Expanding the Reach of Evidence-Based Mental Health Treatment: Diffusion and Spillover of Mental Health Benefits Among Peer Networks and Caregivers of Youth Facing Compounded Adversity in Sierra Leone

扩大循证心理健康治疗的范围：在塞拉利昂面临复杂逆境的青少年的同伴网络和照顾者中传播和溢出心理健康益处

• 批准号: 9912848
• 负责人: Theresa Stichick Betancourt
• 金额: $ 70.66万
• 依托单位: BOSTON COLLEGE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-11 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9912848
• 关键词: Acquired Immunodeficiency Syndrome; Address; Adopted; Affect; Africa South of the Sahara; Anxiety; Asia; Behavior; Behavioral; Boston; Caregivers; Child; Cognitive; Cognitive Therapy; Consent; Control Groups; Cost Effectiveness Analysis; Costs and Benefits; Country; Data; Development; Diffuse; Diffusion; Ebola; Economics; Educational Materials; Effectiveness; Elements; Evaluation; Evidence based practice; Factor Analysis; Funding; Gender; Geographic Locations; German population; Government; Guilt; Health; Health Benefit; Health Care Costs; Health Services; Health Services Research; Household; Intervention; Investments; Knowledge; Learning; Link; Measurable; Measures; Mental Depression; Mental Health; Mental Health Services; Middle East; Outcome; Outcome Study; Outcomes Research; Participant; Peer Group; Penetration; Policies; Policy Maker; Population; Process; Provider; Public Health; Readiness; Recording of previous events; Reporting; Research; Research Design; Research Personnel; Resources; Schools; Sierra Leone; Social Network; Social Work; Stress; Symptoms; System; Techniques; Time; Violence; War; Widespread Disease; Youth; aged; base; behavioral health; biological adaptation to stress; care burden; college; commune; comparison intervention; cost; cost effectiveness; daily functioning; effective intervention; emotion dysregulation; emotion regulation; emotional distress; evidence base; experience; follow-up; functional disability; implementation research; implementation science; implementation strategy; improved; innovation; intervention cost; intervention effect; intervention participants; low and middle-income countries; member; peer; peer networks; post-traumatic stress; scale up; service gap; skills; social; success; therapy design; therapy development; violence exposure

PROJECT SUMMARY The proposed study links with and leverages an ongoing scale up study of a cognitive behavioral therapy (CBT) based intervention, the Youth Readiness Intervention (YRI), among youth facing adversity in Sierra Leone that is currently being implemented in partnership with the Government of Sierra Leone (GoSL) and the Gesellschaft für Internationale Zusammenarbeit (GIZ). The YRI has demonstrated feasibility and effectiveness for improving emotion regulation and daily functioning in youth. This study aims to harness the mechanisms of natural diffusion of CBT techniques learned among peer groups and spillover phenomenon in reduction of burden to cohabitating caregivers. Preliminary studies of the YRI in Sierra Leone indicate both mechanisms occur. Researchers from the Boston College School of Social Work will examine the potential of the YRI to reach a larger segment of the population by examining the extent to which indirect effects result in measureable incremental health benefits (symptoms and functioning) among nonparticipants. Study aims are to investigate (1) mechanism of diffusion—the untargeted and unplanned spread of new practices among social network members—of YRI components and mental health benefits experienced by nonparticipant peers who learn YRI practices from YRI participants; (2) indirect mental health benefits experienced by nonparticipants among cohabitating caregivers of YRI participants (spillover effects); and (c) incremental health costs and benefits among YRI participants' caregivers and peers through cost-effectiveness and return on investment analysis. Study design includes a control group (current YRI participants and YRI nonparticipants). YRI participants and control participants who consent to the current study will nominate 3 peers in their social networks aged 18-24 and will also identify their primary cohabitating caregiver. Following consent, peers and caregivers will be assessed at baseline and 6-month follow-up on mental health, emotion regulation, daily functioning, and sense of burden (caregivers only). Study outcomes also incorporate common indicators for implementation science, including measures of project context, evaluation, and scale-up, to enhance knowledge exchange across global research networks. Assessing implementation research outcomes, including penetration of YRI effects and cost-effectiveness of the YRI as distinct outcomes will provide key information about the success of YRI implementation, thereby supporting decisions about whether to increase scale up efforts in Sub-Saharan Africa and other LMICs. Findings on diffusion of the YRI will inform the feasibility of peer-led interventions and the development of additional educational materials to amplify YRI components identified as most transferrable. Findings on spillover effects will inform the potential reach and penetration of evidence-based practices in LMICs. Lessons learned will inform the GoSL, GIZ, and development actors on investing in evidence-based mental health interventions in low-resource settings.

项目摘要 拟议的研究与认知行为疗法的持续研究联系并利用了持续的规模 （CBT）干预，青年准备干预措施（YRI），面对塞拉的逆境 目前正在与塞拉利昂政府（GOSL）和 gesellschaftfürinternationale zusammenarbeit（giz）。 YRI表现出可行性和有效性 改善年轻人的情绪调节和日常功能。这项研究旨在利用 CBT技术的自然扩散在同龄人群中学到了 同居护理人员的负担。塞拉利昂的YRI的初步研究表明了这两种机制 发生。波士顿学院社会工作学院的研究人员将研究YRI的潜力 通过检查间接影响导致的程度，达到较大的人群 非参与者中可衡量的增量健康益处（症状和功能）。研究目的是 调查（1）扩散机制 - 在 社交网络成员 - YRI组成部分和精神健康的好处 谁从YRI参与者那里学习YRI的实践； （2）间接心理健康益处 YRI参与者同居的护理人员之间的非参与者（溢出效果）； （c）增量健康 YRI参与者的照顾者和同伴之间的成本和收益，通过成本效益和回报 投资分析。研究设计包括对照组（当前的YRI参与者和YRI非参与者）。 同意当前研究的YRI参与者和对照参与者将提名3名同行 18-24岁的网络还将确定其主要同居者。遵循同意，同伴和 护理人员将在基线和6个月的心理健康，情绪调节，每日评估6个月的随访中进行评估 功能和伯恩的感觉（仅护理人员）。研究成果还包含了常见的指标 实施科学，包括测量项目环境，评估和扩大规模，以增强 跨全球研究网络的知识交流。评估实施研究结果， 包括YRI效应的渗透和YRI作为不同结果的成本效益将提供关键 有关YRI实施成功的信息，从而支持有关是否增加的决定 扩大撒哈拉以南非洲和其他LMIC的努力。关于扩散YRI的发现将告知 同伴主导的干预措施的可行性和开发其他教育材料以扩大YRI 组件被确定为大多数转移。关于Spilover效应的发现将为潜在的影响和 LMIC中基于证据的实践的渗透。汲取的教训将告知GOSL，GIZ和 开发参与者在低资源环境中投资基于证据的心理健康干预措施。