Abstract

BackgroundAdolescent multiple risk behaviour (MRB) continues to be a global health issue. Most interventions have focused on the proximal causes of adolescent MRB such as peer or family influence, rather than targeting the wider environmental or structural context. There is increasing recognition that community mobilisation approaches could be beneficial for adolescent health. Despite this, there are gaps in the current literature, theory and implementation that would benefit from a realist approach due to the suitability of this methodology to analysing complex interventions. The objective of this study is to understand ‘how, why, for whom and in what circumstances and time periods’ do community mobilisation interventions work to prevent and/or reduce adolescent multiple risk behaviour.MethodsThis is a protocol for a realist review. The review will use a six-stage iterative process, guided by the RAMESES framework. We will systematically search PubMed, MEDLINE, PsycINFO, Web of Science, CINAHL and Sociological s, from their inception to 2021. Studies will be screened for relevance to the programme theory and included based on a priori eligibility criteria including (1) reporting a community mobilisation intervention (2) targeting two health risk behaviors (3) for adolescent populations. Two independent reviewers will select, screen and extract data related to the program theory from all relevant sources. A realist logic of analysis will be used to identify all context-mechanism-outcome configurations that contribute to our programme theory. The findings will be synthesised to produce a refined programme theory model.DiscussionThe goal of this realist review is to identify and refine a programme theory for community mobilisation approaches to the prevention and/or reduction of adolescent multiple risk behaviour. Our aim is that the findings surrounding the programme theory refinement can be used to develop and implement adolescent multiple risk behaviour interventions and maintain collaboration between local policy makers, researchers and community members.Systematic review registrationThis realist review is registered on the PROSPERO database (registration number: CRD42020205342).

Highlights

  • Adolescent multiple risk behaviour (MRB) continues to be a global health issue

  • Systematic review registration: This realist review is registered on the PROSPERO database

  • We aim to address the gap in the literature through investigating community mobilisation interventions aimed at preventing and/or reducing adolescent multiple risk behaviour

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Summary

Introduction

Adolescent multiple risk behaviour (MRB) continues to be a global health issue. Most interventions have focused on the proximal causes of adolescent MRB such as peer or family influence, rather than targeting the wider environmental or structural context. MRB has been found to be associated with a number of adverse health and social outcomes such as poor educational attainment [7]; obesity, depression and anxiety in adulthood [8]; and cancers and premature mortality [7, 9] This has, in turn, led to public health interventions that address multiple as opposed to single behaviours [10]. Most interventions addressing adolescent MRB have focused on the proximal causes such as peer or family influence, rather than targeting the wider environmental, social or structural context [11]. Two Cochrane systematic reviews have assessed the impact of individual, family and school-level interventions on adolescent multiple risk behaviour [10, 12]. There is increasing recognition that structural changes that extend beyond individually focused educational programmes could be beneficial for adolescent health [14, 15]

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