Work

Changemaker: study protocol for sustainable adolescent health interventions to reduce non-communicable disease risks in urban Burkina Faso, Kenya and Tanzania – a hybrid type 2 cluster-randomised controlled trial

Year: 2026

Type: article

Abstract: Introduction Adolescent obesity is a growing global health concern that significantly contributes to adult multimorbidity and the rising burden of non-communicable diseases (NCDs). Adolescence presents a critical window for shaping lifelong health behaviours that can prevent these outcomes. Effective health promotion during this stage can play a pivotal role in the primary prevention of NCDs. In low- and middle-income countries, urban adolescents encounter a complex interplay of risk factors, including unhealthy diets, physical inactivity and limited access to supportive health environments. However, evidence on designing and sustainably implementing multi-component, adolescent-centred health promotion and prevention interventions in these settings remains limited. This study aims to evaluate the implementation and effectiveness of a multicomponent intervention focusing on the primary prevention of NCD risks among adolescents. Methods and analysis After a co-design process, we will conduct three cluster-randomised controlled trials in secondary schools in three sub-Saharan African cities: Ouagadougou (Burkina Faso), Kisumu (Kenya) and Dar es Salaam (Tanzania). The study will include 2280 participants aged 12–16 years (190 students per school across four schools at each site). Over one academic year, a four-component intervention will be implemented: (1) establishment of school gardens and organic waste composting; (2) integration of sustainable health education modules into classes; (3) delivery of health talks using motivational strategies and (4) creating mass media campaigns promoting healthy lifestyles. The primary effectiveness outcomes for health and nutrition constitute mid-upper arm circumference z-score and haemoglobin concentration, respectively. Implementation outcomes will be assessed through a process evaluation examining participation and emotional and cognitive engagement (primary implementation outcomes), along with acceptability, adoption, feasibility, fidelity, reach and sustainability (secondary implementation outcomes). We will also evaluate the implementation costs of the intervention. Ethics and dissemination The Institutional Review Board (IRB) of University Hospital and Medical Faculty, University of Bonn (UoB) reviewed and approved the Changemaker study protocol and all its annexes in July 2024 (reference: 2024-265 BO). This serves as the principal approval from one of the coordinating institutions. In addition, the study protocol, its processes, and tools were reviewed and approved by local IRBs of the participating institutions. All participants will provide informed written consent or assent. Data will be pseudonymised and stored on secure UoB servers. Results will be disseminated via peer-reviewed publications, conferences and participant summaries. Trial registration number DRKS00034129.

Source: BMJ Open

DOI: 10.1136/bmjopen-2026-123282