Children in Sub-Saharan Africa (SSA) comprise half of the total regional population, yet mental health services are severely under-equipped to meet their needs. Although child mental health evidence-based practices (EBPs) exist, attempts to take them to scale have been plagued by serious challenges related to uptake, implementation, integration and sustainability in the U.S. and have rarely been undertaken in SSA. This application, in response to RFA-MH-16-350, seeks funding for an African Center for Collaborative Child mental health implementation Research (ACCCR), an African Regional Trans-disciplinary Collaborative Center, aimed at reducing child mental health service and research gaps in Uganda, Ghana, and Kenya through a population approach to child mental health. The proposed ACCCR is guided by the following Specific Aims: 1) To establish and engage a trans-disciplinary research consortium of academic, government, NGO, community and cultural stakeholders in Uganda, Ghana, Kenya, and South Africa to focus on addressing child mental health burden, evidence-based intervention implementation, scale-up, service gaps; 2) To build child mental health implementation research capacity (including developing monitoring systems, conducting small-scale implementation studies) in two countries, Ghana and Kenya; 3) To conduct an EBP scale-up research study in Uganda, which will examine multi-level (State/government, NGOs, families, schools, communities) influences on the uptake, implementation, effectiveness and sustainability of EBPs that address serious child disruptive behavioral challenges; 4) To disseminate timely and pragmatic findings to government officials (Ministries of Health and Education) and consortium partners to optimize roll-outs of EBPs and scale-up process via an African Policy Research Advisory Board, consisting of an expanded network of scientists, NGOs and government officials. The US-based team consists of scientific leaders in child mental health services and implementation science, as well as investigators with current NIH-funded studies and capacity building programs set across Africa, Drs. McKay, Ogedegbe, Hoagwood, Huang, Ssewamala. SSA investigators are drawn from leading academic institutions, including Makerere University, Rakai Health Sciences Program (Uganda), University of Ghana and University of Nairobi (Kenya). NGOs with multi-country presence have expressed strong commitment to supporting the goals of the ACCCR. The ACCCR leadership team will work closely with five Subcontract PIs to develop strategies to engage collaborating institutions, as well as relevant community stakeholders. This trans-disciplinary partnership within and across countries will lay foundation work for subsequent scale up studies in Uganda, Ghana and Kenya and ultimately sustainment of efforts. The work of the ACCCR targets the core goal of the Grand Challenges in Global Mental Health initiative to expand access to effective mental health care worldwide, and NIMH's priority of strengthening the public health impact of research by improving knowledge on transporting evidence-based interventions into practice.

Public Health Relevance

This project, which aims at reducing child mental health service and research gaps in Uganda, Ghana, and Kenya, addresses critical implementation policy, research and service gaps by applying a comprehensive regional capacity building approach to scale up child behavioral health services in diverse community settings.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Program--Cooperative Agreements (U19)
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Special Emphasis Panel (ZMH1)
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Campbell-Rosen, Holly Renee
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Washington University
Social Sciences
Schools of Social Welfare/Work
Saint Louis
United States
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Ssewamala, Fred M; Sensoy Bahar, Ozge; McKay, Mary M et al. (2018) Strengthening mental health and research training in Sub-Saharan Africa (SMART Africa): Uganda study protocol. Trials 19:423
Huang, Keng-Yen; Bornheimer, Lindsay A; Dankyi, Ernestina et al. (2018) Parental Wellbeing, Parenting and Child Development in Ghanaian Families with Young Children. Child Psychiatry Hum Dev 49:833-841
Kumar, Manasi; Huang, Keng-Yen; Othieno, Caleb et al. (2018) Adolescent Pregnancy and Challenges in Kenyan Context: Perspectives from Multiple Community Stakeholders. Glob Soc Welf 5:11-27
Mutavi, Teresia; Obondo, Anne; Mathai, Muthoni et al. (2018) Incidence of Self-esteem among Children Exposed to Sexual Abuse in Kenya. Glob Soc Welf 5:39-47
Osok, Judith; Kigamwa, Pius; Stoep, Ann Vander et al. (2018) Depression and its psychosocial risk factors in pregnant Kenyan adolescents: a cross-sectional study in a community health Centre of Nairobi. BMC Psychiatry 18:136
Huang, Keng-Yen; Kwon, Simona C; Cheng, Sabrina et al. (2018) Unpacking Partnership, Engagement, and Collaboration Research to Inform Implementation Strategies Development: Theoretical Frameworks and Emerging Methodologies. Front Public Health 6:190
Ssewamala, Fred M; Wang, Julia Shu-Huah; Neilands, Torsten B et al. (2018) Cost-Effectiveness of a Savings-Led Economic Empowerment Intervention for AIDS-Affected Adolescents in Uganda: Implications for Scale-up in Low-Resource Communities. J Adolesc Health 62:S29-S36
Ssewamala, Fred M; Bermudez, Laura Gauer; Santelli, John (2018) The Power of Financial Inclusion: Reporting on the Efficacy of Economic Strengthening Interventions in Sub-Saharan Africa. J Adolesc Health 62:S3-S5
Pardo, Gisselle; Saisaengjan, Chutima; Gopalan, Priya et al. (2017) Cultural Adaptation of an Evidence-Informed Psychosocial Intervention to Address the Needs of PHIV+ Youth in Thailand. Glob Soc Welf 4:209-218
Huang, Keng-Yen; Abura, Gloria; Theise, Rachelle et al. (2017) Parental Depression and Associations with Parenting and Children's Physical and Mental Health in a Sub-Saharan African Setting. Child Psychiatry Hum Dev 48:517-527

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