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Table 1 Replicating Effective Programs (REP) framework applied to contextualization of a psychological treatment, group interpersonal therapy (IPT-G), within the Uganda public health system

From: Contextualization of psychological treatments for government health systems in low-resource settings: group interpersonal psychotherapy for caregivers of children with nodding syndrome in Uganda

REP component

Component elements used

Methods: Uganda activities

Pre-conditions

1.1 Identify need for intervention

1.1 Review of government NS program response highlighted mental health needs of caregivers of children with NS

1.2 Identify intervention for local setting

1.2 Desk review of pre-existing literature on EBTs in Uganda led to selection of IPT-G based on prior effectiveness demonstrated in NGO settings

1.3 Package intervention for training and assessment

1.3 Review of literature and consultations with IPT therapists revealed IPT-G materials previously developed with illustrations and Luo language adaptation

Pre-implementation

2.1 Orientation to core elements

2.1 Stakeholder meeting with government administrative health officials and IPT-G experts refined and agreed on core elements

2.2 Customize delivery

2.2 Adaptation of package based on formative research with families affected by NS and contextualization to government health system delivery

2.3 Identification of barriers

2.3 Coordination with existing NS health service delivery

2.4 Staff training needs

2.4 Identification of government health staff to be trained in IPT-G delivery

2.5 Technical assistance needs

2.5 Supervision to be carried out by IPT-G experts in Uganda and study team

Implementation

3.1 Ongoing community partnership

3.1 Coordination with government health system and local community during delivery of IPT-G

3.2 Training and technical assistance

3.2 Training of village health team members to implement IPT-G. Training of government health workers to be field supervisors. Establish weekly supervision meetings between village health teams and their health worker supervisors facilitated by IPT-G experts

3.3 Process evaluation

3.3 Collection of video, audio, and written documentation from trainings, IPT-G weekly sessions, supervision, and coordination meetings; controlled before and after study with evaluation of caregiver and child outcomes

3.4 Feedback and refinement of intervention packageand training

3.4 Post-intervention feedback from government health system workers, village health team members, IPT-G recipients, and community members

Maintenance and evolution

4.1 Organizational and financial changes to sustain intervention

4.1 Costs of delivering IPT-G for NS affected families estimated

4.2 Prepare package for national dissemination

4.2 Intervention manualized, materials and implementation plan modified for integration in national guidelines for NS health services

4.3 Re-customize delivery as need arises

4.3 Plan to conduct validation study to incorporate livelihoods scheme, develop quality assurance and customization guidelines

  1. Abbreviations: EBT evidence-based treatment, HWs health workers, IPT-G group interpersonal therapy, NGO non-governmental organization, NS nodding syndrome, REP Replicating Effective Programs