Youth FORWARD (Youth Functioning and Organizational Success for West African Regional Development) will establish an implementation science hub in West Africa with a dual mission: (a) to accelerate scaling up innovative and sustainable delivery of evidence-based mental health interventions for youth exposed to violence and other forms of adversity across a range of delivery settings; and (b) to serve as a global hub for capacity building in mental health services research on children, youth and families facing adversity and to conduct implementation science on the delivery of evidence-based mental health services via alternate delivery systems such as youth employment programs in West Africa. Youth FORWARD will establish partnerships that leverage the expertise and resources of the Harvard T.H. Chan School of Public Health, University of Georgia College of Public Health, CARITAS, World Bank, the governments of Sierra Leone and Liberia, and a network of youth service providers and universities. A proposed Scale-Up Study will use a hybrid implementation- effectiveness trial design across N=24 youth employment programs to evaluate an innovative approach to training and supervision-Interagency Collaborative Teams (ICTs)-and their influence on integration, fidelity, cost and sustainment of a quality mental health intervention-the Youth Readiness Intervention (YRI)-into a national youth employment program-the Youth Employment Scheme (YES). The concurrent effectiveness trial will assess youth mental health, emotion regulation, functioning and economic self-sufficiency among N=960 Sierra Leonean male and female youth aged 15-24 over time to determine effects of the YRI when implemented under this new delivery platform. Guided by the EPIS implementation model, qualitative data on attitudes towards mental health and barriers and facilitators to the integration of mental health services into youth employment programs will be collected. A Capacity Building Core will build sustainable capacity to conduct and apply mental health services and implementation research by fostering exchange and mutual learning between sites, through the development and delivery of innovative and locally relevant training and technical assistance programs for stakeholders including West African faculty, students, government partners, and NGO leaders. Links between the Scale-Up Study and Capacity Building Core will provide opportunities for on-the-job learning in quantitative and qualitative research to increase capacity for implementation science. These capacity building efforts will accelerate the scale up of evidence-based mental health programs to address the treatment gap in West Africa and will help government stakeholders make greater use of the evidence-base in policy and program development and evaluation methods to measure program effectiveness.
Proposed is a regional hub for West Africa that will (a) study delivery of evidence-based behavioral intervention via the alternate delivery platform, a World Bank-financed, government sponsored youth employment programs; and (b) build capacity in health implementation science, mental health services research, and science-based decision making by policy makers and program developers in West Africa and other low resource settings.