Effectiveness of educational interventions on knowledge and behavioral practices of adolescents for prevention of noncommunicable diseases in low- and middle-income countries: A systematic review protocol

Introduction: The rising burden of noncommunicable diseases (NCDs) is a dominating public health crisis, globally causing 38 million of 57 million deaths annually, with 85% of these deaths occurring in low- and middle-income countries (LMICs). However, while addressing NCDs, adolescents have been largely overlooked, who have a notable share in the NCD burden globally. Adolescents are vulnerable for developing high-risk behaviors, which puts them at high risk of NCDs such as ischemic heart diseases, diabetes, and stroke. Objective: The objective of this systematic review will be to identify the effectiveness of educational interventions on the knowledge and behavioral practices of adolescents for the prevention of NCDs in LMICs. Methodology: Five electronic databases such as PubMed, the Cochrane Central Register of Controlled Trials, Google Scholar, Embase, and Scopus will be utilized for generating pooled evidence. Two reviewers will individually screen the titles and abstracts for eligibility, and in case of any disagreement, the help of a third reviewer will be taken. Recognized studies will be critically appraised for methodological quality using the Cochrane risk-of-bias tool. Data will be extracted from the studies included in the review for author's name, year of study, study setting, study design, study participants and their age, sample size in the intervention group, NCD domain covered by the study intervention, intervention details, measure of outcome, etc. For data synthesis, studies will be pooled using RevMan software and effect sizes will be depicted using forest plots. The Grading of Recommendations, Assessment, Development, and Evaluation approach to grade the certainty of evidence will be followed for assessing the quality of evidence. Publication bias will also be checked using funnel plots and Egger's test. Clinical Relevance: To the best of our knowledge, this will be the first systematic review that will assess the empirical evidence and evaluate the effectiveness of educational interventions for the prevention of NCDs among adolescents of LMICs. This review will assist the public health experts and policymakers in designing effective intervention for preventing NCDs among adolescents. Results and Conclusion: The results of this systematic review will provide an in-depth insight of the existing country-specific educational policies and interventions for the prevention of NCDs among adolescents in various LMICs. This will help in the replication of such cost-effective educational models or interventions in other LMICs followed by advocacy in their school policy reforms and other related programs focusing on NCDs.