Tailoring implementation of a youth-focused mental health intervention in Sierra Leone using an implementation blueprint methodology

Alethea Desrosiers; Bidemi Carrol; Jacqueline Hayes; Fatoma Momoh; Haley Ritsema; Hannah E Frank; Unisa Jalloh

doi:10.1186/s12889-024-20896-w

Tailoring implementation of a youth-focused mental health intervention in Sierra Leone using an implementation blueprint methodology

BMC Public Health. 2024 Dec 18;24(1):3418. doi: 10.1186/s12889-024-20896-w.

Authors

Alethea Desrosiers¹, Bidemi Carrol², Jacqueline Hayes³, Fatoma Momoh⁴, Haley Ritsema⁵, Hannah E Frank³, Unisa Jalloh⁶

Affiliations

¹ Department of Psychiatry and Human Behavior, Brown University, Warren Alport Medical School, 345 Blackstone Blvd, Providence, RI, 02906, United States. alethea_desrosiers@brown.edu.
² RTI International, 701 13th St NW #750, Durham, Washington, D.C., 20005, United States.
³ Department of Psychiatry and Human Behavior, Brown University, Warren Alport Medical School, 345 Blackstone Blvd, Providence, RI, 02906, United States.
⁴ Innovations for Poverty Action, 47A&B Johnson Street, Freetown, Sierra Leone.
⁵ Save the Children International, St Vincent House, 30 Orange Street, London, WC2H 7HH, United Kingdom.
⁶ Caritas-Freetown, 55 Savage Road, Freetown, Sierra Leone.

Abstract

Background: Identifying contextual factors that might support or hinder implementation of evidence-based mental health interventions for youth in low- and middle- income countries may improve implementation success by increasing the alignment of intervention implementation with local needs and resources. This study engaged community partners in Sierra Leone to: (a) investigate barriers and facilitators to implementing a mental health intervention within Sierra Leone's schools; (b) develop an implementation blueprint to address identified implementation barriers; (c) explore the feasibility of using the implementation blueprint methodology in Sierra Leone.

Methods: We recruited Ministry of Education Officials (n = 2), teachers (n = 15) and principals (n = 15) in Sierra Leone to participate in needs assessment qualitative interviews. We used a rapid qualitative analysis approach to analyze data. Three team members summarized transcripts based on domains aligned with the structured research questions, organized themes into a matrix, and identified and discussed key themes to arrive at consensus. We then reconvened community partners to discuss implementation strategies that could address identified barriers. Participants ranked barriers according to high/low feasibility and high/low importance and selected implementation strategies for the blueprint.

Results: Qualitative results revealed several implementation barriers: teacher/parent/student buy-in; teacher motivation; scheduling time; limited funding; waning interest; daily hardships outside of school. Strategies selected included: develop/distribute educational materials; conduct education meetings/outreach; identify and prepare champions; access new funding.

Conclusions: Engaging community partners to develop an implementation blueprint for integration of a mental health intervention within Sierra Leone's schools was feasible and may increase implementation effectiveness.

Keywords: Implementation blueprint; Qualitative methods, Schools, LMICs, Adolescents.

MeSH terms

Adolescent
Child
Female
Humans
Interviews as Topic
Male
Mental Health Services / organization & administration
Needs Assessment
Qualitative Research*
Sierra Leone

Abstract

MeSH terms

Grants and funding