Peer-reviewed article
Context of Violence in Adolescence Cohort (CoVAC) study: protocol for a mixed methods longitudinal study in Uganda
Karen M. Devries, Jenny Parkes, Louise Knight, Elizabeth Allen, Sophie Namy et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001CoVAC is a longitudinal cohort study following Ugandan adolescents from 2014 to 2022 to understand how violence exposure in adolescence relates to later violence perpetration and victimisation in relationships. The study combines quantitative surveys at three time points (when participants were aged 11-14, 15-18, and 18-21 years) with qualitative interviews and co-design workshops with intervention developers. The research aims to identify individual and contextual factors that increase or reduce violence risk, and to directly inform violence prevention programmes.
Key points
- 3,431 adolescents participated in the Wave 1 survey in 2014, with follow-up waves in 2018 and 2021
- Violence exposure in adolescence is associated with poor health outcomes and with perpetration and victimisation in later intimate relationships
- The study uses mixed methods including quantitative surveys, qualitative interviews with 36 young people, and iterative analysis with intervention developers
- This is described as the first longitudinal study on violence aetiology over adolescence in sub-Saharan Africa
- Findings are being integrated directly into intervention development by Uganda-based NGO Raising Voices
Limitations
This is a study protocol rather than results, so it describes intended methods rather than actual findings. The document does not provide data on outcomes, effectiveness of any interventions, or evidence of impact on violence reduction.
Abstract
BACKGROUND: Violence exposure in adolescence is associated with a range of poor health and social outcomes, including both the perpetration and experience of violence in later intimate relationships. However, there is little longitudinal evidence on how both individual and contextual characteristics encourage or interrupt these associations. We designed the Contexts of Violence in Adolescence Cohort study (CoVAC) to provide evidence on these pathways for Ugandan adolescents, with the aim of providing information to improve the design of violence prevention interventions for adolescents and young adults. METHODS: CoVAC is a mixed-methods prospective cohort study with three parallel strands. Between 2014 and 2022, the study comprises three waves of quantitative survey data collection; qualitative data from five time points; and a series of workshops to facilitate direct use of emerging findings by intervention developers at Uganda-based NGO Raising Voices in their ongoing work to prevent violence. 3431 adolescents participated in a survey in 2014 when the majority were aged 11-14 years, and agreed to be re-contacted for a Wave 2 survey in 2018 (aged about 15-18 years); and again in 2021 (aged 18-21 years). 36 young people from Wave 1 survey sample will be invited to participate in longitudinal qualitative data collection. Adolescents aged 18 years and over will provide informed consent; for those under age 18 years, adolescents will be invited to assent, except in cases where caregivers, following notification, have opted not to consent to their adolescent's participation. Quantitative and qualitative data will be analysed iteratively, and triangulation will be used to confirm, clarify and deepen our interpretation of findings. We will hold regular structured meetings so that emerging findings can be integrated into intervention development. DISCUSSION: This will be the first longitudinal study on the aetiology of violence over adolescence in sub-Saharan Africa which will enable examination of pathways using mixed methods at multiple time points. Quantitative mediation analysis, and annual qualitative fieldwork will provide detailed insights into how adolescents' violence-related experiences, perspectives and practices relate to their social contexts and how these change over time. Results will feed directly into intervention development to reduce violence and harmful sequelae. TRIAL REGISTRATION: This study is a long-term follow up of participants in the Good Schools Study (NCT01678846, clinicaltrials.gov). This protocol is for cohort follow-up only; we have a separate protocol paper describing an evaluation of the long-term effects of the Good School Toolkit (In preparation).