Overview of the results and their exploitation and dissemination
Child mental health problems are a leading cause of impairment and disability everywhere in the world, but these problems are particularly challenging to address in economically restricted regions with limited human and financial resources and with limited mental health service provision. Early intervention is one of the key strategies for the effective prevention of mental health problems in children and adolescents and has the potential to reduce later mental health problems.
The aim of the RISE project was to address this urgent need for effective and affordable programs targeted at preventing child mental health problems in low-to moderate income countries. We selected three middle-income countries in Southeastern Europe as implementation sites, North Macedonia, Republic of Moldova and Romania. The RISE project was focused on families with at least one child showing elevated behavior problems (compared to other children his/her age).
We selected the Parenting for Lifelong Health (PLH) for Young Children (2-9 years) program as the prototype to adapt to the context because the program is evidence-based (found to be effective in randomized trials), is part of a suite of programs offered under the Creative Common License, freely available and easily adapted in content, structure and service delivery. It is considered a low-cost program because the original development of the program suites occurred in South Africa, a country classified as middle-income. The original program development already considered the needs of economic restrictions in service delivery, e.g. it can be delivered by para-professionals.
The project was divided into three phases: a Preparation Phase (Phase 1) in which we examined the regional / local situation of each country, sought to develop and maintain relationships with parents and professionals to jointly explore how to best implement such a program in different communities, and to find out about its acceptability and the best way to deliver it with fidelity in these contexts. In the Optimization Phase (Phase 2) we examined which implementation factors were most efficacious and cost-effective. By doing so, we created an optimized version of the program that required less human and financial resources to implement in each country. In the Evaluation Phase (Phase 3), we then tested this optimized version in a randomized controlled trial comparing it to a one-off lecture on child development (both delivered online via Zoom due to COVID-19 restrictions).
The RISE project is continuously working on developing strategies with local stakeholders to embed the optimized program into practice and policy and to sustain the intervention at scale (using the built up infrastructure).
