Multi-component interventions to reducing unhealthy diets and physical inactivity among adolescents and youth in sub-Saharan Africa (Generation H)

撒哈拉以南非洲城市脆弱的卫生系统已经不堪非传染性疾病的重负。尽管如此，世卫组织非传染性疾病预防的循证最佳购买政策在非洲区域的执行工作被发现偏离了轨道。此外，对青少年的关注较少，但这是一个确立非传染性疾病风险因素行为模式并跟踪到成年的时期。在撒哈拉以南非洲，我们对如何在真实的世界环境中实施和扩大有效的饮食和体育活动干预措施的理解也存在差距。因此，我们的项目旨在减少两个重要的非传染性疾病可改变的风险因素：生活在两个撒哈拉以南非洲国家（加纳和肯尼亚）混合社会经济城市社区的青少年（10-19岁）中的不健康饮食和缺乏身体活动及其潜在的社会决定因素，方法是设计、部署和评估战略，以实施世卫组织最佳购买计划中的有证据和有理论依据的干预措施。我们之所以选择这两个国家，是因为它们代表了营养转型的不同文化背景（东非和西非），而且这两个国家都在经历快速的经济发展、城市化和非传染性疾病患病率的增加。干预措施的实施将采取多部门办法，以提高青少年吃得更健康和更积极参加体育活动的能力、机会和动力。我们将重点关注三个设置来增强覆盖范围：这一项目将共同增加机会、提高认识、增加知识和健康知识，激励志愿者提高自我效能，指导自我调节行动，并采取积极的健康行为（例如劝阻人们不要缺乏身体活动和久坐不动的行为，或选择不健康的食物），以预防非传染性疾病。

The fragile health systems in urban sub-Saharan Africa (SSA) are already overwhelmed with NCDs. Despite this, the implementationof the evidence-based WHO Best Buys policies for NCDs prevention in the African region has been found to be off-track. Additionally,less attention has been given to adolescents and yet this is a period in life where behavioural patterns of NCDs risk factors are establishedand track into adulthood. There is also a gap in our understanding on how to implement and scale up effective diet and physical activityinterventions in real world settings in SSA. Our project therefore aims to reduce two important modifiable risk factors for NCDs:unhealthy diets and physical inactivity and their underlying social determinants among adolescents (aged 10-19 years) living in mixedsocio-economic urban communities in two SSA countries (Ghana & Kenya) by designing, deploying, and evaluating strategies forimplementation of evidenced and theory based interventions mapped on to the WHO Best Buys. We selected the two countries becausethey represent different cultural contexts of nutrition transition (East and West Africa), and both countries are undergoing rapid economicdevelopment, urbanisation and increases in NCD prevalence. The intervention delivery will take a multi-sectoral approach to increasingthe capability, opportunity and motivation of adolescents to eat healthier and be more physically active. We will focus on three settingsto enhance the reach: secondary schools and, family/community/faith-based settings and the digital environment using social media.Together, this project will increase opportunities, awareness, knowledge and health literacy, motivate adolescentsto increase self-efficacy,guide self-regulatory actions and adopt positive health behaviour (such as dissuasion from physical inactivity and sedentary behaviours,or unhealthy food choices) to prevent NCDs.