Kukaa Salama (Staying Safe): a pre-post trial of an interactive informational mobile health intervention for increasing COVID-19 prevention practices with urban refugee youth in Uganda

Abstract

Background Tailored coronavirus disease 2019 (COVID-19) prevention strategies are needed for urban refugee youth in resource-constrained contexts. We developed an 8-wk interactive informational mobile health intervention focused on COVID-19 prevention practices informed by the Risk, Attitude, Norms, Ability, Self-regulation—or RANAS—approach. Methods We conducted a pre-post trial with a community-recruited sample of refugee youth aged 16–24 y in Kampala, Uganda. Data were collected before (T1) and immediately following (T2) the intervention, and at the 16-wk follow up (T3), to examine changes in primary (COVID-19 prevention self-efficacy) and secondary outcomes (COVID-19 risk awareness, attitudes, norms and self-regulation practices; depression; sexual and reproductive health [SRH] access; food/water security; COVID-19 vaccine acceptability). Results Participants (n=346; mean age: 21.2 [SD 2.6] y; cisgender women: 50.3%; cisgender men: 48.0%; transgender persons: 1.7%) were largely retained (T2: n=316, 91.3%; T3: n=302, 87.3%). In adjusted analyses, COVID-19 prevention self-efficacy, risk awareness, attitudes and vaccine acceptance increased significantly from T1 to T2, but were not sustained at T3. Between T1 and T3, COVID-19 norms and self-regulation significantly increased, while community violence, water insecurity and community SRH access decreased. Conclusions Digital approaches for behaviour change hold promise with urban refugee youth but may need booster messaging and complementary programming for sustained effects.

Exploring ecosocial contexts of alcohol use and misuse during the COVID-19 pandemic among urban refugee youth in Kampala, Uganda: Multi-method findings

“…This multi-methods study uses cross-sectional data collected as part of an embedded COVID-19 study ( Kukaa Salama ) within the parent cohort study, the Tushirikiane HIV self-testing randomized control trial (RCT) conducted with refugee adolescent youth in Kampala, Uganda ( Logie et al, 2021 ). The intervention and primary outcomes for Tushirikiane ( Logie et al, 2021 , 2023 ) and Kukaa Salama ( Logie et al, 2021 , 2023 ) have been described elsewhere. We use cross-sectional data in this analysis at a timepoint (February to March 2022) that included measurement of the variables of interest, namely alcohol use and COVID-19 stressors.…”