Abstract
OBJECTIVE
To implement and evaluate a culturally adapted multi-sectoral program to improve Indigenous adolescent mental health (MH) in Brazil (Guarita Lands) and Dominica (Kalinago Territory).
DESIGN AND METHODS
The He Pekinga Waiora implementation framework guides IMPACT and embodies a participatory research approach to co-design. About 1400 adolescents will take part in IMPACT via their school and village activities in 2 components (i) Mental health promotion programme to improve awareness of maintaining good MH, preventing, and treating MH problems, and (ii) Mental health care programme, supported by trained Indigenous Community Health Workers, to identify and manage common adolescent MH problems. Trained Indigenous researchers will support evaluation over 3 years.
FINDINGS IMPACT started in August 2023. We report on co-development to date. A detailed co-developed Logic Model and Theory of Change contains 4 work packages (WPs): WP1: Partnership building and co-development. Local Adolescent Indigenous Groups and Stakeholder Implementation groups (SIG) co-developed all aspects of the study. WP2: Training of Indigenous implementors in MH promotion and mental health Gap Action Programme (mhGAP). WP3: Programme evaluation will use a theory-generating case study methodology to facilitate theoretical generalisations for wide-scale implementation. WP4: Knowledge exchange and impact include a Youth Expert Group and a capacity building hub. Co-development of narratives with young people for the MH promotion programme used a context-based approach to problem solving, rather than the conventional ‘problem’ focused approach. The narratives centred around family, school, and community life, and will be developed using creative arts (poems, skits, stories, dance, music, drawings). Co-adaptation of mh-GAP Community is developing a culturally appropriate Toolkit. Role-
play for training and creative methods for the training of carers and communities on mh-GAP were felt to be critical.
CONCLUSION
Respectful and equitable coproduction processes with Indigenous adolescents and their communities are critical for a sustainable and culturally acceptable MH programme.
To implement and evaluate a culturally adapted multi-sectoral program to improve Indigenous adolescent mental health (MH) in Brazil (Guarita Lands) and Dominica (Kalinago Territory).
DESIGN AND METHODS
The He Pekinga Waiora implementation framework guides IMPACT and embodies a participatory research approach to co-design. About 1400 adolescents will take part in IMPACT via their school and village activities in 2 components (i) Mental health promotion programme to improve awareness of maintaining good MH, preventing, and treating MH problems, and (ii) Mental health care programme, supported by trained Indigenous Community Health Workers, to identify and manage common adolescent MH problems. Trained Indigenous researchers will support evaluation over 3 years.
FINDINGS IMPACT started in August 2023. We report on co-development to date. A detailed co-developed Logic Model and Theory of Change contains 4 work packages (WPs): WP1: Partnership building and co-development. Local Adolescent Indigenous Groups and Stakeholder Implementation groups (SIG) co-developed all aspects of the study. WP2: Training of Indigenous implementors in MH promotion and mental health Gap Action Programme (mhGAP). WP3: Programme evaluation will use a theory-generating case study methodology to facilitate theoretical generalisations for wide-scale implementation. WP4: Knowledge exchange and impact include a Youth Expert Group and a capacity building hub. Co-development of narratives with young people for the MH promotion programme used a context-based approach to problem solving, rather than the conventional ‘problem’ focused approach. The narratives centred around family, school, and community life, and will be developed using creative arts (poems, skits, stories, dance, music, drawings). Co-adaptation of mh-GAP Community is developing a culturally appropriate Toolkit. Role-
play for training and creative methods for the training of carers and communities on mh-GAP were felt to be critical.
CONCLUSION
Respectful and equitable coproduction processes with Indigenous adolescents and their communities are critical for a sustainable and culturally acceptable MH programme.
| Original language | English |
|---|---|
| Title of host publication | The Caribbean Public Health Agency |
| Publication status | Accepted/In press - 31 Dec 2023 |
