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Streamlined Treatment and Evidence-based Adolescent counseling and Medication Support (STREAMS)

Award Number: R01MH140406
ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/19/2025
PERIOD OF PERFORMANCE END DATE: 05/31/2030

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Streamlined Treatment and Evidence-based Adolescent counseling and Medication Support (STREAMS) - STREAMS Abstract Interventions that use a combination approach—as recommended by UNAIDS—to address mental health in low- and middle-income countries (LMICs), are crucial to achieving the UNAIDS 95-95-95 targets, yet few such evidence-based combination interventions currently exist for the 1.7 million adolescents living with HIV (ALWHIV) in Africa. We propose Streamlined Treatment and Evidence-based Adolescent counseling and Medication Support (STREAMS) to evaluate a combination intervention comprising of streamlined interpersonal psychotherapy groups (IPT-G) tailored to adolescents (15-19 years) and streamlined family strengthening and treatment adherence counseling in rural Uganda. In our pilot work, PI Kreniske (K01MH122319) collaborated with StrongMinds and Brown School’s International Center for Child Health and Development (ICHAD) to demonstrate feasibility and acceptability of a streamlined text message based PHQ-9 screener to assess depression. Adolescents were successfully linked to StrongMinds 6-week IPT-G counseling and experienced a reduction in depressive symptoms. StrongMinds IPT-G counseling is tailored to the Ugandan context and has been reduced from a program based on 16 IPT-G sessions to the streamlined 6 sessions. To date, this approach has not been evaluated among ALWHIV. To address HIV counseling and adherence, we propose streamlining Suubi+Adherence (R01HD074949; PI Ssewamala), a family-based combination intervention combining economic empowerment intervention with medication adherence counseling for ALWHIV in Uganda that improves antiretroviral (ART) treatment adherence but has not been examined specifically among youth experiencing symptoms of depression. STREAMS will be implemented across 24 ICHAD-affiliated HIV health clinics within the greater Masaka region of Uganda—a region heavily impacted by HIV compared to national averages. We will use a Type I Hybrid design 3-arm cluster-randomized trial to evaluate effectiveness at both reducing depressive symptoms and improving ART adherence, with the secondary aim of characterizing the combined interventions’ feasibility and acceptability comparing (1) streamlined IPT-G and streamlined Suubi+Adherence in combination, (2) streamlined IPT-G and SOC ART counseling (3) SOC mental health and SOC ART counseling. Randomized at the clinic level, adolescents will be consecutively sampled, and those who screen positive for depressive symptoms on the mobile phone administered PHQ-9 will be enrolled. Using Consolidated Framework for Implementation Research (CFIR) informed in-depth interviews and analysis, we will systematically assess barriers and facilitators to accessing mental health care and adhering to ART across CFIR domains (e.g., individual characteristics, inner – healthcare settings) to inform scalable changes to care to support HIV treatment among ALWHIV in rural Uganda. STREAMS examines if our mobile phone screening tool along with a combination of streamlined StrongMinds IPT-G and streamlined Suubi+Adherence ART counseling, provides a low-cost, efficacious, and scalable approach for improving mental health and ART adherence.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $1,057,586 )
2025	2025	RESEARCH FOUNDATION OF THE CITY UNIVERSITY OF NEW YORK	55 W 125TH ST FL 7	NEW YORK	NY	10027	NEW YORK	USA	Mental Health Research Grants	000	1	9/17/2025	NEW	$1,057,586
														Subtotal = $1,057,586

Grand Total All Awards = $1,057,586

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Streamlined Treatment and Evidence-based Adolescent counseling and Medication Support (STREAMS)

Award Number: R01MH140406

ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/19/2025

PERIOD OF PERFORMANCE END DATE: 05/31/2030

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