# Advancing mHealth-supported Adoption and Sustainment of an Evidence-based Mental Health Intervention for Youth in a School-based Delivery Setting in Sierra Leone

> **NIH NIH R01** · BROWN UNIVERSITY · 2024 · $673,972

## Abstract

PROJECT SUMMARY
 This study will examine a new implementation strategy for the Youth Readiness Intervention (YRI), an
evidence-based mental health intervention. The strategy will (a) leverage a delivery setting (schools) and
workforce (teachers) used effectively in low- and middle- income countries; and (b) innovate with technology
and mHealth tools to enhance mental health service delivery quality. The YRI will be implemented as an
extracurricular resilience-building afterschool activity in Sierra Leone. Teachers will deliver the YRI and receive
either mobile phone-supported supervision or standard in-person supervision. Mobile-based supervision will
integrate WhatsApp, a free cross-platform messaging and voice service used widely throughout Africa, with a
new mHealth app. The mHealth app was recently designed to support fidelity monitoring of Sierra Leonean lay
workers delivering the evidence-based Family Strengthening Intervention (R21MH124071). The mHealth app
will support supervision through key features, including voice activated content, fillable forms (i.e., YRI fidelity
checklist), visual dashboards to monitor fidelity, and training videos to support school-based YRI delivery.
 The Exploration, Preparation, Implementation, Sustainment (EPIS) framework, a broad multilevel, context-
sensitive implementation science model, will guide the study. A hybrid type 3 implementation-effectiveness
design will allow for evaluation of both mobile phone-based supervision as a new implementation strategy, and
clinical effectiveness of the YRI on youth mental and behavioral health as secondary outcomes.
 Aim 1 (Exploration and Preparation) will investigate barriers and facilitators to successful YRI
implementation aided by mobile-based tools in Sierra Leone’s secondary schools. A mixed methods evaluation
with teachers, principals, and government ministry officials will inform co-development of an implementation
blueprint prior to YRI delivery. User-centered design methods will be used to adapt the mHealth supervision
app and incorporate WhatsApp to create an integrated user model of mobile phone-based supervision. Aim 2
(Implementation) will examine the feasibility, acceptability, cost, and fidelity to the YRI delivered by teachers
receiving mobile-based supervision compared with those receiving standard supervision via a mixed methods
approach. Aim 3 (Impact of Delivery Approach on YRI Effectiveness) will compare the effectiveness of the YRI
in improving mental health, emotion regulation and daily functioning in youth (aged 14-24) when delivered in
school settings by teachers who receive either mobile-based supervision (N=480 youth) or those who receive
standard supervision (N=480 youth). Aim 4 (Sustainment) will (a) investigate mechanisms of adoption and
sustainment of the YRI delivered by teachers through a mixed methods evaluation with teachers, youth, and
principals; and (b) conduct a cost-effectiveness and return on investment analysis to evaluate ...

## Key facts

- **NIH application ID:** 10877804
- **Project number:** 5R01MH130320-03
- **Recipient organization:** BROWN UNIVERSITY
- **Principal Investigator:** Alethea Desrosiers
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $673,972
- **Award type:** 5
- **Project period:** 2022-08-05 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10877804

## Citation

> US National Institutes of Health, RePORTER application 10877804, Advancing mHealth-supported Adoption and Sustainment of an Evidence-based Mental Health Intervention for Youth in a School-based Delivery Setting in Sierra Leone (5R01MH130320-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10877804. Licensed CC0.

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