Eastern Mediterranean Partnership to implement the Regional Framework for Mental Health: Going to scale with school mental health

描述（由申请人提供）：全球估计有10-20%的儿童受到心理健康问题的影响。儿童心理健康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）的一个优先事项。在与国际和区域专家及利益攸关方协商后，世卫组织心理健康干预办公室制定了一份以证据为基础的手册性学校心理健康干预（EMRO SMHI），得到了包括巴基斯坦在内的所有成员国的认可，巴基斯坦的联邦和省级卫生部门已制定了分阶段在全国大规模实施的计划。为了实现这些计划，必须解决利益攸关方在世卫组织EMRO磋商中确定的一些实施挑战，包括可持续地大规模提供高质量培训和监督；对结果进行常规监测；确保方案质量的机制；以及适应不同区域环境的干预措施。我们将在巴基斯坦开展研究，在国家实施EMRO SMHI的过程中应对这些挑战，应用在巴基斯坦开发并经过可行性测试的可扩展技术和社会创新。这是基于多年来在巴基斯坦这一地区资源贫乏和具有挑战性的社区环境中成功实施类似方案的经验。能力建设将纳入该项目，重点是儿童心理健康。这将涉及加强四个EMRO国家（巴基斯坦、伊朗、约旦和埃及）的目标研究人员和决策者群体的能力，以便：1)发展产生、应用和有效传播研究的技能，以帮助实施以学校为基础的儿童心理健康干预措施；2)理解、解释和应用基于科学的方法和信息来制定儿童心理健康政策和计划；3)利用他们的技能建设其国家和整个区域的儿童心理健康研究和政策能力。研究部分由两个阶段组成，将被纳入巴基斯坦分阶段扩大实施EMRO SMHI的计划。研究将在巴基斯坦旁遮普省具有既定研究基础设施的地点、Kallar sydan和Gujar Khan分区进行。研究小组将与巴基斯坦卫生部和世界卫生组织合作，通过整合我们的技术和社会创新，研究并协助其扩大计划。我们将通过与利益相关者合作来开发一个全面的“变革理论”来开始我们的工作，以指导扩大规模，并支持关于结构、协作和知识的可测试假设，这些假设对扩大创新的过程最重要。在下一阶段，研究小组将与WCC-IoP合作，进行混合有效性实施研究，比较实施EMRO SMHI的两种方法。我们将使用混合方法，将传统的培训、监督、服务提供和项目监控与基于平板电脑的技术辅助平台进行比较，该平台集成了这些基本功能。该平台使用易于适应的视频和音频模块，为教师提供层叠的个性化知识和技能教学结构，因此他们可以反过来应用普遍和有针对性的策略来解决儿童及其家庭的心理健康问题。我们假设使用该平台将导致临床和实施结果的改善。

DESCRIPTION (provided by applicant): 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.