Transportability of an Evidence-Based Early Childhood Intervention in a Low-Income African Country: Results of a
Keng-Yen Huang1, Janet Nakigudde2, Dana Rhule3
1Department of Population Health, New York University School of Medicine, 227 East 30th Street, 1st Floor, New York, NY, 10016, USA. Keng-Yen.Huang@nyumc.org.
Insights
Training Ugandan teachers in evidence-based practices (EBPs) improved their knowledge and classroom use of these strategies. This professional development initiative also enhanced child social competence, demonstrating feasibility in Sub-Saharan Africa.
Area of Science:
- Child and Adolescent Mental Health
- Global Mental Health
- Implementation Science
Background:
- Sub-Saharan Africa faces significant unmet child mental health needs, with limited access to evidence-based interventions (EBIs).
- School-based interventions show promise, but adapting EBIs for diverse cultural contexts remains a challenge.
Purpose of the Study:
- To assess the implementation quality and effectiveness of a US-developed EBI component, Professional Development, in Uganda.
- To evaluate the feasibility of training local mental health professionals to deliver this intervention to primary school teachers.
Main Methods:
- A cluster randomized trial involving 10 schools (intervention and wait-list control) with 79 early childhood teachers.
- Teachers received training and coaching on evidence-based practices (EBPs) for nurturing classroom environments.
- Child behavior was assessed via parent reports, and teacher knowledge/EBP use was measured pre- and post-intervention.
Main Results:
- Professional Development was delivered with high fidelity by trained Ugandan professionals.
- Teachers demonstrated improved knowledge of EBPs and increased their use of these practices in the classroom.
- Children exhibited enhanced social competence following the intervention.
Conclusions:
- Training local mental health professionals to deliver Professional Development to teachers is feasible and effective.
- This approach successfully adapted an EBI component for a Sub-Saharan African context, improving teacher practices and child outcomes.
- Findings support the scalability of such interventions to address child mental health disparities in low-resource settings.
Abstract:
Children in Sub-Saharan Africa (SSA) are burdened by significant unmet mental health needs. Despite the successes of numerous school-based interventions for promoting child mental health, most evidence-based interventions (EBIs) are not available in SSA. This study investigated the implementation quality and effectiveness of one component of an EBI from a developed country (USA) in a SSA country (Uganda). The EBI component, Professional Development, was provided by trained Ugandan mental health professionals to Ugandan primary school teachers. It included large-group experiential training and small-group coaching to introduce and support a range of evidence-based practices (EBPs) to create nurturing and predictable classroom experiences. The study was guided by the Consolidated Framework for Implementation Research, the Teacher Training Implementation Model, and the RE-AIM evaluation framework. Effectiveness outcomes were studied using a cluster randomized design, in which 10 schools were randomized to intervention and wait-list control conditions. A total of 79 early childhood teachers participated. Teacher knowledge and the use of EBPs were assessed at baseline and immediately post-intervention (4-5 months later). A sample of 154 parents was randomly selected to report on child behavior at baseline and post-intervention. Linear mixed effect modeling was applied to examine effectiveness outcomes. Findings support the feasibility of training Ugandan mental health professionals to provide Professional Development for Ugandan teachers. Professional Development was delivered with high levels of fidelity and resulted in improved teacher EBP knowledge and the use of EBPs in the classroom, and child social competence.
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