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Table 2 Summary of pre-implementation phase adaptations

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

Method Findings
Consultation meetings and stakeholder adaptation workshop • Government health officials emphasized the lack of mental health support for caregivers of children with nodding syndrome, and they agreed with the proposed study design using interpersonal therapy for groups (IPT-G).
• Health officials and other government leaders recommended study sites.
• A group size of 8–12 members was recommended, with one group per village based on health records of households with children living with NS in proposed study sites.
• It was agreed that members of village health teams (VHTs) would deliver IPT-G to caregivers of children affected by NS.
• Stakeholders in the adaptation workshop suggested that 12-session IPT-G would be feasible. Mixed gender groups were considered acceptable by the community because both male and female caregivers face similar challenges with children living with NS.
• Health officials set a limit of fewer than 14 days for training of VHTs to minimize disruption of other work and personal activities. They recommended a 5-day workshop type of training and 2 days of role plays to practice implementation of IPT-G.
• To maintain the hierarchical divide between primary health workers and VHTs, health workers would be oriented to IPT concepts, design, and supervision activities in separate sessions conducted in parallel with VHT training. Health workers would attend some VHT training sessions to appreciate the practicalities of IPT-G intervention.
• Previously trained Ugandan IPT-G therapists, working together with the study clinical psychologist would supervise both the health workers and VHTs for technical assistance.
• IPT groups would be co-facilitated by 2 VHTs to ensure continuity of the group sessions in the event that one of the VHTs was absent.
Qualitative study with caregiver beneficiaries • Three themes linked to caring for a child with nodding syndrome were identified as targets for IPT-G: (1) agony resulting from community stigma and fear; (2) cognitive, emotional, and behavioral disturbances; and (3) physical and financial constraints.