# Optimizing prevention approaches for children reintegrating from orphanages in Azerbaijan

> **NIH NIH R01** · UNIVERSITY OF CHICAGO · 2021 · $474,321

## Abstract

ABSTRACT
The UN estimates that globally between 2 to 8 million children live in orphanages and the countries of the
former Soviet Union (fSU) and Eastern Europe have the highest number of children in institutional care
worldwide--up to 1.3 million children. Due to the economic crisis following the collapse of the Soviet Union,
Azerbaijan hosts a large population of “social orphans,” children left by destitute parents in state-run
institutions. Years of deprivation, separation from parents, and maltreatment in orphanages severely heighten
the risk of mental health problems among institutionalized children. However, current deinstitutionalization and
family reunification initiatives provide basic case management services, but do not address the mental health
problems of institutionalized children and do not attend to the poverty-related factors that led to
institutionalization in the first place. To prevent mental health problems among 6-12 children from orphanages
reunited with their biological or extended families in Azerbaijan, the proposed study will refine and test three
evidence-based intervention approaches (a) family strengthening intervention; b) mental health screening and
referral for treatment; and c) economic empowerment in the form of Child Savings Accounts). Based on the
formative research conducted by the study team in collaboration with a local Community Collaborative Board,
the intervention components have been adapted to maximize fit to the cultural context of Azerbaijan. In the
proposed study, the adapted interventions will be tested with 400 child-caregiver dyads in a trial using the
Multiphase Optimization Strategy (MOST) to compare different intervention components and identify the most
optimal combination. The study will test effects of each intervention component on children's mental health
outcomes (symptoms of depression, anxiety; disruptive behaviors; post-traumatic symptoms; and disturbances
of attachment). If efficacious, the study results study could transform large-scale deinstitutionalization initiatives
implemented by UNICEF or other organizations in Azerbaijan and in the fSU region. The study addresses top
two challenges within the NIMH Grand Challenges in Global Mental Health Goal B (Advance prevention and
implementation of early interventions): 1) to develop locally appropriate strategies to eliminate childhood abuse
and 2) to develop interventions to reduce the long-term negative impact of low childhood socioeconomic status
on mental health. Additionally, the goal of this R01 application is to strengthen the local research expertise in
testing and adaptation of individual, family, and structural interventions for preventing child mental health
problems. Through training and collaborative research, the project will enhance knowledge and skills in: 1)
core components and mechanisms of change in preventive mental health interventions for children with a
history of trauma, abuse and deprivation; 2) adaptation of mu...

## Key facts

- **NIH application ID:** 10212436
- **Project number:** 5R01HD099847-03
- **Recipient organization:** UNIVERSITY OF CHICAGO
- **Principal Investigator:** Fuad Ismayilov
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $474,321
- **Award type:** 5
- **Project period:** 2019-09-12 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10212436

## Citation

> US National Institutes of Health, RePORTER application 10212436, Optimizing prevention approaches for children reintegrating from orphanages in Azerbaijan (5R01HD099847-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10212436. Licensed CC0.

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