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Transportability of an Evidence-Based Early Childhood Intervention in a Low-Income African Country: Results of a Cluster Randomized Controlled Study

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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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Authors and Affiliations

  1. Department of Population Health, New York University School of Medicine, 227 East 30th Street, 1st Floor, New York, NY, 10016, USA

    Keng-Yen Huang, Dana Rhule, Bukky Kolawole, Gbenga Ogedegbe & Laurie Miller Brotman

  2. College of Health Science, Makerere University, Kampala, Uganda

    Janet Nakigudde, Joy Louise Gumikiriza-Onoria & Gloria Abura

  3. Ministry of Health, Kampala, Uganda

    Sheila Ndyanabangi

  4. Department of Applied Psychology and Institute of Human Development and Social Change, New York University, New York, NY, USA

    Sharon Kim & Edward Seidman

Authors
  1. Keng-Yen Huang
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  2. Janet Nakigudde
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  3. Dana Rhule
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  4. Joy Louise Gumikiriza-Onoria
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  5. Gloria Abura
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  6. Bukky Kolawole
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  7. Sheila Ndyanabangi
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  8. Sharon Kim
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  9. Edward Seidman
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  10. Gbenga Ogedegbe
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  11. Laurie Miller Brotman
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Corresponding author

Correspondence to Keng-Yen Huang.

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Funding

This study was funded by the National Institutes of Health (R21MH097115-01A1).

Conflict of Interest

The authors declare that they have no competing interests.

Ethical Approval

The ethics related to this study was approved by the Institutional Review Boards of New York University School of Medicine (IRB No. S13-00362), Makerere University (IRB No. SBS110), and Ugandan National Science and Technology (IRB Nos. SS3194 and SBS132).

Informed Consent

The study involved human participants. All participants, including mental health professionals, school principals, teachers, and parents, were consented prior to the study.

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Huang, KY., Nakigudde, J., Rhule, D. et al. Transportability of an Evidence-Based Early Childhood Intervention in a Low-Income African Country: Results of a Cluster Randomized Controlled Study. Prev Sci 18, 964–975 (2017). https://doi.org/10.1007/s11121-017-0822-0

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