Changemaker: study protocol for sustainable adolescent health interventions to reduce non-communicable disease risks in urban Burkina Faso, Kenya and Tanzania – a hybrid type 2 cluster-randomised controlled trial
15 affiliations
- 1Transdisciplinary Research Area "Technology and Innovation for Sustainable Futures" and Center for Development Research (ZEF), University of Bonn, Bonn, Germany
- 2Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- 3Tampere University, Tampere, Finland
- 4Global Public Health, Karolinska Institutet, Stockholm, Sweden
- 5Department of Agriculture, Livestock and Fisheries (DALF), County Government of Kisumu, Kisumu, Kenya
- 6School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
- 7Aga Khan University, Nairobi, Kenya
- 8Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
- 9Technical University of Kenya, Nairobi, Kenya
- 10Africa Academy for Public Health (AAPH), Dar es Salaam, United Republic of Tanzania
- 11Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso
- 12Institut Supérieur des Sciences de la Population (ISSP), Joseph Ki-Zerbo University of Ouagadougou, Ouagadougou, Burkina Faso
- 13Centre of Excellence Women and Child Health, Aga Khan University, Nairobi, Kenya
- 14Food Security for Peace and Nutrition (FSPN), Nairobi, Kenya
- 15Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
Abstract
Introduction: Adolescent obesity is a growing global health concern that significantly contributes to adult multimorbidity and the rising burden of non-communicable diseases (NCDs). Adolescence presents a critical window for shaping lifelong health behaviours that can prevent these outcomes. Effective health promotion during this stage can play a pivotal role in the primary prevention of NCDs. In low- and middle-income countries, urban adolescents encounter a complex interplay of risk factors, including unhealthy diets, physical inactivity and limited access to supportive health environments. However, evidence on designing and sustainably implementing multi-component, adolescent-centred health promotion and prevention interventions in these settings remains limited. This study aims to evaluate the implementation and effectiveness of a multicomponent intervention focusing on the primary prevention of NCD risks among adolescents.
Methods and analysis: After a co-design process, we will conduct three cluster-randomised controlled trials in secondary schools in three sub-Saharan African cities: Ouagadougou (Burkina Faso), Kisumu (Kenya) and Dar es Salaam (Tanzania). The study will include 2280 participants aged 12–16 years (190 students per school across four schools at each site). Over one academic year, a four-component intervention will be implemented: (1) establishment of school gardens and organic waste composting; (2) integration of sustainable health education modules into classes; (3) delivery of health talks using motivational strategies and (4) creating mass media campaigns promoting healthy lifestyles. The primary effectiveness outcomes for health and nutrition constitute mid-upper arm circumference z-score and haemoglobin concentration, respectively. Implementation outcomes will be assessed through a process evaluation examining participation and emotional and cognitive engagement (primary implementation outcomes), along with acceptability, adoption, feasibility, fidelity, reach and sustainability (secondary implementation outcomes). We will also evaluate the implementation costs of the intervention.
Ethics and dissemination: The Institutional Review Board (IRB) of University Hospital and Medical Faculty, University of Bonn (UoB) reviewed and approved the Changemaker study protocol and all its annexes in July 2024 (reference: 2024-265 BO). This serves as the principal approval from one of the coordinating institutions. In addition, the study protocol, its processes, and tools were reviewed and approved by local IRBs of the participating institutions. All participants will provide informed written consent or assent. Data will be pseudonymised and stored on secure UoB servers. Results will be disseminated via peer-reviewed publications, conferences and participant summaries.
Trial registration number: DRKS00034129.
Related
- Community-driven interventions for the prevention of non-communicable diseases (NCDs) in urban South Asia: a scoping review
- Comparative effectiveness of exercise and self-management interventions delivered through different modes of digital support on pain and patient-reported physical function in people with knee osteoarthritis: a systematic review and network meta-analysis of randomised controlled trials
- AI-enabled and comparator digital interventions for adolescent mental health (2020–2025): early detection, human–AI collaboration, and ethical governance—a PRISMA-ScR scoping review
- Promoting Positive Adolescent Mental Health (PPAMH!) for School Climate: protocol for a feasibility randomised control trial in secondary schools [version 2; peer review: 1 approved, 2 approved with reservations]
- Adolescent idiopathic scoliosis and comorbid anxiety and depression: advances in psychophysiological interaction mechanisms and integrated interventions
BibTeX
@article{sorgho2026changemaker,
title = {{Changemaker: study protocol for sustainable adolescent health interventions to reduce non-communicable disease risks in urban Burkina Faso, Kenya and Tanzania – a hybrid type 2 cluster-randomised controlled trial}},
author = {Raissa Sorgho and Sachin Shinde and Pilvikki Absetz and Helle Mölsted Alvesson and Joseph Ochieng Amoke and Anu Linnansaari and Linda B Mlunde and Abdu Mohiddin and Erick M O Muok and Alice Achieng Ojwang and Mary Mwanyika Sando and Ali Sié and Abdramane Bassiahi Soura and Bruno Sunguya and Marleen Temmerman and Amani Tinkasimile and Arthur Wamani and Changemaker Consortium and Kristi Sidney Annerstedt and Ina Danquah},
journal = {BMJ Open},
year = {2026},
month = oct,
doi = {10.1136/bmjopen-2026-123282},
url = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-123282},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Changemaker: study protocol for sustainable adolescent health interventions to reduce non-communicable disease risks in urban Burkina Faso, Kenya and Tanzania – a hybrid type 2 cluster-randomised controlled trial
AU - Raissa Sorgho
AU - Sachin Shinde
AU - Pilvikki Absetz
AU - Helle Mölsted Alvesson
AU - Joseph Ochieng Amoke
AU - Anu Linnansaari
AU - Linda B Mlunde
AU - Abdu Mohiddin
AU - Erick M O Muok
AU - Alice Achieng Ojwang
AU - Mary Mwanyika Sando
AU - Ali Sié
AU - Abdramane Bassiahi Soura
AU - Bruno Sunguya
AU - Marleen Temmerman
AU - Amani Tinkasimile
AU - Arthur Wamani
AU - Changemaker Consortium
AU - Kristi Sidney Annerstedt
AU - Ina Danquah
PY - 2026
DA - 2026/10/28
JO - BMJ Open
DO - 10.1136/bmjopen-2026-123282
UR - https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-123282
AB - Introduction: Adolescent obesity is a growing global health concern that significantly contributes to adult multimorbidity and the rising burden of non-communicable diseases (NCDs). Adolescence presents a critical window for shaping lifelong health behaviours that can prevent these outcomes. Effective health promotion during this stage can play a pivotal role in the primary prevention of NCDs. In low- and middle-income countries, urban adolescents encounter a complex interplay of risk factors, including unhealthy diets, physical inactivity and limited access to supportive health environments. However, evidence on designing and sustainably implementing multi-component, adolescent-centred health promotion and prevention interventions in these settings remains limited. This study aims to evaluate the implementation and effectiveness of a multicomponent intervention focusing on the primary prevention of NCD risks among adolescents. Methods and analysis: After a co-design process, we will conduct three cluster-randomised controlled trials in secondary schools in three sub-Saharan African cities: Ouagadougou (Burkina Faso), Kisumu (Kenya) and Dar es Salaam (Tanzania). The study will include 2280 participants aged 12–16 years (190 students per school across four schools at each site). Over one academic year, a four-component intervention will be implemented: (1) establishment of school gardens and organic waste composting; (2) integration of sustainable health education modules into classes; (3) delivery of health talks using motivational strategies and (4) creating mass media campaigns promoting healthy lifestyles. The primary effectiveness outcomes for health and nutrition constitute mid-upper arm circumference z-score and haemoglobin concentration, respectively. Implementation outcomes will be assessed through a process evaluation examining participation and emotional and cognitive engagement (primary implementation outcomes), along with acceptability, adoption, feasibility, fidelity, reach and sustainability (secondary implementation outcomes). We will also evaluate the implementation costs of the intervention. Ethics and dissemination: The Institutional Review Board (IRB) of University Hospital and Medical Faculty, University of Bonn (UoB) reviewed and approved the Changemaker study protocol and all its annexes in July 2024 (reference: 2024-265 BO). This serves as the principal approval from one of the coordinating institutions. In addition, the study protocol, its processes, and tools were reviewed and approved by local IRBs of the participating institutions. All participants will provide informed written consent or assent. Data will be pseudonymised and stored on secure UoB servers. Results will be disseminated via peer-reviewed publications, conferences and participant summaries. Trial registration number: DRKS00034129.
SN - 2044-6055
SN - 2044-6055
ER -