Factors associated with youth competency as lay health promoters of GxE literacy related to Podoconiosis in rural highlands of Southern Ethiopia Open Access

Desta, Alembo (Fall 2020)

Permanent URL: https://etd.library.emory.edu/concern/etds/1z40kt97c?locale=en


Background: Engaging youth as peer educators is a common approach that has been shown to be effective for improving healthy behavior in a variety of settings. However, this approach has not been considered in the context of promoting literacy concerning conjoint genetic and environmental (GxE) influences on health. This cross-sectional survey explored the youth self-rated competencies and commitment to civic organizations in rural Ethiopia where a heritable form of non-filarial elephantiasis (i.e., podoconiosis) is endemic.

Methods: A cross sectional survey was conducted in the Wolaita zone of Southern Ethiopia.  Surveys were administered by trained data collectors. Eligible youth ages 15 to 24 were enumerated. All the respondents (377 youth), randomly selected, completed the survey. Bivariate associations were tested for social and demographic factors associated with willingness to serve as lay health GxE literacy builders. A composite measure of competency was developed and its association with willingness was tested in logistic regression model with other cofactors.

Results: The odds of willingness was 2.3 time higher for the participants with high competency than for those with low competency (OR 2.34; 95% CI, 1.55, 3.54). Males, participants who had attended formal education, who had experience in civic engagement and those who had assumed leadership roles were more willing to volunteer to serve as peer GxE literacy builders than their counterparts OR 1.95 (95% CI, 1.29, 2.94); OR 6.6 (95% CI 1.59, 23.04); OR 1.96 (95% CI, 1.29, 2.96); OR 2.12 (95% CI, 1.10, 4.03) respectively. There was no interaction effect between competency and other variables in predicting high willingness p>0.05.

Conclusion: Young volunteers with formal school backgrounds and experience in social activities in the community could be recruited as disseminators of GxE literacy. Interventions should consider these attributes to build the skills of potential peer leaders through training tailored to GxE literacy.

Table of Contents

Abstract iv


Acronyms. vii

List of Tables. viii

List of Figures. viii

Chapter 1: Introduction. 1

1.1       Background. 1

1.2       Research Questions. 5

Chapter 2: Literature Review.. 6

2.1 Gene x Environment Contributors to Health. 6

2.2 Gene x Environment Education Studies. 9

2.3 Studies on factors influencing youths’ competency and willingness. 14

2.4 Theoretical framework: Diffusion of innovation theory. 16

2.4 1 Core concepts. 17

2.4.2 Relevance and Application of DOI to Peer Education Programs. 18

2.5 Chapter Summary. 19

Chapter 3: Methods. 21

3.1 Study overview: 21

3.2 Study settings and population. 21

3.3 Instruments. 22

3.4 Data collection. 23

3.5 Measures. 23

3.6 Data analysis. 25

Chapter 4: Results. 26

4.1. Description of sample participants. 26

4.2. Which attributes are associated with youths’ competency to disseminate GxE explanations of podoconiosis?. 27

4.3. Which attributes are associated with youth willingness to disseminate GxE explanations of podoconiosis?. 28

4.4.1 Main effects. 30

4.4.2 Interaction effect 31

Chapter 5: Discussion and Implication. 33

5.1 Discussion. 33

5.2 Strengths and Limitations. 37

5.3 Implication and recommendation. 37

References. 41

Annex : A 2x2 table showing willingness moderated at various levels of gender and civic engagement 45

Competency by Gender 45

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