# Expanding the Reach of Evidence-Based Mental Health Treatment: Diffusion and Spillover of Mental Health Benefits Among Peer Networks and Caregivers of Youth Facing Compounded Adversity in Sierra Leone

> **NIH NIH R01** · BOSTON COLLEGE · 2021 · $616,267

## Abstract

PROJECT SUMMARY
The proposed study links with and leverages an ongoing scale up study of a cognitive behavioral therapy
(CBT) based intervention, the Youth Readiness Intervention (YRI), among youth facing adversity in Sierra
Leone that is currently being implemented in partnership with the Government of Sierra Leone (GoSL) and the
Gesellschaft für Internationale Zusammenarbeit (GIZ). The YRI has demonstrated feasibility and effectiveness
for improving emotion regulation and daily functioning in youth. This study aims to harness the mechanisms of
natural diffusion of CBT techniques learned among peer groups and spillover phenomenon in reduction of
burden to cohabitating caregivers. Preliminary studies of the YRI in Sierra Leone indicate both mechanisms
occur. Researchers from the Boston College School of Social Work will examine the potential of the YRI to
reach a larger segment of the population by examining the extent to which indirect effects result in
measureable incremental health benefits (symptoms and functioning) among nonparticipants. Study aims are
to investigate (1) mechanism of diffusion—the untargeted and unplanned spread of new practices among
social network members—of YRI components and mental health benefits experienced by nonparticipant peers
who learn YRI practices from YRI participants; (2) indirect mental health benefits experienced by
nonparticipants among cohabitating caregivers of YRI participants (spillover effects); and (c) incremental health
costs and benefits among YRI participants' caregivers and peers through cost-effectiveness and return on
investment analysis. Study design includes a control group (current YRI participants and YRI nonparticipants).
YRI participants and control participants who consent to the current study will nominate 3 peers in their social
networks aged 18-24 and will also identify their primary cohabitating caregiver. Following consent, peers and
caregivers will be assessed at baseline and 6-month follow-up on mental health, emotion regulation, daily
functioning, and sense of burden (caregivers only). Study outcomes also incorporate common indicators for
implementation science, including measures of project context, evaluation, and scale-up, to enhance
knowledge exchange across global research networks. Assessing implementation research outcomes,
including penetration of YRI effects and cost-effectiveness of the YRI as distinct outcomes will provide key
information about the success of YRI implementation, thereby supporting decisions about whether to increase
scale up efforts in Sub-Saharan Africa and other LMICs. Findings on diffusion of the YRI will inform the
feasibility of peer-led interventions and the development of additional educational materials to amplify YRI
components identified as most transferrable. Findings on spillover effects will inform the potential reach and
penetration of evidence-based practices in LMICs. Lessons learned will inform the GoSL, GIZ, and
development actors on i...

## Key facts

- **NIH application ID:** 10093136
- **Project number:** 5R01MH117359-03
- **Recipient organization:** BOSTON COLLEGE
- **Principal Investigator:** Theresa Stichick Betancourt
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $616,267
- **Award type:** 5
- **Project period:** 2019-04-11 → 2024-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10093136

## Citation

> US National Institutes of Health, RePORTER application 10093136, Expanding the Reach of Evidence-Based Mental Health Treatment: Diffusion and Spillover of Mental Health Benefits Among Peer Networks and Caregivers of Youth Facing Compounded Adversity in Sierra Leone (5R01MH117359-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10093136. Licensed CC0.

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