Human immunodeficiency virus education kit for adolescents (prem-kit): development, validation and evaluation in Malaysia

The growing Human immunodeficiency virus (HIV) incidences and insufficient HIV knowledge among Malaysian late adolescents necessitate immediate attention to HIV prevention via education. This study aims to develop, validate and evaluate an Information-motivation-behavioural skills (IMB)-based education kit for adolescents (PREM-Kit), in improving knowledge, attitudes, and practices (KAP) related to HIV prevention among Malaysian late adolescents. Utilising a methodological framework derived from the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model, Phase I of the study was conducted in three steps: (i) a needs assessment; (ii) the development of PREM-Kit; and (iii) the validation of PREM-Kit by applying the IMB model to map the PREM-Kit’s contents. A literature search combined with a series of experts’ discussions was conducted to formulate the content of PREMKit, followed by expert validation using content validity index (CVI), and end-users’ validation using the Malay version of the Patient Education Materials Assessment Tool for Printable and Audio-visual Materials. In Phase II, a 16-week quasi-experimental study was conducted in two campuses of a local public university, involving a total of 187 participants. The intervention group received the PREM-Kit’s intervention in addition to the curriculum-mandated basic science and biology module, whereas the control group only continued the same curriculum. Repeated measure analysis of variance (RMANOVA) and covariance (RMANCOVA) were used to examine the effectiveness of PREM-Kit’s intervention on knowledge, attitudes, and practices (KAP) related to HIV prevention between groups at four different time points. PREM-Kit contained 18 topics in Malay language and was designed in the form of an infographic flip chart and three animated videos. It had excellent CVI scores (1.0) and scored more than 80% for its understandability and actionability. There was a significant increase from t0 to t1 in knowledge score (mean difference = -4.49; 95% CI = -5.28, -3.71; p<0.001), attitude score (mean difference = -5.93; 95% CI = -6.89, -4.98; p<0.001), and practice score (mean difference = -0.23; 95% CI = -0.46, -0.01; p=0.031). The increase in the knowledge score (mean difference = 2.66; 95% CI = 2.22, 3.10; p<0.001) and attitude score (mean difference = 2.74; 95% CI = 1.90, 3.59; p<0.001) of the intervention group was significantly sustained across the 16-week study duration. In conclusion, the newly developed PREM-Kit has good content validity and is simple to comprehend and apply. It was effective in improving the knowledge and attitudes related to HIV prevention among the adolescents and had a sustainable effect on the knowledge and attitudes related to HIV prevention for up to 16 weeks. The PREM-Kit is suggestively useful kit to educate and empower late adolescents regarding HIV prevention.