719111163100_daaf083-B35","doi-asserted-by":"publisher","first-page":"h1258","DOI":"10.1136\/bmj.h1258","article-title":"Process evaluation of complex interventions: Medical Research Council guidance","volume":"350","author":"Moore","year":"2015","journal-title":"BMJ"},{"key":"2025062719111163100_daaf083-B36","author":"New African"},{"key":"2025062719111163100_daaf083-B37","author":"Nyblade"},{"key":"2025062719111163100_daaf083-B38","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/s12916-019-1256-2","article-title":"Stigma in health facilities: why it matters and how we can change it","volume":"17","author":"Nyblade","year":"2019","journal-title":"BMC Med"},{"key":"2025062719111163100_daaf083-B39","author":"Omoro District Local Government"},{"key":"2025062719111163100_daaf083-B40","doi-asserted-by":"publisher","first-page":"21771","DOI":"10.7448\/IAS.20.1.21771","article-title":"HIV, violence, blame and shame: pathways of risk to internalized HIV stigma among South African adolescents living with HIV","volume":"20","author":"Pantelic","year":"2017","journal-title":"J Int AIDS Soc"},{"key":"2025062719111163100_daaf083-B41","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1007\/s12187-016-9428-5","article-title":"'They say HIV is a punishment from god or from ancestors\u2019: cross-cultural adaptation and psychometric assessment of an HIV stigma scale for South African adolescents living with HIV (ALHIV-SS)","volume":"11","author":"Pantelic","year":"2018","journal-title":"Child Indic Res"},{"key":"2025062719111163100_daaf083-B42","author":"Robert"},{"key":"2025062719111163100_daaf083-B43","volume-title":"Diffusion of Innovations","author":"Rogers","year":"1962"},{"key":"2025062719111163100_daaf083-B44","doi-asserted-by":"publisher","first-page":"e0253616","DOI":"10.1371\/journal.pone.0253616","article-title":"Pregnant women, their male partners and health care providers\u2019 perceptions of HIV self-testing in Kampala, Uganda: implications for integration in prevention of mother-to-child transmission programs and scale-up","volume":"16","author":"Rujumba","year":"2021","journal-title":"PLoS One"},{"key":"2025062719111163100_daaf083-B45","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1177\/1524839904273387","article-title":"Developing a process-evaluation plan for assessing health promotion program implementation: a how-to guide","volume":"6","author":"Saunders","year":"2005","journal-title":"Health Promot Pract"},{"key":"2025062719111163100_daaf083-B46","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1186\/s12916-019-1271-3","article-title":"The health stigma and discrimination framework: a global, crosscutting framework to inform research, intervention development, and policy on health-related stigmas","volume":"17","author":"Stangl","year":"2019","journal-title":"BMC Med"},{"key":"2025062719111163100_daaf083-B47","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.1016\/j.socscimed.2008.05.032","article-title":"HIV-related stigma: adapting a theoretical framework for use in India","volume":"67","author":"Steward","year":"2008","journal-title":"Soc Sci Med"},{"key":"2025062719111163100_daaf083-B48","doi-asserted-by":"publisher","first-page":"107","DOI":"10.5582\/bst.2019.01009","article-title":"Prevention of mother-to-child transmission (PMTCT) continues to play a vital role in the response to HIV\/AIDS: current status and future perspectives","volume":"13","author":"Tang","year":"2019","journal-title":"Biosci Trends"},{"key":"2025062719111163100_daaf083-B49","author":"Uganda AIDS Commission"},{"key":"2025062719111163100_daaf083-B50","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1097\/JOM.0b013e318269e5a6","article-title":"Process evaluation of a workplace health promotion intervention aimed at improving work engagement and energy balance","volume":"55","author":"Van Berkel","year":"2013","journal-title":"J Occup Environ Med"},{"key":"2025062719111163100_daaf083-B51","first-page":"178","article-title":"Using performance and theatre arts in HIV interventions and HIV programming in sub-Saharan Africa: a scoping review of extant literature","volume":"21","author":"Van Hout","year":"2020","journal-title":"J Sustaina Dev Afr"},{"key":"2025062719111163100_daaf083-B52","doi-asserted-by":"publisher","first-page":"S40","DOI":"10.2105\/AJPH.2009.184036","article-title":"Community-based participatory research contributions to intervention research: the intersection of science and practice to improve health equity","volume":"100","author":"Wallerstein","year":"2010","journal-title":"Am J Public Health"}],"container-title":["Health Promotion International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/heapro\/article-pdf\/40\/3\/daaf083\/63532712\/daaf083.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/heapro\/article-pdf\/40\/3\/daaf083\/63532712\/daaf083.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T23:11:18Z","timestamp":1751065878000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/heapro\/article\/doi\/10.1093\/heapro\/daaf083\/8169766"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,13]]},"references-count":52,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,5,13]]}},"URL":"https:\/\/doi.org\/10.1093\/heapro\/daaf083","relation":{},"ISSN":["0957-4824","1460-2245"],"issn-type":[{"value":"0957-4824","type":"print"},{"value":"1460-2245","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,6]]},"published":{"date-parts":[[2025,5,13]]},"article-number":"daaf083"}}