Kukaa Salama (Staying Safe): A Pre-Post Trial of a WhatsApp Social Group for Increasing COVID-19 Prevention Practices with Urban Refugee and Displaced Youth in Kampala, Uganda

THE ISSUE: Poverty, overcrowded living conditions, and poor sanitation increase COVID-19 risks in humanitarian settings while limiting the ability to practice prevention strategies (e.g. physical distancing, hand washing). There is an urgent need for tailored COVID-19 responses with refugee/displaced persons. We address knowledge gaps regarding COVID-19 prevention in humanitarian contexts. We focus on urban refugee/displaced youth in Uganda, where 1.4 million refugees are hosted-Sub-Saharan Africa's largest refugee hosting nation and the 3rd largest globally. Our study is located in Kampala, Uganda that hosts 90,000 urban refugee/displaced persons living in informal settlements. Adolescents and youth comprise half of the world's 70.8 million refugee/displaced persons yet are understudied in pandemics. OUR IDEA: We will develop and evaluate the effectiveness of a WhatsApp social group intervention in increasing COVID-19 prevention practices (hand and respiratory hygiene, physical distancing) among our existing CIHR Project Grant cohort of urban refugee/displaced youth aged 16-24 living in informal settlements in Kampala. Our project involves: 1) qualitative phone interviews with refugee/displaced youth (n=24) and key informants (n=6) to understand barriers and facilitators to COVID-19 prevention, following the RANAS (risk, attitude, norms, ability, self-regulation) approach to behaviour change; 2) integration of the qualitative findings to develop Kukaa Salama (Staying Safe), a 16-week COVID-19 prevention intervention (weekly SMS and moderated WhatsApp discussions); 3) conducting a single arm, pre-test/post-test trial to test the effectiveness of Kukaa Salama in improving COVID-19 prevention with refugee/displaced youth aged 16-24 (n=340); 4) knowledge mobilization, including a think tank to produce a refugee policy analysis. Findings will advance the COVID-19 global response with new knowledge of mHealth approaches for COVID-19 prevention in humanitarian contexts.