How to successfully design and implement sustainable, evidence-based prevention packages targeting tobacco use and air pollution exposure in adolescents in disadvantaged populations?

Background: Non-Communicable Diseases (NCDs) are the number one cause of premature mortality and morbidity worldwide, with disadvantaged populations bearing most of this burden. Tobacco use and ambient and household air pollution exposure are two leading NCD risk factors. Community- and individual-level interventions are needed to address NCD risk factors effectively, especially targeting adolescents. Adolescents, facing a high NCD burden and being at a crucial stage of cognitive development with a growing interest in social and societal topics, can benefit from early preventive measures and serve as catalysts for community health change. Despite mounting evidence for NCD prevention, we have failed to translate knowledge into practice. We aim to bridge this translational gap and, building on the previously successful FRESHAIR project, gain knowledge, resources and capacity to optimize the implementation of prevention packages targeting adolescents in disadvantaged populations. Methodology: We will perform this research in five countries with significantly different contexts (i.e. Greece, the Kyrgyz Republic, Pakistan, Romania and Uganda), but all facing a high risk factor and NCD burden, allowing for extrapolating results to settings worldwide. Situational analysis will identify at-risk adolescents and assess their perception and needs towards NCD prevention. We will build dual capacity and establish local teams (e.g. consisting of youth advocates and practitioners) to develop tailored FRESHAIR4LIFE prevention packages and implementation strategies. Subsequently, we will pilot, implement, evaluate and iteratively refine the packages. To promote upscaling and make sustainable impact, we will co-create actionable messages and provide access to a digital implementation toolbox. Questions to discuss: •What are possible incentives for stakeholders (i.e. healthcare workers and adolescents) to engage? •How to measure implementation integrity without causing research fatigue among participants? •How to maximize global impact of results in similar contexts?