Scaling up home-visiting to promote early childhood development and prevent violence in Rwanda: a hybrid type-2 effectiveness-implementation trial / Candace J. BLACK in Journal of Child Psychology and Psychiatry, 66-10 (October 2025)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 66-10 (October 2025) . - p.1484-1499 Titre : Scaling up home-visiting to promote early childhood development and prevent violence in Rwanda: a hybrid type-2 effectiveness-implementation trial Type de document : texte imprimé Auteurs : Candace J. BLACK, Auteur ; Matias PLACENCIO-CASTRO, Auteur ; Gabriela PHEND, Auteur ; Jean Marie Vianney HAVUGIMANA, Auteur ; Grace UMULISA, Auteur ; Pacifique UWAMAHORO, Auteur ; Marie Gaudence NYIRAHABIMANA, Auteur ; Laura BOND, Auteur ; Kayla HERNANDEZ, Auteur ; Sarah K.G. JENSEN, Auteur ; Ursula KAJANI, Auteur ; Shauna M. MURRAY, Auteur ; Laura B. RAWLINGS, Auteur ; Vincent SEZIBERA, Auteur ; Theresa S. BETANCOURT, Auteur Article en page(s) : p.1484-1499 Langues : Anglais (eng) Mots-clés : Implementation science  implementation strategy  Hybrid Type-2 Trial  early child development  global health  violence prevention  father engagement  poverty  social protection  home-visiting Index. décimale : PER Périodiques Résumé : Background Children in impoverished families?especially those affected by violence?face risks to healthy development. In the years of strong economic recovery since the 1994 Genocide Against the Tutsi, the Rwandan Government has invested in early child development, social and child protection and violence prevention, but few strategies for scaling evidence-based interventions (EBIs) in these areas have been studied. Methods We present a Hybrid Type-2 Implementation-Effectiveness study of the PLAY Collaborative implementation strategy to engage government and other stakeholders in scaling Sugira Muryango (SM, ?Strong Family?) to families eligible for social protection in three rural districts. SM promotes nurturing care of children under three while reducing family violence. We assessed delivery quality (fidelity, competence) and perceptions of the PLAY Collaborative (e.g, feasibility, leadership, organisation, sustainability). An embedded trial of 538 households (778 caregivers, 555 children) tested SM effectiveness when delivered by child protection volunteers. Results Child protection volunteers delivered SM with high fidelity and competence that improved with time and routine supervision. The PLAY Collaborative was rated moderately to highly across implementation outcomes. The embedded trial revealed improvements in children's stimulation at home (d 0.20, 95% CI: 0.04 0.36) as caregivers involved them more in daily activities (d 0.37, 95% CI: 0.18 0.57) and provided more learning materials (d 0.37, 95% CI: 0.16 0.59). SM families increased stimulating care (e.g. singing, playing; d 0.26, 95% CI: 0.07 0.46); involved fathers more in caregiving (IRR 1.18, 95% CI: 1.03 1.37); reduced harsh discipline (OR 0.34, 95% CI: 0.14 0.82); and increased dietary diversity (d 0.25, 95% CI: 0.04 0.45). SM caregivers reported improved mental health (d 0.13, 95% CI: 0.26 to 0.01). SM households increased safe water storage (OR 3.14, 95% CI: 1.64 6.03) and water treatment (OR 3.56, 95% CI: 1.80 7.05) practices. Conclusions The PLAY Collaborative successfully overcame implementation barriers and maintained effectiveness across most outcomes while scaling delivery to N 8,745 families, highlighting the value of systematically investigating implementation strategies while scaling an EBI as integrated into existing social and child protection systems. En ligne : https://doi.org/10.1111/jcpp.14160 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=568 [article] Scaling up home-visiting to promote early childhood development and prevent violence in Rwanda: a hybrid type-2 effectiveness-implementation trial [texte imprimé] / Candace J. BLACK, Auteur ; Matias PLACENCIO-CASTRO, Auteur ; Gabriela PHEND, Auteur ; Jean Marie Vianney HAVUGIMANA, Auteur ; Grace UMULISA, Auteur ; Pacifique UWAMAHORO, Auteur ; Marie Gaudence NYIRAHABIMANA, Auteur ; Laura BOND, Auteur ; Kayla HERNANDEZ, Auteur ; Sarah K.G. JENSEN, Auteur ; Ursula KAJANI, Auteur ; Shauna M. MURRAY, Auteur ; Laura B. RAWLINGS, Auteur ; Vincent SEZIBERA, Auteur ; Theresa S. BETANCOURT, Auteur . - p.1484-1499. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 66-10 (October 2025) . - p.1484-1499 Mots-clés : Implementation science  implementation strategy  Hybrid Type-2 Trial  early child development  global health  violence prevention  father engagement  poverty  social protection  home-visiting Index. décimale : PER Périodiques Résumé : Background Children in impoverished families?especially those affected by violence?face risks to healthy development. In the years of strong economic recovery since the 1994 Genocide Against the Tutsi, the Rwandan Government has invested in early child development, social and child protection and violence prevention, but few strategies for scaling evidence-based interventions (EBIs) in these areas have been studied. Methods We present a Hybrid Type-2 Implementation-Effectiveness study of the PLAY Collaborative implementation strategy to engage government and other stakeholders in scaling Sugira Muryango (SM, ?Strong Family?) to families eligible for social protection in three rural districts. SM promotes nurturing care of children under three while reducing family violence. We assessed delivery quality (fidelity, competence) and perceptions of the PLAY Collaborative (e.g, feasibility, leadership, organisation, sustainability). An embedded trial of 538 households (778 caregivers, 555 children) tested SM effectiveness when delivered by child protection volunteers. Results Child protection volunteers delivered SM with high fidelity and competence that improved with time and routine supervision. The PLAY Collaborative was rated moderately to highly across implementation outcomes. The embedded trial revealed improvements in children's stimulation at home (d 0.20, 95% CI: 0.04 0.36) as caregivers involved them more in daily activities (d 0.37, 95% CI: 0.18 0.57) and provided more learning materials (d 0.37, 95% CI: 0.16 0.59). SM families increased stimulating care (e.g. singing, playing; d 0.26, 95% CI: 0.07 0.46); involved fathers more in caregiving (IRR 1.18, 95% CI: 1.03 1.37); reduced harsh discipline (OR 0.34, 95% CI: 0.14 0.82); and increased dietary diversity (d 0.25, 95% CI: 0.04 0.45). SM caregivers reported improved mental health (d 0.13, 95% CI: 0.26 to 0.01). SM households increased safe water storage (OR 3.14, 95% CI: 1.64 6.03) and water treatment (OR 3.56, 95% CI: 1.80 7.05) practices. Conclusions The PLAY Collaborative successfully overcame implementation barriers and maintained effectiveness across most outcomes while scaling delivery to N 8,745 families, highlighting the value of systematically investigating implementation strategies while scaling an EBI as integrated into existing social and child protection systems. En ligne : https://doi.org/10.1111/jcpp.14160 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=568

Sustained mental health outcomes from the youth readiness intervention: A four-year effectiveness follow-up of a hybrid type II trial in Sierra Leone / Wijnand VAN DEN BOOM in Journal of Child Psychology and Psychiatry, 67-9 (September 2026)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 67-9 (September 2026) . - p.1537-1546 Titre : Sustained mental health outcomes from the youth readiness intervention: A four-year effectiveness follow-up of a hybrid type II trial in Sierra Leone Type de document : texte imprimé Auteurs : Wijnand VAN DEN BOOM, Auteur ; Kathryn NOON, Auteur ; Shuangshuang YANG, Auteur ; Renee MENART, Auteur ; Fatoma MOMOH, Auteur ; Abdulai Jawo BAH, Auteur ; Matias PLACENCIO-CASTRO, Auteur ; Theresa S. BETANCOURT, Auteur Article en page(s) : p.1537-1546 Langues : Anglais (eng) Mots-clés : Youth Readiness Intervention  cognitive-behavioral therapy  entrepreneurship training  implementation science  hybrid type II cluster-randomized trial  mental health  emotion regulation  daily functioning  Sierra Leone Index. décimale : PER Périodiques Résumé : Background Strategies to expand access to care and sustain evidence-based mental health interventions (EBIs) must be tested within novel delivery platforms to extend the reach of services in fragile and conflict-affected settings. Integration into broader development programs may help maintain long-term effects. This study presents a four-year follow-up of a previously conducted Hybrid Type II implementation-effectiveness cluster-randomized trial (CRT) of the Youth Readiness Intervention (YRI)?an EBI drawing on cognitive-behavioral, interpersonal, and mindfulness-based approaches?delivered within a youth entrepreneurship program in Sierra Leone (2018?2019). Methods Long-term mental health outcomes (emotion regulation, psychological distress, and interpersonal functioning) were examined among a randomly selected subgroup of 584 participants across three study arms: a control group, a group that only received entrepreneurship training (?ENTR?), and a group that received both YRI and ENTR (?YRI?+?ENTR?). Linear mixed-effect models accounted for the nested structure of the data. Impact of the COVID-19 pandemic was also assessed through economic and relationship stressors using structural equation modeling. Results Four years postintervention, YRI?+?ENTR-youth maintained improvements in depression (??=??.057; 95% CI ?0.09 to ?0.02; [effect size] d?=??.111) and combined depression/anxiety symptoms (??=??.047; 95% CI ?0.08 to ?0.01; [effect size] d?=??.096) though no sustained effects were observed for daily functioning or emotion regulation. No differences were found for ENTR-only participants versus controls and YRI?+?ENTR. COVID-19-related economic stressors mediated the relationship between study arm and mental health, revealing small but significant effects. Conclusions In low-income settings like Sierra Leone, where formal mental health services are scarce, sustainable community-based interventions such as the combined YRI?+?ENTR intervention offer a critical approach to reducing psychological distress. Sustained long-term benefits suggest that participants developed coping strategies that supported resilience during challenges like the COVID-19 pandemic. These gains may also foster broader community resilience, enhancing both individual well-being and collective capacity to withstand future adversity. En ligne : https://doi.org/10.1111/jcpp.70158 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=592 [article] Sustained mental health outcomes from the youth readiness intervention: A four-year effectiveness follow-up of a hybrid type II trial in Sierra Leone [texte imprimé] / Wijnand VAN DEN BOOM, Auteur ; Kathryn NOON, Auteur ; Shuangshuang YANG, Auteur ; Renee MENART, Auteur ; Fatoma MOMOH, Auteur ; Abdulai Jawo BAH, Auteur ; Matias PLACENCIO-CASTRO, Auteur ; Theresa S. BETANCOURT, Auteur . - p.1537-1546. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 67-9 (September 2026) . - p.1537-1546 Mots-clés : Youth Readiness Intervention  cognitive-behavioral therapy  entrepreneurship training  implementation science  hybrid type II cluster-randomized trial  mental health  emotion regulation  daily functioning  Sierra Leone Index. décimale : PER Périodiques Résumé : Background Strategies to expand access to care and sustain evidence-based mental health interventions (EBIs) must be tested within novel delivery platforms to extend the reach of services in fragile and conflict-affected settings. Integration into broader development programs may help maintain long-term effects. This study presents a four-year follow-up of a previously conducted Hybrid Type II implementation-effectiveness cluster-randomized trial (CRT) of the Youth Readiness Intervention (YRI)?an EBI drawing on cognitive-behavioral, interpersonal, and mindfulness-based approaches?delivered within a youth entrepreneurship program in Sierra Leone (2018?2019). Methods Long-term mental health outcomes (emotion regulation, psychological distress, and interpersonal functioning) were examined among a randomly selected subgroup of 584 participants across three study arms: a control group, a group that only received entrepreneurship training (?ENTR?), and a group that received both YRI and ENTR (?YRI?+?ENTR?). Linear mixed-effect models accounted for the nested structure of the data. Impact of the COVID-19 pandemic was also assessed through economic and relationship stressors using structural equation modeling. Results Four years postintervention, YRI?+?ENTR-youth maintained improvements in depression (??=??.057; 95% CI ?0.09 to ?0.02; [effect size] d?=??.111) and combined depression/anxiety symptoms (??=??.047; 95% CI ?0.08 to ?0.01; [effect size] d?=??.096) though no sustained effects were observed for daily functioning or emotion regulation. No differences were found for ENTR-only participants versus controls and YRI?+?ENTR. COVID-19-related economic stressors mediated the relationship between study arm and mental health, revealing small but significant effects. Conclusions In low-income settings like Sierra Leone, where formal mental health services are scarce, sustainable community-based interventions such as the combined YRI?+?ENTR intervention offer a critical approach to reducing psychological distress. Sustained long-term benefits suggest that participants developed coping strategies that supported resilience during challenges like the COVID-19 pandemic. These gains may also foster broader community resilience, enhancing both individual well-being and collective capacity to withstand future adversity. En ligne : https://doi.org/10.1111/jcpp.70158 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=592

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