Abstract
Background: Prevention of non-communicable diseases (NCDs) and their behavioral risk factors (tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol) among children and adolescents have garnered paramount importance under the Sustainable Development Goals. Methods: Project PaThWay is a school-based, two years, multi-component intervention to prevent key behavioral NCD risk factors among school-going children (classes 6-8th; 10-14 years) from private and public schools across two Indian cities (Pune and Bengaluru). We assessed the baseline knowledge, attitude, and behavior related to NCD risk factors (unhealthy diet, physical inactivity, and tobacco use) of the participating students through a survey. The intervention was developed and designed for implementation by the trained teachers and similar-age peers, as facilitators. The teachers and peer leaders were trained through organising school-level orientation workshops for implementation of intervention activities, after baseline assessment. Year 1 of the intervention focuses on the knowledge and learnings and year 2 on enhancing the life-skills (leadership, communication, refusal, health advocacy, etc.). Regular monitoring visits by the project team to ensure intervention activities are being carried out as planned and providing continuous support. The end line evaluation will be done after the completion of two years’ intervention to evaluate the effectiveness of the Project PaThWay intervention. Outcome measures will include improved knowledge, positive attitude, improve behaviors related to diet, physical activity, and tobacco use, and enhanced skills in handling NCD risk factors. A process evaluation will explore several aspects of Project PaTHWay intervention (fidelity, dosage, reach, adaptations), social validity (acceptability, feasibility, utility). Conclusion: Project PaTHWay, having a multiple-component intervention, may offer the best chance for success, as it addresses multiple risk factors using multi-pronged strategies. The agents of intervention implementation are trained teachers and similar-age student peer leaders (as facilitators), one of the successful and effective approaches in school-based interventions globally and in India.
Highlights
Non-communicable diseases (NCDs) are the world’s leading public health challenge in the twenty-first century, contributing to poor health, economic and life loss, impaired quality of life, and poor social development, in high and low-resource countries[1,2]
The children and adolescents are at more risk due to reduced physical inactivity and unhealthy eating, due to confinement at home
Project PathWay is a timely initiative for preventing non-communicable diseases (NCDs) behavioral risk factors by engaging teachers, peer leaders and students
Summary
Non-communicable diseases (NCDs) are the world’s leading public health challenge in the twenty-first century, contributing to poor health, economic and life loss, impaired quality of life, and poor social development, in high and low-resource countries[1,2]. The specific objectives of Project PaTHWay are to: conduct a baseline evaluation to assess students’ knowledge, attitude, and behaviors (KAB) relevant to key behavioral NCD risk factors; develop a school-based, multi-component intervention for improving knowledge and bringing a positive change in attitude and behaviors of students, teachers, parents, and community by promoting healthy behaviors such as healthy diet, physical activity and non-use of tobacco; implement and evaluate the utility, feasibility, and acceptability of the developed intervention for enhancing the KAB of the target population. This questionnaire was developed based on the socio-ecological model[28], adapting measuresfrom reliable instruments that have been validated with adolescents in India[29,30,31,32] and questionnaires used by the authors
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