mHealth Intervention for Increasing COVID-19 Prevention Practices With Urban Refugee and Displaced Youth in Uganda

NCT04631367 | Completed DMC

• 1 other identifier: idrc_covid
• Study Type: interventional
• Target: 330
• Locations: 1 country
• Sites: 1

Brief Summary

Uganda hosts 1.4 million refugees, making it Sub-Saharan Africa's largest refugee host community and the third largest globally. Adolescents and young people (AYP) comprise half of the world's 70.8 million forcibly displaced persons, yet they are understudied in pandemics, including in COVID-19. Poverty, overcrowded living conditions, and poor sanitation likely elevate forcibly displaced persons' COVID-19 risks by limiting their ability to practice mitigation strategies. There continue to be significant knowledge gaps regarding the implementation and effectiveness of behaviour change interventions on improving COVID-19 prevention practices (i.e. hand and respiratory hygiene, physical distancing). mHealth (healthcare delivered by mobile phones) is cost-effective, aligned with how youth learn and socialize, vital for physical distancing, and has been used for COVID-19 messaging in other low- and middle-income countries. Nested within an ongoing HIV self-testing cluster-randomized trial, this study aims to develop, implement, and evaluate the effectiveness of an mHealth intervention in increasing COVID-19 prevention practices with displaced/refugee AYP aged 16-24 in Kampala, Uganda. Participants will be enrolled in a 8-week mHealth social group intervention program that is informed by the RANAS (Risks, Attitudes, Norms, Abilities, and Self-Regulation) approach to Water, Sanitation, and Hygiene. Using a pre-test/post-test design, this study will assess changes in participants' self-efficacy (e.g. ability, confidence, adherence) in COVID-19 prevention practices.

Conditions

Knowledge, Attitudes, Practice; Covid19

Keywords

Uganda; Forcibly displaced youth; mHealth; Water, Sanitation and Hygiene; RANAS (Risks, Attitudes, Norms, Abilities, Self-Regulation); COVID-19

Outcome Measures

Primary Outcomes (1)

• Changes in COVID-19 Prevention Practices

  To assess changes in COVID-19 prevention practices, participants are asked to report on their self-efficacy (i.e. ability, confidence, adherence) to practice hand and respiratory hygiene (i.e. hand washing with soap, face mask usage) and physical distancing.

  Time 1 (1 week), Time 2 (8 week), Time 3 (month 16 week)

Secondary Outcomes (7)

• Changes in COVID-19 Risk Awareness

  Time 1 (1 week), Time 2 (8 week), Time 3 (month 16 week)

• Changes in Attitude towards COVID-19

  Time 1 (1 week), Time 2 (8 week), Time 3 (month 16 week)

• Changes in COVID-19 Norms

  Time 1 (1 week), Time 2 (8 week), Time 3 (month 16 week)

• Changes in COVID-19 Self-Regulation

  Time 1 (1 week), Time 2 (8 week), Time 3 (month 16 week)

• Changes in Depression

  Time 1 (1 week), Time 2 (8 week), Time 3 (month 16 week)

Study Arms (1)

Kukaa Salama: mHealth intervention

EXPERIMENTAL

This is a pre-test/post-test trial, therefore all participants will receive the Kukaa Salama mHealth intervention and will be offered a COVID-19 prevention parcel.

Behavioral: Kukaa Salama: mHealth intervention; Device: Face Mask + Soap

Interventions

Kukaa Salama: mHealth intervention BEHAVIORAL

Kukaa Salama is a 8-week social group program of COVID-19 prevention messaging, which includes sending informational SMS once per week and holding secure group discussions on COVID-19 prevention. Weekly SMS messages will focus on COVID-19 knowledge, including information about transmission, hand washing, respiratory hygiene (coughing and sneezing in ways that won't spread germs), face masks, and physical distancing. Participants can also respond to the SMS with any questions about COVID-19, and the study team will respond with further information and/or additional resources. Weekly group chats will be administered using the customized WelTel platform, and will focus on discussions of how participants can apply and practice the information on COVID-19 prevention in their daily lives. Each group chat will be composed of 15-20 participants, and will be facilitated by a research assistant in Kampala as well as a peer navigator.

Kukaa Salama: mHealth intervention

Face Mask + Soap DEVICE

Participants will be offered the opportunity to pick up a parcel that contains a face mask, bar of soap, and a small parcel of food from the partner agency YARID.

Kukaa Salama: mHealth intervention

Eligibility Criteria

• Age: 16 Years - 24 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Enrolled within the Tushirikiane HIV-self Testing cluster randomized trial
• Live in one of the 5 slum/informal settlement sites (Kabalanga, Kasanga, Katwe, Nsambya Rubaga)
• Identify as a refugee/displaced person or have refugee parents
• Age 16-24 years
• Speak English, Luganda, French, Swahili, or Kinyarwanda
• Own or have access to a mobile phone for the duration of the study

You may not qualify if:

• Not currently enrolled in the Tushirikiane HIV-self Testing cluster randomized trial
• Lives outside of 5 selected study sites
• Does not identify as a refugee or does not have refugee parents
• Less than 16 or older than 24 years
• Does not speak English, Luganda, French, Swahili, or Kinyarwanda
• Does not have mobile phone

Sponsors & Collaborators

• University of Toronto: lead

Study Sites (1)

Factor-Inwentash Faculty of Social Work, University of Toronto

Toronto, Ontario, M5S1V4, Canada

Location

Related Publications (2)

• Logie CH, Okumu M, Berry I, McAlpine A, Musoke DK, Hakiza R, Perez-Brumer A, Baral S, Kyambadde P. Multi-method findings on COVID-19 vaccine acceptability among urban refugee adolescents and youth in Kampala, Uganda. Glob Public Health. 2023 Jan;18(1):2185800. doi: 10.1080/17441692.2023.2185800.

  PMID: 36883681 DERIVED

• Logie CH, Okumu M, Berry I, Hakiza R, Kibuuka Musoke D, Kyambadde P, Mwima S, Lester RT, Perez-Brumer AG, Baral S, Mbuagbaw L. Kukaa Salama (Staying Safe): study protocol for a pre/post-trial of an interactive mHealth intervention for increasing COVID-19 prevention practices with urban refugee youth in Kampala, Uganda. BMJ Open. 2021 Nov 22;11(11):e055530. doi: 10.1136/bmjopen-2021-055530.

  PMID: 34810193 DERIVED

MeSH Terms

Conditions

Behavior; COVID-19; Self-Control

Interventions

Masks

Condition Hierarchy (Ancestors)

Pneumonia, Viral; Pneumonia; Respiratory Tract Infections; Infections; Virus Diseases; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Lung Diseases; Respiratory Tract Diseases; Social Behavior

Intervention Hierarchy (Ancestors)

Surgical Attire; Equipment and Supplies, Hospital; Equipment and Supplies; Protective Devices; Personal Protective Equipment; Surgical Equipment; Manufactured Materials; Technology, Industry, and Agriculture

Study Officials

• Carmen H Logie, PhD

  University of Toronto, Canada

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Model Details: A single arm, pre-test/post-test trial design will be used to evaluate the effectiveness of a RANAS-informed WhatsApp Social Group intervention on uptake of COVID-19 prevention practices (i.e. hand and respiratory hygiene, physical distancing) with displaced/refugee youth in Kampala, Uganda. A control group design is intentionally not used based on recommendations regarding ethical concerns over the potential withholding of any intervention benefits from a vulnerable group (refugee youth living in informal settlements) in the midst of a pandemic.

Study Record Dates

• First Submitted: November 13, 2020
• First Posted: November 17, 2020
• Study Start: February 1, 2021
• Primary Completion: August 20, 2021
• Study Completion: October 31, 2021
• Last Updated: December 28, 2021

Record last verified: 2021-12

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)