GEAS to Launch JAH Special Supplement

Join the Global Early Adolescent Study on September 20, 2017 at the National Press Building for a special celebration of the publication of a special supplement of the Journal of Adolescent Health on this date.

We are excited to be joined by authors Kristin Mmari, Deb Tolman, Xiauyun Zuo, and Bamidele Bello, who will describe their methods, analyses, and findings. 

Stay tuned for registration details.

Questions? Study Coordinator Lydia Animosa.

Dissemination Meeting in Cairo

Last week the Global Early Adolescent Study team in Assiut, Egypt held a dissemination meeting to coincide with the International Association of Adolescent Health (IAAH) Middle East & North Africa regional conference in Cairo. 

(L-R) Study PI Dr. Blum, Assiut site-PI Dr. El-Gibaly, Assiut field coordinator Dr. Darwish, and WHO partner Dr. Chandra-Mouli at the GEAS dissemination meeting in Cairo, Egypt, May 11, 2017.

(L-R) Study PI Dr. Blum, Assiut site-PI Dr. El-Gibaly, Assiut field coordinator Dr. Darwish, and WHO partner Dr. Chandra-Mouli at the GEAS dissemination meeting in Cairo, Egypt, May 11, 2017.

Study PI Dr. Robert Blum opened the meeting with a history of the Study and an overview of the primary activities of Phase 1. Dr. V. Chandra-Mouli of the WHO Department of Reproductive Health and Research situated the Study in the wider adolescent reproductive health context and touched on its programmatic implications.

Dr. Blum presenting multi-cultural illustrations designed by youth used in the survey instrument. Photo courtesy of @smostaja.

Dr. Blum presenting multi-cultural illustrations designed by youth used in the survey instrument. Photo courtesy of @smostaja.

Joined by stakeholders and representatives of WHO regional office, UNICEF country office, International Development Research Centre (Canada), USAID, Population Council International, Ford Foundation, Save the Children, PLAN international, the Swedish Embassy, the UNFPA country deputy, Drosos Foundation (Egypt), Zanaty Co. (Egypt), and Tadwein (Egypt), Dr. Omaima El-Gibaly, site-PI, and Drs. Ghada Al-Attar and Manal Darwish, field coordinators, described the findings from their work in Assiut and led a discussion session.

Field coordinator Dr. Al-Attar presenting findings from a gender analysis of narrative interviews conducted in Assiut and Ghent, Belgium, manuscript forthcoming in a special supplement of the Journal of Adolescent Health.

Field coordinator Dr. Al-Attar presenting findings from a gender analysis of narrative interviews conducted in Assiut and Ghent, Belgium, manuscript forthcoming in a special supplement of the Journal of Adolescent Health.



(L-R) Dr. Chandra-Mouli, Dr. El-Gibaly, and Dr. Blum each enjoying a tea break in their own way.

(L-R) Dr. Chandra-Mouli, Dr. El-Gibaly, and Dr. Blum each enjoying a tea break in their own way.

Special thanks to Salina Mostajabian for live tweeting the event, and to everyone who attended for your attention and dedication to the health and well-being of young adolescents in Egypt, MENA, and beyond.

GEAS Breakfast @ Women Deliver 2016

Will you be in Copenhagen for the 2016 Women Deliver conference May 16-19? If so, please join us for an interactive workshop and breakfast on Thursday, May 19 from 6:30 AM - 8 AM at conference room B4, Bella Center. Brief description here. RSVP appreciated but not necessary. For details or questions, please email Lydia.


GEAS Breakfast at ICFP Rescheduled

The GEAS informational panel discussion over breakfast to be held at the International Conference on Family Planning will now be held on Tuesday, January 26, 2016 from 7:00 - 8:15 AM with breakfast beginning at 6:45 AM, at the Westin Hotel in Nusa Dua, Bali. This event is free and open to people interested in adolescent sexual and reproductive health, particularly those working with NGOs.

Discussion will cover the preliminary findings of the GEAS from a methodological perspective, incorporating voices from multiple study sites and partners.

The period for online registration has passed, but if you are interested in attending, please email Anna at

Note: the breakfast will be held in the Medan Room.

Inviting The Voices of Young Adolescents

As the GEAS nears the end of phase 1 (piloting of the toolkit is underway), we have been brainstorming ways to effectively communicate the need for investment in young adolescents worldwide. 

While Bob and Anna were "stuck" in Bali last month for the youth pre-conference to the International Conference on Family Planning (which had been postponed due to a volcano eruption), they, perhaps inspired by the (surprisingly) clear skies and warm breeze, conceptualized a video contest for help youth make their voices heard, and to tell supporters, in their own words, why the GEAS is significant.

After discussing and refining the idea with our partners, we are excited to launch a competition to capture the voices of young adolescents on the issues of transitions into adolescence and their stories and experiences of becoming an adolescent. While we have quotes and stories from the narratives of 900 young people around the world that we have collected, we feel that nothing could better capture our work than to hear directly from young people. A few important things to know:

  • This is not research
  • Contestants do not need to be part of the study
  • Winners will receive $50 and an opportunity to be part of a GEAS Youth Advisory Committee

If you work with an organization that serves youth, please help us get the word out. If you can help resource-limited youth produce their video submission, all the better! Click here to see the submission rules and guidelines.

If you work with adolescents internationally, we welcome you to apply to serve as a judge. If you are interested in volunteering in this capacity, please email Rebkha Atnafou at

For more information or to submit a video, visit the page dedicated to the competition.

The latest GEAS newsletter is available

Thanks to all who contributed to volume 2, issue 2 of The GEAS News

In this issue:

  • Understanding Our Youth, Building Our Capacity
  • Visiting a Family in Cape Town
  • Toolkit Development: Update
  • Fruits of Our Labor: A Conversation
  • Adrenaline Rush at 1st Local Advisory Committee Meeting, Assiut
  • Tapping Hidden Gender Biases through Cross-Cultural Vignettes
  • Uncovering Contradictions in Cuenca
  • A Mobile Platform: Learning from PMA2020
  • On the Horizon

GEAS to Host Breakfast Discussion at the 2015 International Conference on Family Planning

***As you may be aware, a volcano caused the postponement of the ICFP in November. It has been rescheduled for January 25-28, 2016. The GEAS breakfast will be rescheduled as well. More information to follow!***

The Global Early Adolescent Study and the World Health Organization will host a discussion on Tuesday, November 10th from 7:00-8:15 AM with breakfast being served starting at 6:45 AM. To join, please register by November 3rd, and kindly share the word with friends and colleagues who may be interested in attending.

The event is free and will cater to individuals and NGOs interested in promoting early adolescent sexual and reproductive health. Discussion will cover the preliminary findings of the GEAS from a methodological perspective, incorporating voices from multiple study sites and partners.

GEAS Descends on Geneva

Last month, advisory committee members and investigators from each of the fifteen GEAS sites met at the World Health Organization in Geneva, Switzerland for a week of information sharing, discussion, training, and decision making.

The blue sky over Geneva must have been very concerned about our comfort, for it made sure that temperatures were in the triple digits (Fahrenheit) throughout our stay. Our gracious hosts at the WHO took care that we didn’t get too comfortable, treating the team to some of the grounds’ most lovely and delightful accommodations.

During one exercise, we listened to quotes from narrative interviews from China to Belgium and many countries in between, then broke into groups to discuss what we found most surprising, what commonalities we saw among sites, what differences, and how these understandings might move the GEAS closer to addressing its primary research questions.

I immersed myself in GEAS that week, taking detailed notes and speaking with advisers and investigators whenever possible. As a new member of the GEAS team at Hopkins, the meeting was the perfect opportunity to meet each of the collaborators face to face and to get to know not only their needs as investigators, but their interests and stories as well. I am very grateful that I had the opportunity to spend a little time with the passionate and dedicated people who are the GEAS.

Contributed by Lydia Animosa, Research Program Coordinator

Research Alert: "Adolescent first births in East Africa: disaggregating characteristics, trends and determinants"



The use of a single national figure fails to capture the complex patterns and inequalities in early childbearing that occur within countries, as well as the differing contexts in which these pregnancies occur. Further disaggregated data that examine patterns and trends for different groups are needed to enable programmes to be focused on those most at risk. This paper describes a comprehensive analysis of adolescent first births using disaggregated data from Demographic and Household surveys (DHS) for three East African countries: Uganda, Kenya and Tanzania.


The study initially produces cross-sectional descriptive data on adolescent motherhood by age (under 16, 16–17 and 18–19 years), marital status, wealth, education, state or region, urban/rural residence and religion. Trends for two or more surveys over a period of 18–23 years are then analysed, and again disaggregated by age, wealth, urban/rural residence and marital status to ascertain which groups within the population have benefited most from reductions in adolescent first birth. In order to adjust for confounding factors we also use multinomial logistic regression to analyse the social and economic determinants of adolescent first birth, with outcomes again divided by age.


In all three countries, a significant proportion of women gave birth before age 16 (7%-12%). Both the bivariate analysis and logistic regression show that adolescent motherhood is strongly associated with poverty and lack of education/literacy, and this relationship is strongest among births within the youngest age group (<16 years). There are also marked differences by region, religion and urban/rural residence. Trends over time show there has been limited progress in reducing adolescent first births overall, with no reductions among the poorest.


Adolescent first births, particularly at the youngest ages, are most common among the poorest and least educated, and progress in reducing rates within this group has not been made over the last few decades. Disaggregating data allows such patterns to be understood, and enables efforts to be better directed where needed.

Click here to read the full report.

Because I Am A Girl Campaign Report: "Hear our Voices: Do Adolescent Girls Issues Really Matter"

The purpose of the study was to help girls, communities and Plan to understand the key issues that adolescent girls face today – in their own words. The study had three objectives:

I. To empower adolescent girls and boys;

II. To help Plan’s field staff learn more from adolescent girls and boys about the issues and improvements needed to directly benefit these youth; and

III. To report data and analysis about adolescent girls’ and boys’ perceptions of their own empowerment and gender equality at school in order to provide senior decision makers with credible information to impact change.

The research process aimed to combine social action with social research, by placing explicit value on girls’ and boys’ views. It focused on girls and boys themselves as valuable social actors whose opinions and aspirations matter. In so doing, the methodology builds on emerging good practice from across the development sector.

In order to achieve the three study objectives, the methodology used structured participatory methods to generate a mixture of quantitative and qualitative data. The quantitative data allowed participants’ perceptions to be easily summarised and compared (within strict limits). The qualitative data, generated through participatory focus group discussions on findings from the quantitative tools, provided detailed insight into how participants viewed the issues on a personal level and the underlying factors beneath their perceptions to contextualise the findings from the quantitative study.

The research process yielded substantive results across all three objectives, notwithstanding inherent challenges. Notably, the research process created safe spaces for adolescent girls and boys to share their views on girls’ empowerment and gender equality at school. The study demonstrated that actively listening to girls and boys opened up critical opportunities for them to take more charge of their own development. The study generated findings that can be analysed at local, national and international levels, and can inform strategic decision-making by development agencies, including Plan. There is great potential to influence programme practice: the findings show great promise to empower field managers to respond with greater focus to the most pressing issues of adolescent girls localised at community level.

The study participants were girls and boys between the ages of 12 and 16 from the 11 countries who lived in identified communities and had some level of participation in Plan’s on-going activities. Due to this purposive approach to sampling, different findings might be generated if the study was repeated with adolescent girls and boys who live in more remote rural areas than those targeted in the study, or do not attend school, or do not participate in Plan’s development projects. The findings of this study cannot be taken as representative of any wider population.

11 Plan Country Offices involved in the study: Bangladesh, Benin, Cameroon, Ecuador, Egypt, Liberia, Nicaragua, Pakistan, Paraguay, Uganda, and Zimbabwe. Thank you to the 21 Plan Programme Units that participated in the study, along with the 60 communities and 95 schools involved.

Click here to read the full report.

Click here for report summary.

Click here to view the Practitioner's Toolkit.



Research Alert: "Internalized Sexualization and its relation to Sexualized Appearance, Body Surveillance, and Body Shame among Early Adolescent Girls"


Sexually objectifying messages about girls and women are common in U.S. popular culture. As a consequence of exposure to such messages, girls may develop “internalized sexualization,” or internalization of the belief that sexual attractiveness to males is an important aspect of their identity. We hypothesized that internalized sexualization is associated with behavioral and psychological consequences, including sexualized clothing use, body surveillance, and body shame. In two studies of early adolescent girls (total N= 330, age range = 10-15), we found that girls with higher levels of internalized sexualization wear more sexualized clothing (Study 1) and show higher levels of body surveillance and body shame (Study 2) than girls with lower levels of internalized sexualization.

Click here to read the full article.

Research Alert: "Seeds of Prevention: The impact on health behaviors of young adolescent girls in Uttar Predesh, India, a cluster randomized control trail"


Of the world's 1.2 billion adolescents (10-19 years), India is home to the largest number globally, about 243 million. However not much is known about the health of young adolescent girls (11-14 years) in India who enter puberty with substantial nutritional and health deficits. Identifying early adolescence as a “gateway” moment, the Saloni pilot study is a randomized control trial (RCT) to improve nutrition, hygiene and reproductive health behaviors in 30 schools in rural Uttar Pradesh (UP), India. A prevention model that includes Sadharanikaran, an ancient Indian theory of communication, guided the development of the intervention. The Saloni strategy includes a 10 session in-school intervention based on compassion, self efficacy, emotional wellbeing, peer, and parental support,packaged in the form of short, easy-to-use instructional modules. A diary designed to engage adolescent girls is provided to each girl. The cluster RCT was conducted from January 2010 to October 2011 with adolescent girls (11e14 years of age) in Hardoi district. The trial is a two-level, nested RCT with the unit of randomization being the block with 15 schools in the intervention arm and 15 schools in the control arm. A sample of 1200 girls was randomly selected. The intervention had a significant impact on more than 13 preventive health behaviors. About 65 percent girls in the intervention group had adopted 13 or more health behaviors at end line compared 4.5 percent in the control group at end line and 5 percent at baseline. Behavioral impact was demonstrated in all three areas of nutrition, hygiene and reproductive health. The study provides evidence that early adolescence is indeed a “gateway moment” to build nutritional and health reserves.

Click here to read the full article.

Research Alert: "Protective Effects of Middle School Comprehensive Sex Education with Family Involvement"


BACKGROUND: School-based comprehensive sex education programs can reduce early adolescents’ risky sexual behavior. The purpose of this study was to assess the effectiveness of a 3-year comprehensive sex education program in delaying vaginal sex for middle school students and whether the family component of the intervention contributes to its effectiveness.

METHODS: This longitudinal evaluation followed a cohort of 6th graders (N=2453) through the end of 8th grade. The design used random assignment of 24 schools into treatment and comparison conditions. The analysis included multiple-group logistic regression to assess differences in delay of sex between intervention and comparison groups.

RESULTS: In schools where the program was taught, 16% fewer boys and 15% fewer girls had had sex by the end of 8th grade compared to boys and girls at comparison schools. Completing family activities during the first year of the program predicted delayed sexual debut for boys.

CONCLUSIONS: Theory-based, developmentally appropriate, comprehensive sex education programs that include parent involvement can be effective in delaying vaginal sex for middle school students. Parent involvement is particularly important for boys, as family activities may encourage parents to talk with their sons earlier and more frequently.

Click here to read the full article.


Four countries join the study

Four additional countries have joined the Global Early Adolescent Study bridging Latin America, Francophone Africa and Southeast Asia.

Vietnam Joins GEAS Phase #1: Through support from the Vietnam office of UNFPA, Hanoi, Vietnam is officially part of the GEAS. The UNFPA gender program coordinator, Hien Phan, said “the issues that are the focus of the Global Early Adolescent Study are of critical importance for Vietnam.” Vu Manh Loi PhD and the Institute for Sociology will serve as the site PI and study base. Professor Vu received his PhD in sociology from the University of Washington and has an illustrious reputation leading many studies of youth in Vietnam including both SAVY 1 and 2— the Survey Assessment of Vietnamese Youth undertaken in 2004 and again in 2009. 

Burkina Faso and the Democratic Republic of the Congo join GEAS: With support anticipated from the Gates Foundation, two Francophone countries of sub-Saharan Africa will join Malawi, Kenya, Nigeria, and South Africa. Their engagement will begin in early 2015. The Burkina Faso team will be headed by Georges Guiella of the Institut Supérieur des Sciences de la Population (ISSP) of the University of Ouagadougou. Discussions are currently underway with colleagues in Kinshasa to identify the lead researcher in the DRC.

Bolivia to join GEAS: Through support from Save the Children and UNFPA, Bolivia will join the GEAS in 2015. Bolivia will be the first Latin American site for the GEAS; and the study site will be in Cochabamba. Dr. Edgar Valdez will serve as the site lead. Dr. Valdez is the director of the Instituto para el Desarrollo Humano

Stories from the Field: Ghent

After being part of an international and national training in qualitative fieldwork, after translating and back translating informed consents and interview protocols, searching for interviewers and calling people to convince to participate in the international research project on gender socialization, the rush stopped. Suddenly I found myself in front of you.  All the things I heard, I read, I said, they all came together to that one moment when we looked in each other’s eyes.

I was there–where I had to be–and you were there because you wanted to. Maybe you were curious about the questions I would ask? Or maybe your mother convinced you that it was important to participate? Most important: you said yes. And I imagine I was as excited as you were to be there together and to start this new adventure. I wondered… Would I be able to capture the thoughts you were willing to share with me?

Then you started talking…. My first interview–the first 5 minutes of many more–and you start to cry! “My dad died, and I still miss him terribly. I planned not to talk about him but I suppose you ought to know”And although you cried, I did not only feel your pain, I also felt a fire within. I felt grateful because you shared this and I got convinced to go searching for more true stories which I would handle with uttermost respect.

The loss of your dad and how you loved him, the friends you thought you had and have, the boy who is in love with you but whom you 'hate.' I see you peeping through the window of a small house on the play garden because you want to be sure if the boy you like is really kissing another girl. I smell the lasagna your sister allowed you to make for the first time in your life, and I see you leaving the store–head up high–because you bought your first clothes in an ‘adult store.’ I feel that you are a bit ashamed when somebody at school compliments your beautiful looks and hear you laughing in the park when you are discussing boys with your friends. You are honest, shy and secure. You are brave, talking to me, a researcher you don’t know and who asks all these curious questions. I feel thankful to hear all of this, to be part of these stories, your story. I am curious to hear more, eager to understand you and her and him. You are full of wonders, you amaze me! It is very interesting to hear how you perceive influence from others and how you really want to fit in. But what I love even more is how you are you: painting your nails when no girls are watching or explaining how you–if you would be a boy–at times would like to misbehave or pee against a tree, or how you say you are happy just the way you are.

Contributed by Sara de Meyer, Field Coordinator in Ghent, Belgium