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

Abstract

IntroductionWith 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 analysisWe 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 disseminationThis 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 numberClinicalTrials.gov Registry (NCT04631367).

Leveraging interactive voice response technology to mitigate COVID-19 risk in refugee settlements in Uganda: Lessons learned implementing “Dial-COVID” a toll-free mobile phone symptom surveillance and information dissemination tool

“…Telephone-based interventions that do not require the internet may be an effective alternative. Investigators are currently researching an SMS-based intervention in a cluster randomized controlled trial among refugee youth in Kampala in which SMS messages are used to check-in with study participants and share COVID-19 information with the aim of increasing COVID-19 prevention practices [ 20 ]. Considering the varying levels of literacy among refugee populations, an intervention that relies on SMS messages with text may not be optimal to share and collect information [ 9 , 12 ].…”

Mobile Health Technologies Are Essential for Reimagining the Future of Water, Sanitation, and Hygiene

“…29 mHealth strategies have been successfully applied to a wide variety of public health problems 30,31 including use for WASH-related conditions such as diarrheal disease surveillance, 32 enhancing child health and caregiver attention to WASH conditions, 33 and addressing COVID-19 response in Africa. 34,35 There is growing evidence that mHealth may improve gender inequality 36 and address urban environmental injustice in many settings. 29,37,38 However, evidence is limited about successful integration of mHealth applications and their effectiveness for environmental health interventions-especially in urban communities where this work is critical.…”

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.…”