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被非传染性疾病压垮。尽管如此，世卫组织在非洲区域实施以证据为基础的非传染性疾病预防最划算政策的工作被发现偏离了轨道。此外，对青少年的关注较少，但这是一个非传染性疾病风险因素的行为模式被确立并追踪到成年期的生命阶段。在如何在SSA的现实世界环境中实施和扩大有效的饮食和体育活动干预方面，我们的理解也存在差距。因此，我们的项目旨在通过设计、部署和评估将证据和理论为基础的干预措施纳入世卫组织最佳购买方案的实施战略，减少两个重要的可改变的非传染性疾病风险因素：生活在两个SSA国家（加纳和肯尼亚）社会经济混合城市社区的青少年（10-19岁）中不健康的饮食和缺乏身体活动及其潜在的社会决定因素。我们之所以选择这两个国家，是因为它们代表了不同的营养转型文化背景（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方法，以提高青少年的能力、机会和动力，使他们吃得更健康，进行更多的身体活动。我们将重点关注三个环境以扩大覆盖面：中学和家庭/社区/基于信仰的环境以及使用社交媒体的数字环境。该项目将共同增加机会、提高认识、知识和健康素养，激励青少年提高自我效能感，指导自我调节行动，并采取积极的健康行为（如劝阻不活动和久坐行为，或不健康的食物选择），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.