The limits of nudging: Results of a randomized trial of text messages to promote home-based caregiving and reduce perceptions of stigma for COVID-19 patients in Kenyan informal settlements.

During the early stages of the global COVID-19 pandemic, governments searched for effective means to rapidly disseminate information about how to prevent the disease and care for sick household members. In June 2020, the government of Kenya considered sending text messages, a behavioral nudging approach, to inform and persuade the public to practice home-based care for those who were infected. We conducted a randomized evaluation of simple informational messages compared to messages targeting personal and social benefits for those receiving the messages.

Exploring COVID-19 vaccine hesitancy and uptake in Nairobi's urban informal settlements: an unsupervised machine learning analysis of a longitudinal prospective cohort study from 2021 to 2022.

Objectives: To illustrate the utility of unsupervised machine learning compared with traditional methods of analysis by identifying archetypes within the population that may be more or less likely to get the COVID-19 vaccine.

Design: A longitudinal prospective cohort study (n=2009 households) with recurring phone surveys from 2020 to 2022 to assess COVID-19 knowledge, attitudes and practices. Vaccine questions were added in 2021 (n=1117) and 2022 (n=1121) rounds.

Effects of a single cash transfer on school re-enrollment during COVID-19 among vulnerable adolescent girls in Kenya: Randomized controlled trial.

COVID-19 related school closures in Kenya were among the longest in Africa, putting older adolescent girls nearing the end of secondary school at risk of permanent dropout. Using a randomized-controlled trial we evaluated a logistically simple cash transfer intervention in urban areas designed to promote their return to school. There were no required conditions for receiving the transfer and the intervention is interpreted as a labeled cash transfer.

Impacts of Multisectoral Cash Plus Programs on Marriage and Fertility After 4 Years in Pastoralist Kenya: A Randomized Trial.

Purpose: Early marriage has multiple drivers including cultural and social norms alongside lack of educational and economic opportunities. This complexity may explain why few programs have demonstrated marriage delays and suggests multisectoral interventions are necessary. This study examined a 2-year multisectoral program designed to delay marriage in a marginalized setting.

Impacts of multisectoral cash plus programs after four years in an urban informal settlement: Adolescent Girls Initiative-Kenya (AGI-K) randomized trial.

Background: The vast majority of adolescent births occur in low- and middle-income countries and are associated with negative outcomes for both the mother and her child. A multitude of risk factors may explain why few programs have been successful in delaying childbearing and suggest that multisectoral interventions may be necessary. This study examines the longer-term impact of a two-year (2015-17) multisectoral program on early sexual debut and fertility in an urban informal settlement in Kenya.

How Has COVID-19-Related Income Loss and Household Stress Affected Adolescent Mental Health in Kenya?

Purpose: Adolescent mental health has been under-researched, particularly in Africa. COVID-19-related household economic stress and school closures will likely have adverse effects. We investigate the relationship among adolescent mental health, adult income loss, and household dynamics during the pandemic in Kenya.

Youth Relationships in the Era of COVID-19: A Mixed-Methods Study Among Adolescent Girls and Young Women in Kenya.

Background: Measures to mitigate COVID-19's impact may inhibit development of healthy youth relationships, affecting partnership quality and sexual and reproductive health (SRH) outcomes.

Methods: We conducted a mixed-methods study to understand how COVID-19 affected girls' and young women's relationships in Kenya. Bivariate and multivariate logistic regression examined factors associated with relationship quality dynamics and SRH outcomes among 756 partnered adolescents aged 15-24 years.

Gendered economic, social and health effects of the COVID-19 pandemic and mitigation policies in Kenya: evidence from a prospective cohort survey in Nairobi informal settlements.

Objectives: COVID-19 may spread rapidly in densely populated urban informal settlements. Kenya swiftly implemented mitigation policies; we assess the economic, social and health-related harm disproportionately impacting women.

Design: A prospective longitudinal cohort study with repeated mobile phone surveys in April, May and June 2020.

Mobility Patterns During COVID-19 Travel Restrictions in Nairobi Urban Informal Settlements: Who Is Leaving Home and Why.

Nairobi's urban slums are ill equipped to prevent spread of the novel coronavirus disease (COVID-19) due to high population density, multigenerational families in poorly ventilated informal housing, and poor sanitation. Physical distancing policies, curfews, and a citywide lockdown were implemented in March and April 2020 resulting in sharp decreases in movement across the city. However, most people cannot afford to stay home completely (e.