Our study?Alternate Delivery Platforms and Implementation Models for Bringing Evidence- Based Behavioral Interventions to Scale for Youth Facing Adversity in West Africa?presents a coherent and coordinated plan to establish Youth FORWARD (Youth Functioning and Organizational Success for West African Regional Development) as a model research partnership and regional hub for the advancement of implementation science focused on scaling up evidence-based mental health interventions for youth exposed to war, community violence, and other adversities. Our innovative approach to closing the mental health treatment gap is to study the delivery of mental health services in the alternate setting of youth employment programs tied to regional economic development led by the German Corporation for International Cooperation (GIZ) and the Government of Sierra Leone; and to examine the use of a Collaborative Team Approach as an implementation scale up strategy that addresses the human resource and related access to care and capacity challenges in Low and Middle Income Countries (LMICs). This will be achieved through the following aims:
AIM 1 : To establish a West Africa research partnership and implementation science hub, Youth FORWARD that leverages the expertise and resources of academic, NGOs and government entities that provide services to youth in Sierra Leone, Liberia, and the broader West Africa region.
AIM 2 : To conduct a pilot and scale-up study on the use of a Collaborative Team Approach in scaling up and sustaining quality in the delivery of a Cognitive-Behavioral Therapy-based intervention?the Youth Readiness Intervention (YRI)?into the Employment Promotion Programme (EPP), implemented and funded by GIZ and supported by the Government of Sierra Leone.
AIM 3 : To provide health policy leaders and decision makers within the governments of Sierra Leone and Liberia with practical information on the effectiveness and cost of integrating behavioral interventions as a standard service into employment and other youth programs.
AIM 4 : To establish a Capacity Building Core within the Youth FORWARD Hub that will develop and deliver innovative and locally relevant training and technical assistance programs to (a) increase the regional knowledge base and capacity for implementation research in mental health; (b) increase the use of science-based methods for developing mental health policies and programs; (c) increase the use of rigorous evaluation methods to measure program effectiveness; and (d) accelerate efforts to scale up evidence based mental health programs that can help to close the mental health treatment gap.
The Youth FORWARD scale-up study (Aim 2) builds on 15 years of research on effects of war, violence, and other post-conflict adversity (e.g., Ebola outbreak) on the mental health of youth in Sierra Leone. Our findings suggest that malleable protective factors (e.g., social support, securing a livelihood) are key factors associated with favorable life outcomes, which led to the creation of the YRI. Although a few mental health interventions have been developed and tested for war-affected youth, identifying and conducting research on the integration of mental health services into alternate delivery systems (like the integration of the YRI and EPP) can help to overcome some limitations of the decimated health system and the limited human resources for mental health that exist in Sierra Leone and other low-resource LMICs.
