Co-design of an intervention to address alcohol use among adolescent boys and young men in Tanzania

该项目解决了在如何全面解决撒哈拉以南非洲青春期男孩和青年男子开始、使用和滥用酒精问题方面的一个关键证据缺口。最近的全球健康调查发现，酒精是世界上15-49岁男性死亡的最大风险因素。在非洲，男性青少年（10-19岁）之间的人际暴力等可预防原因造成的死亡高于任何其他区域。青少年饮酒是这些问题的一个重要原因，主要发生在男孩和青年男子中。过早饮酒会使你更有可能在成年后成为一个酒鬼，导致成人健康状况不佳，并对家庭、就业和社会产生不良影响。减少男性青少年酒精使用的干预措施可以减少非洲的死亡和疾病，并使男孩充分发挥潜力。在富裕国家进行的一些研究表明，这些干预措施可能有效，但在撒哈拉以南非洲进行的试验却很少。坦桑尼亚的年轻人喝酒的方式和东非和中非的许多其他地方一样。因此，我们的研究将对非洲其他地区有用。此外，我们的研究小组在坦桑尼亚的青少年健康研究方面具有经验和技能，并已建立了国内伙伴关系和网络。当地教师、与年轻人一起工作的人以及卫生部和教育部的关键人物都要求我们帮助制定针对其男性青少年的干预措施，因为认识到目前国际上的重点一直放在女童身上。我们的研究还支持世界卫生组织（世卫组织）减少有害使用酒精的全球战略，并将有助于填补东非酒精政策的空白。该项目是两个主要的英国和坦桑尼亚研究和学习机构、一个坦桑尼亚转诊医院和研究中心、三个坦桑尼亚社区组织以及坦桑尼亚全国和两个地区的地方政府当局之间的伙伴关系。我们的总体目标是共同制定一揽子学校和社区干预措施，并制定战略，优化它们之间的相互作用，以预防、延迟和减少坦桑尼亚高酒精使用环境中的青少年男性的酒精使用。这将通过四个具体目标来实现：目标1：了解社区中人们对什么使青春期男孩和年轻男子饮酒以及饮酒的方式和地点的看法目标2：与社区中的人们合作，在社区和学校设计活动，以防止和减少青春期男孩和年轻男子的酒精使用。目的3：评估相关人员是否喜欢干预并相信它会起作用。目的4：收集信息以帮助设计更大的研究，以确定干预是否实际起作用。我们的研究项目将直接惠及坦桑尼亚的青春期男孩和青年男子、他们的社区、教师和学校官员以及地方和国家政府。我们将发现新的方法来制定复杂的干预措施，以减少年轻人，特别是那些易受伤害的年轻人的饮酒。我们学到的东西将与政治家、与年轻人一起工作的人以及研究人员分享。这也将帮助我们计划一个更大的研究来测试这种干预是如何大规模地起作用的。

The project addresses a critical evidence gap in how to comprehensively address alcohol initiation, use and abuse amongst adolescent boys and young men (ABYM) in sub Saharan Africa (SSA). The most recent survey of global health found that alcohol is the biggest risk factor for death among 15-49 year old men in the world. Death from preventable causes in Africa, such as interpersonal violence among male adolescents (aged 10-19 years) is higher than in any other region. Adolescent alcohol use is an important cause of these problems and predominantly amongst boys and young men. Drinking at an early age makes it more likely that you will be an alcoholic in adulthood, and causes poor adult health and bad effects on family, employment, and society. Interventions to decrease alcohol use among male adolescents could decrease death and illness in Africa and let boys reach their full potential. Some studies in rich countries have shown that these interventions might work, but very few have been tested in sub Saharan Africa. The way young people drink in Tanzania is like many other places in East and Central Africa. Our research will therefore be useful to other African settings. Also, our research team has experience and skill in adolescent health research in Tanzania with in-country partnerships and networks already in place. Local teachers, people who work with young people and key people from the ministries of health and education have asked us to help develop interventions for their male adolescents, in recognition that current international focus has been on the girl-child. Our research also supports the World Health Organisation (WHO) Global Strategy to Reduce the Harmful Use of Alcohol and will help fill gaps in alcohol policy in East Africa.The project is a partnership between two leading UK and Tanzanian research and learning institutes, a Tanzanian referral hospital and research centre, three Tanzanian based community based organisation, and local government authorities nationally and within two districts of Tanzania. Our overall aim is to co-create a package of school and community interventions and develop strategies to optimise the interplay between them in order to prevent, delay and reduce alcohol use among adolescent males in high alcohol use settings in Tanzania. This will be achieved through 4 specific objectives:OBJECTIVE 1: To understand what people in the community think about what makes adolescent boys and young men drink and how and where that drinking happensOBJECTIVE 2: To work with people in the community do design activities in the community and schools that will prevent and decrease alcohol use among adolescent boys and young men. OBJECTIVE 3: To assess the whether the relevant people like the intervention and believe that it will workOBJECTIVE 4: To collect information to help design a bigger study that will see if the intervention actually works.Our research project will directly benefit Tanzanian adolescent boys and young men, their communities, teachers and school officials as well as local and national government. We will discover new ways to develop complex interventions to decrease drinking amongst young people, especially those who are vulnerable. What we learn will be shared with politicians, people who work with with young people and researchers. It will also help us plan a larger study to test how the intervention works on a large scale.