Empowering Adolescents to Lead Change Using Health Data

Study Overview
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Brief Summary
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This study is a cluster randomized trial carried out in schools of secondary cities of four low- and middle income countries. Baseline surveys in 30 randomly selected schools will assess the health behaviours of 13-17 year old students as well as school policies and practices. The intervention arm (15 schools) will use the baseline information to develop a package of actions in collaboration with students, teachers, and local authorities that will subsequently be implemented an monitored over two years. Follow-up surveys to evaluate the effectiveness of the implemented actions will be conducted after two years in all 30 previously selected schools.

Detailed Description
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The objective of this study is to generate health information through school surveys and use this information directly and locally, involving adolescents, to change policies and plan programmes to improve health. The study is carried out in secondary cities of four low- and middle income countries, including Sekondi-Takoradi, Ghana; Jaipur, India; Spanish Town, Jamaica; and Fez, Morocco. In each of the four cities, 30 schools are randomly selected. Baseline surveys will be conducted to assess (1) 13-17 year old student's health behaviours using the Global School-based Student Health Survey (GSHS); and (2) health policies and practices in the selected schools using the Global School Health Policies and Practices Study (G-SHPPS). Additionally, the physical activity module of the GSHS questionnaire will be validated against objective measurement devices in one randomly selected class of 15 randomly selected schools. Schools will be randomly allocated to the intervention (15 schools) or control arm (15 schools) of the study. The intervention group will participate in interactive workshops using the Global Accelerated Action for the Health of Adolescents (Global AA-HA!) approach and the framework of Making every school a health-promoting school to: Identify adolescent health needs through exploring the collected data; Assess policies and practices already in place; Identify gaps and needs for action to improve health. Students, teachers and local authorities will propose and prioritize policy and programme solutions from menus of effective interventions for school-, community- or city-level implementation, supported by the Ministries of Health and Education and WHO. Repeat GSHS and G-SHPPS surveys will be conducted two years later in all schools to assess effectiveness of the interventions.

Official Title
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Empowering Adolescents to Lead Change Using Health Data

Conditions
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Healthy

Intervention / Treatment
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* Behavioral: Behavioral interventions targeting multiple risk behaviors as well as protective factors
* Other: School-level interventions targeting the school environment and system


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: School going Aged 13-17 years Exclusion Criteria: Not going to school Outside the age range 13-17 years

Ages Eligible for Study
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Minimum Age: 13 Years
Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention arm<br>The intervention consists of interactive workshops that will be facilitated by WHO and trained local personnel and involve students, teachers and local authorities. In the workshops, the Global Accelerated Action for the Health of Adolescents (Global AA-HA!) approach will be used to: identify adolescent health needs through exploring the collected baseline data; assess policies and practices already in place; identify gaps and needs for action to improve health. A menu of actions will be identified, prioritized, implemented and monitored. | Behavioral: Behavioral interventions targeting multiple risk behaviors as well as protective factors<br>* Depending on the baseline data and prioritization of actions, behavioral interventions related to the following topics will be implemented: alcohol use, dietary behaviors, drug use, hygiene, mental health, physical activity, protective factors, sexual behaviors, tobacco use, violence and unintentional injury.<br>Other: School-level interventions targeting the school environment and system<br>* Depending on the baseline data and prioritization of actions, and based on the Global Standards for Health Promoting Schools, school-level interventions related to the following will be implemented: school policies and resources, school governance and leadership, school and community partnerships, school curriculum, school social-emotional environment, school physical environment, school health services<br>|
| No Intervention: Control arm<br>The schools in the control arm will not participate in any intervention and continue 'as usual' after the baseline surveys. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Alcohol use | Self-reported alcohol use measured with the Global School-based Student Health Survey (GSHS) | Two years | 
| Dietary behaviors | Self-reported dietary behaviors measured with the Global School-based Student Health Survey (GSHS) | Two years | 
| Drug use | Self-reported drug use measured with the Global School-based Student Health Survey (GSHS) | Two years | 
| Hygiene | Self-reported hygiene measured with the Global School-based Student Health Survey (GSHS) | Two years | 
| Mental health | Self-reported mental health measured with the Global School-based Student Health Survey (GSHS) | Two years | 
| Physical activity | Self-reported physical activity measured with the Global School-based Student Health Survey (GSHS) | Two years | 
| Protective factors | Self-reported protective factors measured with the Global School-based Student Health Survey (GSHS) | Two years | 
| Sexual behaviors | Self-reported sexual behaviors measured with the Global School-based Student Health Survey (GSHS) | Two years | 
| Tobacco use | Self-reported tobacco use measured with the Global School-based Student Health Survey (GSHS) | Two years | 
| Violence and unintentional injury | Self-reported violence and unintentional injury measured with the Global School-based Student Health Survey (GSHS) | Two years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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adolescent health, students, schools, risk factors, protective factors, school health services