This README.txt file was generated on 20230824 by Corissa T. Rohloff (edited by curator 20230906) Recommended citation for the data: Rosser, B. R. Simon; Mkoka, Dickson A.; Leshabari, Sebalda; Kohli, Nidhi; Lukumay, Gift G.; Rohloff, Corissa T.; Trent, Maria; Mgopa, Lucy R.; Mkonyi, Ever; Ross, Michael W.; Mushy, Stella E.; Mohammed, Inari; Massae, Agnes F.; Zhang, Ziwei; Mwakawanga, Dorkasi L.. (2023). Training Health Professionals in Tanzania: Effects of an Afrocentric Sexual Health Education Curriculum for Medical, Nursing and Midwifery Students (Randomized Controlled Trial Data). Retrieved from the Data Repository for the University of Minnesota, https://doi.org/10.13020/S565-YX03. ------------------- GENERAL INFORMATION ------------------- 1. Title of Dataset: Training Health Professionals in Tanzania: Effects of an Afrocentric Sexual Health Education Curriculum for Medical, Nursing and Midwifery Students (Randomized Controlled Trial Data) 2. Author Information Principal Investigator Contact Information Name: B.R. Simon Rosser Institution: University of Minnesota – Twin Cities Address: 1300 S 2nd St, Minneapolis, MN 55454 USA Email: rosser@umn.edu ORCID: 0000-0001-8862-531X Principal Investigator Contact Information Name: Dickson Ally Mkoka Institution: Muhimbili University of Health and Allied Sciences Address: United Nations Rd, Dar es Salaam, Tanzania Email: mkokamalinga@yahoo.co.uk ORCID: 0000-0002-1159-0953 Principal Investigator Contact Information Name: Sebalda Leshabari (deceased) Institution: Muhimbili University of Health and Allied Sciences Address: United Nations Rd, Dar es Salaam, Tanzania Email: NA ORCID: 0000-0002-0571-1405 Associate or Co-investigator Contact Information Name: Nidhi Kohli Institution: University of Minnesota – Twin Cities Address: 56 E River Pkwy, Minneapolis, MN 55455 USA Email: nkohli@umn.edu ORCID: 0000-0003-4690-2854 Associate or Co-investigator Contact Information Name: Gift Gadiel Lukumay Institution: Muhimbili University of Health and Allied Sciences Address: United Nations Rd, Dar es Salaam, Tanzania Email: giftgadiel@yahoo.com ORCID: 0000-0003-0428-0161 Associate or Co-investigator Contact Information Name: Corissa T. Rohloff Institution: University of Minnesota – Twin Cities Address: 56 E River Pkwy, Minneapolis, MN 55455 USA Email: wurth005@umn.edu ORCID: 0000-0003-3228-4653 Associate or Co-investigator Contact Information Name: Maria Trent Institution: Johns Hopkins University Address: 200 N. Wolfe Street Baltimore, Maryland, 21287 USA Email: mtrent2@jhmi.edu ORCID: 0000-0002-4973-5417 Associate or Co-investigator Contact Information Name: Lucy R. Mgopa Institution: Muhimbili University of Health and Allied Sciences Address: United Nations Rd, Dar es Salaam, Tanzania Email: lucymgopa@gmail.com ORCID: 0000-0001-7527-8195 Associate or Co-investigator Contact Information Name: Ever Mkonyi Institution: University of Minnesota – Twin Cities Address: 1300 S 2nd St, Minneapolis, MN 55454 USA Email: emkonyi@umn.edu ORCID: 0000-0001-8189-1295 Associate or Co-investigator Contact Information Name: Michael W. Ross Institution: University of Minnesota – Twin Cities Address: 1300 S 2nd St, Minneapolis, MN 55454 USA Email: mwross@umn.edu ORCID: 0000-0002-5718-9989 Associate or Co-investigator Contact Information Name: Stella Emmanuel Mushy Institution: Muhimbili University of Health and Allied Sciences Address: United Nations Rd, Dar es Salaam, Tanzania Email: pendostellam@gmail.com ORCID: 0000-0002-4867-2709 Associate or Co-investigator Contact Information Name: Inari Mohammed Institution: University of Minnesota – Twin Cities Address: 1300 S 2nd St, Minneapolis, MN 55454 USA Email: moham629@umn.edu ORCID: 0000-0002-5618-318X Associate or Co-investigator Contact Information Name: Agnes F. Massae Institution: Muhimbili University of Health and Allied Sciences Address: United Nations Rd, Dar es Salaam, Tanzania Email: agysawe@yahoo.com ORCID: 0000-0001-5375-3741 Associate or Co-investigator Contact Information Name: Ziwei Zhang Institution: University of Minnesota – Twin Cities Address: 56 E River Pkwy, Minneapolis, MN 55455 USA Email: zhan7511@umn.edu ORCID: 0000-0003-4247-3212 Associate or Co-investigator Contact Information Name: Dorkasi L. Mwakawanga Institution: Muhimbili University of Health and Allied Sciences Address: United Nations Rd, Dar es Salaam, Tanzania Email: dorkasmwakawanga@gmail.com ORCID: 0000-0003-0975-4493 3. Date published or finalized for release: 2023-08-31 4. Date of data collection (single date, range, approximate date): 20210501 – 20220902 5. Geographic location of data collection (where was data collected?): Dar es Salaam, Tanzania 6. Information about funding sources that supported the collection of the data: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH, Grant number: 1 R01 HD092655) 7. Overview of the data (abstract): "Training for Health Professionals” was a randomized, controlled, single-blind, trial conducted at Muhimbili University of Health and Allied Sciences (MUHAS) in Dar es Salaam, Tanzania. As part of the study, 412 medical, nursing and midwifery students were stratified by discipline, completed baseline assessments, then randomized to attend a 4-day sexual health workshop (intervention, n=206) or to a waitlist control (n=206). The workshop curriculum covered sexual health across the lifespan, male and female sexual dysfunctions, key populations (LGBT), sexual violence, clinical skills building, ethics, policy writing, and cultural considerations. Primary outcomes were sexual health knowledge, attitudes, and clinical skills. The primary outcomes of sexual health knowledge and attitudes were assessed at baseline, post-intervention (intervention group only), and 3-month follow-up via a quantitative survey. This survey also included demographic information, education background, and evaluation of the sexual health workshop. The primary outcome of clinical skills was assessed at baseline and 3-month follow-up via videotaped standardized patient (SP) interviews. Each of the videos (2 at baseline, 2 at follow-up) was independently rated by an expert (a faculty member) and the patient (the SP actor). After each interview participants completed a survey reflecting on their performance as a student clinician. At the end of the follow-up videos, participants completed a survey evaluating the standardized patient experience (SPE). In sum, this record includes an Excel file with the data codebook (also provided as six separate CSV files for accessibility) and five CSV data files covering the above outcomes. The responses were de-identified as described below in the README file. -------------------------- SHARING/ACCESS INFORMATION -------------------------- 1. Licenses/restrictions placed on the data: Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0). https://creativecommons.org/licenses/by-nc-sa/4.0/ 2. Links to publications that cite or use the data: CONFERENCES/PRESENTATIONS Lukumay, G.G., Maticka-Tyndale, E., Mgopa, L.R., Rosser, B.R.S. Mkoka, D.A. (2022). Researching sexual health in Africa: Cultural, ethical and legal considerations. Symposium of the International Academy of Sex Research Annual Meeting, Reykjavik, Iceland, July 6-9. Mkoka, D.A. (2022). Researching sexual health in Africa: Cultural, ethical and legal considerations. Symposium of the International Academy of Sex Research Annual Meeting, Reykjavik, Iceland, July 6-9. Rosser BRS, Mkoka DA, Trent M, et al. The effects of an Afrocentric sexual health curriculum on medical, nursing and midwifery students' knowledge, attitudes and clinical skills: Early results from the "Training for Health Professionals" randomized controlled trial in Dar es Salaam, Tanzania July 6-9. International Academy of Sex Research Annual Meeting; 2022; Reykjavik, Iceland. Rosser BRS, Mkoka DA, Trent M, et al. (2023). The effects of an Afrocentric sexual health curriculum on medical, nursing and midwifery students' knowledge, attitudes and clinical skills: Early results from the "Training for Health Professionals" randomized controlled trial in Dar es Salaam, Tanzania. U of MN Epidemiology & Community Health Departmnetal Seminar; April 14, 2023, Minneapolis MN (and virtual). Trent, M., Mkonyi, E., Rohloff, C.T., Lukumay, G.G., Ross, M.W., Kohli, N. Mgopa, L.R., Massae, A.F., Mohammend, I., Mushy, S.E., Mwakawanga, D.L., Mkoka, D.A., Rosser, B.R.S. (2023) Simulations with Standardized Patients Improve Sexual Health-Related Interpersonal Communication Health Medical History Taking for Health Professional Students: Results from the Tanzanian Health Professionals Trial. STI/HIV World Conference, Chicago, July 24-27. Rosser, B.R.S., Mkoka, D.A., Trent, M., Mgopa, L.R., Kohli, N., Lukumay, G.G., Rohloff, C., Mkonyi, E., Ross, M.W., Mushy, S.E., Mohammed, I., MPH,1 Massawe, A. F., Mwakawanga, D.L. Effects of an Afrocentric sexual health education curriculum for medical, nursing and midwifery students in Tanzania: A single blinded randomized controlled phase 3 trial. AIDS Impact Conference, Stockholm, Sweden, June 12-15. Rosser, B.R.S., Mkoka, D.A., Trent, M., Mgopa, L.R., Kohli, N., Lukumay, G.G., Rohloff, C., Mkonyi, E., Ross, M.W., Mushy, S.E., Mohammed, I., MPH,1 Massawe, A. F., Mwakawanga, D.L. Trent, M. (2023). Effects of training medical, nursing, and midwifery students in a comprehensive sexual health curriculum tailored for Africa: Results of the “Training for Health Professionals” Randomized, Controlled, Single-Blind Trial. World Association for Sexual Health SUBMITTED MANUSCRIPTS Massae, A., Mgopa, L., Bonilla, Z.E., Mohammed, I., Mushy S.E., Gadiel, G., Rosser, B.R.S., Mkonyi, E., Mwakawanga, D., Ross, M.W., Leshabari, S., Wadley, J., Trent, M. (In Review, 2023). Sexual health problems in Tanzania: Perceived barriers among midwifery, nursing and medical students and providers in the Training for Health Professionals study. Culture, Health and Sexuality. Rosser, B.R.S., PhD,1 Mkoka, D.A., Trent, M., Mgopa, L.R., Kohli, N., Lukumay, G.G., Rohloff, C., Mkonyi, E., Ross, M.W., Mushy, S.E., Mohammed, I., MPH,1 Massawe, A. F., Mwakawanga, D.L. (In Review, 2023). Effects of an Afrocentric sexual health education curriculum for medical, nursing and midwifery students in Tanzania: A single blinded randomized controlled phase 3 trial. British Medical Journal (BMJ) Open. Mwakawanga, D.L, Massae, A.F., Lukumay, G.G., Mushy, S.E., Mkoka, D.A., Kohli, N., Mgopa, L.R., Rohloff, C.T., Mkonyi, E., Trent, M., Ross, M.W., Rosser, B.R.S., Connor, J. (In Review, 2023). The need for, acceptability and feasibility of a curriculum to train nursing and medical students in the sexual health care of patients with female genital mutilation/circumcision in Tanzania: A Mixed-methods study. Biomedical Central (BMC) Women's Health. Mushy, S.E., Mkoka, D.A., Lukumay, G.G., Massae, A.F., Mark, K., Rohloff, C.T., Mgopa, L.R., Mwakawanga, D.L., Kohli, N., Ross, M.W., Trent, M., Athuman, K., Rosser, B.R.S. (In Review, 2023). The need for, acceptability of a cancer curriculum training for nursing and medical doctor students in Tanzania: Results from the Training for Health Professionals needs assessment. Journal of Cancer Education. Mushy, S.E., Lukumay, G.G., Massae, A.F., Mkoka, D.A., Rohloff, C., Mgopa, L.R., Mwakawanga, D.L., Mkonyi, E., Kohli, N., Rosds, M.W., Trent, M., Rosser, B.R.S. (In Review, 2023). Knowledge of mandatory reporting laws and recording of patients’ confidential information on child sexual abuse: Effects of a sexual health training for health students in Tanzania. Child Abuse & Neglect. Mgopa, L.R., Ross M.W., Massae, A., Trent, M. Lukumay, G.G., Mushy, S., Mwakawanga, D., Rohloff, C.T., Mkoka,D. A., Kohli, N., Mkonyi, E. Rosser, B.R.S. (In Review, 2023). Health students’ awareness, comfort and perception when treating sexual and gender minority patients: A mixed methods study from Tanzania. International Medical Education. 3. Was data derived from another source? No If yes, list source(s): N/A 4. Terms of Use: Data Repository for the U of Minnesota (DRUM) By using these files, users agree to the Terms of Use. https://conservancy.umn.edu/pages/drum/policies/#terms-of-use --------------------- DATA & FILE OVERVIEW --------------------- 1. File List A. Filename: Quantitative_Survey_Data.csv Short description: Data from the quantitative surveys administered at baseline, post-test (intervention group only), and follow-up. Includes demographic information, education background, sexual health knowledge outcomes, sexual health attitude outcomes, and evaluation of the sexual health workshop. B. Filename: SPE_Surveys_ESPE_Items.csv Short description: Data from the SPE surveys given at baseline and follow-up. This specific file contains data from the Evaluation of the Standardized Patient Experience (ESPE) items where participants reflected on the SP study activity (at follow-up only). C. Filename: SPE_Surveys_Faculty_Ratings.csv Short description: Data from the SPE surveys given at baseline and follow-up to all participants. This specific file contains ratings from the faculty members for each participant SPE video (at baseline and follow-up). D. Filename: SPE_Surveys_SC_Items.csv Short description: Data from the SPE surveys given at baseline and follow-up to all participants. This specific file contains data from the Student Clinician (SC) items where participants reflected on each SP video that they completed (at baseline and follow-up). E. Filename: SPE_Surveys_SP_Ratings.csv Short description: Data from the SPE surveys given at baseline and follow-up to all participants. This specific file contains ratings from the SPs for each participant SPE video (at baseline and follow-up). F. Filename: Data_Codebook.xlsx Short description: Excel document with a worksheet for each dataset included in this record. Lists all variables included in each dataset, a description of the variable, and the value labels. Also includes notes about administration of the surveys corresponding to each dataset and how the content relates across the datasets/variables. Curator note: Worksheets contained in Data_Codebook.xlsx were separated, zipped, and saved as .csv for preservation and interoperability. G. Filename: Data_Codebook_Section_Key.csv Short description: Corresponds to the “Section Key” worksheet from Data_Codebook.xlsx. Includes notes about administration of the surveys corresponding to each dataset and how the content relates across the datasets/variables. H. Filename: Data_Codebook_Quantitative_Survey_Data.csv Short description: Corresponds to the “Quantitative_Survey_Data” worksheet from Data_Codebook.xlsx. Lists all variables included in the Quantitative Survey data, a description of the variables, and the value labels. I. Filename: Data_Codebook_SPE_Surveys_ESPE_Items.csv Short description: Corresponds to the “SPE_Surveys_ESPE_Items” worksheet from Data_Codebook.xlsx. Lists all the ESPE items included in the SPE Survey data, a description of the variables, and the value labels. J. Filename: Data_Codebook_SPE_Surveys_Faculty_Ratings.csv Short description: Corresponds to the “SPE_Surveys_Faculty_Ratings” worksheet from Data_Codebook.xlsx. Lists all the faculty ratings items included in the SPE Survey data, a description of the variables, and the value labels. K. Filename: Data_Codebook_SPE_Surveys_SC_Items.csv Short description: Corresponds to the “SPE_Surveys_SC_Items” worksheet from Data_Codebook.xlsx. Lists all the SC items included in the SPE Survey data, a description of the variables, and the value labels. L. Filename: Data_Codebook_SPE_Surveys_SP_Ratings.csv Short description: Corresponds to the “SPE_Surveys_SP_Ratings” worksheet from Data_Codebook.xlsx. Lists all the SP ratings items included in the SPE Survey data, a description of the variables, and the value labels. 2. Relationship between files: Files A-F are data files. All data files can be merged using the “ID” column which designates the participant IDs. Files G-L are codebooks for the data files. -------------------------- METHODOLOGICAL INFORMATION -------------------------- 1. Description of methods used for collection/generation of data: Participants Eligibility criteria for this study were: (a) Current student at MUHAS in midwifery, nursing, or medicine; (b) in their 3rd or 4th year (for medical students) or 2nd or 3rd year (nursing and midwifery students) so they would have sustained patient contact in the three months following the seminar and be on campus for the follow-up; (c) able to attend the full 4-day training during the first week of student vacation; (d) fluent in English (the language of instruction at MUHAS) and Kiswahili (the lingua franca in Tanzania); and (e) willing to volunteer and complete all evaluation procedures. Quantitative Survey All participants were required to complete the online Qualtrics baseline survey on tablets at the study office. The survey took about 60 minutes to complete and covered demographic information, educational background, sexual health knowledge, and attitudes toward sexual health topics. Immediately after the training, intervention arm participants completed a Qualtrics post-test survey that covered the same sexual health knowledge and attitudes toward sexual health topic items and asked participants to evaluate the sexual health training workshop (90 minutes). Three to four months later, both intervention and control group participants completed an online follow-up survey that assessed their sexual health knowledge and attitudes toward sexual health topics (90 minutes). Note, the waitlist control group also had the opportunity to participate in and evaluate the sexual health workshop after the completion of the randomized control trial. All the survey data from baseline, post-test, and follow-up data collection were combined into one CSV file (Quantitative_Survey_Data; 597KB). Only the quantitative responses from the survey are included in this record. Standardized Patient Experience (SPE) Surveys After completing the baseline survey, participants completed two SP interviews. The interviews involved actors role-playing one of four sexual health-related patient scenarios developed by the team. Participants had 10 minutes per scenario to interview the patient and discuss a treatment plan. The four SP cases were: a) a woman who had been physically and sexually assaulted (Sexual Violence; SV), b) a heterosexually married man with situational erectile dysfunction and past homosexual experience (Erectile Dysfunction; ED), c) a 16-year-old girl who is worried she is pregnant from her older “sugar daddy” boyfriend (Adolescent Pregnancy; AP), and d) a young heterosexual man with penile discharge, groin pain, and a history of paying for sex (Penile Drip; PD). The participants were randomly assigned two of the four scenarios which they completed at baseline. Then they completed the remaining two scenarios at follow-up. > Faculty Ratings. In their videotaped SP scenarios, participants were rated on their interpersonal communication (IC) skills and their ability to uncover a patient’s medical history (MH). Each of the SP scenarios was rated by one MUHAS faculty member who was part of the research team. Ratings were collected via an online Qualtrics survey. > SP Ratings. Participants were also rated on their interpersonal communication (IC) skills and their ability to uncover a patient’s medical history (MH). by the SP actor that they interviewed. Ratings were collected via an online Qualtrics survey. > Student Clinician (SC) Items. After each video interview, participants completed an online Qualtrics survey reflecting on how they performed as a student clinician (SC). > Evaluation of the Standardized Patient Experience (ESPE) Items. At the end of follow-up data collection, participants completed an online Qualtrics survey evaluating the SPE. All the survey responses and ratings for the SPE were combined across baseline and follow-up data collection but separated into four separate CSV files: faculty ratings (178KB), SP ratings (171KB), SC items (70KB), and ESPE items (11KB). The quantitative responses and ratings from the SPE are included in this record. 2. Methods for processing the data: All online survey responses were saved automatically in the Qualtrics database upon participants' completion. Two research staff monitored the database and ensured that all survey data had been recorded and completed. Some data cleaning was done in Qualtrics (see quality-assurance procedures below) before exporting the Qualtrics data into CSV format. Once the data were exported from Qualtrics, all data cleaning and manipulation was done using R (R Core Team, v. 4.3.0). Note: To protect the identities of participants, sexual orientation and place of birth were removed from this public dataset. Age was collapsed into categories, and religion was regrouped into Christian, Muslim, Other. If you have a need for the original data, please contact the lead investigator listed in the digital record. 3. Instrument- or software-specific information needed to interpret the data: None 4. Standards and calibration information, if appropriate: N/A 5. Environmental/experimental conditions: The intervention was a 4-day, Afrocentric, comprehensive sexual health curriculum. The pilot curriculum was based on one developed by the senior author for the Pan American Health Organization/World Health Organization. To deeply embed it in the African context, we reviewed the sexual health literature and epidemiology from Africa and used local statistics (e.g., HIV and STIs in Tanzania) wherever available. In addition, we conducted focus groups with clinicians and students in Tanzania to identify local sexual health concerns and clinical practices; and interviewed community leaders to identify barriers, common myths, and misconceptions. Then, we rewrote the curriculum to focus on the most common sexual health challenges clinicians experience in Tanzania. To further tailor it, all materials and exercises were translated to make the curriculum fully bilingual (in English and Kiswahili) and all modules were written and delivered by Tanzanian faculty. We knew from our formative research that midwifery, nursing, and medical students stated they would prefer to learn together so we developed one curriculum deliverable across the three disciplines rather than separate curricula tailored to each discipline. The curriculum covered sexual health across the lifespan and male and female sexual dysfunctions (Day 1); key populations (LGBT, sex workers) and sexual violence (Day 2); clinical skills training, ethics, and policy writing (Day 3); and community resources and cultural considerations (Day 4). To maximize relevance for health students, Day 3 was framed as a clinical skills “boot camp” for them to practice sexual health history taking, counseling, ethical decision making and policy writing. 6. Describe any quality-assurance procedures performed on the data: Data collection was done in waves. As data were entered into Qualtrics a Tanzanian-based researcher communicated any corrections needed to be made to the data in Qualtrics to a US-based researcher. These corrections were based on feedback from participants (e.g., known typos, duplicate submissions). After the data were exported from Qualtrics, two different US-based researchers cleaned and manipulated the dataset. All R code was reviewed by both researchers before reaching the final version. 7. People involved with sample collection, processing, analysis and/or submission: All authors of this dataset (listed above) were involved with the creation of data collection materials, recruiting participants, data collection, processing, analysis, and/or submission of this data. ----------------------------------------------------------- DATA-SPECIFIC INFORMATION FOR: Quantitative_Survey_Data.csv ----------------------------------------------------------- 1. Number of variables: 636 2. Number of cases/rows: 412 3. Missing data codes: NA 1. Item was not administered or relevant (e.g., control group participants did not complete most post-test items -- see Data_Codebook.xlsx for more information) - or - 2. Participant did not attend that data collection (some participants were missing from post-test and/or follow-up data collection) 99 “Prefer not to answer” response 4. Variable List [See Data_Codebook.xlsx -> “Quantatiative_Survey_Data” worksheet] --------------------------------------------------------- DATA-SPECIFIC INFORMATION FOR: SPE_Surveys_ESPE_Items.csv --------------------------------------------------------- 1. Number of variables: 11 2. Number of cases/rows: 409 3. Missing data codes: None 4. Variable List [See Data_Codebook.xlsx -> “SPE_Surveys_ESPE_Items” worksheet] -------------------------------------------------------------- DATA-SPECIFIC INFORMATION FOR: SPE_Surveys_Faculty_Ratings.csv -------------------------------------------------------------- 1. Number of variables: 39 2. Number of cases/rows: 1683 3. Missing data codes: NA 1. Video was not completed (e.g., it was expected that all participants would complete all 4 SP cases, but some participants repeated cases at baseline and, thus, are missing 1-2 cases) - or - 2. Participant did not attend that data collection (some participants were missing from follow-up data collection) 4. Variable List [See Data_Codebook.xlsx -> “SPE_Surveys_Faculty_Ratings” worksheet] ------------------------------------------------------- DATA-SPECIFIC INFORMATION FOR: SPE_Surveys_SC_Items.csv ------------------------------------------------------- 1. Number of variables: 17 2. Number of cases/rows: 1683 3. Missing data codes: NA 1. Video was not completed (e.g., it was expected that all participants would complete all 4 SP cases, but some participants repeated cases at baseline and, thus, are missing 1-2 cases) - or - 2. Participant did not attend that data collection (some participants were missing from follow-up data collection) 4. Variable List [See Data_Codebook.xlsx -> “SPE_Surveys_SC_Items” worksheet] --------------------------------------------------------- DATA-SPECIFIC INFORMATION FOR: SPE_Surveys_SP_Ratings.csv --------------------------------------------------------- 1. Number of variables: 38 2. Number of cases/rows: 1683 3. Missing data codes: NA 1. Video was not completed (e.g., it was expected that all participants would complete all 4 SP cases, but some participants repeated cases at baseline and, thus, are missing 1-2 cases) - or - 2. Participant did not attend that data collection (some participants were missing from follow-up data collection) 4. Variable List [See Data_Codebook.xlsx -> “SPE_Surveys_SP_Ratings” worksheet]