Radar de Ensayos Clínicos

Anemia prevalence

Anemia prevalence at 9 months post-baseline, defined using WHO age- and sex-specific hemoglobin cutoffs: * Boys aged ≥15 years: hemoglobin \<13.0 g/dL. * Girls aged ≥15 years: hemoglobin \<12.0 g/dL. * Hemoglobin will be measured at baseline, 4 months, and 9 months using finger-prick capillary blood samples and point-of-care devices (e.g., HemoCue hemoglobinometer or equivalent).

Baseline, at 4 months and 9 months after baseline

Moderate and severe anemia

Moderate and severe anemia at 9 months: Boys aged ≥15 years: Moderate anemia: 8.0-10.9 g/dL. Severe anemia: \<8.0 g/dL. Girls aged ≥15 years: Moderate anemia: 7.0-10.9 g/dL. Severe anemia: \<7.0 g/dL.

Baseline and at 9 months after baseline

Hemoglobin concentration (continuous, g/dL)

Hemoglobin concentration (continuous, g/dL) at baseline and 4 and 9 months after baseline.

At baseline and 4 and 9 months after baseline.

Adherence to MMS

* Self-reported daily consumption of MMS. * On-time pick-up of MMS refills from designated facilities. * Where feasible, facility or provider logs will be used to verify refill adherence.

At baseline, at 4 and 9 months after baseline

Nutrition literacy

The Adolescent Nutrition Literacy Scale is a 22 item, Likert type (1-5) instrument with good internal consistency (Cronbach's α=0.80), yielding total scores from 22 to 110 where higher scores indicate greater nutrition literacy across three dimensions: functional nutritional literacy (7 items), interactive nutritional literacy (6 items), and critical nutritional literacy (9 items).

At baseline and 4 and 9 months after baseline

Dietary behaviors

Fruit and vegetable intake will be calculated as the sum of affirmative (1 = Yes) responses to consumption of dark green leafy vegetables, vitamin A-rich vegetables, roots and tubers, vitamin A-rich fruits, other vegetables, and other fruits within the past 24 hours. 18 item 24 hour Dietary Diversity Score (DDS) based on FAO MDD W food groups, adapted for adolescents to also capture energy dense, nutrient poor foods: Dietary diversity indices will be based on the total 18 food group scores and yes/no item responses, summed to give a total score from 0 to 18, where higher scores indicate more diverse and potentially more nutritionally adequate diets.

At baseline and 4 and 9 months after baseline

Physical activity

Self-reported frequency and duration of moderate-to-vigorous physical activity, using validated or adapted tools appropriate for adolescents.

At baseline and 4 and 9 months after baseline

Anthropometric outcomes

Height will be measured to the nearest 0.1 cm using a stadiometer and weight will be measured to the nearest 100 g using an electronic scale. Body Mass Index (BMI) will be calculated as weight in kilograms divided by height in meters squared and rounded to one decimal place. BMI-for-age z-scores will be calculated using the WHO standard for children aged 15-19 years.

At baseline and 4 and 9 months after baseline

Digital literacy

* Skills and confidence in using digital devices, applications, and online information sources. * Assessed using a brief tool integrated into adolescent surveys.

At baseline and 4 and 9 months after baseline