64 Multi-component-intervention to combat unhealthy diets and physical inactivity among adolescents in sub-Saharan Africa: the Generation H study protocol

Abstract EP3.2, e-Poster Terminal 3, September 3, 2025, 13:05 - 14:00 Aims To reduce two key modifiable risk factors for Noncommunicable diseases (NCD)—unhealthy diets and physical inactivity—among adolescents (aged 10-19 years) in various socio-economic urban communities in Nairobi, Kenya, and Accra, Ghana. The study also aims to assess young people in disadvantaged communities mainly driven by rural-urban migration. The project will design, deploy, and evaluate interventions based on the evidence-based “WHO Best Buys” to improve physical activity and nutrition among urban youth. Methods The study will involve approximately 5,300 adolescents from Kibera slum and Buruburu (non-slum) in Nairobi, and Ga-East (low SES) and Ayawaso-West (high SES) in Accra. Guided by MRC’s Intervention Mapping framework, we will engage stakeholders (adolescents, parents, and those in education, health, and community leadership positions) through formative and participatory work. Using qualitative approaches, we aim to adapt, optimize, and co-create the Generation-H multicomponent intervention, focusing on enhanced implementation strategies. The intervention will be delivered in selected sites through schools and faith-based organizations. Repeated cross-sectional surveys at baseline, 6 and 18 months will assess implementation outcomes (primary, e.g. REACH of the intervention) and secondary outcomes (e.g. health literacy, self-efficacy, health behaviors), and analyse outcomes using mixed-effects models. Cost-effectiveness will be assessed over a short-term and long-term life horizon and a mixed-methods process evaluation will evaluate acceptability, feasibility, and adoption within different socio-economic contexts. Conclusions By involving adolescents, parents and other stakeholders in the design and delivery of interventions, leveraging diverse delivery platforms, and evaluating the (cost-)effectiveness and sustainability of these strategies, this five-year project seeks to provide a model for NCD prevention that can be adapted across Sub-Saharan Africa and other low- and middle-income countries. This aligns with the GSMERH-congress theme by promoting health equity and fostering a multi-ethnic, racism-free world.