Youth Functioning and Organizational Success for West African Regional Development (Youth FORWARD): Study Protocol

Betancourt, Theresa S.; Hansen, Nathan B.; Farrar, Jordan; Borg, Ryan; Callands, Tamora A.; Desrosiers, Alethea; Antonaccio, Cara M.; Williams, Makeda; Bangura, Joseph Benjamin; Brennan, Robert T.

doi:10.1176/appi.ps.202000009

Cited by 10 publications

(10 citation statements)

References 34 publications

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“…Lessons from implementing the Youth FORWARD study, which utilized a collaborative team approach, including a seed team of YRI experts, to implement the YRI, can serve as a foundation for addressing many of these concerns (Betancourt, Hansen et al, 2020). The use of this approach enabled the training of new facilitators and developed a structure for a multi-agency system of employment structures.…”

Section: Discussionmentioning

confidence: 99%

The adaptation of a youth mental health intervention to a peer-delivery model utilizing CBPR methods and the ADAPT-ITT framework in Sierra Leone

Freeman,

Desrosiers,

Schafer

et al. 2023

Transcult Psychiatry

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Low- and middle-income countries (LMICs) carry a significant proportion of the global burden of untreated mental health disorders. Peer-delivered programs offer LMICs with limited mental health professionals an opportunity to increase mental health service access. This study describes the process of adapting a lay-worker-delivered evidence-based youth mental health intervention to a peer-delivery model in Sierra Leone using participatory methods. We convened Youth Community Advisory Boards (YCABs) as partners to develop a peer-delivery model for an evidence-based intervention. In collaboration with YCABs, the Assessment, Decision, Administration, Production, Topical experts, Integration, Training, Testing (ADAPT-ITT) framework was applied to guide the adaptation. The ADAPT-ITT framework is an eight-step process to adapt evidence-based interventions. The ADAPT-ITT framework facilitated the adaptation of the Youth Readiness Intervention (YRI), an evidence-based mental health program intervention that has been delivered by adult lay-workers to the youth peer-delivery platform in Sierra Leone. The YCABs identified program modifications, including the incorporation of storytelling, refinement of metaphors, and alterations to make delivery more accessible to low-literacy youth with particular attention to gender. YCABs also provided recommendations on how to support youth facilitators in providing psychosocial support, emphasizing self-care and boundary setting to ensure high-quality intervention delivery and do-no-harm principles. Study findings suggest that the ADAPT-ITT framework can be feasibly applied to guide the intervention adaptation process in LMICs. The use of participatory methods generated modifications that reflected youth experiences, needs, and concerns as facilitators and participants. Next steps include refinement and pilot testing of the adapted intervention.

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Section: Discussionmentioning

confidence: 99%

The adaptation of a youth mental health intervention to a peer-delivery model utilizing CBPR methods and the ADAPT-ITT framework in Sierra Leone

Freeman,

Desrosiers,

Schafer

et al. 2023

Transcult Psychiatry

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“…Topics of note for families with adolescents include how to discuss problem drinking, use of substances, and sexuality as these are often difficult. With the use of both adult and youth community advisory boards, these themes can be brought to the wider community and pathways forward can be illuminated (Betancourt, Hansen, et al, 2020).…”

Section: Create Interventions That Strengthen Family Relationshipsmentioning

confidence: 99%

“…For example, cultural brokers and community health workers have played an important role, by providing not only mental health but also caregiving interventions. Interventions conducted by refugees for refugees using cultural brokers and community health worker models can help to make an important impact (Betancourt, Hansen, et al, 2020; Im & Swan, 2021).…”

Section: Strategies and Recommendations For Supporting Refugee Adoles...mentioning

confidence: 99%

Promoting positive development among refugee adolescents

Abdi,

Akinsulure‐Smith,

Sarkadi

et al. 2023

J of Research on Adolesc

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Of the estimated 35.3 million refugees around the world (UNHCR, Figures at a Glance, 2022), approximately 50% are children under the age of 18. Refugee adolescents represent a unique group as they navigate developmental tasks in an unstable and often threatening environment or in resettlement contexts in which they often face marginalization. In addition to physiological, social, and psychological changes that mark adolescence, refugee youth often face traumatic experiences, acculturative stress, discrimination, and a lack of basic resources. In this consensus statement, we examine research on refugee adolescents' developmental tasks, acculturative tasks, and psychological adjustment using Suárez‐Orozco and colleague's integrative risk and resilience model for immigrant‐origin children and youth proposed by Suárez‐Orozco et al. Finally, we discuss recommendations—moving from proximal to more distal contexts.

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“…The scale-out study utilized a staggered approach to rolling out the YRI across study districts, which allowed for cost-effective resource sharing between study sites, cross-site learning between CTA stakeholders, and quality improvement through PDSA cycles [31].…”

Section: Adaptationsmentioning

confidence: 99%

“…Youth FORWARD is part of a network of hubs delivering interventions in low-resource settings [31]. Tremendous challenges lie in complying with regulatory processes, sometimes at odds with field realities.…”

Section: " (Mkf6)mentioning

confidence: 99%

Alternate delivery platforms and implementation models for bringing evidence-based behavioral interventions to scale for youth facing adversity: a case study in West Africa

Bond

Farrar

Borg

et al. 2022

Implement Sci Commun

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Background Youth Functioning and Organizational Success for West African Regional Development (Youth FORWARD) was launched as an implementation science collaboration focused on scaling out evidence-based mental health interventions for youth exposed to war and other adversities through novel delivery platforms. This implementation science case study examines the use of a collaborative team approach (CTA) as a scale-out strategy to foster the integration of an evidence-based group mental health intervention, the Youth Readiness Intervention, into youth employment programs tied to regional economic development in Sierra Leone. Methods A case study methodology is used to explore the feasibility and acceptability of integrating an evidence-based intervention, the Youth Readiness Intervention (YRI), into youth entrepreneurship programs (ENTR) in Sierra Leone, facilitated by the CTA. The authors analyzed field notes logged during program implementation, 8 weeks of supervision notes, 20 interviews with agency leaders and front-line staff delivering the YRI within this alternate delivery platform. Quantitative dissemination and implementation interviews administered to youth, facilitators, and agency leaders were analyzed using descriptive statistics and mixed linear models. A linked Hybrid Type II effectiveness-implementation cluster randomized trial is evaluating the clinical effectiveness of the YRI within this delivery platform. Results Extant data indicate the strong feasibility and acceptability of integrating the YRI into the ENTR program. Facilitators of integration of the YRI into the ENTR include mission alignment of the organizations with the delivery of psychosocial interventions, shared commitment to serving vulnerable youth, support from local District Youth Councils, and high interest from the youth served. Barriers include perceived competition between frontline organizations seeking funding for psychosocial interventions, and challenges in flexibility between donors and implementation partners operating in a fragile/post-conflict setting. The CTA was a feasible and acceptable strategy to support fidelity and quality improvement while scaling out the YRI. Conclusions Youth entrepreneurship and livelihood programs offer a promising mechanism for expanding the reach of evidence-based interventions to youth in fragile and post-conflict settings. Quality improvement and sustainment of evidence-based interventions are novel concepts in such settings. The CTA strategy institutionalizes the integration of an evidence-based intervention into youth entrepreneurship programs. Trial registration NCT03603613 (phase 1 pilot, registered May 18, 2018) and NCT03542500 (phase 2 scale-out study, registered May 18, 2018).

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Youth Functioning and Organizational Success for West African Regional Development (Youth FORWARD): Study Protocol

Cited by 10 publications

References 34 publications

The adaptation of a youth mental health intervention to a peer-delivery model utilizing CBPR methods and the ADAPT-ITT framework in Sierra Leone

The adaptation of a youth mental health intervention to a peer-delivery model utilizing CBPR methods and the ADAPT-ITT framework in Sierra Leone

Promoting positive development among refugee adolescents

Alternate delivery platforms and implementation models for bringing evidence-based behavioral interventions to scale for youth facing adversity: a case study in West Africa

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