Health Promotion, Physical Activity, Screen Use, Sleep
Conditions
Keywords
Participatory Action Research, Health Promotion, Systems Approach, Adolescents, 24-hour movement behaviour, Physical activity, Urban health
Brief summary
Background A vast majority of adolescents do not meet guidelines for healthy physical activity, sedentary behaviour, and sleep, posing major risks for developing multiple non-communicable diseases. Unhealthy lifestyles seem more prevalent in urban than rural areas, with the neighbourhood environment as a mediating pathway linking urban living and poor health. How to develop and implement sustainable and effective interventions focused on adolescent health and wellbeing in urban vulnerable life situations is a key challenge and research gap. This paper describes the protocol of a Youth-centred Participatory Action (YoPA) project aiming to tailor, implement, and evaluate social and physical environmental interventions using an evidence-informed youth-centred co-creation approach, for structural improvement of the lifestyles of adolescents in urban vulnerable life situations. Methods In diverse urban environments in Denmark, the Netherlands, Nigeria, and South Africa, academic researchers will engage adolescents (12-19 years) growing up in vulnerable life situations and other key stakeholders (e.g., policy makers, urban planners, community leaders) in local co-creation communities. Together with academic researchers and local stakeholders, adolescents will take a leading role in mapping the local system for needs and opportunities; tailoring interventions to their local context; implementing and evaluating interventions during participatory meetings over the course of three years. YoPA applies a participatory mixed methods design guided by the newly developed SUPER-AIM framework assessing: (i) the local Systems, (ii) User perspectives, (iii) the Participatory co-creation process, (ii) Effects, iv) Reach, (vi) Adoption, (vii) Implementation, and (viii) Maintenance of interventions, in an integrated manner. Discussion YoPA aims to fill various research gaps, including the development of a practical protocol guiding the application of co-creation to tailor evidence-informed interventions to divers, multi-country contexts. Additionally, it focuses on advancing the research gap in physical activity and health within Sub-Saharan Africa and the involvement of adolescents in shaping their physical and social environments. Academic researchers envision that the YoPA co-creation approach will serve as a guide for participation of adolescents in vulnerable life situations in implementation of health promotion and urban planning in Europe, Africa and globally.
Interventions
OTHERSocial and/or physical environmental interventions
To be determined in the co-creation groups at the four sites (Denmark, the Netherlands, Nigeria, South Africa)
Sponsors
Stichting Alexander (the Netherlands)
Syddansk Universitet, Denmark
Aalborg Municipality
University of the Witwatersrand Johannesburg (South Africa)
WITS Health Consortium (South Africa)
Redeemer's University (Nigeria)
Value Re-Orientation for Community Enhancement (Nigeria)
Instituut voor Tropische Geneeskunde, Belgium
COFAC Cooperativa de Formacao e Animacao Cultural CRL (Portugal)
EMMA Communicatie B.V.
Amsterdam UMC, location VUmc
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
YoPA introduces teen-centred, evidence-informed co-creation to tackle the complex real-world challenge of unhealthy lifestyles and health inequalities. In urban environments in 'Minority World' countries (i.e., Denmark, the Netherlands) and 'Majority World' countries (i.e., Nigeria, South Africa), academic researchers will engage adolescents and other key stakeholders in local co-creation communities. Together with academic researchers and local stakeholders, adolescents will be central in 1) mapping the local system, including needs and opportunities; 2) tailoring interventions to the local context; 3) implementing, and 4) evaluating interventions guided by our novel SUPER-AIM framework assessing local Systems, User perspective, Participatory co-creation process, Reach, Effects, Adoption, Implementation, and Maintenance of interventions in an integrated manner.
Eligibility
Sex/Gender
ALL
Age
12 Years to 18 Years
Healthy volunteers
Yes
Inclusion criteria
* aged 12 to 18 years * living in a disadvantaged area in Aalborg (Denmark), Amsterdam (the Netherlands), Osogbo (Nigeria), or Soweto (South Africa) * active informed consent by the adolescents and at least one parent/caregiver where applicable for the participation of the adolescent
Exclusion criteria
* none
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 24-h movement behaviours (i.e., physical activity, sedentary behaviour and sleep). | Pre-implementation, directly after implementation, and 3-6 months after implementation of the intervention. | 24-h movement behaviours will be assesed by questionnaire and accelerometers. The questionnaire contains questions on sleep (time spent on sleeping on a school day and weekend day, number of days feeling sleepy in the last week), physical activity (time spent in physical activity) and screentime (watching a screen on weekdays and weekend days). |
| Physical activity and associated environmental characteristics in selected outdoor spaces | Pre-implementation, directly after implementation, and 3-6 months after implementation of the intervention. | SOPLAY is a validated tool for directly observing physical activity and associated environmental characteristics in free play settings (e.g., recess and lunch at school). SOPLAY provides objective data on the number of participants and their physical activity levels during play and leisure opportunities in targeted areas. Separate scans are made for males and females, and simultaneous entries for contextual characteristics of areas including their accessibility, usability, and whether or not supervision, organized activities, and equipment are provided. The predominant type of activity engaged in by area users is also recorded (e.g., basketball, dance). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Agency | Pre-implementation, directly after implementation, and 3-6 months after implementation of the intervention. | Agency is assessed by two domains scales of the Global Early Adolescent Study (GEAS): voice and freedom of movement, The voice scale conists of seven items. the freedom of movement scale consists of six items. Each item is scored from 0 (never / rarely) to 2 (often), and each domain is scored as the mean of the items scores. Higher domain scores indicate a higher level of voice and freedom of movement. |
| Wellbeing | Pre-implementation, directly after implementation, and 3-6 months after implementation of the intervention. | Wellbeing is assessed by the PROMIS short form 8b Pediatric Life Satisfaction. This short form Pediatric Life Satisfaction consists of 8 items, which are scored from 1 (never) to 5 (almost always). Total scores are calculated by applying the original U.S. IRT model to the data and estimating the level of functioning of the patient (θ). This level of functioning is transformed into a T-score and is calculated by the formula (θ × 10) + 50, with higher scores representing higher levels of life satisfaction. |
| Peer relationships | Pre-implementation, directly after implementation, and 3-6 months after implementation of the intervention. | Peer relationships is assessed by the PROMIS short form 8a Pediatric Peer Relationships. The Pediatric Peer Relationships short form consists of 8 items, which are scored from 1 (never) to 5 (almost always). Total scores are calculated by applying the original U.S. IRT model to the data and estimating the level of functioning of the patient (θ). This level of functioning is transformed into a T-score and is calculated by the formula (θ × 10) + 50, with higher scores representing higher levels of peer relationships. |
Countries
Denmark, Netherlands, Nigeria, South Africa
Contacts
Primary ContactLeonie H Klaufus, Dr.
Backup ContactLara Martín Sánchez, Dr.
Outcome results
None listed