Dengue Reduction through Education Awareness and Monitoring in Schools (DREAMS) initiative in Puducherry, India: protocol for a hybrid type 3 effectiveness-implementation study
Arya Rahul, Srikanth Srirama, Jency Priskilla, Gnanasekaran Vijayalakshmi, Amala Ramasamy, Ananganallur Nagarajan Shriram, Vasantha Kumari Ramadass, Sivasankari Thirumurthy, Manju RahiBackground
Dengue continues to be a global public health challenge despite sustained control efforts. Dengue control strategies rely primarily on effective Aedes mosquito control. Sustaining community participation in mosquito control requires innovative efforts, especially in achieving consistent behavioural change. Schools offer a strategic entry point, with children being both learners and influencers. This leads to a ripple effect of intervention impacting beyond the classroom. While behaviour change strategies for dengue prevention exist, there is sparsity of studies addressing the implementation aspects including contextual factors and sustainable mechanisms.
Methods and analysis
We propose a hybrid type 3 effectiveness-implementation study to design, implement and evaluate a school-based dengue control initiative in Puducherry. The study will be conducted in three phases: (1) formative research and co-development of the intervention package and implementation strategies, (2) implementation and (3) evaluation. The intervention will be co-developed using the principles of Communication for Behavioural Impact, with school teachers serving as key change agents to deliver knowledge and promote dengue prevention practices among students. The Consolidated Framework for Implementation Research 2.0 will guide the implementation process across all phases. Evaluation will be carried out using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework, adopting a mixed-methods approach to assess intervention effectiveness, implementation outcomes and cost implications.
Ethics and dissemination
The study protocol was approved by ICMR- NIVCR Institutional Human Ethics Committee (IHEC 0123/N/D). All standard ethical practices will be adhered to. Written informed consent (or age-appropriate assent) will be obtained from all participants. Findings will be shared via policy briefs/reports to stakeholders followed by publication in reputed journals.
Trial registration number
CTRI/2026/02/104985