Sunday, June 1, 2025
6/1/2025
Optimizing Multi-level Interventions to Improve Child Mental Health in Azerbaijan - PROJECT SUMMARY/ABSTRACT Adversity, economic deprivation, poverty-induced stress, prolonged exposure to trauma and parental distress increase the risk of child maltreatment and may severely undermine the mental health functioning of children. While there are efficacious interventions targeting individual, family, and structural-level factors associated with children’s emotional and behavioral well-being, it is unknown how these interventions interact and complement each other and whether their effects can be synergistic (i.e., if the interventions’ combined effects are greater than the sum of the individual effects). To improve mental health outcomes among children aged 7–14 from low-income families in Azerbaijan, the proposed study will refine and test three evidence-based intervention approaches: (a) family-strengthening intervention; b) trauma-focused mental health care for parents; and c) economic empowerment in the form of Child Savings Accounts. These interventions have been adapted to the context of Azerbaijan. The adapted interventions will be tested with 600 child-caregiver dyads in a trial using the Multiphase Optimization Strategy (MOST) to compare different intervention components and identify the most optimal combination. Given the limited human and financial resources in the LMICs, it will be important to identify whether each of these interventions is necessary and/or sufficient for improving the mental health of children. The study will test the effects of each intervention component on children’s clinical mental health outcomes (symptoms of depression, anxiety; disruptive behaviors; post-traumatic symptoms;) and on cognitive and social processes associated with these outcomes (e.g., attention, inhibitory control, working memory, emotion recognition bias). The study will also examine the mediating pathways associated with each intervention component. If successful, the study results could inform the National Mental Health Care reforms implemented by the Ministry of Health, WHO, UNICEF and other organizations in Azerbaijan and other post-Soviet countries. The proposed study addresses the NIMH’s Strategic Plan Objective 3.2.A by tailoring existing interventions to optimize outcomes, and targets two top challenges within the NIMH Grand Challenges in Global Mental Health Goal B (Advance prevention and implementation of early interventions): 1) to develop locally appropriate strategies to eliminate childhood abuse and enhance child protection and 2) to develop interventions to reduce the long-term negative impact of low childhood socioeconomic status on mental health. Through training, mentoring and collaborative research, the project also aims to strengthen local research expertise in: 1) the core components and mechanisms of change of psychosocial mental health interventions for children and families living in conditions of chronic adversity; 2) the adaptation of multilevel evidence-based interventions and measurement tools to the new socio-cultural context of a post-Soviet country; and 3) methodological and statistical techniques for evaluating complex interventions with multiple components.
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