How does the FRESHAIR4Life Teach the Teacher programme impact the competence, confidence, and intervention fidelity of master trainers in five low- and middle-income contexts?

Context: FRESHAIR4Life is an implementation science project to reduce adolescents’ exposure to air pollution and tobacco in five high-risk countries: Greece, Kyrgyzstan, Romania, Pakistan and Uganda. Evidence-based community interventions were selected following in-depth situational analyses. However, successful implementation depends on the fidelity of local adaptation, underscoring the need for robust capacity-building initiatives. Change strategy: FRESHAIR4Life Teach the Teacher programme, created by IPCRG, delivered three 2.5 hour online sessions using a two-tier cascade model. An international “master faculty” was recruited to co-develop a novel curriculum that enabled national "master teachers" to adapt and implement interventions suited to their local context. The international master faculty offered expertise in working with adolescents, behaviour change, educational design, health policy and the specific interventions: Very Brief Advice, Brief Advice, and the If-Then approach. National master teachers were selected for their educational experience and knowledge of the local context. Aims: - Foster collegial peer learning - Clarify unique situational factors and how these impact on intervention delivery - Offer strategies and tools for engaging with adolescents and behaviour change - Develop practical implementation strategies in settings such as schools, primary care clinics and sports clubs. Impact: Initial feedback is positive. Online teaching enabled affordable delivery of a world-class programme engaging an experienced international master faculty and five countries. Each country was paired with a dedicated faculty mentor to support fidelity in both intervention adaptation and teaching methods. The national programmes are now being developed. Programme impact is being assessed using mixed methods, including curriculum analysis, surveys, observation and focus groups to evaluate improvements in competence, confidence, and intervention fidelity. Lessons learned: Implementation science needs underpinning capacity building programmes to build confidence and competence to teach, adapt and deliver the intervention. An online cascade approach is feasible, with ongoing mentoring.