(P07-016-25) Co-creation and Prototyping of a COMprehensive Health and Nutrition Program for AdolescentS in Schools in Tanzania – The COMPASS Study

Objectives: Adolescents in Tanzania face both undernutrition and a rising prevalence of obesity. We co-created and tested a school-based nutrition intervention for young adolescents in Dar es Salaam, Tanzania.

Methods: We developed the intervention using human-centered design principles through four co-creation workshops with school stakeholders, followed by a mixed-methods prototyping study at two schools to assess the intervention’s acceptability, appropriateness, and feasibility.

Results: Workshops identified four key challenges: poor nutritional status, limited health and nutrition awareness, low physical activity, and poor sanitation and hygiene practices. The resulting COMPASS intervention integrates the Health Promoting Schools framework with the Behavior Change Wheel model. Activities were designed at whole-school, group, and individual levels, and delivered by trained teachers over 16 weeks in two government-run secondary schools.

Qualitative feedback was positive, with students appreciating the enhanced nutrition knowledge and health practices and feeling empowered as change agents. A quantitative survey of 220 students showed high levels of enjoyment (93.6%), acceptability (97.3%), and comfort (96.4%) with participation.

The whole-school approach facilitated collaboration, with students contributing to health policy implementation and school assemblies. Group activities like nutrition education and physical activity were well-received. A key facilitator was the strong leadership of the school principals, while challenges included limited participation from parents and food vendors and student fatigue, affecting attendance at some activities. Stakeholders recommended providing incentives, adopting flexible schedules, and increasing education and sensitization efforts. Despite financial constraints, there was strong interest in continuing the program.

Conclusions: COMPASS offers a structured whole-school approach to addressing adolescent malnutrition in low-resource schools. Future research is needed to evaluate its effectiveness and cost-effectiveness at scale in Tanzania and beyond.

Funding Sources: This work was supported by the Motsepe Foundation through the Motsepe Presidential Research Accelerator Fund for Africa at Harvard University.