Browsing by Author "Huang, Keng-Yen"

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    Implementing an early childhood school-based mental health promotion intervention in low-resource Ugandan schools: study protocol for a cluster randomized controlled trial
    (Trials, 2014) Huang, Keng-Yen; Nakigudde, Janet; Calzada, Esther; Boivin, Michael J.; Ogedegbe, Gbenga; Brotman, Laurie Miller
    Children in Sub-Saharan Africa (SSA) are burdened by significant unmet mental health needs, but this region has limited access to mental health workers and resources to address these needs. Despite the successes of numerous school-based interventions for promoting child mental health, most evidence-based interventions are not available in SSA. This study will investigate the transportability of an evidence-based program from a developed country (United States) to a SSA country (Uganda). The approach includes task-shifting to early childhood teachers and consists of professional development (five days) to introduce strategies for effective behavior management and positive teacher-student interactions, and group-based consultation (14 sessions) to support adoption of effective practices and tailoring to meet the needs of individual students. Methods/Design: The design of this study is guided by two implementation frameworks, the Consolidated Framework for Implementation Research and the Teacher Training Implementation Model, that consider multidimensional aspects of intervention fidelity and contextual predictors that may influence implementation and teacher outcomes. Using a cluster randomized design, 10 schools in Uganda will be randomized to either the intervention group (five schools) or the waitlist control group (five schools). A total of 80 to 100 early childhood teachers will be enrolled in the study. Teacher utilization of evidence-based strategies and practices will be assessed at baseline, immediate post-intervention (six months after baseline), and at seven months post-intervention (during a new academic year). Fidelity measures will be assessed throughout the program implementation period (during professional development and consultation sessions). Individual teacher and contextual factors will be assessed at baseline. Data will be collected from multiple sources. Linear mixed-effect modeling, adjusting for school nesting, will be applied to address study questions. Discussion: The study will produce important information regarding the value of an evidence-based early intervention, and a theory-guided implementation process and tools designed for use in implementing early childhood evidence-based programs in SSA countries or resource-constrained community settings.
  • Thumbnail Image
    Item
    Parental Depression and Associations with Parenting and Children’s Physical and Mental Health in a Sub-Saharan African Setting
    (Child Psychiatry & Human Development, 2017) Huang, Keng-Yen; Abura, Gloria; Theise, Rachelle; Nakigudde, Janet
    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.
  • Thumbnail Image
    Item
    Transportability of an Evidence-Based Early Childhood Intervention in a Low-Income African Country: Results of a Cluster Randomized Controlled Study
    (Prevention Science, 2017) Huang, Keng-Yen; Nakigudde, Janet; Rhule, Dana; Gumikiriza-Onoria, Joy Louise; Abura, Gloria; Kolawole, Bukky; Ndyanabangi, Sheila; Kim, Sharon; Seidman, Edward; Ogedegbe, Gbenga; Brotman, Laurie Miller
    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 knowl-
  • Thumbnail Image
    Item
    Use of task-shifting to scale-up child mental health services in low-resource Ugandan schools: role of contextual factors on program implementation
    (Implementation Science, 2015) Huang, Keng-Yen; Nakigudde, Janet; Brotman, Laurie Miller
    Children in Sub-Saharan Africa (SSA) are burdened by significant unmet mental health needs, but this region has limited access to mental health services to address these needs. Despite the success of numerous interventions for promoting child mental health, most evidencebased programs (EBPs) are not available in SSA. This study utilizes a task-shifting strategy and trains teachers as community health workers (CHWs) to utilize EBP strategies and provide basic child mental health services in schools. This paper focuses on two implementation objectives: 1) investigating the transportability of an EBP (ParentCorps-a school-based mental health program) from a developed country to a SSA country-Uganda by evaluating quality of implementation; and 2) studying the influences of contextual factors (i.e., agency setting, individual characteristics) on implementation processes and outcomes (e.g., CHWs’ level of engagement and utilization of EBP strategies).