Advancing Scalability and Impacts of a Teacher Training Program for Promoting Child Mental Health in Ugandan Primary Schools: Protocol for a Hybrid-Type II Effectiveness-Implementation Cluster Randomized Trial
Bibliographic record
Abstract
Abstract Background: There are numerous challenges to promoting child mental health in low-and-middle income countries (LMICs). Most evidence-based interventions (EBIs) adapted to LMICs have not been scaled widely or evaluated for effectiveness and underlying mechanisms. Most mental health EBIs in LMICs rely on a task-shifting approach of implementation because of the shortage of mental health professionals; however, challenges related to task-shifting are understudied. Most EBIs have not been implemented using a scalable and sustainable model that leverages and strengthens existing structures. Through a cross-sector collaboration, we are carrying out a second generation investigation of implementation and effectiveness of a school-based mental health EBI for early childhood students that uses task-shifting and builds on existing educational structures. The ultimate shared goal of this collaboration is to scale and sustain the EBI country wide. The systems-level approach to promoting child mental health builds on ParentCorps, an EBI implemented in schools that has been shown in multiple trials to yield long-term benefits on mental health and school performance. Previous studies in Uganda found that ParentCorps Professional Development (PD) for teachers resulted in short-term benefits for classrooms, children and families. Objectives: This paper describes the rationale and protocol for an effectiveness-implementation study of ParentCorps-PD for teachers in urban and rural Ugandan schools. The study considers the added value (i.e. impact and costs) of a brief wellness intervention for teachers in their task-shifting role and explores mechanisms and outcomes. Methods: Using a hybrid-type II effectiveness-implementation cluster randomized controlled trial (cRCT), we will randomize 36 schools (18 urban and 18 rural) with 540 teachers and nearly 2,000 families to one of three conditions: PD + Teacher-Wellness (PDT), PD alone (PD), and control. Primary effectiveness outcomes are teachers’ use of mental health promoting strategies, teacher stress management, and child mental health. Mixed methods will be employed to examine underlying mechanisms of implementation and impact as well as cost-effectiveness. Discussion: This research will generate important knowledge regarding the value of an EBI in urban and rural communities in a LMIC, and efforts toward supporting teachers who are task-shifting as a potentially cost-effective strategy for promoting child mental health. Trial Registration: This trial was registered with ClinicalTrials.gov (registration number: NCT04383327; https://clinicaltrials.gov/ct2/show/NCT04383327) on May13, 2020.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.085 | 0.076 |
| Meta-epidemiology (narrow) | 0.008 | 0.004 |
| Meta-epidemiology (broad) | 0.011 | 0.010 |
| Bibliometrics | 0.004 | 0.005 |
| Science and technology studies | 0.005 | 0.006 |
| Scholarly communication | 0.007 | 0.006 |
| Open science | 0.005 | 0.004 |
| Research integrity | 0.009 | 0.010 |
| Insufficient payload (model declined to judge) | 0.074 | 0.014 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".