PROJECT SUMMARY
The proposed exploratory research will pilot a family-focused, behavioral health intervention while also
developing and piloting innovative and cost-effective mHealth tools to support Community Health Workers in
Sierra Leone's underserved, rural Western region. This dual focus will help build urgently needed capacity both
for delivery of evidence-based mental health services to reduce family violence and harsh parenting practices,
and for effective use of mHealth strategies to improve healthcare delivery and quality. The Government of
Sierra Leone has invested heavily in its Community Health Worker Programme and has identified innovative
use of technology to improve performance monitoring, surveillance data collection, and health data usage as a
high priority. This study will leverage government investments in community health initiatives and mHealth
innovations as a strategy to address critical healthcare workforce limitations that plague delivery of evidence-
based interventions to vulnerable families in post-conflict Sierra Leone. The study will pilot mHealth-supported
delivery of a culturally adapted version of the Family Strengthening Intervention for Early Childhood
Development (FSI-ECD). The FSI-ECD has demonstrated effectiveness in improving parental emotion
regulation and reducing family violence and harsh parenting practices. Study aims are to:
Aim 1. Employ a five-stage user-centered design approach to develop and test mHealth tools to improve
training, supervision, and fidelity monitoring of Community Health Workers.
Aim 2. Conduct a Type II Implementation-Effectiveness Randomized Controlled Pilot Study to assess
feasibility, acceptability, and preliminary effects of mHealth-supported delivery of FSI-ECD on parent mental
health, emotion regulation, and familial violence in high risk families with children aged 6–36 months (n=40) in
comparison to control families (n=40) who receive standard care. Parental mental health, emotion regulation,
household violence, and parenting practices will be assessed at baseline, post-intervention and 6-month
follow-up. Feasibility, acceptability, and adoption of the FSI-ECD and mHealth tools will be assessed via
quantitative measures and key informant interviews. The pilot study will also integrate a cost-effectiveness
analysis to assess the economic value of the mHealth-supported delivery of the FSI-ECD vs. standard care.
Aim 3. Leverage well-established relationships and government partners to strengthen capacity for
mHealth research and quality healthcare delivery in Sierra Leone. Partners include the University of Makeni,
the Directorate of Science, Technology and Innovation, and the Ministry of Health and Sanitation.
This study will provide a foundation for expanding knowledge, fostering collaboration, and developing local
research expertise in Sierra Leone. Study findings will inform a planned R01-funded Hybrid Implementation
Effectiveness trial to study mHealth-supported mental health services integrated into existing delivery platforms
and to scale up mHealth-supported training and supervision of service providers in low resource settings.
