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

Carmen H Logie, Moses Okumu, Isha Berry, Robert Hakiza, Daniel Kibuuka Musoke, Peter Kyambadde, Simon Mwima, Richard T Lester, Amaya G Perez-Brumer, Stefan Baral, Lawrence Mbuagbaw, Carmen H Logie, Moses Okumu, Isha Berry, Robert Hakiza, Daniel Kibuuka Musoke, Peter Kyambadde, Simon Mwima, Richard T Lester, Amaya G Perez-Brumer, Stefan Baral, Lawrence Mbuagbaw

Abstract

Introduction: With over 82.4 million forcibly displaced persons worldwide, there remains an urgent need to better describe culturally, contextually and age-tailored strategies for preventing COVID-19 in humanitarian contexts. Knowledge gaps are particularly pronounced for urban refugees who experience poverty, overcrowded living conditions and poor sanitation access that constrain the ability to practise COVID-19 mitigation strategies such as physical distancing and frequent hand washing. With over 1.4 million refugees, Uganda is sub-Saharan Africa's largest refugee hosting nation. More than 90 000 of Uganda's refugees live in Kampala, most in informal settlements, and 27% are aged 15-24 years old. There is an urgent need for tailored COVID-19 responses with urban refugee adolescents and youth. This study aims to evaluate the effectiveness of an 8-week interactive informational mobile health intervention on COVID-19 prevention practices among refugee and displaced youth aged 16-24 years in Kampala, Uganda.

Methods and analysis: We will conduct a pre-test/post-test study nested within a larger cluster randomised trial. Approximately 385 youth participants will be enrolled and followed for 6 months. Data will be collected at three time points: before the intervention (time 1); immediately after the intervention (time 2) and at 16-week follow-up (time 3). The primary outcome (self-efficacy to practise COVID-19 prevention measures) and secondary outcomes (COVID-19 risk awareness, attitudes, norms and self-regulation practices; depression; sexual and reproductive health practices; food and water security; COVID-19 vaccine acceptability) will be evaluated using descriptive statistics and regression analyses.

Ethics and dissemination: This study has been approved by the University of Toronto Research Ethics Board, the Mildmay Uganda Research Ethics Committee, and the Uganda National Council for Science & Technology. The results will be published in peer-reviewed journals, and findings communicated through reports and conference presentations.

Trial registration number: ClinicalTrials.gov Registry (NCT04631367).

Keywords: COVID-19; preventive medicine; public health.

Conflict of interest statement

Competing interests: RL is an academic physician-researcher and also has interests in a non-profit and private company social enterprise, WelTel, that develops and provides digital health software. He is not being paid or otherwise compensated by WelTel for this project. No other authors declare a conflict of interest.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Study design for Kukaa Salama, a pre-test/post-test trial of an interactive and informational mobile health (mHealth) strategy among urban refugee and displaced youth in Kamala, Uganda.

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