Implementing a Digital Child Mental Health Screening, Literacy, and Management Tool in Faith-Based Settings

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ABSTRACT The burden of pediatric mental, neurological, and substance (MNS) disorders in low-and middle-income countries (LMICs) is tremendous, but solutions for addressing the MNS burden remain limited in global pediatric health research. Although many pediatric associations have developed and disseminated resources to assist pediatric health providers in screening, promoting behavioral health literacy, and managing childhood behavioral problems, these tools and resources have not been adapted and broadly utilized in Sub-Saharan African (SSA) countries. Other challenges for child mental health burden control in LMICs also include (i) cultural norms (e.g., influences of socio-cultural contexts hinders opportunities to engage in early screening and intervention); (ii) communication deficiencies (e.g., dissemination of health knowledge are not delivered using appropriate health information channels); and (iii) resource barriers (e.g., lack of health resources, access to evidence-based intervention). Therefore, developing cost-effective strategies that consider these challenges in child mental health interventions are urgently needed. This application seeks to respond to the pediatric mental health service and intervention gaps by utilizing a task-shifting and faith-based organization (FBO)-government- academic partnership approach to test feasibility and impacts of a digital health intervention, the Pediatric-Mental Health Digital Toolkit (P-MHDT), to promote child mental health in one SSA country- Uganda. The P-MHDT is a preventive intervention Toolkit designed to be used by trained community-health-workers (CHWs) within FBOs to facilitate caregivers’ access to basic preventive mental health services for their young children. The Toolkit integrates 4 key mental health service functions: i) screening for child mental health and family functioning, ii) a strengths and weaknesses profile for a child’s behaviors, iii) tailored child mental health literacy/parenting materials to discuss with parents, and iv) tailored referral resources for families. This project is conceptualized within the Social Action Theory, mHealth/ Technology Acceptance Model, and Implementation Outcomes Framework. The specific aims of this proposed study are: (1) To build research and service capacity for digital and public health approaches of child mental health promotion in Uganda; (2) To employ a user-centered design to test and enhance usability of the Digital Toolkit (P-MHDT); and (3) To estimate potential impacts of the P-MHDT on Ugandan FBO children’s mental health, caregivers’ mental health literacy and practices, CHWs’ implementation competency, and FBO system.