Advancing sustainable implementation of an evidence-based mental health intervention in Sierra Leone's schools: protocol for a hybrid type 3 implementation-effectiveness trial.

Journal: BMC public health

Volume: 24

Issue: 1

Year of Publication: 2024

Affiliated Institutions:  Department of Psychiatry and Human Behavior, Brown University, Warren Alport Medical School, Blackstone Blvd Providence, Providence, RI, , USA. alethea_desrosiers@brown.edu. RTI International, th St NW #, Washington, DC, , USA. Department of Psychiatry and Human Behavior, Brown University, Warren Alport Medical School, Blackstone Blvd Providence, Providence, RI, , USA. Innovations For Poverty Action, A&B Johnson Street, Freetown, Sierra Leone. Boston College School of Social Work, Commonwealth Avenue, Chestnut Hill, MA, , USA.

Abstract summary 

Mental health disorders among youth contribute substantially to the global burden of disease, which is exacerbated in low- and middle-income countries (LMICs) due to large mental health treatment gaps. In Sierra Leone, a West African country with a long history of complex adversity, the mental health treatment gap is estimated at 98%. Implementing innovative mental health interventions that can be sustained at scale is a priority. The Youth Readiness Intervention (YRI) is an evidence-based mental health intervention for youth that can be delivered feasibly by lay health workers/nonspecialists. Using mobile-based technologies to assist implementation could improve the reach and sustainability of the YRI in Sierra Leone. This study aims to train teachers to deliver the YRI in Sierra Leone's secondary schools and test the feasibility, acceptability, cost, and fidelity to the YRI of a mobile-based supervision model compared with standard, in-person supervision.We will conduct a hybrid type 3 implementation-effectiveness cluster randomized trial to assess the feasibility, acceptability, costs and fidelity to the YRI implemented by teachers receiving mobile-based supervision vs. standard supervision. Enrolled schools (N = 50) will be randomized to YRI + mobile supervision (N = 20), YRI + standard supervision (N = 20) or waitlist control (N = 10). We will recruit and enroll four teachers per intervention-condition school (N = 160) and 1200 youth. We will collect data on implementation outcomes among teachers, principals and youth via a mixed methods approach at baseline and post-intervention. We will also collect quantitative data on youth mental health and functioning as secondary outcomes at baseline and post-intervention, as well as cost-effectiveness data at 12-month follow-up.Study findings have the potential to expand the reach of mental health services among youth in low-resource settings via a teacher workforce. The use of mobile tools, if successful, could support further scale out and sustainment of the YRI to other regions of Sierra Leone and West Africa more broadly, which could help address the mental health treatment gap.Clinical Trial Network: NCT05737667.

Authors & Co-authors:  Desrosiers Carrol Ritsema Higgins Momoh Betancourt

Study Outcome 

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Statistics
Citations :  Vos T, Lim SS, Abbafati C, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the global burden of Disease Study 2019. Lancet. 2020;396(10258):1204–22. doi: 10.1016/S0140-6736(20)30925-9.
Authors :  6
Identifiers
Doi : 362
SSN : 1471-2458
Study Population
Male,Female
Mesh Terms
Adolescent
Other Terms
Implementation science;Low-resource settings;Mental health;Youth
Study Design
Study Approach
Quantitative,Mixed Methods
Country of Study
Sierra leone
Publication Country
England