Testing Multi-level Scale-Up Strategies: Ugandan School System

TESTING MULTI-LEVEL SCALE-UP STRATEGIES TO IMPLEMENT A SCHOOL-BASED POPULATION APPROACH OF MENTAL HEALTH PREVENTIVE INTERVENTION: UGANDA

The overall objective of the project is to address the school mental health evidence-based interventions (EBIs) scale-up and sustainability challenges in low-and-middle-income countries (LMICs) by studying "system level intervention" strategies. The project tests a scale-up model utilizing a two-level train-the-trainer model to support the expansion of an evidence-based intervention (mWEL -Teacher Professional Development; PD) in one LMIC (Uganda). mWEL-PD is the abbreviation of "Promoting Mental Wellbeing & Empowering Lives of the School Community". mWEL -PD is a teacher intervention that trains teachers to apply evidence-based strategies to engage parents and to promote student's mental health in classroom, as well as to promote teachers' own mental wellbeing. PD has been adapted and tested in Uganda and has demonstrated effectiveness in promoting Ugandan teachers' practices, teacher wellbeing, and students' mental health. Previous studies only applied one-level of the train-the-trainer model. This new study will test a new two-level of the train-the-trainer model that include a digital-learning system to scale PD, so that more teachers can be trained on PD, and more students can benefit from teachers' training and practice changes. Investigators will also test the new EBI/PD scale-up model with and without including additional sustainability strategies (including technical assistance and continuing education strategies). Investigators will carry out an evaluation study (using a cluster-randomized trial design) to understand the impacts of the new two-level training model. The participants of the study will be the trainers and trainees, and the outcomes will be their implementation and practice outcomes.

Inclusion Criteria:

TTCs and tutors:

• 12 TTCs (out of a total 26 TTCs) will be selected.
• All tutors will be aged 18-65, and currently employed under the educational system.
• Tutors from each TTC will be recruited and trained in EBI implementation and management

Schools:

• 10 public schools (5 match pairs, match in size) under each TTC will be selected, and Principals of public schools will be invited to attend information sessions.
• All principals will be aged 18-65, and currently employed under the educational system.

PTTs and teachers:

• All pre-primary teachers serving students between the ages of 3 and 12 years at the 120 study schools will be eligible to participate.
• All teachers will be aged 18-65, and currently employed under the educational system.

Exclusion Criteria:

• Inability to provide informed consent
• Teachers who are not teaching students in the selected schools or not within the TTC service region.