Expanding the Reach of Evidence-Based Mental Health Treatment: Diffusion and Spillover of Mental Health Benefits Among Peer Networks and Caregivers of Youth Facing Compounded Adversity in Sierra Leone

扩大循证心理健康治疗的范围：在塞拉利昂面临复杂逆境的青少年的同伴网络和照顾者中传播和溢出心理健康益处

• 批准号: 10375098
• 负责人: Theresa Stichick Betancourt
• 金额: $ 8.18万
• 依托单位: BOSTON COLLEGE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-11 至 2023-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10375098
• 关键词: Africa South of the Sahara; Boston; Caregivers; Cognitive Therapy; Consent; Control Groups; Costs and Benefits; Data; Development; Diffusion; Educational Materials; Effectiveness; Evaluation; Evidence based practice; Government; Health Benefit; Health Care Costs; Health Services; Intervention; Investments; Knowledge; Learning; Link; Measures; Mental Health; Outcome; Outcome Study; Outcomes Research; Participant; Peer Group; Penetration; Policy Maker; Population; Public Health; Readiness; Research; Research Design; Research Personnel; Resources; Schools; Sierra Leone; Social Network; Social Work; Symptoms; Techniques; Youth; aged; base; college; cost effectiveness; daily functioning; emotion regulation; evidence base; experience; follow-up; implementation intervention; implementation research; implementation science; improved; intervention cost; intervention effect; intervention participants; low and middle-income countries; member; peer; peer networks; scale up; service gap; success; therapy development

PROJECT SUMMARY The proposed study links with and leverages an ongoing scale up study of a cognitive behavioral therapy (CBT) based intervention, the Youth Readiness Intervention (YRI), among youth facing adversity in Sierra Leone that is currently being implemented in partnership with the Government of Sierra Leone (GoSL) and the Gesellschaft für Internationale Zusammenarbeit (GIZ). The YRI has demonstrated feasibility and effectiveness for improving emotion regulation and daily functioning in youth. This study aims to harness the mechanisms of natural diffusion of CBT techniques learned among peer groups and spillover phenomenon in reduction of burden to cohabitating caregivers. Preliminary studies of the YRI in Sierra Leone indicate both mechanisms occur. Researchers from the Boston College School of Social Work will examine the potential of the YRI to reach a larger segment of the population by examining the extent to which indirect effects result in measureable incremental health benefits (symptoms and functioning) among nonparticipants. Study aims are to investigate (1) mechanism of diffusion—the untargeted and unplanned spread of new practices among social network members—of YRI components and mental health benefits experienced by nonparticipant peers who learn YRI practices from YRI participants; (2) indirect mental health benefits experienced by nonparticipants among cohabitating caregivers of YRI participants (spillover effects); and (c) incremental health costs and benefits among YRI participants' caregivers and peers through cost-effectiveness and return on investment analysis. Study design includes a control group (current YRI participants and YRI nonparticipants). YRI participants and control participants who consent to the current study will nominate 3 peers in their social networks aged 18-24 and will also identify their primary cohabitating caregiver. Following consent, peers and caregivers will be assessed at baseline and 6-month follow-up on mental health, emotion regulation, daily functioning, and sense of burden (caregivers only). Study outcomes also incorporate common indicators for implementation science, including measures of project context, evaluation, and scale-up, to enhance knowledge exchange across global research networks. Assessing implementation research outcomes, including penetration of YRI effects and cost-effectiveness of the YRI as distinct outcomes will provide key information about the success of YRI implementation, thereby supporting decisions about whether to increase scale up efforts in Sub-Saharan Africa and other LMICs. Findings on diffusion of the YRI will inform the feasibility of peer-led interventions and the development of additional educational materials to amplify YRI components identified as most transferrable. Findings on spillover effects will inform the potential reach and penetration of evidence-based practices in LMICs. Lessons learned will inform the GoSL, GIZ, and development actors on investing in evidence-based mental health interventions in low-resource settings.

项目总结