Unlocking potential: developing innovative adolescent screening visits for health promotion, prevention and treatment in low-resource settings

释放潜力：开发创新型青少年筛查访视，以促进资源匮乏地区的健康、预防和治疗

• 批准号: MR/T043156/1
• 负责人: Aoife Doyle
• 金额: $ 155.72万
• 依托单位: London School of Hygiene & Tropical Medicine
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2021
• 资助国家: 英国
• 起止时间: 2021 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FT043156%2F1
• 关键词: Unlocking; potential; developing; innovative; adolescent

In adolescence, health-related behaviours are adopted that will have substantial positive or negative impacts on the individual's short- and long-term health, educational attainment, and employment prospects. However, in most low-income countries few adolescents have any contact with health services, especially for health promotion and disease prevention, and services are not always appropriate for their needs. Due to resource constraints there is often limited capacity to provide high-quality youth-friendly health services. Technological advances provide opportunities to deliver services and information away from traditional clinical settings, hence reducing barriers such as cost or confidentiality. Adolescents may be particularly receptive to digital platforms that allow them to self-manage their health and well-being. What is A-CHECK? The programme will screen and treat/refer adolescents for common conditions through health check-ups in younger (10-13y) and older (16-19y) adolescents. Adolescents will only be screened for conditions with an accurate and acceptable test and a locally accessible effective intervention e.g. mental health, HIV, vision and hearing, anaemia. What exactly will be done? I will develop, pilot-test, implement and evaluate the innovative A-CHECK programme and an accompanying digital platform in Zimbabwe. Check-up visits will take place at schools for younger and in the community for older adolescents. The platform will reduce the workload of staff by allowing adolescents to self-screen using questionnaires (e.g. mental health, risk behaviours) and pre-existing apps (to test hearing, eyesight, body composition), and will help the team to keep in touch with adolescents and provide information on referral appointments. I will analyse the data collected through the A-CHECK programme to improve its future acceptability and cost-effectiveness. What are the main outcomes? Answers to the following questions - Do adolescents attend the screening and referral appointments? What impact do visits have on their health and education? How much does it cost for an adolescent to be screened and to obtain the recommended care for a condition? Is this a good value for money?What is innovative about this study? The approach is innovative and novel, because, few LMICs currently provide check-up visits for adolescents and in countries where they are provided, the visits don't always meet the needs of adolescents e.g. don't include mental health screening. This proposal takes the innovative and bold step of moving from condition-specific health programmes towards an adolescent-centred approach focusing on what matters most to adolescents. This is the first empirical study to have investigated the effectiveness and cost-effectiveness of multi-component adolescent health check-ups. Specific innovations: - Youth Researchers will participate in a human-centred design approach to intervention development- Digital platform on which adolescents will complete some of the health screening activities, saving consultation time and improving the quality and efficiency of data collection- Novel adolescent engagement activities including crowdsourcing contests and a reward system in the digital platform with adolescents gaining points when they complete screening and/or attend referral visits- Machine learning and innovative data analysis to maximise A-CHECK efficiency and engagement by providing targeted messages and servicesWhy Zimbabwe? Zimbabwe is an ideal location for A-CHECK with great potential for scale-up given the close collaboration between BRTI and the Ministries of Health and Education, the emphasis on prevention within the 2018 School Health Policy, and the absence of other good ways to screen and refer adolescents. In other African settings, there is considerable interest in adolescent check-ups and potential for the Zimbabwean model to be adapted elsewhere.

在青春期，所采取的与健康相关的行为将对个人的短期和长期健康、教育程度和就业前景产生重大的积极或消极影响。然而，在大多数低收入国家，很少有青少年接触过卫生服务，特别是健康促进和疾病预防服务，而且服务并不总是适合他们的需求。由于资源限制，提供高质量的青年友好型卫生服务的能力往往有限。技术进步提供了在传统临床环境之外提供服务和信息的机会，从而减少了成本或保密性等障碍。青少年可能特别容易接受数字平台，让他们能够自我管理自己的健康和福祉。什么是A-CHECK？该计划将通过对年轻（10-13 岁）和较大（16-19 岁）青少年的健康检查来筛查和治疗/转诊青少年的常见病症。仅通过准确且可接受的测试和当地可及的有效干预措施（例如，心理健康、艾滋病毒、视力和听力、贫血。具体会做什么？我将在津巴布韦开发、试点测试、实施和评估创新的 A-CHECK 计划以及配套的数字平台。年龄较小的青少年将在学校进行检查，年龄较大的青少年将在社区进行检查。该平台将允许青少年使用问卷（例如心理健康、危险行为）和预先存在的应用程序（测试听力、视力、身体成分）进行自我筛查，从而减少工作人员的工作量，并将帮助团队保持联系与青少年联系，并提供有关转诊预约的信息。我将分析通过 A-CHECK 计划收集的数据，以提高其未来的可接受性和成本效益。主要成果是什么？以下问题的答案 - 青少年是否参加筛查和转诊预约？访问对他们的健康和教育有何影响？青少年接受筛查并获得针对某种疾病的建议护理需要花费多少费用？这个性价比高吗？这项研究有何创新之处？这种方法具有创新性和新颖性，因为目前很少有中低收入国家为青少年提供体检服务，而且在提供此类服务的国家，这些体检并不总能满足青少年的需求，例如不包括心理健康筛查。该提案迈出了创新和大胆的一步，从针对具体情况的健康计划转向以青少年为中心的方法，重点关注对青少年最重要的事情。这是第一项调查多成分青少年健康检查的有效性和成本效益的实证研究。具体创新： - 青年研究人员将参与以人为本的设计方法来制定干预措施 - 青少年将在数字平台上完成一些健康筛查活动，节省咨询时间并提高数据收集的质量和效率 - 新颖的青少年参与活动包括众包竞赛和数字平台中的奖励系统，青少年在完成筛选和/或参加推荐访问时获得积分 - 机器学习和创新数据分析，通过提供有针对性的信息和服务来最大限度地提高 A-CHECK 效率和参与度为什么选择津巴布韦？鉴于 BRTI 与卫生和教育部之间的密切合作、2018 年学校卫生政策中对预防的强调以及缺乏其他良好的筛查方法，津巴布韦是 A-CHECK 的理想地点，具有巨大的扩大潜力并推荐青少年。在非洲其他地区，人们对青少年检查非常感兴趣，津巴布韦模式有可能在其他地方采用。

项目成果

Designing Routine Health Checkups for Adolescents in Zimbabwe.

• DOI: 10.1016/j.jadohealth.2021.07.002
• 发表时间: 2021-12
• 期刊: The Journal of adolescent health : official publication of the Society for Adolescent Medicine
• 作者: Chingono RMS;Mackworth-Young CRS;Ross DA;Tshuma M;Chiweshe T;Nyamayaro C;Sekanevana C;Doyle AM;Weiss HA;Kohl K;Mangombe A;Madzima B;McHugh G;Ferrand RA
• 通讯作者: Ferrand RA