Kelly L L'Engle

Kelly L L'Engle
University of San Francisco | USFCA · School of Nursing and Health Professions

PhD, MPH

About

57
Publications
31,207
Reads
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3,264
Citations
Citations since 2016
24 Research Items
2041 Citations
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2016201720182019202020212022050100150200250300
2016201720182019202020212022050100150200250300
2016201720182019202020212022050100150200250300
Introduction

Publications

Publications (57)
Article
Over 20 years, interventions have targeted HIV among female sex workers (FSWs) in Kenya given their central role in new infections. To determine the effects of these interventions, we assessed the prevalence and correlates of HIV among a random sample of FSWs and modelled prevalence estimates from studies since 1993. FSWs aged 16–34 years were enro...
Article
Full-text available
Background Female sex workers in low-income and middle-income countries face high risks of unintended pregnancy. We developed a 12-month, multifaceted short messaging service intervention (WHISPER) for female sex workers in Kenya who had the potential to become pregnant, to improve their contraceptive knowledge and behaviours. The aim of this study...
Preprint
BACKGROUND Female sex workers (FSWs) have high rates of both unintended pregnancy and HIV, but few health promotion interventions address their contraceptive needs or other sexual and reproductive health and rights (SRHR) concerns. A broader approach integrates contraceptive promotion with HIV and STI prevention and management, alcohol awareness, g...
Article
Full-text available
Background: Female sex workers (FSWs) have high rates of both unintended pregnancy and HIV, but few health promotion interventions address their contraceptive needs or other sexual and reproductive health and rights (SRHR) concerns. A broader approach integrates contraceptive promotion with HIV and sexually transmitted infection (STI) prevention a...
Technical Report
Full-text available
A shared language to describe the uses of digital technology for health The classification of digital health interventions (DHIs) categorizes the different ways in which digital and mobile technologies are being used to support health system needs. Targeted primarily at public health audiences, this Classification framework aims to promote an acces...
Article
Full-text available
Introduction Generating a nationally representative sample in low and middle income countries typically requires resource-intensive household level sampling with door-to-door data collection. High mobile phone penetration rates in developing countries provide new opportunities for alternative sampling and data collection methods, but there is limit...
Data
Survey script in English. (DOCX) (DOCX)
Data
Dataset for full and partial interviews. (XLSX) (XLSX)
Article
Full-text available
Introduction New interventions are required to reduce unintended pregnancies among female sex workers (FSWs) in low- and middle-income countries and to improve their nutritional health. Given sex workers’ high mobile phone usage, repeated exposure to short messaging service (SMS) messages could address individual and interpersonal barriers to contr...
Article
Background: The research base recommending the use of mobile phone interventions for health improvement is growing at a rapid pace. The use of mobile phones to deliver health behavior change and maintenance interventions in particular is gaining a robust evidence base across geographies, populations, and health topics. However, research on best pra...
Article
Text message programs for sexual health are becoming increasingly popular as practitioners aim to meet youth on media they use frequently. Two-way mobile health (mHealth) interventions allow for feedback solicitation from participants. This study explores the use of a text message survey to assess demographics and program feedback from users of an...
Article
Full-text available
Introduction: mHealth as a technical area has seen increasing interest and promise from both developed and developing countries. While published research from higher income countries on mHealth solutions for adolescent sexual and reproductive health (SRH) is growing, there is much less documentation of SRH mHealth interventions for youth living in...
Article
Between 20 and 40 % of female sex workers (FSWs) began sex work before age 18. Little is known concerning whether early initiation of sex work impacts later experiences in adulthood, including violence victimization. This paper examines the relationship between early initiation of sex work and violence victimization during adulthood. The sample inc...
Article
Full-text available
Context: Interventions for adolescent sexual and reproductive health (ASRH) are increasingly using mobile phones but may not effectively report evidence. Objective: To assess strategies, findings, and quality of evidence on using mobile phones to improve ASRH by using the mHealth Evidence Reporting and Assessment (mERA) checklist recently publis...
Article
Objectives Early initiation of sex work is prevalent among female sex workers (FSWs) worldwide. The objectives of this study were to investigate if early initiation of sex work was associated with: (1) consistent condom use, (2) condom negotiation self-efficacy or (3) condom use norms among alcohol-using FSWs in Mombasa, Kenya. Methods In-person in...
Article
Objectives: The global rapid growth in mobile technology provides unique opportunities to support community health workers (CHWs) in providing family planning (FP) services. FHI 360, Pathfinder International and D-tree International developed an evidence-based mobile job aid to support CHW counseling, screening, service provision and referrals, wi...
Article
Full-text available
Background: There is increasing evidence that mobile phone health interventions ("mHealth") can improve health behaviors and outcomes and are critically important in low-resource, low-access settings. However, the majority of mHealth programs in developing countries fail to reach scale. One reason may be the challenge of developing financially sus...
Data
Excel File of Breakeven Analysis and Monte Carlo Simulation. (XLSX)
Article
Full-text available
Aims: To evaluate whether an alcohol harm reduction intervention was associated with reduced interpersonal violence or engagement in sex work among female sex workers (FSWs) in Mombasa, Kenya. Design: Randomized controlled trial. Setting: HIV prevention drop-in centers in Mombasa, Kenya. Participants: 818 women 18 or older in Mombasa who vis...
Article
Sexual health text message services are becoming an increasingly popular way to reach young people with sexual health information. A variety of service types exist: some send automated messages on a set schedule; others provide personalized responses to individual questions. Young people’s perceptions of interactivity, which is often based on syste...
Article
Background: According to the transtheoretical model (TTM) behavior change occurs through a series of steps when an individual becomes aware of a behavior, prepares to change, and executes those changes using certain processes. This model has not yet been used to describe alcohol-reduction behavior change processes in resource-limited settings. Ob...
Article
Full-text available
There is a high unmet need for sexual and reproductive health (SRH) information and services among youth (ages 15-24) worldwide (MacQuarrie KLD. Unmet Need for Family Planning among Young Women: Levels and Trends 2014). With the proliferation of mobile technology, and its popularity with this age group, mobile phones offer a novel and accessible pl...
Article
Full-text available
Background: Adherence to prevention, care, and treatment recommendations among people living with HIV (PLHIV) is a critical challenge. Yet good clinical outcomes depend on consistent, high adherence to antiretroviral therapy (ART) regimens. Mobile phones offer a promising means to improve patient adherence and health outcomes. However, limited info...
Article
Objective: We assessed whether a brief alcohol intervention would lead to reduced alcohol use and sexually transmitted infection (STI)/HIV incidence and related sexual risk behaviors among moderate drinking female sex workers. Methods: A randomized controlled intervention trial was conducted with 818 female sex workers affiliated with the AIDS,...
Article
Full-text available
Context: Little is known about the frequency and patterns of use of emergency contraceptive pills among women in urban Kenya and Nigeria. Methods: To recruit women who had used emergency contraceptive pills, individuals aged 18-49 were intercepted and interviewed at shopping venues in Nairobi, Kenya, and Lagos, Nigeria, in 2011. Information was...
Article
Full-text available
HIV testing is a critical first step to accessing HIV care and treatment, particularly for high-risk groups such as female sex workers (FSWs). Alcohol use may be a barrier to accessing HIV services, including HIV testing. We analyzed data from a cross-sectional survey of 818 FSWs in Mombasa, Kenya, and estimated the association between different le...
Article
Full-text available
A suite of resources provides implementation guidance for mHealth initiatives, particularly in less developed countries. The suite includes an eLearning course, online guide, evidence database, and a High-Impact Practices brief, along with the mHealth Working Group and website.
Article
Female sex workers are known to be at risk of intimate partner violence (IPV) from numerous sources including clients, pimps, boyfriends and husbands. Better understanding the factors associated with IPV in this population will enhance prevention efforts. This work examines baseline survey data collected as part of a randomised controlled trial for...
Article
Full-text available
In the midst of scaling up voluntary medical male circumcision (VMMC) in Kenya, there is concern that men do not adequately understand that circumcision provides only partial protection against HIV. The study goal was to determine men's understanding of partial protection, perceptions of HIV risk before and after VMMC and use of protective measures...
Conference Paper
Mobile for Reproductive Health (m4RH) is a short message service (SMS) system that provides automated information about nine Family Planning (FP) methods through a free, opt-in, interactive menu-based platform. m4RH, originally promoted through clinics and community health workers, is available across all mobile networks in Tanzania. Mass media pro...
Article
Full-text available
Emergency contraceptive pills (ECPs) were developed and marketed with the emergency aspect firmly in mind, but research and anecdotal evidence indicate that some women use them as a form of regular contraception, spurring efforts in the reproductive health community to explore the development of a coitally-dependent oral contraceptive pill. We aske...
Article
Full-text available
To evaluate the acceptability, information access, and potential behavioral impact of providing contraception information via text message on mobile phones to young people in Kenya. Three methods of data collection were implemented during the 17-month pilot period for the Mobile for Reproductive Health (m4RH) program in Kenya: automatic logging of...
Conference Paper
The developing world is experiencing an explosive growth in the use of mobile phones. Increasingly, these technologies are being developed to provide point-of-care support by community health workers (CHWs). In June 2011, FHI360, Pathfinder, and D-Tree International began developing a mobile phone family planning decision support tool for CHWs in D...
Conference Paper
Background Anecdotal accounts and some research suggest that dedicated EC products are being used more frequently than intended. However, observations or even interviews with pharmacy-based ECP users over a limited time period cannot corroborate claims of repeat use, as frequent ECP users tend to be oversampled in point-of-service settings. Met...
Article
Full-text available
Women are an important audience for voluntary medical male circumcision (VMMC) communication messages so that they know that VMMC provides only partial protection against HIV. They may also be able to influence their male partners to get circumcised and practice other HIV protective measures after VMMC. This study was conducted in two phases of qua...
Article
Background: The objective of this research was to evaluate the feasibility, reach and potential behavioral impact of providing automated family planning information via mobile phones to the general public in Tanzania. Study design: Data from users of the Mobile for Reproductive Health (m4RH) program were collected during the 10-month pilot perio...
Conference Paper
Comprehensive sexuality education is a critical tool in efforts to curb the HIV epidemic and prevent unintended pregnancy among youth. Yet many countries have poor quality or no sexuality education, due largely to local resistance. FHI, with support from USAID and in partnership with UNESCO, worked with the Kenya Ministry of Education (MOE) to st...
Conference Paper
Background. In the midst of scale-up for voluntary medical male circumcision (VMMC) in rural and peri-urban settings in western Kenya, there is concern that men do not adequately understand that circumcision provides only partial protection against HIV. The study goal was to determine men's understanding of partial protection and HIV risk and behav...
Article
As emergency contraceptive pills (ECPs) become increasingly available through pharmacies, concerns about potential overuse of this product have emerged. In response, bridging women from ECPs to ongoing contraception was advanced as a solution. We collected information in Ghanaian pharmacies on ECP users' sexual activity, use of contraceptive method...
Article
In the last decade, three randomized controlled trials in Kenya, South Africa, and Uganda have shown that medical male circumcision (MMC) reduces the sexual transmission of HIV from women to men. Objectives of this assessment were to measure acceptability of adult MMC and circumcision of children to inform policies regarding whether and how to prom...
Article
Full-text available
Emergency contraceptive pills (ECPs) are becoming more popular, yet little is known about the contraceptive preferences of women who take ECPs. Women purchasing ECPs were recruited from pharmacies in Accra, Ghana. A total of 24 semi-structured, qualitative interviews were conducted in May 2008. Nearly all participants preferred ECPs to other contra...
Conference Paper
Since 2006, the Interagency Youth Working Group (IYWG), a network of nongovernmental organizations, donors, and cooperating agencies, has aimed to improve reproductive health (RH) and HIV/ AIDS outcomes for youth ages 10-24 in low-resource settings by increasing access to information on effective youth RH/ HIV programs, research, and resources tail...
Article
We evaluated female adolescents' comprehension of a prototype over-the-counter package label for an emergency contraceptive pill product. Volunteers aged 12-17 years who could read English were recruited at malls and clinics in six United States metropolitan areas. After completing a literacy assessment, subjects examined the prototype package and...
Article
Full-text available
Correlates of use and subsequent sexual attitudes and behaviors predicted by exposure to sexually explicit content (i.e., pornography and erotica) in adult magazines, X-rated movies, and the Internet were examined in a prospective survey of a diverse sample of early adolescents (average age at baseline = 13.6 years; N = 967). Two-thirds (66%) of ma...
Article
This study examined the relationship between perceived socialization from parents, school, peers, and media and adolescents' cognitive susceptibility to initiating sexual intercourse and transition to intercourse 2 years later. Baseline and follow-up in-home Audio-Computer Assisted Self Interview surveys were completed by 854 Black and White male a...
Article
Full-text available
To test movie exposure and television use as predictors of smoking initiation among white and black adolescents who had never smoked cigarettes. Survey research using audio computer-assisted self-interviews at baseline and at 2-year follow-up (2002-2004). Participants' homes located in central North Carolina. A sample of 735 12- to 14-year-old adol...
Article
Better methods for investigating sexual risk before the initiation of sexual intercourse are needed to support programming for younger adolescents, especially for abstinent adolescents who are susceptible to initiating intercourse. A sample of 854 adolescents in seventh or eighth grade who had never had sexual intercourse completed sexuality survey...
Article
Full-text available
To assess over time whether exposure to sexual content in 4 mass media (television, movies, music, and magazines) used by early adolescents predicts sexual behavior in middle adolescence. An in-home longitudinal survey of 1017 black and white adolescents from 14 middle schools in central North Carolina was conducted. Each teen was interviewed at ba...
Article
This study compared influences from the mass media (television, music, movies, magazines) on adolescents' sexual intentions and behaviors to other socialization contexts, including family, religion, school, and peers. A sample of 1011 Black and White adolescents from 14 middle schools in the Southeastern United States completed linked mail surveys...
Article
To investigate the possibility that the mass media (television, movies, music, and magazines) serve as a kind of super peer for girls who enter puberty sooner than their age-mates. Multiple studies have demonstrated significant associations between earlier pubertal timing and earlier transition to first sex. Does puberty also stimulate interest in...
Article
Full-text available
This article describes a protocol that was effective in collecting media-use pattern and sensitive health data from young adolescents. Students from three public school districts in the southeastern United States were recruited to participate in a study of the impact of the media on adolescents’ sexual health. Using a 34-page mailed survey, extensi...
Article
This article describes a protocol that was effective in collecting media-use pattern and sensitive health data from young adolescents. Students from three public school districts in the southeastern United States were recruited to participate in a study of the impact of the media on adolescents' sexual health. Using a 34-page mailed survey, extensi...

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Question
Trying to identify source for 3 questions on sleep:
Over the past [7] days, have you:
had trouble sleeping?
woken up for reasons during the night?
felt tired during the day?
Any clues? Thank you all so much!

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