I have a project to write on and the brief goes thus:
Write a proposal for your behaviour change intervention to tackle the chosen health problem. The proposal should entail: (70%, 2500 WORDS) 
• Abstract
• Introduction of the health behaviour problem
•Needs assessment; provide a logic model of the problem
•Specify program outcomes and objectives; provide a logic model of change
•Design the intervention; specify the behaviour change methods and practical 
applications used for the change objectives
•Description of the program production; detail potential testing phase
•Implementation strategy
• Evaluation plan
•Discussion / Implications of the intervention / Future research and limitations
•References

Introduction
• A clear rationale why you focus on a specific health behaviour/problem and the specific target  population
• Literature search (journals and authoritative websites) for high level information on:
• Health problem, behavioural factors in geographical location, implication for that location, constraints on interventions
• Link to theoretical frameworks and intervention mapping, including whether these tools have been used previously in that location

Step 1: Needs Assessment and Logic Model of Problem
• Convened a planning group
• Needs assessment linked to PRECEDE. Carried out through literature review – more detailed searches on health problem, its complications, findings in High Income Countries (more in literature), WHO emphasis and future projections, what is known about risk factors and interventions. 
• Described rationale at lower level and overall programme objectives
• Determinants: Searched literature to bring in a theoretical framework (Social Cognitive Theory, Health Belief Model, Theory of Reasoned Action  I-Change) and empirical evidence relevant to the selected topic and identify personal determinants linked to the dietary behavioural problem. 
• Knowledge, Attitudes, Perceived Barriers – matched to typical comments from the local population
• Supported creation of Logic Model of the Problem

Step 2: Program Outcomes and Objectives; Logic Model of Change
• Identified performance objectives as logical steps in the overall dietary behaviour change (but not too many!) 
• Identified change objectives: Linked performance objectives with personal determinants to form a matrix to support identification of change objectives for each performance objective-determinant pair (link to literature) 
• Example of Change Matrix – The Change Matrix is a tool to help!.

Step 3: Program Design
• Reviewed literature evidence for theory based general and determinant specific Behaviour Change Techniques (BCT) applicability to type of intervention and geographic location/culture
• For each determinant in each performance objective, identified potential BCT which might be apply for the associated change objective in that culture and supported by literature where possible
• E.g. Persuasive communication, active learning, using imagery, discussion, direct experience, cultural sensitivity, guided practice
• Acknowledged that there may be parameters which could impact the BCT effectiveness
• Identified culturally appropriate practical applications for the BCT chosen
• Group based health education sessions with flip charts, images, story telling, drama, discussion; Tasting sessions; Practical education sessions on growing fruit and vegetables

Step 4: Pre-Testing within Program Production
• Planned for members of the planning group to review the materials and activities and assess clarity and consistency with the programme requirements
• Planned for assessment during training of the community health workers and community/volunteers who will be delivering the intervention.  • Specific knowledge of the target population, through their involvement in the screening and the chronic care clinic, • Collected by interview • To assess relevance and suitability to that population, especially in terms of cultural issues and ability to understand. 
• Planned for materials to be refined if required, following intervention implementation in the first village.

Step 5: Implementation Strategy (Planning for Program Use) - simplified
• Adoption and Implementation only • Considered from start of project by inclusion of implementers (clinic health workers) on the programme planning team and government officials/academics as consultants • Linkage approach/proposed linkage group to be included in implementation planning
• Identification of stakeholder early adopters – EG: Diffusion of Innovation Theory
• Identification of barriers for stakeholders and techniques to address

Step 6: Evaluation Plan - simplified
• Described evaluation plan and how informed. • Process Evaluation: Described main purpose (assess completeness and fidelity), what was assessed (becomes variables), how assessed, instruments to assess and frequency
• Effect Evaluation: Described main components – determinant/change objective based versus behaviour, how assessed, instruments to assess (questionnaires and Likert scales), and cultural adaptions necessary
• Described limitations due to lack of control group

Discussion/Implications of the Intervention
• Was the intervention different/same as other similar interventions in the literature, and why
• Are there likely to be parameters or other special constraints which may put the success of the 
implementation at risk?
• Is the intervention consistent with existing policies?
• Is it providing evidence to support policy development or to support public health practice?
• Could it have wider dissemination?

Ensure to Cite anything that is not considered "general knowledge"










Go through the following write-up thoroughly and mention how i can improve it in light of the above brief

Course Module: Behaviour Change and Intervention Design   
Essay Title: Preventing HIV in Nigeria: School-Based Program for Youths (Ages 15-24)

Word Count: 2500

Abstract: 
In Nigeria, the prevalence of HIV among adolescents and young adults remains a major public health concern. This intervention proposal aims to implement a school-based behaviour change program to strengthen HIV prevention among Nigerian Youths . Drawing from evidence-based Social and Behavior Change Communication (SBCC) interventions, Bose et al. (2023) and successful combination prevention packages Arije et al. (2023), The programme will focus on the specific needs and challenges that this population faces.
Tise proposed intervention will incorporate peer education, a proven effective tool for long-term behaviour changes among high-risk HIV groups He et al. (2020). By engaging youth in the development and implementation of the program, we aim to foster a sense of ownership and commitment to HIV prevention. This approach aligns with the National HIV Strategy for Adolescents and Young People and has shown success in previous projects targeting Nigerian youth Iwelunmor et al. (2023)
In addition to peer education, the program will include tailored, innovative, and adaptive HIV prevention solutions, such as school-based sexual and reproductive health education and community engagement to address the gendered nature of HIV vulnerability Arije et al. (2023). The intervention will also promote the uptake of HIV testing and counselling services, as well as the use of HIV self-testing kits Iwelunmor et al. (2023)
To ensure the sustainability and effectiveness of the program, we will employ participatory learning communities, periodic meetings with research staff and key stakeholders, and booster sessions with research staff Iwelunmor et al. (2023). The intervention's impact will be evaluated through a rigorous monitoring and evaluation framework, assessing changes in knowledge, attitudes, and behaviours related to HIV prevention among participating Youths.
In conclusion, this school-based program for Youths aims to reduce HIV vulnerability in Nigeria by leveraging evidence-based behaviour change interventions and engaging youth in the design and implementation process. 

Introduction 
In Nigeria today there is a high prevalence of HIV among adolescents and young adults in the country, particularly among adolescent girls and young women. Factors such as multiple concurrent sexual relationships, transgenerational sex, and transactional sex contribute to their vulnerability to HIV, which is linked to sociocultural contexts that vary across the country, according to a study, adolescents constitute about 7% of the total number of individuals with HIV in Nigeria, and young women are disproportionately affected by HIV compared to their male counterparts Arije et al. (2023). The vulnerability of adolescent girls and young women to HIV is linked to multiple concurrent sexual relationships, transgenerational sex, and transactional sex, amongst other factors Arije et al. (2023). Lack of adequate knowledge has also been implied as a major reason for high-risk heterosexual behaviour among young people in Nigeria Okudo (2014).
Nigeria has achieved two of the 95-95-95 targets already but is still lagging behind on the first 95 with only 90% of people with HIV aware of their status, Be in the KNOW (n.d.) 
Further literature search reveals that lack of adequate knowledge has been implied as a major reason for high-risk heterosexual behaviour, and in Nigeria, the most common mode of transmission of HIV Okudo (2014). Studies have shown that young people in Nigeria have low comprehensive HIV knowledge. Less than half of adolescents answer correctly that HIV can be transmitted by having unprotected sex with an HIV-infected person. Therefore, adequate HIV knowledge is critical for protecting young adolescents from HIV, as they are among the most vulnerable Badru et al. (2020).

Figure 1: HIV prevalence among young people aged 15-24 disaggregated by sex Source- Report of the Gender Assessment of the HIV Response in Nigeria 2022, UNAIDS (2021))
The graph above clearly highlights that HIV prevalence among young women between the ages of 15- 24 is doubled that of you men between the ages of 15-24 (women 0.6 vs men 0.3) according to the report of the Gender Assessment of the HIV Response in Nigeria in 2022 support by UNAIDS (2021) data. There this intervention is clearly timely to address the infection and transmission rates.

Figure 1. Number of young people living with HIV aged 15-24 years disaggregated by sex (Source- Report of the Gender Assessment of the HIV Response in Nigeria 2022, UNAIDS (2021))
According to the table above young women between the ages of 15 -24 living with HIV account for two-thirds (63%) of young people living with HIV (110,000 vs 64,000) according to the report of the Gender Assessment of the HIV Response in Nigeria in 2022 support by UNAIDS (2021) data.

Figure 3: Comprehensive knowledge of HIV in different populations NDHS (2018)
The National Demographic Health Survey of 2018 also highlights the significant knowledge gap on HIV by the target population which stood at 38.5. Considering the age of the target population, this is considerably on the high side and constitutes a significant public health challenge that would require immediate intervention, NDHS (2018).
The proposed school-based program for Youths to prevent HIV in Nigeria can be linked to theoretical frameworks and intervention mapping in public health behaviour change intervention design. The program's design and implementation would align with the Social and Behavior Change Communication (SBCC) framework, which emphasizes the importance of addressing knowledge, attitudes, and behaviours related to HIV prevention (Gallant and Maticka-Tyndale, 2004). The program would also incorporate peer education, which is consistent with the Diffusion of Innovations theory, which posits that behaviour change is more likely to occur when individuals receive information from peers who share similar characteristics Arije et al. (2023).
Constraints for the intervention, such as limited funding and cultural and religious beliefs, can be addressed using intervention mapping. For example, the program's design would be tailored to be culturally sensitive and appropriate, and community leaders can be involved in the program's development and implementation to ensure its success and sustainability (Gallant and Maticka-Tyndale, 2004) (Chizoba et al., 2020).
Needs assessment, logic model of the problem. 
The need assessment would be conducted to identify the factors that predispose young adults to HIV transmission, such as lack of adequate knowledge about HIV, attitudes, beliefs, and behaviours related to HIV prevention Hart (2011) Theunissen et al. (2013). This would also be used to identify the environmental, and  social, factors that contribute to HIV transmission among young adults and strategies would be developed to address these factors(Gallant and Maticka-Tyndale, 2004) (Chizoba et al., 2020).
Based on the needs assessment, the program's objectives, design, and implementation would be tailored to address the identified factors and ensure the program's success and sustainability. For example, the program can incorporate peer education to address knowledge gaps and attitudes related to HIV prevention, community engagement to address environmental and social factors, and policy advocacy to address policy factors that contribute to the high prevalence of HIV among Nigerian Youths Arije et al. (2023). (Gallant and Maticka-Tyndale, 2004) (Chizoba et al., 2020) (Kim et al., 2022).

Figure 4: Logic Model of Problem for Preventing HIV among Youths in Nigeria
Behavioural factors affecting HIV prevention among Youths include inadequate knowledge about HIV transmission and prevention methods, misconceptions about the disease, and low condom use during sexual encounters. A study in Nigeria found that more than half of the respondents (53.9%) reported not using a condom in their last sexual encounter (O et al., 2013). Additionally, the willingness to pay for HIV prevention commodities, such as condoms, among key population groups can influence the accessibility and utilization of these commodities (Durosinmi-Etti et al., 2022). 
Furthermore, cultural factors and social stigma surrounding HIV and sexual health discussions can also impact the effectiveness of prevention efforts (Iwelunmor et al., 2014) and limited access to prevention resources. 
To address these factors, it is essential to provide accurate information, promote open discussions, create supportive environments for Youths to make informed decisions about their sexual health and provide adequate infrastructural facilities and trained human resources providing services.
Program outcomes and objectives; Logic model of change 
The program objectives for the proposed school-based program for youths to prevent HIV in Nigeria are to increase knowledge, attitudes, and behaviours related to HIV prevention among Nigerian teens. The program aims to address the knowledge gap and behaviour risks related to HIV among adolescents and young adults in Nigeria (Okudo, 2014) (Chizoba et al., 2020).
The program objectives will be achieved through a combination of evidence-based behaviour change interventions, including peer education, tailored, innovative, and adaptive HIV prevention solutions, and community engagement (Maduakolam et al., 2022) (Chizoba et al., 2020). The program will also promote the uptake of HIV testing and counselling services, as well as the use of HIV self-testing kits Arije et al. (2023).
Overall, the program objectives aim to reduce HIV vulnerability in Nigeria by leveraging evidence-based behaviour change interventions and engaging youth in the design and implementation process. By addressing the unique needs of this population, the program aims to contribute to the ongoing efforts to curb the HIV epidemic in Nigeria and improve the overall health and well-being of adolescents and young adults (Maduakolam et al., 2022) (Chizoba et al., 2020).The program's primary outcome is to reduce the incidence of HIV among Nigerian Youths. 

Figure 5: Logic Model of Change for Preventing HIV among Youths in Nigeria 
Intervention Design; Behaviour change methods and practical applications used for the change objectives 
In creating the behaviour change matrix for the school-based HIV prevention program, we identified the change objectives for each determinant, the behaviour change techniques, and the communication methods/practical applications.

Figure 6: Behaviour change matrix  for Preventing HIV among Youths in Nigeria (Zimmerman, Kamal and Kim, 2013)
For example, increasing knowledge about HIV prevention among Nigerian teens. The social-cognitive determinants that could be targeted to achieve this objective include attitudes, beliefs, and self-efficacy related to HIV prevention. The changes required in these determinants could include increasing positive attitudes towards HIV prevention, correcting misconceptions about HIV transmission, and increasing confidence in using HIV prevention methods. (Sassen, 2023)
Program production; potential testing phase 
The program production involves collaboration with local stakeholders, including schools, health professionals, and community organizations. The development process includes:
Conducting a needs assessment to identify the specific requirements of the target population.
Designing the intervention based on the behaviour change matrix, incorporating culturally appropriate content and materials.
Developing training materials and resources for teachers and peer educators.
Establishing partnerships with local organizations to provide condoms and HIV testing services.
Potential Testing Phase:
Before full-scale implementation, the program will undergo a testing phase to refine the intervention and ensure its effectiveness. This phase will involve:
Piloting the intervention in a small number of schools, with a diverse group of students.
Collecting feedback from students, teachers, and peer educators on the program's content, delivery, and impact.
Analyzing the results of the pilot to identify areas for improvement and make necessary adjustments to the intervention.
Revising the training materials and resources based on the pilot findings.
The purpose of the testing phase in the school-based HIV prevention program is to ensure the intervention's effectiveness, relevance, and appropriateness before full-scale implementation. The testing phase serves several key functions:
Assess the feasibility and acceptability of the program among the target population, teachers, and peer educators.
Identify any potential issues or barriers in the program's content, delivery, or impact that may need to be addressed. e.t.c 
By conducting a testing phase, the program can be adapted and optimized to better address the health behaviour problem among Nigerian Youths, increasing the likelihood of success and sustainability in the long term (Meyer, Louder and Nicolas, 2021) (Zimmerman, Kamal and Kim, 2013)
Implementation strategy 
In developing the implementation strategy for the school-based HIV prevention program, we can consider the linkage approach and diffusion theory. The linkage approach emphasizes the importance of building partnerships and collaborations with local stakeholders, including schools, health professionals, and community organizations. This approach will help to help ensure that the program is culturally appropriate, relevant, and sustainable in the long term.
Diffusion theory, on the other hand, would focuse on the spread of innovations and ideas through social networks. Leveraging existing social networks among Nigerian Youths teachers, and peer educators, the program can increase its reach and impact. Peer-led discussions and group activities can help promote positive social norms around HIV prevention and encourage healthy behaviors.
The implementation strategy will involve a phased approach to ensure the program's success and sustainability and will involve the following steps:
Establish partnerships with local stakeholders, including schools, health professionals, and community organizations.
Train teachers and peer educators on the program's content and delivery methods, using the behaviour change matrix and communication methods/practical applications.
Launch the program in selected schools, with ongoing support and supervision provided by the program team.
Encourage peer-led discussions and group activities to promote positive social norms and healthy behaviours.
Monitor the program's progress through regular check-ins with teachers, peer educators, and school administrators.
Establish a feedback loop to continuously improve the program based on the experiences and outcomes of the participants.
Evaluate the program's effectiveness using a pre-post design, as described in the evaluation plan.
If successful, scale up the program to additional schools and, adapting the intervention as needed to suit different contexts.
By incorporating the linkage approach and diffusion theory into the implementation strategy, the school-based HIV prevention program can maximize its impact and sustainability in addressing the health behaviour problem among Nigerian Youths (Meyer, Louder and Nicolas, 2021) 
Evaluation plan 
The evaluation plan for the school-based HIV prevention program will include both process and effect evaluations. The process evaluation will assess the completeness and fidelity of the program's implementation, including context, reach, dose delivered, dose received, and recruitment. The process evaluation will use both qualitative and quantitative methods, such as surveys, interviews, and focus groups with teachers, peer educators, and students. The frequency of assessment will depend on the specific variable being assessed.
The effect evaluation will focus on the specific behaviour change objectives identified in the behaviour change matrix. The effect evaluation will be determinant/change objective-based, measuring changes in knowledge, attitudes, skills, social norms, and access related to HIV prevention. The instruments used to assess the program's impact may include questionnaires and Likert scales, which may require cultural adaptations to ensure their appropriateness and relevance to the Nigerian context (Finkbeiner et al., 2013) (Falconi‐McCahill, Lee and Knights, 2022)
Discussion / Implications of the Intervention / Future Research and Limitations 
One limitation of the evaluation plan is the lack of a control group, which may limit the ability to attribute changes in behaviour and health outcomes solely to the program. However, the use of a pre-post design and the inclusion of multiple variables in the process evaluation can help strengthen the evaluation's internal validity.
The evaluation plan for the school-based HIV prevention program is informed by similar evaluation plans for other sexual health and HIV prevention programs, such as those described in the search results of ((Finkbeiner et al., 2013) (Falconi‐McCahill, Lee and Knights, 2022) (Zango, Crutzen and de Vries, 2021) (Mustanski et al., 2020) (Mustanski et al., 2020a)). These evaluation plans emphasize the importance of assessing both process and effect evaluations, using a combination of qualitative and quantitative methods, and adapting instruments to the cultural context.
The proposed intervention has the potential to significantly reduce HIV incidence among Nigerian Youths. Future research should explore the scalability of the program and potential adaptations for other settings. Limitations may include the reliance on self-reported data and potential resistance from conservative communities.