Changemaker

Changemaker will use a whole systems approach on different social ecological levels through urban farming in schools with satellite (home) farms and organic waste composting; sustainable health related educational modules delivered in the classroom; linking to the healthcare providers through health talks using motivational interviewing (MI) techniques; and mass media campaigns (MMC) to promote healthy lifestyle habits. Together, these address risk and protective factors related to dietary and physical activity behavior and other NCD risks by operating on different social ecological levels. They tap into the overarching mechanisms that drive behavior change, i.e., capabilities, opportunities, and motivation (the COM-B model). These drivers are equally important for behavior change among the adolescents, and for behavior change among the implementers. COM-B posits that the interaction of ‘capability’ (physical – skills or psychological – knowledge), ‘opportunity’ (physical – environmental resources or social – societal influences) and ‘motivation’ (automatic – emotions or reflective –
beliefs, intentions) results in a specific behavior, presumably by promoting self-efficacy through the interaction of these different domains. Interventions aiming to change behavior need to influence one or more of these components:

Capability: The intervention aims to build adolescents’ capability to engage in sustainable behaviors by increasing their knowledge and skills. Urban farming will be established at the school and in the community to provide hands-on learning opportunities for adolescents on healthy food production and organic waste management. Health workers will use MI techniques to provide education and support to adolescents on healthy eating, physical activity, stress management, and sleep hygiene, among other identified needs, to meet the complexity of adolescents’ needs.

Opportunity: The intervention will create opportunities for sustainable behaviors by addressing the social determinants of health. MMCs will be used to increase awareness and promote sustainable behaviors among adolescents, their families, and the wider community. The campaigns will address healthy eating habits and social determinants of health such as access to healthy food and safe spaces for physical activity.

Motivation: The intervention aims to build adolescents’ motivation to engage in sustainable behaviors by addressing the underlying psychological and emotional factors that influence behavior. Health workers will use MI techniques to explore adolescents’ values, beliefs, and goals related to healthy behaviors. They will also provide feedback and support to reinforce positive behaviors and help adolescents overcome barriers to change.

Below is the implementation research logic model that will be used to guide the implementation and design of the Changemaker theory of change.