Evaluating the Effectiveness of a Participatory Video Nutrition Education Trial on Nutrition Literacy With Adolescent Girls in the Upper Manya Krobo District, Ghana.

Although there are a number of health and nutrition services targeted to adolescent girls in rural Ghana, there continues to be a high prevalence of anemia, preventable ailments, and teen pregnancies among adolescent girls in the Upper Manya Krobo district. This project builds on a health literacy framework and social cognitive theory and explores salient features in nutrition education delivery with adolescent girls in the Upper Manya Krobo district of Ghana, and investigates their influence on nutritional knowledge and behaviour.

The primary research objective is (1) to assess the feasibility of a participatory nutrition education model in the Upper Manya Krobo district and, (2) to determine if there is a difference in adolescent girls' nutrition literacy between the intervention and control groups. The research will provide a process evaluation and offer insight into a replicable and feasible protocol that can implemented in other schools. We hypothesize that there will be a difference in nutrition literacy indicators and dietary patterns between intervention and control groups.

To address our research objectives, we will conduct a school-based cluster randomized control pilot trial with adolescent girls, 12-16 years of age, who are part of existing girls' clubs in 20 schools of the Upper Manya Krobo district. Eligible clusters consist of primary and/or junior high schools in UMK district that are implementing standardized girls' clubs and who intend to continue to implement girls' clubs for the upcoming 2018-2019 school year (n = 59). Clusters will be stratified based on 1) the presence of the school feeding program and 2) accessibility to the school. Accessibility will be based on the quality of roads and time needed to travel to the cluster from the district capital, Asesewa. After stratification, clusters will be randomized into control and treatment arms. In each cluster, approximately 20 female adolescent girls' club participants who are 12-16 years of age will be randomly selected and enrolled in the study through seeking informed guardian's consent and adolescent's assent.

The control groups (10 schools) represent the standard-of-care. Participants in these clubs meet on a weekly basis during designated time for club activities in the school schedule. With the guidance of their club facilitator they talk about a variety of health and nutrition topics. The intervention groups (10 schools) will follow a similar curriculum and will include a participatory video education model. The intervention groups develop a storyboard and produce a short 5-7 minute film on a nutritional issue where they are the individuals who draft the script, create the characters, video-record the shots, and act (if they wish) in the video. These videos will be used in the group as a means of sharing nutrition information with students and in stimulating discussion around the nutrition topic.

Data Collection Procedures