Table_15_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.

背景：本研究阐述了旨在应对加纳肥胖及营养相关非传染性疾病（NR-NCDs）增加的项目 rationale、adaptation 以及最终 protocol。该项目代号 MEALS4NCDs（测量、评估、问责制和领导力支持非传染性疾病），旨在利用国际食物与肥胖/非传染性疾病研究监测与行动支持网络（INFORMAS）的改进方法，衡量并支持公共部门采取行动，为加纳儿童创造健康食品营销、零售和供应环境。方法：本观察性研究的 protocol 从 INFORMAS 的食品推广和食品供应模块中汲取了大量灵感。然而，为了评估当地社区实施具有改善加纳儿童食品环境强烈潜力的干预措施的准备情况，MEALS4NCDs 的 protocol 独创性地将基于社区准备模型（CRM）的当地社区参与方法融入了 INFORMAS 的方法之中。研究地点位于加纳，参与者包括卫生与营养政策制定者、营养与食品服务提供者、消费者、学校管理者和加纳基础教育学校的学童。结果：本研究确立了提供实施科学证据的标准化方法，以预防加纳的非传染性疾病（NCDs）。它展示了 INFORMAS 扩展的食品推广和食品供应模块在中等收入环境中的可行性及其创新应用，以及 CRM 的融入。结论：本研究将有助于理解 INFORMAS 方法如何本土化于中等收入非洲环境中的过程。该 protocol 可以为类似国家环境调整，以监测与儿童食品环境相关的各个方面。