An Adolescent Health and Wellbeing Check-up Programme in Three African Cities (Y-Check): Protocol for a Multimethod, Prospective, Hybrid Implementation-effectiveness Study
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Adolescent Development
- Sponsor
- World Health Organization
- Enrollment
- 6000
- Locations
- 2
- Primary Endpoint
- Y-Check Screening outcome
- Status
- Recruiting
- Last Updated
- 2 years ago
Overview
Brief Summary
This is a multi-country prospective intervention study, with a mixed-method process evaluation to assess the implementation, effects and short-term cost-effectiveness of Y-Check. The intervention involves screening, on-the-spot care and, if needed, referral of adolescents through health and wellbeing check-up visits in early adolescence (10-14 years) and older adolescence (15-19 years old). In each city, the intervention will be delivered to 2000 adolescents recruited in schools (both age groups) or community venues (older adolescents only).
Detailed Description
Background: During adolescence, behaviours are initiated that will have substantial positive or negative impacts on the individual's short- and long-term health and wellbeing, educational attainment and employment prospects. However, adolescents rarely have regular contact with health services, especially for health promotion and disease prevention, and services are not always appropriate for their needs. The investigators co-developed with adolescents a health and wellbeing check-up programme, to improve adolescent health and wellbeing (Y-Check). This paper describes the methods to evaluate the feasibility, acceptability, short-term effects, and cost-effectiveness of Y-Check in three African cities: Cape Coast in Ghana, Mwanza in Tanzania and Chitungwiza in Zimbabwe. Method: This is a multi-country prospective intervention study, with a mixed-method process evaluation to assess the implementation, effects and short-term cost-effectiveness of Y-Check. The intervention involves screening, on-the-spot care and, if needed, referral of adolescents through health and wellbeing check-up visits in early adolescence (10-14 years) and older adolescence (15-19 years old). In each city, the intervention will be delivered to 2000 adolescents recruited in schools (both age groups) or community venues (older adolescents only). The adolescents will be followed-up at 4 months (all sites) and 12 months (Zimbabwe only). The study will assess the effects of Y-Check on knowledge and behaviours, as well as clinical outcomes and costs. The primary outcome will be the proportion of those screening positive for at least one condition who receive appropriate on-the-spot care or complete appropriate referral for all identified conditions within four months. Secondary outcomes include yield of untreated conditions, reported health-related risk and protective behaviours, engagement with health services, wellbeing, clinical and educational outcomes. A process evaluation will understand acceptability, feasibility, uptake, and fidelity, and an economic evaluation will explore cost effectiveness. Discussion: This study is innovative in evaluating a comprehensive adolescent health and wellbeing check-up intervention which addresses both health conditions that impact on wellbeing during adolescence, and risk factors for non-communicable diseases in three African cities. Evidence of the intervention´s feasibility, acceptability, and short-term positive effects and costs will support larger scale intervention implementation and rigorous evaluation.
Investigators
Prerna Banati
Scientist, Principal Investigator
World Health Organization
Eligibility Criteria
Inclusion Criteria
- •To be included in the study, adolescents aged 10-19 must fall into one of the first three categories below and fulfil category
- •Be attending selected classes of Year 5 of primary school in Mwanza (median age 11 years); Grade 5/6 of primary school in Chitungwiza (median age 11 years); or Year 1 of Junior Secondary School in Cape Coast (median age 12 years) OR
- •Be attending selected classes in Year 3 of Secondary School in Mwanza (median age 17 years), Form 3/4 in Chitungwiza (median age 17 years), or Year 2 of Senior Secondary School in Cape Coast (median age 16 years) OR
- •Be resident in a selected community during the time of the Y-Check intervention, and be aged 16-19 years AND
- •Have a completed and signed Informed Consent and have a signed Informed Assent Form if the adolescent is below the national age of consent or is seen in a school, irrespective of their age.
Exclusion Criteria
- •Not meeting above inclusion criteria
Outcomes
Primary Outcomes
Y-Check Screening outcome
Time Frame: 16 weeks (4 months)
Proportion of those screening positive for at least one condition who receive appropriate on-the-spot care or complete appropriate referral for all identified conditions within 4 months (i.e. they attend a provider for referral care who has been accredited by the study team and has been shown to be capable of providing appropriate referral care).
Secondary Outcomes
- Proportion of youth reporting youth friendly health services received with quality(16 weeks (4 months))
- Previously untreated conditions identified (yield)(16 weeks (4 months))
- Qualitative assessment of teachers, parents and health workers who find the intervention acceptable(16 weeks (4 months))
- Qualitative assessment of adolescents who find the intervention acceptable(16 weeks (4 months))
- Condition Screening outcome(16 weeks (4 months))
- Qualitative assessment of perceived value of the intervention to adolescents and to other stakeholders.(16 weeks (4 months))
- Proportion of adolescents who take up and use Y-Check services and referrals(16 weeks (4 months))
- Proportion of Y-Check visits completed(16 weeks (4 months))
- Proportion of referrals completed(16 weeks (4 months))