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Community youth teams facilitating participatory adolescent groups, youth leadership activities and livelihood promotion to improve school attendance, dietary diversity and mental health among adolescent girls in rural eastern India: protocol for a cluster-randomised controlled trial.

ABSTRACT: BACKGROUND:Improving the health and development of adolescents aged 10-19?years is a global health priority. One in five adolescents globally live in India. The Rashtriya Kishor Swasthya Karyakram (RKSK), India's national adolescent health strategy, recommends supporting community-based peer educators to conduct group meetings with boys and girls. Groups aim to give adolescents a space to discuss the social and health issues affecting them and build their capacity to become active community members and leaders. There have been no evaluations of the community component of RKSK to date. In this protocol, we describe the evaluation of the Jharkhand Initiative for Adolescent Health (JIAH), a community intervention aligned with RKSK and designed to improve school attendance, dietary diversity and mental health among adolescent girls aged 10-19 years in rural Jharkhand, eastern India. METHODS:The JIAH intervention is delivered by a community youth team consisting of yuva saathis (friends of youth), youth leadership facilitators and livelihood promoters. Teams conduct (a) peer-led Participatory Learning and Action meetings with girls and boys, mobilising adolescents, parents, health workers, teachers and the wider community to make changes for adolescent health and development; (b) group-based youth leadership activities to build adolescents' confidence and resilience; and (c) livelihood promotion with adolescents and their families to provide training and practical skills. We are evaluating the JIAH intervention through a parallel-group, two-arm, superiority, cluster-randomised controlled trial. The unit of randomisation is a geographic cluster of ~1000 people. A total of 38 clusters covering an estimated population of 40,676 have been randomised to control or intervention arms. Nineteen intervention clusters have adolescent groups, youth leadership activities and livelihood promotion. Nineteen control clusters receive livelihood promotion only. Study participants are adolescent girls aged 10-19?years, married or unmarried, in or out of school, living in the study area. Intervention activities are open to all adolescent boys and girls, regardless of their participation in surveys. We will collect data through baseline and endline surveys. Primary trial outcomes are school attendance, dietary diversity and internalising and externalising mental health problems. Secondary outcomes include access to school-related entitlements, emotional or physical violence, self-efficacy and resilience. TRIAL REGISTRATION:ISRCTN17206016. Registered on 27 June 2018.

SUBMITTER: Rath S

PROVIDER: S-EPMC6950906 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Community youth teams facilitating participatory adolescent groups, youth leadership activities and livelihood promotion to improve school attendance, dietary diversity and mental health among adolescent girls in rural eastern India: protocol for a cluster-randomised controlled trial.

Rath Suchitra S Prost Audrey A Samal Subhashree S Pradhan Hemanta H Copas Andrew A Gagrai Sumitra S Rath Shibanand S Gope Raj Kumar RK Nair Nirmala N Tripathy Prasanta P Bhatia Komal K Rose-Clarke Kelly K

Trials 20200108 1

<h4>Background</h4>Improving the health and development of adolescents aged 10-19 years is a global health priority. One in five adolescents globally live in India. The Rashtriya Kishor Swasthya Karyakram (RKSK), India's national adolescent health strategy, recommends supporting community-based peer educators to conduct group meetings with boys and girls. Groups aim to give adolescents a space to discuss the social and health issues affecting them and build their capacity to become active commun ...[more]

PMID: 31915039

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Project description:Abstract Objectives This study assessed the influence of a participatory video nutrition education intervention on Ghanaian adolescent girls’ critical nutrition literacy (CNL), food knowledge, and dietary behaviours. Methods A 2018–19 cluster randomized control trial (ClinicalTrials.gov NCT03704649) selected 20 schools (10 intervention, 10 control) in one Ghanaian rural district and enrolled 351 girls, 13–16 years of age. All schools received a nutrition curriculum for their girls’ clubs. The intervention schools also received two participatory video workshops where adolescents identified the most pressing challenges they faced to getting (i) a balanced diet and (ii) iron-rich foods. The adolescents devised solutions to each challenge and then planned, acted, filmed, and screened an educational video on each topic with their classmates. Participants completed baseline and endline surveys that measured English literacy, nutrition and health literacy, food purchasing habits, and dietary intake through a food frequency questionnaire. Critical nutrition literacy, the capability to critically analyze and apply nutrition information to influence personal behaviours and environment was the primary outcome. An intent-to-treat analysis assessed the intervention effect on CNL and the secondary outcomes using general linear mixed models with cluster-level random effects (CIETmap 2.2 software). Results Exposure to the participatory video nutrition education program led to a 4-fold increase in CNL (aOR = 4.39; 95% CI: 2.22, 8.70). There was a significant increase in food knowledge (OR = 6.62; 95% CI: 6.59, 6.66) and in adolescent food purchases for themselves. Exposure to the intervention led to 12-fold increase in intervention participants choosing iron-rich foods (beans, cocoyam leaf, and animal foods) when buying a meal for themselves. Dietary intakes measured with the FFQ showed no change. Conclusions A participatory video intervention promoted critical nutrition literacy among low literacy adolescents. It improved food knowledge and food choices. Funding Sources The Canadian Queen Elizabeth II Diamond Jubilee Scholarships (QES) is managed through a unique partnership of Universities Canada, RHF, CFC, and Canadian universities. The QES-AS is made possible with financial support from IDRC and SSHRC.

Project description:ObjectivesSince 2018, four establishments in Quebec have been instrumental in implementing the PAROLE-Onco program, which introduced accompanying patients (APs) into healthcare teams to improve cancer patients' experience. APs are patient advisors who have acquired specific experiential knowledge related to living with cancer, using services, and interacting with healthcare professionals. They are therefore in a unique and reliable position to be able to provide emotional, informational, cognitive and navigational support to patients who are dealing with cancer. We aimed to explore APs' perspectives regarding the limiting and facilitating factors in terms of how they are integrated into the clinical oncology teams.MethodsA qualitative study based on semi-structured interviews and focus groups was conducted with 20 APs at the beginning of their intervention (T1) and, two years later, during a second data collection (T2). Limiting and facilitating factors of APs' integration into clinical teams were analyzed in terms of governance, culture, resources and tools.ResultsThe limited factors raised by APs to be integrated into clinical teams include the following: confusion about the specific roles played by APs, lifting the egos of certain professionals who feel they are already doing what APs typically do, lack of identification of patient needs, absence of APs in project governance organizational boundaries, and team members' availability. Various communication challenges were also raised, resulting in the program being inadequately promoted among patients. Also mentioned as limiting factors were the lack of time, space and compensation. Creating opportunities for team members to meet with APs, building trust and teaching team members how APs' activities complement theirs were enhancing factors. Other facilitators include APs being involved in decision-making committees, being leaders in promoting the PAROLE-Onco program to patients and clinical team members and creating opportunities to communicate with team members to help enhance their work and provide feedback to improve patient services. Awareness of APs' added value for the team and patients is also a key facilitator. Regarding tools, offering accompanying services by telephone allows both patients and APs to benefit from the flexibility they need.ConclusionOver time, APs were able to identify optimal factors for successful implementation. Recommendations include APs and professionals working in co-construction on organization, leadership, resources and status factors. This could help catalyze a change in culture within health establishments and allow people dealing with cancer to benefit from the experiential knowledge of other patients within their clinical team.

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Dataset Information

Community youth teams facilitating participatory adolescent groups, youth leadership activities and livelihood promotion to improve school attendance, dietary diversity and mental health among adolescent girls in rural eastern India: protocol for a cluster-randomised controlled trial.

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Community youth teams facilitating participatory adolescent groups, youth leadership activities and livelihood promotion to improve school attendance, dietary diversity and mental health among adolescent girls in rural eastern India: protocol for a cluster-randomised controlled trial.

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