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

摘要 低收入和中等收入国家儿童精神、神经和物质（MNS）障碍的负担 （LMIC）是巨大的，但解决MNS负担的解决方案在全球儿科健康研究中仍然有限。 虽然许多儿科协会已经开发和传播资源，以帮助儿科健康提供者， 筛查，促进行为健康素养，管理儿童行为问题，这些工具和资源 尚未在撒哈拉以南非洲国家得到调整和广泛使用。儿童心理的其他挑战 低收入国家的健康负担控制还包括：（i）文化规范（例如，社会文化背景的影响 参与早期筛查和干预的机会）;（ii）沟通缺陷（例如，传播卫生 没有通过适当的卫生信息渠道提供知识）;以及（iii）资源障碍（例如，缺乏健康 资源，获得循证干预）。因此，制定考虑到这些因素的具有成本效益的战略， 儿童心理健康干预措施面临的挑战是迫切需要的。本申请旨在回应儿科 通过利用任务转移和基于信仰的组织（FBO）-政府- 学术伙伴关系的方法来测试数字健康干预的可行性和影响，儿科心理健康 数字工具包（P-MHDT），在一个撒哈拉以南非洲国家-乌干达促进儿童心理健康。P-MHDT是一种预防性药物， 干预工具包，供FBO内经过培训的社区卫生工作者使用， 照料者为其幼儿获得基本预防性心理健康服务的机会。该工具包集成了4个关键的心理 保健服务职能：㈠儿童心理健康和家庭功能筛查，㈡强项和弱项简介 为儿童的行为，iii）量身定制的儿童心理健康素养/育儿材料，与父母讨论，以及iv）量身定制 为家庭提供转介资源。该项目是概念化的社会行动理论，移动健康/技术 接受模型和实施成果框架。本研究的具体目标是：（1）建立 乌干达儿童心理健康促进的数字和公共卫生方法的研究和服务能力;（2） 采用以用户为中心的设计来测试和提高数字工具包（P-MHDT）的可用性;以及（3）评估 P-MHDT对乌干达FBO儿童的心理健康，照顾者的心理健康素养和 实践，CHW的实施能力和FBO系统。

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.