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

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.

Parental Depression and Associations with Parenting and Children's Physical and Mental Health in a Sub-Saharan African Setting.

Depression is one of the most prevalent mental health challenges in low- and middle-income countries. However, the mechanisms of parental depression on children's development are understudied in these countries. This study examined the prevalence of parental depression, contextual predictors of parental depression, and the associations between parental depression, parenting and children's development in one of the Sub-Saharan African countries-Uganda. Three hundred and three Ugandan parents of young children were recruited and interviewed. Results indicated that about 28 % of parents were depressed. Contextual factors such as low educational attainment, food insecurity, low social support, and high number of children were associated with parental depression. Structural equation modeling also indicated that Ugandan parents' depression was associated with less optimal parenting, and higher problem behavior, lower social competence, and poorer physical health and school functioning in children. Results provide several cross cultural consistency evidence in associations among parental depression, parenting, and child development.