Performing high-quality situational analysis into the burden of tobacco and air pollution exposure among adolescents in disadvantaged populations

Background: Non-Communicable Diseases (NCDs) are the number one cause of premature mortality and morbidity worldwide, with disadvantaged populations being disproportionally affected. Tobacco use and ambient and household air pollution (AP) exposure are leading NCD risk factors. Adolescents, facing a high NCD burden and being at a crucial stage of cognitive development, can benefit from early preventive interventions and can serve as catalysts for community health change. Preventive interventions aimed at reducing tobacco use and AP exposure among adolescents have not been effective in practice. This is often due to a poor match with contextual factors, NCD burden, and population needs. To improve the implementation, situational analysis is necessary to identify target areas and populations and develop customized prevention strategies. Methodology: As part of the larger FRESHAIR4LIFE study, a two-step situational analysis will be performed in five countries that all face a high risk factor and NCD burden but with varying contexts (i.e. Greece, the Kyrgyz Republic, Pakistan, Romania and Uganda). First, literature and (local) databases will be searched to map the burden and identify areas and adolescents most at risk. After population segmentation and risk stratification, a consensus workshop with local partners will guide final decisions on target site and population. Second, a mixed-method study will be performed based on the principles of the Rapid Youth Context Assessment. The FRESHAIR SETTING-tool, validated in disadvantaged populations, will be used for context mapping. Questionnaires, focus groups and interviews will provide in-depth insight into the local perceptions and needs towards NCD prevention. Results will guide the development and implementation of FRESHAIR4LIFE prevention packages in the next phases of the study. Questions to discuss: •What (data) resources exist for mapping risk factor burden? •What tools can aid the context assessment?