Effectiveness of a participatory approach to develop school health interventions in four low resource cities: study protocol of the 'empowering adolescents to lead change using health data' cluster randomised controlled trial.

INTRODUCTION: Comprehensive local data on adolescent health are often lacking, particularly in lower resource settings. Furthermore, there are knowledge gaps around which interventions are effective to support healthy behaviours. This study generates health information for students from cities in four middle-income countries to plan, implement and subsequently evaluate a package of interventions to improve health outcomes. METHODS AND ANALYSIS: We will conduct a cluster randomised controlled trial in schools in Fez, Morocco; Jaipur, India; Saint Catherine Parish, Jamaica; and Sekondi-Takoradi, Ghana. In each city, approximately 30 schools will be randomly selected and assigned to the control or intervention arm. Baseline data collection includes three components. First, a Global School Health Policies and Practices Survey (G-SHPPS) to be completed by principals of all selected schools. Second, a Global School-based Student Health Survey (GSHS) to be administered to a target sample of n=3153 13-17 years old students of randomly selected classes of these schools, including questions on alcohol, tobacco and drug use, diet, hygiene, mental health, physical activity, protective factors, sexual behaviours, violence and injury. Third, a study validating the GSHS physical activity questions against wrist-worn accelerometry in one randomly selected class in each control school (n approximately 300 students per city). Intervention schools will develop a suite of interventions using a participatory approach driven by students and involving parents/guardians, teachers and community stakeholders. Interventions will aim to change existing structures and policies at schools to positively influence students' behaviour, using the collected data and guided by the framework for Making Every School a Health Promoting School. Outcomes will be assessed for differential change after a 2-year follow-up. ETHICS AND DISSEMINATION: The study was approved by WHO's Research Ethics Review Committee; by the Jodhpur School of Public Health's Institutional Review Board for Jaipur, India; by the Noguchi Memorial Institute for Medical Research Institutional Review Board for Sekondi-Takoradi, Ghana; by the Ministry of Health and Wellness' Advisory Panel on Ethics and Medico-Legal Affairs for St Catherine Parish, Jamaica, and by the Comité d'éthique pour la recherche biomédicale of the Université Mohammed V of Rabat for Fez, Morocco. Findings will be shared through open access publications and conferences. TRIAL REGISTRATION NUMBER: NCT04963426.

Previsit Multidomain Psychosocial Screening Tools for Adolescents and Young Adults: A Systematic Review.

Adolescence and young adulthood constitute a period when exploratory behaviors can evolve into risky behaviors. Most causes of adolescent ill health are preventable; therefore, it is a priority to detect them early before they turn into health problems. Previsit multidomain psychosocial screening tools are used by professionals to detect and prioritize potentially problematic issues. In conjunction with appropriate clinician training, these tools have improved clinician screening rates in several areas of adolescent health. This article reviews existing multidomain previsit psychosocial screening tools developed in the 21st century and describes their characteristics using a systematic methodology. We reviewed 10,623 records to identify 15 different tools in use since 2000 and described their characteristics. Results show that all tools were developed in high-income countries. The tools provide sufficient coverage of many psychosocial domains relevant to young people's health. However, some psychosocial domains such as screen use and strengths are seldomly addressed. Furthermore, the tools rarely focus on young adults as a target population. Future research should assess the effectiveness, acceptability, and psychometric properties of validated psychosocial screening tools and examine how to expand their use in low- and middle-income countries.