Periodic Reporting for period 1 - YoPAAPE (A Youth-centred Preventive Action Approach towards co-created implementation of socially and Physically activating Environmental interventions)
Reporting period: 2023-01-01 to 2024-06-30
Insufficient physical activity is associated with many non-communicable diseases (NCDs) and responsible for >5 million deaths worldwide each year. Public health guidelines recommend at least 60 minutes/day of moderate-to-vigorous physical activity for youth. An alarmingly low number of teenagers meet these public health guidelines: on a global level, only 22% of boys and 15% of girls between the age of 12-18 years. As a result, many young people have an increased risk of developing physical inactivity-related NCDs, both physical and mental.
Many interventions on improving physical activity in adolescents have had disappointing impact because they were not context-specific and implemented top-down and adult-driven, not addressing the real needs and lived experience of young people. For example, the beneficial long-term effects of regular physical activity on reducing morbidity and health-care cost are highly relevant for health professionals and policy makers, while for teenagers the more immediate benefits on wellbeing, directly or indirectly through social interaction, and having fun are relevant. In programmes that did engage young people, those selected were often already confident, articulate, and naturally identified leaders. In practice, engagement of youth growing up in vulnerable life situations (e.g. living in socially and economically underprivileged neighbourhoods, those with lower educational levels) in implementation of preventive interventions would have greater impact on closing equity gaps in health and wellbeing.
By introducing teen-centred evidence-informed co-creation, a Youth-centred Participatory Action (YoPA; formerly called YoPAAPE: A Youth-centred Preventive Action Approach towards co-created implementation of socially and Physically activating Environmental interventions) proposes an alternative approach to tackle the complex real-world societal challenges of physical inactivity and health inequalities. In this novel participatory approach, teenagers are central to the implementation and evaluation of holistic, systemic interventions tailored to their local communities. YoPA focuses on the physical and built environment as well as the social environment in light of the importance of peer influence and social networks for both physical activity and wellbeing. Through empowerment, YoPA aims to enhance personal and collective agency and perceptions of personal control, which has a direct effect on improving health outcomes.
The overall aim of YoPA is to optimally tailor, implement and evaluate social and physical environmental interventions for structural improvement in the lifestyle of teenagers (12-18 years) in vulnerable life situations to reduce their risk for NCDs.
Many interventions on improving physical activity in adolescents have had disappointing impact because they were not context-specific and implemented top-down and adult-driven, not addressing the real needs and lived experience of young people. For example, the beneficial long-term effects of regular physical activity on reducing morbidity and health-care cost are highly relevant for health professionals and policy makers, while for teenagers the more immediate benefits on wellbeing, directly or indirectly through social interaction, and having fun are relevant. In programmes that did engage young people, those selected were often already confident, articulate, and naturally identified leaders. In practice, engagement of youth growing up in vulnerable life situations (e.g. living in socially and economically underprivileged neighbourhoods, those with lower educational levels) in implementation of preventive interventions would have greater impact on closing equity gaps in health and wellbeing.
By introducing teen-centred evidence-informed co-creation, a Youth-centred Participatory Action (YoPA; formerly called YoPAAPE: A Youth-centred Preventive Action Approach towards co-created implementation of socially and Physically activating Environmental interventions) proposes an alternative approach to tackle the complex real-world societal challenges of physical inactivity and health inequalities. In this novel participatory approach, teenagers are central to the implementation and evaluation of holistic, systemic interventions tailored to their local communities. YoPA focuses on the physical and built environment as well as the social environment in light of the importance of peer influence and social networks for both physical activity and wellbeing. Through empowerment, YoPA aims to enhance personal and collective agency and perceptions of personal control, which has a direct effect on improving health outcomes.
The overall aim of YoPA is to optimally tailor, implement and evaluate social and physical environmental interventions for structural improvement in the lifestyle of teenagers (12-18 years) in vulnerable life situations to reduce their risk for NCDs.
In the first three months, the coordinating team of Amsterdam UMC (AUMC; formerly called VUmc) wrote a Project Handbook, which will be updated during the course of the project. As described in the Project Handbook, the coordinating team has formed a Project Office at AUMC, and a General Assembly, consisting of one representative per beneficiary. The General Assembly has hired six PhD students. Together with the work package (WP) leaders, a recognized and/or senior researcher of each participating country, all PhD students and some supportive personnel, it has formed an extended Executive Board. This extended Executive Board had an in-person meeting of three days in Amsterdam in September 2023 as a kick-off of the project. In addition, this Board met once a month to discuss the research progress and exchange experiences. Additonaly, a Scientific Advisory Board has been installed, consisting of external researchers advicing on the research.
During the first reporting period, the coordinating team organized several educational activities to generate the necessary expertise among consortium members. Experts in Youth Participatory Action Research, all PhD students, research assistants, and other interested researchers or future facilitators met online biweekly to learn about facilitating youth co-creation sessions and collaborate in developing a practical co-creation protocol. During the in-person meeting in Amsterdam in September 2023, the practical co-creation protocol was tested, combined with an in-depth training on research methodology. In May 2024, a two-day online workshop on realist methodology was organized as well as an introduction in applying a systems approach.
The extended Executive Board has booked several results described in the deliverables. The meetings on facilitating co-creation sessions have resulted in a general co-creation protocol. The protocol has been approved by the ethical committees in Denmark, the Netherlands, Nigeria and South Africa where youth co-creation groups have been set-up. The Belgium team has conducted interviews among the YoPA senior researchers to develop an initial program theory as part of the realist evaluation. The coordinating team has written a Data Management Plan which meets all national and international legal requirements and regulations and follows the FAIR principles. Also, the local co-creation groups at the four sites have started their research on mapping their local system.
Concerning the dissemination of YoPA, Professor Oyeyemi presented the YoPA project as part of the International Society of Behavioral Nutrition and Physical Activity (ISBNPA) congress in Uppsala, Sweden. In addition, Dr. Marlene Nunes Silva presented YoPA at ILIND-Ulusofona scientific event, and Professor Chin A Paw presented the YoPA project during a kick-off meeting of a newly funded European research project (i.e. CONNECTION). Furthermore, the principal investigators and senior researchers of YoPA have published a YoPA protocol paper and registered the YoPA protocol at clinicaltrials.gov (trial registration number: NCT06181162). All results are freely available and published on the Open Science Framework website (https://osf.io/rgkvu/).
During the first reporting period, the coordinating team organized several educational activities to generate the necessary expertise among consortium members. Experts in Youth Participatory Action Research, all PhD students, research assistants, and other interested researchers or future facilitators met online biweekly to learn about facilitating youth co-creation sessions and collaborate in developing a practical co-creation protocol. During the in-person meeting in Amsterdam in September 2023, the practical co-creation protocol was tested, combined with an in-depth training on research methodology. In May 2024, a two-day online workshop on realist methodology was organized as well as an introduction in applying a systems approach.
The extended Executive Board has booked several results described in the deliverables. The meetings on facilitating co-creation sessions have resulted in a general co-creation protocol. The protocol has been approved by the ethical committees in Denmark, the Netherlands, Nigeria and South Africa where youth co-creation groups have been set-up. The Belgium team has conducted interviews among the YoPA senior researchers to develop an initial program theory as part of the realist evaluation. The coordinating team has written a Data Management Plan which meets all national and international legal requirements and regulations and follows the FAIR principles. Also, the local co-creation groups at the four sites have started their research on mapping their local system.
Concerning the dissemination of YoPA, Professor Oyeyemi presented the YoPA project as part of the International Society of Behavioral Nutrition and Physical Activity (ISBNPA) congress in Uppsala, Sweden. In addition, Dr. Marlene Nunes Silva presented YoPA at ILIND-Ulusofona scientific event, and Professor Chin A Paw presented the YoPA project during a kick-off meeting of a newly funded European research project (i.e. CONNECTION). Furthermore, the principal investigators and senior researchers of YoPA have published a YoPA protocol paper and registered the YoPA protocol at clinicaltrials.gov (trial registration number: NCT06181162). All results are freely available and published on the Open Science Framework website (https://osf.io/rgkvu/).
YoPA goes beyond the state-of-the-art by combining youth participatory research with a complex systems approach. Youth are currently being trained as co-researchers. Based on the rigorous co-creation protocol, these youth and the PhD students will collaborate with multiple key stakeholders in mapping their local system. These local systems maps will be used to find leverage points that will be targeted by tailored interventions aimed at systems change, supporting healthy 24/7 movement behaviours.
In addition, researchers of AUMC and Cooperativa de Formacao e Animacao Cultural CRL (COFAC) are developing a plan together with the knowledge transfer office at AUMC named IXA. They are exploring the set-up of a licensed training programme to enable dissemination of the YoPA approach (e.g. e-learnings, webinars and manuals).
All results will be integrated in an open access YoPA toolbox targeted at researchers, public health practitioners, policy makers, and citizens.
In addition, researchers of AUMC and Cooperativa de Formacao e Animacao Cultural CRL (COFAC) are developing a plan together with the knowledge transfer office at AUMC named IXA. They are exploring the set-up of a licensed training programme to enable dissemination of the YoPA approach (e.g. e-learnings, webinars and manuals).
All results will be integrated in an open access YoPA toolbox targeted at researchers, public health practitioners, policy makers, and citizens.