Implementing an early childhood school-based mental health promotion intervention in low-resource Ugandan schools: study protocol for a cluster randomized controlled trial

Keng Yen Huang, Janet Nakigudde, Esther Calzada, Michael J. Boivin, Gbenga Ogedegbe, Laurie M iller Brotman

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Children in Sub-Saharan Africa (SSA) are burdened by significant unmet mental health needs, but this region has limited access to mental health workers and resources to address these needs. Despite the successes of numerous school-based interventions for promoting child mental health, most evidence-based interventions are not available in SSA. This study will investigate the transportability of an evidence-based program from a developed country (United States) to a SSA country (Uganda). The approach includes task-shifting to early childhood teachers and consists of professional development (five days) to introduce strategies for effective behavior management and positive teacher-student interactions, and group-based consultation (14 sessions) to support adoption of effective practices and tailoring to meet the needs of individual students.

METHODS/DESIGN: The design of this study is guided by two implementation frameworks, the Consolidated Framework for Implementation Research and the Teacher Training Implementation Model, that consider multidimensional aspects of intervention fidelity and contextual predictors that may influence implementation and teacher outcomes. Using a cluster randomized design, 10 schools in Uganda will be randomized to either the intervention group (five schools) or the waitlist control group (five schools). A total of 80 to 100 early childhood teachers will be enrolled in the study. Teacher utilization of evidence-based strategies and practices will be assessed at baseline, immediate post-intervention (six months after baseline), and at seven months post-intervention (during a new academic year). Fidelity measures will be assessed throughout the program implementation period (during professional development and consultation sessions). Individual teacher and contextual factors will be assessed at baseline. Data will be collected from multiple sources. Linear mixed-effect modeling, adjusting for school nesting, will be applied to address study questions.

DISCUSSION: The study will produce important information regarding the value of an evidence-based early intervention, and a theory-guided implementation process and tools designed for use in implementing early childhood evidence-based programs in SSA countries or resource-constrained community settings.

TRIAL REGISTRATION: This trial was registered with ClinicalTrials.gov (registration number: NCT097115) on 15 May 2013.

Original languageEnglish (US)
Pages (from-to)471
Number of pages1
JournalTrials
Volume15
DOIs
StatePublished - 2014

Fingerprint

Health Promotion
Africa South of the Sahara
Mental Health
Randomized Controlled Trials
Uganda
Referral and Consultation
Students
Health Resources
Evidence-Based Practice
Developed Countries
Control Groups
Research

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Pharmacology (medical)

Cite this

Implementing an early childhood school-based mental health promotion intervention in low-resource Ugandan schools : study protocol for a cluster randomized controlled trial. / Huang, Keng Yen; Nakigudde, Janet; Calzada, Esther; Boivin, Michael J.; Ogedegbe, Gbenga; Brotman, Laurie M iller.

In: Trials, Vol. 15, 2014, p. 471.

Research output: Contribution to journalArticle

@article{bf920482fef949ab9086cba29364ab27,
title = "Implementing an early childhood school-based mental health promotion intervention in low-resource Ugandan schools: study protocol for a cluster randomized controlled trial",
abstract = "BACKGROUND: Children in Sub-Saharan Africa (SSA) are burdened by significant unmet mental health needs, but this region has limited access to mental health workers and resources to address these needs. Despite the successes of numerous school-based interventions for promoting child mental health, most evidence-based interventions are not available in SSA. This study will investigate the transportability of an evidence-based program from a developed country (United States) to a SSA country (Uganda). The approach includes task-shifting to early childhood teachers and consists of professional development (five days) to introduce strategies for effective behavior management and positive teacher-student interactions, and group-based consultation (14 sessions) to support adoption of effective practices and tailoring to meet the needs of individual students.METHODS/DESIGN: The design of this study is guided by two implementation frameworks, the Consolidated Framework for Implementation Research and the Teacher Training Implementation Model, that consider multidimensional aspects of intervention fidelity and contextual predictors that may influence implementation and teacher outcomes. Using a cluster randomized design, 10 schools in Uganda will be randomized to either the intervention group (five schools) or the waitlist control group (five schools). A total of 80 to 100 early childhood teachers will be enrolled in the study. Teacher utilization of evidence-based strategies and practices will be assessed at baseline, immediate post-intervention (six months after baseline), and at seven months post-intervention (during a new academic year). Fidelity measures will be assessed throughout the program implementation period (during professional development and consultation sessions). Individual teacher and contextual factors will be assessed at baseline. Data will be collected from multiple sources. Linear mixed-effect modeling, adjusting for school nesting, will be applied to address study questions.DISCUSSION: The study will produce important information regarding the value of an evidence-based early intervention, and a theory-guided implementation process and tools designed for use in implementing early childhood evidence-based programs in SSA countries or resource-constrained community settings.TRIAL REGISTRATION: This trial was registered with ClinicalTrials.gov (registration number: NCT097115) on 15 May 2013.",
author = "Huang, {Keng Yen} and Janet Nakigudde and Esther Calzada and Boivin, {Michael J.} and Gbenga Ogedegbe and Brotman, {Laurie M iller}",
year = "2014",
doi = "10.1186/1745-6215-15-471",
language = "English (US)",
volume = "15",
pages = "471",
journal = "Trials",
issn = "1745-6215",
publisher = "BioMed Central",

}

TY - JOUR

T1 - Implementing an early childhood school-based mental health promotion intervention in low-resource Ugandan schools

T2 - study protocol for a cluster randomized controlled trial

AU - Huang, Keng Yen

AU - Nakigudde, Janet

AU - Calzada, Esther

AU - Boivin, Michael J.

AU - Ogedegbe, Gbenga

AU - Brotman, Laurie M iller

PY - 2014

Y1 - 2014

N2 - BACKGROUND: Children in Sub-Saharan Africa (SSA) are burdened by significant unmet mental health needs, but this region has limited access to mental health workers and resources to address these needs. Despite the successes of numerous school-based interventions for promoting child mental health, most evidence-based interventions are not available in SSA. This study will investigate the transportability of an evidence-based program from a developed country (United States) to a SSA country (Uganda). The approach includes task-shifting to early childhood teachers and consists of professional development (five days) to introduce strategies for effective behavior management and positive teacher-student interactions, and group-based consultation (14 sessions) to support adoption of effective practices and tailoring to meet the needs of individual students.METHODS/DESIGN: The design of this study is guided by two implementation frameworks, the Consolidated Framework for Implementation Research and the Teacher Training Implementation Model, that consider multidimensional aspects of intervention fidelity and contextual predictors that may influence implementation and teacher outcomes. Using a cluster randomized design, 10 schools in Uganda will be randomized to either the intervention group (five schools) or the waitlist control group (five schools). A total of 80 to 100 early childhood teachers will be enrolled in the study. Teacher utilization of evidence-based strategies and practices will be assessed at baseline, immediate post-intervention (six months after baseline), and at seven months post-intervention (during a new academic year). Fidelity measures will be assessed throughout the program implementation period (during professional development and consultation sessions). Individual teacher and contextual factors will be assessed at baseline. Data will be collected from multiple sources. Linear mixed-effect modeling, adjusting for school nesting, will be applied to address study questions.DISCUSSION: The study will produce important information regarding the value of an evidence-based early intervention, and a theory-guided implementation process and tools designed for use in implementing early childhood evidence-based programs in SSA countries or resource-constrained community settings.TRIAL REGISTRATION: This trial was registered with ClinicalTrials.gov (registration number: NCT097115) on 15 May 2013.

AB - BACKGROUND: Children in Sub-Saharan Africa (SSA) are burdened by significant unmet mental health needs, but this region has limited access to mental health workers and resources to address these needs. Despite the successes of numerous school-based interventions for promoting child mental health, most evidence-based interventions are not available in SSA. This study will investigate the transportability of an evidence-based program from a developed country (United States) to a SSA country (Uganda). The approach includes task-shifting to early childhood teachers and consists of professional development (five days) to introduce strategies for effective behavior management and positive teacher-student interactions, and group-based consultation (14 sessions) to support adoption of effective practices and tailoring to meet the needs of individual students.METHODS/DESIGN: The design of this study is guided by two implementation frameworks, the Consolidated Framework for Implementation Research and the Teacher Training Implementation Model, that consider multidimensional aspects of intervention fidelity and contextual predictors that may influence implementation and teacher outcomes. Using a cluster randomized design, 10 schools in Uganda will be randomized to either the intervention group (five schools) or the waitlist control group (five schools). A total of 80 to 100 early childhood teachers will be enrolled in the study. Teacher utilization of evidence-based strategies and practices will be assessed at baseline, immediate post-intervention (six months after baseline), and at seven months post-intervention (during a new academic year). Fidelity measures will be assessed throughout the program implementation period (during professional development and consultation sessions). Individual teacher and contextual factors will be assessed at baseline. Data will be collected from multiple sources. Linear mixed-effect modeling, adjusting for school nesting, will be applied to address study questions.DISCUSSION: The study will produce important information regarding the value of an evidence-based early intervention, and a theory-guided implementation process and tools designed for use in implementing early childhood evidence-based programs in SSA countries or resource-constrained community settings.TRIAL REGISTRATION: This trial was registered with ClinicalTrials.gov (registration number: NCT097115) on 15 May 2013.

UR - http://www.scopus.com/inward/record.url?scp=84990949401&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84990949401&partnerID=8YFLogxK

U2 - 10.1186/1745-6215-15-471

DO - 10.1186/1745-6215-15-471

M3 - Article

C2 - 25443043

VL - 15

SP - 471

JO - Trials

JF - Trials

SN - 1745-6215

ER -