Youth FORWARD Phase 2 YRI and EPP Study
Mental Health Impairment, Mental Health Disorder, Psychosocial Problem
About this trial
This is an interventional treatment trial for Mental Health Impairment
Eligibility Criteria
Inclusion Criteria:
Youth aged 18-30 will be included in the Youth FORWARD scale-up study based upon eligibility to the employment program, focusing specifically on socioeconomic status and willingness and interest in participation in an employment program, as well as mental health screening, which will include questions on daily functioning and emotional regulation.
Specifically, inclusion criteria for the youth sample is:
- be Sierra Leonean,
- be female or male aged 18-26,
- be considered a vulnerable youth who is disengaged from both education and employment programs,
- have elevated t-scores on functional impairment based on thresholds from our previous research using questions adapted from the World Health Organization Disability Assessment Schedule (WHODAS)54 and,
- have elevated t-scores (62.5 or above) on the Disturbances in Emotion Regulation Scale (DERS).55
Inclusion criteria for agencies in this study is:
- be a "service provision agency" in Sierra Leone,
- have a minimum of two experts employed, one with subject-specific knowledge and; experience, and another with pedagogical experience in adult education and working with youth with low literacy, and
- sign a Memorandum Of Understanding (MOU) with Boston College (BC) regarding intellectual property of the YRI.
Inclusion criteria for facilitators in this study is:
- be employed by one of the agencies selected in GIZ's competitive bidding process, and
- agree to participation in the ICTA which utilizes an enhanced supervision structure throughout the intervention.
Inclusion criteria for third-party reporters in this study is:
- be over age 18,
- be nominated by the youth participant,
- provide oral consent to participate in the quantitative assessments, and
- have daily to weekly contact with the youth participant throughout the duration of this scale-up study, which will be assess via verbal confirmation when obtaining oral consent.
Inclusion criteria for agency leaders is:
- must be a part of one of the agencies selected in GIZ's competitive bidding process and,
- must hold a leadership position in the agency.
Exclusion Criteria:
Exclusion criteria for the youth:
Youth will be excluded from the study if they do not fulfill the inclusion criteria or:
- present with severe mental illness (e.g., psychosis), or
- developmental disability that precludes comprehension of the intervention content and assessments.
Specifically, mental health exclusion criteria are:
- severe, active suicidality or psychosis as assessed via the MINI-KID diagnostic assessment administered by a study social worker and,
- serious cognitive impairments that might preclude one's ability to comprehend informed consent and complete study assessments as determined by a study social worker.
Youth who report active suicidality or symptoms of psychosis requiring more intensive mental health care will be referred for immediate individual mental health services
Exclusion criteria for the agencies:
Agencies will be excluded from participation if:
- they are not considered a "service provision agency", and
- if they do not have a minimum of two experts employed: one with subject-specific knowledge and experience, and another with pedagogical experience in adult education and working with youth with low literacy.
Those holding leadership positions within the agencies selected to deliver the intervention will be excluded from participation in the qualitative interviews if:
- they are not employed at the agencies selected, or
- are not considered to be in a leadership position within the agency.
Exclusion criteria for the facilitators:
Facilitators will be excluded from participation in delivering the intervention if:
- they are unable to deliver core components of the YRI and EPP intervention, and
- if they are unable to meet the logistical demands of the ICTA
Exclusion criteria for the third-party reporters:
The third-party reporter will be excluded from the study if:
- they are under age 18,
- present with severe mental illness (e.g., psychosis), or
- developmental disability that precludes comprehension of the intervention content and assessments (as determined by a study social worker), and
- if the third-party reporter does not have at least monthly contact with the youth participant
Sites / Locations
- Kailahun District
- Koinadugu District
- Kono District
Arms of the Study
Arm 1
Arm 2
Arm 3
No Intervention
Experimental
Experimental
Control
Entrepreneurship Training
YRI+Entrepreneurship Training
Youth randomized into the control arm of this study will be quantitatively assessed at the same time points as youth randomized into the two treatment arms (baseline, 3-months, 12-months). Due to access to funding and feasibility, youth in the control arm and EPP-only arm will not have the opportunity to receive the YRI once the study period concludes. However, GIZ is conducting a phased roll out of their EPP programming, meaning they will offer their EPP throughout 2018 past their participation in Youth FORWARD. Youth will also be compensated for their participation in our quantitative assessments.
Youth randomized into the Entrepreneurship Training-only arm will receive GIZ's employment programming approximately three months after the completion of the baseline assessments. The GIZ-supported Entrepreneurship Training program includes six training modules, delivered over three weeks, to include skills development, financial literacy, and other skills necessary to secure employment or engage in livelihood activities.
Youth randomized into the YRI+Entrepreneurship Training arm will begin the YRI module within two weeks after the completion of baseline assessments. The YRI curriculum (12 modules), will be delivered in 12 weekly 90-minute sessions, with additional time taken as needed. These weekly sessions assume a peer-to-peer group learning format deemed culturally appropriate for a setting like Sierra Leone where limited resources for mental health services exist. Once youth complete the YRI they will complete a post-intervention (3-months) quantitative assessment. Following the completion of the quantitative assessments, youth will receive the Entrepreneurship Training.