Building capacity to adapt the School Mental Health for implementation at scale in the Eastern Mediterranean Region

项目总结： 据估计，全球有10%-20%的儿童受到心理健康问题的影响。儿童心理健康有 已被确定为世卫组织东地中海区域(世卫组织东地中海区域)的优先事项。跟随 与国际和区域专家和利益攸关方协商，世卫组织EMRO制定了一项 循证学校心理健康干预手册(EMRO SMHI)，由所有成员认可 包括巴基斯坦在内的国家，联邦和省级卫生部门已经制定了计划 在全国范围内分阶段实施。利益攸关方确定的一些实施挑战 在世卫组织EMRO磋商中，必须处理这些计划，包括可持续交付 质量培训和大规模监督；对结果的例行监测；确保 方案质量；适应不同区域环境的干预措施。我们将进行 将巴基斯坦的研究纳入EMRO SMHI的国家实施，以解决这些问题 挑战，应用开发和可行性测试的可扩展技术和社会创新 巴基斯坦。这是建立在多年成功交付类似计划的经验基础上的资源- 在巴基斯坦这一地区贫穷和具有挑战性的社区环境。 能力建设将纳入该项目，重点是儿童心理健康。这将涉及到 加强4个EMRO国家的研究人员和政策制定者目标群体的能力 (巴基斯坦、伊朗、约旦和埃及)： 1)培养产生、应用和有效传播研究的技能，以协助执行 以学校为基础的儿童心理健康干预；以及 2)理解、解释和应用以科学为基础的方法和信息，以发展儿童智力 卫生政策和计划； 3)利用他们的技能建设本国和 地区作为一个整体。 研究部分由两个阶段组成，将嵌入巴基斯坦的分阶段扩大 实施EMRO SMHI。研究将在巴基斯坦进行，地点有既定的 旁遮普省Kallar Syedan和Gujar Khan分区的研究基础设施。这个 研究小组将与巴基斯坦卫生部和WCC-IoP合作，研究并协助其 通过整合我们的技术和社会创新来扩大规模计划。我们将通过与 利益相关者制定全面的“变革理论”，以指导规模扩大和支持可测试性 关于对扩展过程最重要的结构、协作和知识的假设 创新。在下一阶段，研究团队将与WCC-IoP合作进行混合 有效性-实施研究，比较两种实施EMRO SMHI的方法。 使用混合方法，我们将比较传统的培训、监督、服务交付和计划 使用基于平板电脑的技术辅助平台进行监控，该平台集成了 功能。该平台使用易于适应的视频和音频模块，为 向教师提供层叠的个性化知识和技能指导，使他们能够反过来应用普遍的和 采取有针对性的战略，解决儿童及其家庭的心理健康问题。我们假设 该平台的使用将导致临床和实施结果的改善。

Project summary: An estimated 10-20% of children globally are affected by a mental health problem. Child mental health has been identified as a priority within the WHO’s Eastern Mediterranean Region (WHO EMRO). Following consultations with international and regional experts and stakeholders, WHO EMRO developed an evidence-based manualised School Mental Health Intervention (EMRO SMHI), endorsed by all member countries, including Pakistan, where the federal and provincial health departments have made plans for phased national implementation at scale. A number of implementation challenges identified by stakeholders at a WHO EMRO consultation have to be addressed to achieve these plans, including sustainable delivery of quality training and supervision at scale; routine monitoring of outcomes; mechanisms for ensuring programme quality; and intervention adaptation for delivery in diverse regional settings. We will conduct research in Pakistan embedded within national implementation of the EMRO SMHI to address these challenges, applying scalable technological and social innovations developed and feasibility-tested in Pakistan. This builds upon many years’ experience of successfully delivering similar programs in resource- poor and challenging community-based settings in this region of Pakistan. Capacity building will be embedded within the project with focus on child mental health. This will involve strengthening the capacity of targeted cohorts of researchers and policy makers in 4 EMRO countries (Pakistan, Iran, Jordan, and Egypt) to: 1) Develop skills in generating, applying and effectively disseminating research to aid implementation of school-based interventions for child mental health; and 2) To understand, interpret and apply science-based methods and information to develop child mental health policies and plans; 3) Use their skills to build the child mental health research and policy capacity of their countries and the region as a whole. The research component, consisting of two stages, will be embedded within Pakistan’s phased scale-up implementation of the EMRO SMHI. Research will be conducted in Pakistan, in sites with an established research infrastructure, sub-districts Kallar Syedan and Gujar Khan, in the Province of Punjab. The research team will partner with the Pakistan Health Ministry and the WCC-IoP to both study and assist its scale-up plans by integrating our technological and social innovation. We will begin our work by engaging stakeholders to develop a comprehensive “theory of change” to both guide scale-up and support testable hypotheses about the structures, collaborations, and knowledge most important to the process of scaling innovations. In the next stage the research team will work with the WCC-IoP to conduct hybrid effectiveness-implementation research comparing two methods of implementing the EMRO SMHI. Using mixed methods, we will compare conventional training, supervision, service delivery and program monitoring with the use of a tablet-based technology-assisted platform that integrates these essential functions. The platform uses readily-adaptable video and audio modules to provide a structure for cascading personalised knowledge and skill instruction to teachers, so they can in turn apply universal and targeted strategies to address mental health problems with children and their families. We hypothesise that use of the platform will lead to improvements in both clinical and implementation outcomes.