Implementing a School-Based Child Mental Health Prevention Program in Uganda

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DESCRIPTION (provided by applicant): 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 success of numerous family and school interventions for violence prevention and mental health promotion, most evidence-based preventive programs are not yet available in SSA. This proposal (R21) seeks to apply a cost-effective population strategy to address the existing mental health service and resource gaps by adapting and implementing an empirically-supported school-based child mental health preventive program, ParentCorps (PC), to schools in Uganda. PC is a culturally-informed universal school-based intervention for young children from disadvantaged communities. PC aims to promote 1) teacher and parent knowledge about child mental health; 2) effective behavior management practices by teachers and parents; 3) teacher and school family engagement practices and policies, and 4) child socioemotional and behavioral competencies with the long- term goal of preventing mental health problems and promoting school success and well-being. PC has been shown to be highly acceptable to ethnically diverse populations in the US. It also has robust and sustained effects on all targeted teacher, parenting, and child outcomes. Yet, this empirically-supported program is not available to children outside of the US. An adaptation of PC would overcome barriers to access universal preventive intervention for Ugandan children. The objectives of this proposal are to: 1) develop a culturally- informed adaptation of PC for Ugandan young children, 2) build human resource capacity to support prevention work and PC implementation; and 3) implement and evaluate the effectiveness of PC when delivered in a real-world school setting. The proposed research involves collaboration with Ugandan mental health and public health experts and school communities to adapt the program, and implement and evaluate the adapted program. This project will yield a prevention program manual that fits the context of Uganda, will improve human resources in child mental health, and provide a feasible implementation process. It will also advance the fields' knowledge and generate new policy and practice recommendations to reduce the global mental health burden among children in low-resource countries. Public Health Relevance: This proposal not only addresses existing human resource barriers in Uganda, but also provides a rich opportunity to study implementation-dissemination research questions (including understanding factors that contribute to quality of implementation, and strategies to overcome implementation challenges in low resource communities). The proposed research will contribute to the development of future mental health prevention management systems in SSA and provide a framework for disseminating evidence-based child mental health programs in SSA.