Youth-led co-creation of a non-communicable disease risk reduction intervention in urban informal settlements of Karachi, Pakistan: a participatory action research
Year: 2026
Type: article
Abstract: Introduction Risk factors for non-communicable diseases (NCDs) are often established during childhood and adolescence, underscoring the importance of early-life health behaviour interventions. Our study co-created a youth-led NCD risk-reduction intervention with school-going adolescents in the urban informal settlement of Karachi, Pakistan.Methods This paper presents the co-creation phase of a broader pretest and post-test intervention study. The main study involved 40 adolescents aged 14 to 16 (grades 9 and 10) recruited from five public and five private schools. During the co-creation phase, focus group discussions (FGDs) were conducted to explore perceptions and priorities related to NCD risk reduction, in which 26 out of 40 youth (across three FGDs) and 18 parents (across two FGDs) participated. In-depth interviews (IDIs) were conducted with 21 key school stakeholders, including headteachers (n=5), class teachers (n=13) and canteen staff (n=3). To develop the intervention, we conducted a 2-day participatory workshop with youth and teachers. Insights from FGDs, IDIs and participatory workshops directly informed the intervention’s content, format and delivery methods.Results In collaboration with youth and teachers, we co-created three core intervention components. An animated video titled ‘Youth Health Heroes—Rooshan Kal ki Umeed’ (Youth Health Heroes—Hope for a Bright Tomorrow) emphasised how adopting healthy habits early in life can prevent NCDs in adulthood. A structured physical activity session was designed to promote the integration of regular exercise into daily routines. Finally, a role-play titled ‘Jahan Sath Wahan Sehat’ (Where there is support, there is health) illustrated how peer support can positively influence health-related behaviours. Visual charts supported these components and reinforced key messages. The intervention was structured to be delivered in two 45-minute sessions within a week. A comprehensive training manual was developed to support standardised intervention delivery across schools.Conclusions Our study co-created a contextually relevant intervention addressing key NCD risk factors among children and adolescents. It highlights the importance of youth engagement in intervention design and lays the groundwork for future implementation and evaluation, with the potential for adoption in other similar settings.Trial registration number NCT06465771.
Source: BMJ Public Health
Institution: Aga Khan University
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7225342088