Table_5_Providing Measurement, Evaluation, Accountability, and Leadership Support (MEALS) for Non-communicable Diseases Prevention in Ghana: Project Implementation Protocol.DOCX

Background: This study describes the rationale, adaptation, and final protocol of a project developed to address the increase in obesity and nutrition-related non-communicable diseases (NR-NCDs) in Ghana. Code-named the Measurement, Evaluation, Accountability, and Leadership Support for NCDs (MEALS4NCDs) project, it aims to measure and support public sector actions that create healthy food marketing, retail, and provisioning environments for Ghanaian children using adapted methods from the International Network for Food and Obesity/NCDs Research Monitoring and Action Support (INFORMAS).
Methods: The protocol for this observational study draws substantially from the INFORMAS' Food Promotion and Food Provision Modules. However, to appraise the readiness of local communities to implement interventions with strong potential to improve food environments of Ghanaian children, the MEALS4NCDs protocol has innovatively integrated a local community participatory approach based on the community readiness model (CRM) into the INFORMAS approaches. The setting is Ghana, and the participants include health and nutrition policy-makers, nutrition and food service providers, consumers, school authorities, and pupils of Ghanaian basic schools.
Results: The study establishes a standardized approach to providing implementation science evidence for the prevention of non-communicable diseases (NCDs) in Ghana. It demonstrates feasibility and the innovative application of the INFORMAS expanded food promotion and food provision modules, together with the integration of the CRM in a lower-middle income setting.
Conclusion: The research will facilitate the understanding of the processes through which the INFORMAS approach is contextualized to a lower-middle income African context. The protocol could be adapted for similar country settings to monitor relevant aspects of food environments of children.

研究背景：本研究阐述了为应对加纳肥胖症及营养相关非传染性疾病（nutrition-related non-communicable diseases，NR-NCDs）增长而开发项目的理论依据、适配方案与最终实施方案。该项目代号为非传染性疾病测量、评估、问责与领导力支持计划（Measurement, Evaluation, Accountability, and Leadership Support for NCDs，MEALS4NCDs），旨在借鉴国际食物与肥胖/非传染性疾病研究监测及行动支持网络（International Network for Food and Obesity/NCDs Research Monitoring and Action Support，INFORMAS）的方法，测量并支持公共部门开展相关行动，为加纳儿童打造健康食品营销、零售与供应环境。
研究方法：本观察性研究方案主要借鉴INFORMAS的食品推广与食品供应模块。然而，为评估当地社区落实可有效改善加纳儿童食品环境的干预措施的准备程度，MEALS4NCDs方案创新性地将基于社区准备度模型（community readiness model，CRM）的本地社区参与式方法融入INFORMAS的既有框架。本研究以加纳为研究场景，研究对象包括健康与营养政策制定者、营养与食品服务提供者、消费者、学校管理人员以及加纳基础教育阶段学生。
研究结果：本研究确立了一套标准化方法，可为加纳非传染性疾病预防提供实施科学相关证据。研究验证了INFORMAS扩展版食品推广与食品供应模块的可行性与创新性应用，并证实了将社区准备度模型融入中低收入国家场景的可行性。
研究结论：本研究将有助于理解INFORMAS方法如何适配非洲中低收入国家场景。该方案可被适配至类似国家场景，用于监测儿童食品环境的相关维度。