Misc-CBO: a cluster randomized control trial to improve the mental health of OVC in south africa

Active Project Grant Awarded Last action

Award ID
R01MH127060
Recipient
Awarding agency
Obligated
$2,777,619

Award facts

Assistance listing
93.242 Mental Health Research Grants
Completion date 86% complete
Place of performance
Houston, TX 77204, USA

Award details come from USAspending.gov.

Description

As the agency reported it.

Abstract
Globally, there are over 16 million orphans and vulnerable children (OVC), with estimates of between 1.9-3.7 million for south africa (SA). Despite high mental health needs of OVC, there is a crisis in scarcity of mental health workers in SA. Community-based organizations (CBOS) offer a strategic point of intervention. In a prior NIH-funded quasi-experimental feasibility trial we showed that the mediational intervention for sensitizing caregivers (MISC) for CBO careworkers, thereafter named MISC-CBO, significantly reduced mental health problems in sesotho-speaking OVC. MISC-CBO is a year-long semi-structured, manualized video-feedback intervention designed to enhance the caregiving capacity of CBO careworkers to improve child outcomes, by targeting the rdoc systems for social processes (affiliation and attachment). Building on this work, we now propose a repeated measures cluster randomized trial to fully establish the effectiveness and trans-diagnostic mechanisms of action of MISC-CBO in 7-11 year olds - a developmental stage critical for building mental health resilience against the adolescent onset of psychiatric problems. In addition, we will use consolidated framework for implementation research (CFIR) constructs and input from a community advisory board (CAB) to leverage the RCT to evaluate implementation costs, climate and readiness that would better position the RCT results for future uptake, scale up, and sustainability. In aim 1, we will evaluate the direct effects of MISC-CBO on video- coded CBO careworker caregiving quality (affiliation and attachment) and children's mental health outcomes over a 24 month period. 24 CBOS (360 children and 72 careworkers) will be recruited using our existing NGO partner (CHILDLINE) in the mangaung and xhariep districts in the free state, SA. CBOS will be randomly assigned to receive either one year of BI-weekly MISC-CBO or TAU. We hypothesize that MISC-CBO will be associated with comparative increases in careworker caregiving quality and reductions in mental health problems in OVC. In aim 2A, we will test the hypothesis that caregiving quality at end-of-intervention (12 months) accounts for intervention effects on child mental health at 18 and 24 months. Aim 2B will evaluate the moderating effects of orphan status and the quality of the home environment, expecting that OVC who are maternal and double orphans, and from impoverished home environments will show reduced response to intervention compared to children without these risk factors. Aim 3A will use world health organization metrics to test the hypothesis that MISC-CBO is cost-effective in terms of disability-adjusted life years (DALYS) averted. Aim 3B will use qualitative methodology to test the hypothesis that community stakeholders deem the climate favorable and ready for the implementation of MISC-CBO, and that additional barriers and facilitators for scale-up and implementation will be identified. Our proposed work extends our formative work to now fully test the real-world effectiveness, mechanisms of action, cost-effectiveness and implementation readiness of MISC-CBO during the critical developmental window of at-risk children aging into adolescence, consistent with nimh's strategic objectives.

Transactions

Action Obligated Date
Amendment $108,000
Amendment $228,775
Amendment $108,000
Amendment $228,917
Amendment $336,880
Amendment $336,808
Amendment $336,808
Amendment $0
Amendment $0
Amendment $0
Amendment $364,477
Amendment $364,477
Original award $364,477
Show all 13

Subawards

Subrecipient Amount Awarded
University Of The Free State The University of the Free State will manage and oversee all aspects of fieldwork, including coordinating and supervising fieldworkers, managing relationships… $108,000
Michigan State University Dr. Felicia Wu is the Principal Investigator (PI) of the Michigan State University portion of this proposed research, with overall PI Dr. Carla Sharp at… $110,734
University Of The Free State The sub-recipients will manage various activities like l field work, fieldworkers, CBOs, NGOs, and also conduct fieldwork, create partnerships, set up community… $108,000
Michigan State University Dr. Felicia Wu is the Principal Investigator (PI) of the Michigan State University portion of this proposed research, with overall PI Dr. Carla Sharp at… $216,509
University Of The Free State Manage and control fieldwork, Manage fieldworkers, Manage CBOs, Manage NGOs, Conduct fieldwork, Create partnerships, Set up a community advisory board $236,800

Quick answers

Who received award R01MH127060?

R01MH127060 was awarded to University Of Houston System by National Institute of Mental Health (National Institutes of Health) on September 1, 2022.

How much is award R01MH127060 worth?

$2,777,619 has been obligated on R01MH127060.

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