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，采用了与健康相关的行为，这些行为将对个人的短期健康，教育成就和就业前景产生重大积极或负面影响。但是，在大多数低收入国家中，很少有青少年与卫生服务有任何联系，尤其是为了促进健康和疾病，并且服务并不总是适合他们的需求。由于资源限制，提供高质量的青少年卫生服务的能力通常有限。技术进步提供了将服务和信息从传统临床环境中传递出来的机会，从而减少了诸如成本或机密性之类的障碍。青少年可能特别接受数字平台，使他们能够自我管理自己的健康和福祉。什么是A-Check？该计划将通过年轻（10-13y）和年龄较大（16-19岁）青少年的健康检查来筛选和治疗/推荐青少年，以期为常见条件。青少年只能通过准确且可接受的测试和本地可访问的有效干预措施来筛选以下条件。心理健康，艾滋病毒，视力和听力，贫血。到底会做什么？我将开发，进行试验，实施和评估津巴布韦的创新A-Check计划和随附的数字平台。检查访问将在学校和社区的学校进行，以供年长的青少年。该平台将通过允许青少年使用问卷（例如心理健康，风险行为）和预先存在的应用程序（测试听力，视力，身体组成）来减少员工的工作量，并将帮助团队与青少年保持联系并提供推荐约会的信息。我将通过A-Check计划分析收集的数据，以提高其未来的可接受性和成本效益。什么是主要结果？回答以下问题 - 青少年是否参加筛选和推荐约会？访问对他们的健康和教育有何影响？青少年被筛选并获得建议的护理费用是多少？这是物有所值的价值吗？这项研究的创新性是什么？这种方法具有创新性和新颖性，因为目前很少有LMIC为青少年和提供的国家提供检查访问，访问并不总是满足青少年的需求，例如不要包括心理健康筛查。该提案采取了从特定条件的健康计划转向以青少年为中心的方法的创新和大胆的步骤，重点是对青少年最重要的事情。这是首次研究多组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： - 青年研究人员将参加以人为中心的设计方法进行干预开发 - 数字平台，青少年将完成一些健康筛查活动，节省咨询时间，并提高咨询时间，并提高数据收集 - 新颖的青少年参与活动的质量和效率 - 众包竞赛以及在数字平台上与数字化的数据进行分析，并在数字平台上进行启用，并在数据范围内进行奖励，并在数据范围内进行奖励，以置于数据范围内，以置于数据范围内，并在数据范围内进行奖励，并在数据中读取了这些奖励，并在数据范围内读取了这些竞赛，并在数据范围内读取了这些竞赛，并且可以在数据范围内进行访问。 A-Check效率和参与度通过提供津巴布韦的目标消息和服务？津巴布韦是A-Check的理想场所，鉴于BRTI与卫生和教育部之间的密切合作，强调2018年学校卫生政策中的预防以及缺乏其他良好的筛查和参考青少年的方式，因此可以进行扩大规模。在其他非洲环境中，人们对青少年检查也引起了极大的兴趣，津巴布韦模型可以在其他地方进行调整的潜力。

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