Scaling-up co-designed adolescent mental health interventions
Lead Research Organisation:
King's College London
Department Name: Health Service and Population Research
Abstract
Up to 1 in every 3 adolescent girls will experience a mental health condition during the pregnancy and the year after birth (known as the perinatal period). While the majority of adolescent pregnancies occur in sub-Saharan Africa, there is limited evidence as to what interventions can improve mental health outcomes in this setting. The Innovative approaches for adolescent periantal wellbeing (INSPIRE) project sought to address this gap in knowledge and care by developing solutions to improve adolescent perinatal mental health outcomes in rural and peri-urban settings in Kenya and Mozambique. Through this project the Thriving Mamas programme was developed. The programme is an enhanced antenatal course designed to provide adolescents with skills and knowledge related to pregnancy and child birth, caregiving, life skills, and family planning. During the course of the INSPIRE project, our engagment with key stakeholders highlighted the difficulties policymakers, health planners, and service providers had in integrating new interventions into existing services. Existing implementation guidelines and frameworks lack utility for those without practical integration experience. The current project (Scaling-up co-designed adolescent mental health interventions) focuses on this challenge. It aims to develop an effective and useable tookit to guide stakeholders through the process of adaptation and integration of adolescent mental health interventions.
A draft operational toolkit for adaptation and delivery will be developed through a series of workshops with policymakers, techinical experts, service providers, and young people. The agreed toolkit will then be tested through the adaptation of the Thriving Mamas programme for delivery in Mombasa (Kenya) and Maputo (Mozambique). Throughout these processes, qualitative and quantitative data will be collected to better understand participants' experiences of engaging in co-design activities, the utility and comprehensiveness of the operational toolkit, and the percieved feasibility, acceptability, and appropriateness of the Thriving Mamas programme in a new, urban setting.
A draft operational toolkit for adaptation and delivery will be developed through a series of workshops with policymakers, techinical experts, service providers, and young people. The agreed toolkit will then be tested through the adaptation of the Thriving Mamas programme for delivery in Mombasa (Kenya) and Maputo (Mozambique). Throughout these processes, qualitative and quantitative data will be collected to better understand participants' experiences of engaging in co-design activities, the utility and comprehensiveness of the operational toolkit, and the percieved feasibility, acceptability, and appropriateness of the Thriving Mamas programme in a new, urban setting.
Organisations
- King's College London (Lead Research Organisation)
- Aga Khan University Hospital, Nairobi (Collaboration)
- International Centre for Reproductive Health Mozambique (Collaboration)
- World Health Organization (WHO) (Collaboration)
- Institute for Research and Development (Collaboration)
- Mahidol University (Collaboration)
- UNIVERSITY OF EDINBURGH (Collaboration)
- Government of Mozambique (Collaboration)
- World Health Organization (Project Partner)
Publications
Taylor Salisbury T.
Supporting the mental health of adolescent mothers in Kenya and Mozambique: Pilot protocol for the Thriving Mamas programme
in BMC Pilot and Feasibility Studies
| Description | Co-designed and delivered a seminar series on adolescent mental health; developed grant applications |
| Organisation | Institute for Research and Development |
| Country | Sri Lanka |
| Sector | Public |
| PI Contribution | My team and I co-designed an online seminar series on adolescent mental health, comprising 7 seminars delivered by us and academics from different institutions (Institute for Research & Development in Health & Social Care, Sri Lanka; Mahidol University, Thailand; King Saud University, Saudi Arabia; University of Edinburgh). The series ran from June-December 2024. We also co-developed grant applications for an intervention to support adolescent perinatal mental health in Sri Lanka. |
| Collaborator Contribution | My partner (IRD, Sri Lanka) co-designed and co-delivered the seminar series, and co-developed grant applications for an intervention to support adolescent perinatal mental health in Sri Lanka |
| Impact | Adolescent mental health online seminar series, comprising the following sessions: (1) Opportunities and barriers to the use of co-design approaches to improve adolescent mental health (4th June 2024) (2) Mental health surveys amongst adolescents in Sri Lanka (24th June 2024) (3) Social media and game addictive behavior in Thailand (22nd July 2024) (4) Need assessment and evaluation of the adolescents' mental health social media campaign in Arabian Gulf Countries (16th September 2024) (5) Introduction to Implementation science (21st October 2024) (6) Community engagement Institute for Research & Development in Health & Social Care (18th November 2024) (7) Developing research ideas, grant writing and barriers to implementation (16th December 2024) |
| Start Year | 2024 |
| Description | Hosted a visiting academic (12 months) and co-designed and delivered a seminar series on adolescent mental health |
| Organisation | Mahidol University |
| Country | Thailand |
| Sector | Academic/University |
| PI Contribution | My team and I co-designed an online seminar series on adolescent mental health, comprising 7 seminars delivered by us and academics from different institutions (Institute for Research & Development in Health & Social Care, Sri Lanka; Mahidol University, Thailand; King Saud University, Saudi Arabia; University of Edinburgh). The series ran from June-December 2024. We also hosted in our department a Visiting Research Fellow from Mahidol University, Thailand. |
| Collaborator Contribution | My partner (Mahidol University, Thailand) co-designed and co-delivered the seminar series. One academic from the Department of Psychiatry was in residence for 12 months at my department as Visiting Research Fellow. |
| Impact | Adolescent mental health online seminar series, comprising the following sessions: (1) Opportunities and barriers to the use of co-design approaches to improve adolescent mental health (4th June 2024) (2) Mental health surveys amongst adolescents in Sri Lanka (24th June 2024) (3) Social media and game addictive behavior in Thailand (22nd July 2024) (4) Need assessment and evaluation of the adolescents' mental health social media campaign in Arabian Gulf Countries (16th September 2024) (5) Introduction to Implementation science (21st October 2024) (6) Community engagement Institute for Research & Development in Health & Social Care (18th November 2024) (7) Developing research ideas, grant writing and barriers to implementation (16th December 2024) |
| Start Year | 2024 |
| Description | INSPIRE/SUMMIT - Kenya |
| Organisation | Aga Khan University Hospital, Nairobi |
| Department | Department of Obstetrics and Gynaecology |
| Country | Kenya |
| Sector | Hospitals |
| PI Contribution | Aga Khan University (AKU) is the implementation lead for our work in Kenya. We have provided support to the team in developing research protocols and assisting in applications for regulatory approvals. In addition we have provided a comprehensive capactiy-building programme to support the field team and the organisation in the implementation of research activities and manuscript writing as well as training in transferable skills (e.g. public speaking, community engagement) and support in career development for early career staff. |
| Collaborator Contribution | AKU has provided their deep knowledge of the field site and networks to support the development of a relevant research protocol. They have developed strong relationships with research participants, partners and local community in order to support the implementation of the research. They have been responsible for qualitative and quantitative data collection and analysis. They are currently writing papers for publication and supporting the development of follow-on research proposals for future grant funding opportunities. In addition they have: established a local advisory board; represented the project at sub-county and national ministry of health meetings; overseen the development of a locally adapted facilitator programme; and presented our findings at local conferences. |
| Impact | Successful application to the UKRI Future Leaders Fellowship (mental health, maternal health, implementation science, human-centred design) Successful renewal of UKRI Future Leaders Fellowship (mental health, maternal health, implementation science, human-centred design) Community sensitisation meeting for community health practitioners (2023) Sub-county study presentation meetings (2023) Convened project local advisory group Sub-county delivery of perinatal mental health training to intervention providers |
| Start Year | 2019 |
| Description | INSPIRE/SUMMIT - Mozambique |
| Organisation | International Centre for Reproductive Health Mozambique |
| Country | Mozambique |
| Sector | Academic/University |
| PI Contribution | The ICRH-Mozambique is the implementation lead for our work in Mozambique. We have provided support to the team in developing research protocols and assisting in applications for regulatory approvals. In addition we have provided a comprehensive capactiy-building programme to support the field team and the organisation in the implementation of research activities and manuscript writing as well as training in transferable skills (e.g. public speaking, community engagement) and support in career development for early career staff. |
| Collaborator Contribution | They have developed strong relationships with research participants, partners and local community in order to support the implementation of the research. They have been responsible for qualitative and quantitative data collection and analysis. They are currently writing papers for publication and supporting the development of follow-on research proposals for future grant funding opportunities. In addition they have: established a local advisory board; represented the project at district health authority and national ministry of health meetings; overseen the development and delivery of a locally adapted facilitator training programme; and presented our findings at an international conference. |
| Impact | Successful application to the UKRI Future Leaders Fellowship (mental health, maternal health, implementation science, human-centred design) Successful renewal of UKRI Future Leaders Fellowship (mental health, maternal health, implementation science, human-centred design) Community sensitisation meeting for community health practitioners (2023) District-level study presentation meetings (2023) Convened project local advisory group and hosted subsequent meetings District-level delivery of perinatal mental health training to intervention providers |
| Start Year | 2019 |
| Description | INSPIRE/SUMMIT - U of Edinburgh |
| Organisation | University of Edinburgh |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | This partnership has led to successful renewal of Dr Salisbury's UKRI Future Leaders Fellowship |
| Collaborator Contribution | University of Edinburgh provides implementation expertise to guide our research methods, analysis and planning of future activities. |
| Impact | This collaboration is multi-disciplinary linking implementation science, human-centred design, systems thinking, mental health and maternal health. Outputs resulting from this collaboration include peer-reviewed journal articles, further funding and conference presentations. |
| Start Year | 2024 |
| Description | INSPIRE/SUMMIT - WHO |
| Organisation | World Health Organization (WHO) |
| Department | Department of Mental Health and Substance Abuse (MSD) |
| Country | Global |
| Sector | Public |
| PI Contribution | We have provided technical support to the WHO by acting as a reviewer for the Helping Adolescents Thrive (HAT) Toolkit. We are currently providing technical support for the WHO's activities to integrate perinatal mental health into maternal and child health services and providing research evidence through the development and testing of an adolescent maternal mental health prevention intervention in Mozambique and Kenya through the Catalyst, INSPIRE and SUMMIT projects. In addition, Dr Salisbury led the writing of the WHO Guide on integrating perinatal mental health into maternal and child health services (2022) and provides technical expertise and support to the WHO and governments of Kenya, Mozambique and Tanzania in their work to develop plans to integrate perinatal mental health care. |
| Collaborator Contribution | The WHO is providing mentorship in policymaking and advocacy in mental health to Dr Salisbury through her UKRI Future Leaders Fellowship. |
| Impact | - Technical review of the WHO product, Helping Adolescents Thrive (HAT) Toolkit - Guide for integration of perinatal mental health into maternal and child health services (lead writer; Sep 2022) - AFRO Region webinar on the integration of perinatal mental health (19 Oct 2023) - Joint WHO and Kenya Ministry of Health perinatal mental health prioritisation workshop (8 Jun 2023) - Tanzania perinatal mental health sensitization webinar (13 Feb 2023) - Joint WHO and Tanzania Ministry of Health perinatal mental health prioritisation workshop (10-11 May 2023) - Collated WHO/UNICEF and national guidelines and tools for providing perinatal mental health care - Facilitated WHO/MoH Tanzania workshop to develop initial planning guide for integration of perinatal mental health care into maternal and child health services (May 2024) - Presented the WHO Guide for integration at 3 conferences (2024) |
| Start Year | 2019 |
| Description | Ministry of health |
| Organisation | Government of Mozambique |
| Department | Ministry of Health Mozambique |
| Country | Mozambique |
| Sector | Public |
| PI Contribution | Training in human-centred design Assistance with journal publications Research capacity building |
| Collaborator Contribution | Increased access to mental health care for referred participants Access to mental health providers within the study locations Assistance in developing the study protocol Assistance with researcher training Support in applying for (and obtaining) additional funding |
| Impact | Ministry of Health human-centred design workshop (Oct 2019) (psychology, psychiatry and design) Submission of results paper to peer-reviewed journal (design, anthropology, psychiatry, psychology) |
| Start Year | 2018 |
| Description | From Zimbabwe to the World: Friendship Bench and the next generation of African mental health research leaders |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Professor Dixon Chibanda, one of the world's leading global mental health experts, gave a talk on the African Mental Health Research Initiative (AMARI), a transformative programme dedicated to building mental health research capacity across Africa. The talk was followed by an expert panel discussion with myself and other global mental health experts, third supervisors to AMARI fellows, and AMARI fellows attending in person or tuning in remotely from across Ethiopia, Ghana, Malawi, Nigeria, Sierra Leone, Somaliland, South Africa and Zimbabwe about the conduct of research and capacity-building in Africa. |
| Year(s) Of Engagement Activity | 2025 |
| URL | https://www.kcl.ac.uk/events/from-zimbabwe-to-the-world |
| Description | International Conference on Maternal Mental Health in Africa (ICAMMHA) (Zimbabwe) |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | ICAMMHA is a new flagship mental health conference focusing on innovation in Maternal Mental Health in Africa with emphasis on research and practice. The conference features world-class plenary speeches, distinguished Symposium talks, exhibits, oral and poster sessions, debates, and panels. At ICAMMHA 2024 I delivered the presentation "An overview of the WHO Guide for integration of perinatal mental health in maternal and child health services and implementation efforts in the African Region". |
| Year(s) Of Engagement Activity | 2024 |
| Description | Presentation at National Health Scientific Conference (Mozambique) |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Policymakers/politicians |
| Results and Impact | Presentation at the National Health Scientific Conference, held in Mozambique in September-October 2024, by the title: "Desafios, necessidades e perspectivas, sobre a gravidez na adolescência na província de Tete". |
| Year(s) Of Engagement Activity | 2024 |
| Description | Presentation at the International Conference on Maternal Mental Health in Africa (ICAMMHA) delivered by Fernando Chissale |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | ICAMMHA was a hybrid conference taking place from 3 to 5 December 2024 in Zimbabwe. It brought together experts, stakeholders, and advocates to drive innovation and foster collaboration on Maternal Mental Health. The year's theme was "The Future of Maternal Mental Health in Africa." Fernando Chissale, INSPIRE Mozambique team Project Coordinator, participated virtually and delivered one oral presentation. |
| Year(s) Of Engagement Activity | 2024 |
| URL | https://www.icammha.com/ |
| Description | Presentation at the International Conference on Maternal Mental Health in Africa (ICAMMHA) delivered by Margrette Hanselmann |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | ICAMMHA was a hybrid conference taking place from 3 to 5 December 2024 in Zimbabwe. It brought together experts, stakeholders, and advocates to drive innovation and foster collaboration on Maternal Mental Health. The year's theme was "The Future of Maternal Mental Health in Africa." Margrette Hanselmann, INSPIRE Kenya team Project Coordinator, participated virtually and delivered a presentation. |
| Year(s) Of Engagement Activity | 2024 |
| URL | https://www.icammha.com/ |
| Description | SUMMIT entry meeting (Mozambique) |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Policymakers/politicians |
| Results and Impact | Presentation of the SUMMIT project at the Ministry of Health of Mozambique. |
| Year(s) Of Engagement Activity | 2024 |
| Description | Seminar series on adolescent mental health |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Online seminar series on adolescent mental health organised in collaboration with Mahidol University, Thailand and the Institute for Research & Development in Health & Social Care, Sri Lanka. The series ran from June-December 2024. It comprised the following sessions: (1) Opportunities and barriers to the use of co-design approaches to improve adolescent mental health (4th June 2024) (2) Mental health surveys amongst adolescents in Sri Lanka (24th June 2024) (3) Social media and game addictive behavior in Thailand (22nd July 2024) (4) Need assessment and evaluation of the adolescents' mental health social media campaign in Arabian Gulf Countries (16th September 2024) (5) Introduction to Implementation science (21st October 2024) (6) Community engagement Institute for Research & Development in Health & Social Care (18th November 2024) (7) Developing research ideas, grant writing and barriers to implementation (16th December 2024). |
| Year(s) Of Engagement Activity | 2024 |
| Description | Unlocking Global Solutions in Perinatal Mental Health: Evidence-Based Approach |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | The webinar 'Unlocking Global Solutions in Perinatal Mental Health: Evidence-Based Approach' brought together leading experts and practitioners from around the world to share the latest research, innovative strategies and best practices in perinatal mental health. |
| Year(s) Of Engagement Activity | 2025 |
| Description | WHO EUR Mental Health Week (Thessaloniki, Greece) |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | In November 2024 the WHO Regional Office for Europe held its 3rd Mental Health Week, Meeting on Quality of Child and Adolescent Mental Health Care in Thessaloniki, Greece. The hybrid meeting brought together more than 200 key stakeholders in child and adolescent mental health care from across Greece and the rest of the WHO European Region, including young people with lived experience of mental health services, early career researchers, academics, service providers and Member State representatives. At the meeting, I participated in a panel discussion and facilitated a session on Sharing Mental Health Initiatives across the EU. |
| Year(s) Of Engagement Activity | 2024 |
| URL | https://www.who.int/europe/news-room/events/item/2024/11/02/default-calendar/strengthening-quality-o... |
| Description | WHO EUR Young Researcher's Forum - Career development and navigating challenges |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Postgraduate students |
| Results and Impact | Online Young Researcher's Forum organised by WHO EUR. This was a career development event where young researchers focused on developing young researchers' skills and providing advice on how to navigate challenges. |
| Year(s) Of Engagement Activity | 2025 |