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Ceccarelli C, Prina E, Alkasaby M, Cadorin C, Gandhi Y, Cristofalo D, Abujamei Y, Muneghina O, Barbui C, Jordans MJD, Purgato M. Implementation outcomes in psychosocial intervention studies for children and adolescents living in low- and middle-income countries: A systematic review. Clin Psychol Rev 2024; 107:102371. [PMID: 38118259 DOI: 10.1016/j.cpr.2023.102371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/16/2023] [Accepted: 12/01/2023] [Indexed: 12/22/2023]
Abstract
Psychosocial interventions play a key role in addressing mental health and substance use needs for children and adolescents living in low- and middle-income countries (LMICs). While research efforts have primarily focused on their effectiveness, implementation outcomes also require examining. We conducted a systematic review of qualitative, quantitative, and mixed-methods studies (PROSPERO: CRD42022335997) to synthesize the literature on implementation outcomes for psychosocial interventions for children and adolescents in LMICs. We searched Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Web of Science, PsychINFO, and Global Health through April 2023. Data were extracted and quality appraised through the Mixed Methods Appraisal Tool (MMAT) independently by two reviewers. A total of 13,380 records were screened, and 87 studies met inclusion criteria. Feasibility was the most reported implementation outcome (69, 79%), followed by acceptability (60, 69%), and fidelity (32, 37%). Appropriateness was assessed in 11 studies (13%), implementation costs in 10 (11%), and sustainability in one (1%). None of the included studies reported on penetration or adoption. Despite a growing body of evidence for implementation research in child and adolescent global mental health, most research focused on earlier-stage implementation outcomes, assessing them in research-controlled settings. To overcome this, future efforts should focus on assessing interventions in routine care, assessing later-stage implementation outcomes through standardized tools.
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Affiliation(s)
- Caterina Ceccarelli
- Global Program Expert Group on Mental Health and Psychosocial Support, SOS Children's Villages, Milan, Italy.
| | - Eleonora Prina
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Muhammad Alkasaby
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Camilla Cadorin
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Yashi Gandhi
- Addictions and related-Research Group, Sangath, Goa, India
| | - Doriana Cristofalo
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Yasser Abujamei
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Orso Muneghina
- Global Program Expert Group on Mental Health and Psychosocial Support, SOS Children's Villages, Milan, Italy
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Mark J D Jordans
- War Child, Amsterdam, the Netherlands; University of Amsterdam, Amsterdam, the Netherlands; IoPPN, King's College London, London, UK
| | - Marianna Purgato
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; Cochrane Global Mental Health, University of Verona, Verona, Italy
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Tran TD, Nguyen H, Shochet I, Nguyen N, La N, Wurfl A, Orr J, Nguyen H, Stocker R, Fisher J. School-based universal mental health promotion intervention for adolescents in Vietnam: Two-arm, parallel, controlled trial. Glob Ment Health (Camb) 2023; 10:e69. [PMID: 38024797 PMCID: PMC10643236 DOI: 10.1017/gmh.2023.66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/25/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
The aim of this study was to evaluate the effects of Happy House, a universal school-based programme, in reducing adolescents' depressive symptoms and improving their mental well-being, coping self-efficacy and school connectedness. This was a school-based, two-arm parallel controlled trial. Depressive symptoms were measured using the Centre for Epidemiologic Studies Depression Scale. Data were collected at recruitment, and at 2 weeks and 6 months post-intervention. Mixed-effect models were conducted to estimate the effects of the intervention on the outcomes. A total of 1,084 students were recruited. At 2 weeks post-intervention, the effect size on depressive symptoms was 0.11 (p = 0.011) and the odds of having clinically significant depressive symptoms were lower in the intervention compared to the control (0.56, p = 0.027). Both of these were no longer significant at 6 months post-intervention. Psychological well-being mean scores in the intervention were significantly higher than in the control at 2 weeks post-intervention (effect size 0.13). Coping self-efficacy mean scores were significantly higher in the intervention group at both 2-week and 6-month post-intervention (effect sizes from 0.17 to 0.26). Data support the potential of Happy House to reduce the prevalence of adolescent mental health problems and to promote positive mental health in the school context in Vietnam.
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Affiliation(s)
- Thach Duc Tran
- Global and Women’s Health, Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Huong Nguyen
- Department of Health Promotion, Hanoi University of Public Health, Hanoi, Vietnam
| | - Ian Shochet
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia
| | - Nga Nguyen
- Department of Health Promotion, Hanoi University of Public Health, Hanoi, Vietnam
| | - Nga La
- Department of Health Promotion, Hanoi University of Public Health, Hanoi, Vietnam
| | - Astrid Wurfl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia
| | - Jayne Orr
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia
| | - Hau Nguyen
- Global and Women’s Health, Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Ruby Stocker
- Global and Women’s Health, Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Jane Fisher
- Global and Women’s Health, Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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