School-Based Mental Health Effectiveness Study

August 17, 2026 updated by: NYU Langone Health

Effectiveness and Implementation of an Early Childhood School-Based Mental Health Intervention in Low-Resource Communities

This study involves efforts to advance the science of prevention in early childhood mental health in low-resource communities. Investigators will assess the effectiveness, practical implementation strategies, and underlying mechanisms of the evidence-based intervention, ParentCorps-Professional Development, in urban and rural Uganda. Two implementation approaches, with and without the teacher stress management package, T-Wellness, will be compared for efficacy.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Promoting child mental health in low-resource or low-income country settings faces numerous challenges in global health research. Although efforts have been made to improve mental health interventions and services for young children, evidence-based interventions (EBIs) for children in low-and middle-income countries (LMICs) are limited. Most mental health EBIs in LMICs have not been scaled widely, and do not focus on early childhood. Mechanisms of action and effectiveness are not well understood. Additionally, most EBIs in LMICs rely on community health workers (CHWs) or a task-shifting approach of implementation because of resource barriers and shortage of mental health professionals (MHPs). However, challenges related to task-shifting (e.g., CHW stress and job burnout) have rarely been studied. For task-shifting to be successful, strategies to overcome challenges faced by CHWs and understanding mechanisms to conduct effective task-shifting are paramount. The overall goal of this study is to address these EBI effectiveness and implementation knowledge gaps by providing a preventive EBI (mWEL-Professional Development (PD), adapted from the US ParentCorps-Professional Development) that utilizes a task-shifting and a scalable implementation model to promote early childhood students' mental health in a LMIC-Uganda. PD is a school-based EBI and preventive mental health service provision model that supports teachers and school personnel to apply EBI strategies to promote young children's mental health. The PD approach represents a task-shifting model of mental healthcare by shifting mental health preventive duties from professionals to teachers to optimize school children's mental health. Therefore, teachers are considered as CHWs. This study examines impacts and cost-effectiveness of the EBI/PD on teachers and students, as well as examines underlying mechanisms (or theories of change) that contribute to intervention effect. In addition, considering most Ugandan teachers (or CHWs) experience occupational stress that threatens PD uptake, effectiveness, and sustainment, this study will also test a teacher stress management package (T-Wellness, adapted from EBIs) as an enhancement to PD. This study will investigate whether PD + T-Wellness (PDT) is more effective for CHWs/teachers than PD alone.

Study Type

Interventional

Enrollment (Actual)

2444

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

      • Hoima, Uganda
        • Hoima School
      • Kampala, Uganda
        • Kampala School

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 65 years (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

In order to be eligible to participate in this study, an individual must meet all of the following criteria:

  1. The inclusion criteria for the school staff (teachers, head teachers) are: they must be in the recruited study schools and teaching in Pre-Primary to Primary 4 classrooms or holding the head teachers/administration leadership position in school. The inclusion criteria for Parent Leaders are: they must be at least 18 years old and have served as a Parent-Teacher-Association member or Parent Leader in the school for at least 1 year.
  2. The inclusion criteria for the PD/PDT program implementers are: they must have current employment with eligible partners (i.e., medical/mental health institutions, Teacher Training Colleges), with professional experiences in teacher training or mental health training.
  3. The inclusion criteria for parents are: caregivers must be at least 18 years old, their children must be enrolled in Pre-Primary or Primary 1 to 4 classes (or between 3 to 10 years old) in the recruited schools, and willing to have their child to be assessed by research staff. Parents and children will have diverse characteristics (e.g., randomly selected from school student lists). About 10% families will be randomly selected from the student lists. The proposed study will be open to both men and women caregivers

Exclusion Criteria

An individual who meets any of the following criteria will be excluded from participation in this study:

  1. Evidence of psychopathology or cognitive impairment severe enough to preclude giving consent, or completing the survey instruments or the focus group of the study.
  2. Minors (age <18) will also be excluded. Additional criteria should be included as appropriate for the study design and risk.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: ParentCorps-Professional Development (PD)

n = 6 Schools in Kampala, Uganda (Urban) - 89 Teachers, 325 Parent-Child Pairs

+ n = 10 Schools in Hoima, Uganda (Rural) - 98 Teachers, 344 Parent-Child Pairs

Multi-component school-based intervention that promotes early childhood mental health and development. Teachers (pre-primary to 4th grade) will participate in a 3-day ParentCorps-PD training during the school term. They will also receive 8 sessions (8 hours) of face-to-face group-based coaching during after the training. Coaching sessions are to help teachers apply EBI strategies in their classrooms, engage families, and develop competencies.
Experimental: ParentCorps-Professional Development (PD) + T-Wellness

n = 6 Schools in Kampala, Uganda (Urban) - 77 Teachers, 300 Parent-Child Pairs

+ n = 10 Schools in Hoima, Uganda (Rural) - 80 Teachers, 329 Parent-Child Pairs

Multi-component school-based intervention that promotes early childhood mental health and development. Teachers (pre-primary to 4th grade) will participate in a 3-day ParentCorps-PD training during the school term. They will also receive 8 sessions (8 hours) of face-to-face group-based coaching during after the training. Coaching sessions are to help teachers apply EBI strategies in their classrooms, engage families, and develop competencies.
A brief teacher stress management psychoeducation package, adapted from EBIs including one-day workshop for common stress management and stress management, and three follow-up group support sessions (3 additional monthly 1-hr wellness sessions for teachers as a group that were integrated into the 3 of the 8 PD coaching sessions. A total 3 hours of coaching were included.
No Intervention: Control

n = 6 Schools in Kampala, Uganda (Urban) - 73 Teachers, 316 Parent-Child Pairs

+ n = 9 Schools in Hoima, Uganda (Rural) - 92 Teachers, 321 Parent-Child Pairs

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Teacher Knowledge of Evidence-Based Practice (Knowledge Score)
Time Frame: Baseline
Teachers will complete a 10-item quiz assessing EBI knowledge. The total score is the number of correct responses and ranges from 0-100; higher scores indicate greater knowledge.
Baseline
Teacher Knowledge of Evidence-Based Practice (Knowledge Score)
Time Frame: Month 6
Teachers will complete a 10-item quiz assessing EBI knowledge. The total score is the number of correct responses and ranges from 0-100; higher scores indicate greater knowledge.
Month 6
Child's Emotion Regulation Score
Time Frame: Baseline
Parents answer 6 questions about their child's emotion regulation behavior over the past 7 days. Each item is rated on a Likert scale from 0 (not at all) to 4 (very well). The total score ranges from 0 to 4; higher scores indicate greater emotion regulation.
Baseline
Child's Emotion Regulation Score
Time Frame: Month 6
Parents answer 6 questions about their child's emotion regulation behavior over the past 7 days. Each item is rated on a Likert scale from 0 (not at all) to 4 (very well). The total score ranges from 0 to 4; higher scores indicate greater emotion regulation.
Month 6
Child's Emotion Regulation Score
Time Frame: Month 18
Parents answer 6 questions about their child's emotion regulation behavior over the past 7 days. Each item is rated on a Likert scale from 0 (not at all) to 4 (very well). The total score ranges from 0 to 4; higher scores indicate greater emotion regulation.
Month 18
Teacher EBI Practice Score
Time Frame: Baseline
Use of Evidence-Based Practices was assessed with six measures: (i) Practice of evidence-based strategies (applied a range of evidence-based behavioral management strategies such as praise and proactive strategies) (9 items, 1-5 point scale); (ii) Non-harsh discipline (4 items, 1-5 point scale); (iii) Mindfulness (awareness of own actions and consideration of student's situations when interacting or disciplining students) (10 items, 1-4 point scale); (iv) Emotion socialization-supporting negative emotion (practice used to support students in managing negative emotions) (6 items, 1-5 point scale); (v) Family engagement (frequency in interacting with families) (2 items, 1-5 point scale); and (vi) Teacher-Student Interaction (5 items, 1-5 point scale). The final score is a mean composite of these six measures and ranges from 1-5; where higher scores indicate greater use of EBI practices.
Baseline
Teacher EBI Practice Score
Time Frame: Month 6
Use of Evidence-Based Practices was assessed with six measures: (i) Practice of evidence-based strategies (applied a range of evidence-based behavioral management strategies such as praise and proactive strategies) (9 items, 1-5 point scale); (ii) Non-harsh discipline (4 items, 1-5 point scale); (iii) Mindfulness (awareness of own actions and consideration of student's situations when interacting or disciplining students) (10 items, 1-4 point scale); (iv) Emotion socialization-supporting negative emotion (practice used to support students in managing negative emotions) (6 items, 1-5 point scale); (v) Family engagement (frequency in interacting with families) (2 items, 1-5 point scale); and (vi) Teacher-Student Interaction (5 items, 1-5 point scale). The final score is a mean composite of these six measures and ranges from 1-5; where higher scores indicate greater use of EBI practices.
Month 6
Teacher EBI Practice Score
Time Frame: Month 18
Use of Evidence-Based Practices was assessed with six measures: (i) Practice of evidence-based strategies (applied a range of evidence-based behavioral management strategies such as praise and proactive strategies) (9 items, 1-5 point scale); (ii) Non-harsh discipline (4 items, 1-5 point scale); (iii) Mindfulness (awareness of own actions and consideration of student's situations when interacting or disciplining students) (10 items, 1-4 point scale); (iv) Emotion socialization-supporting negative emotion (practice used to support students in managing negative emotions) (6 items, 1-5 point scale); (v) Family engagement (frequency in interacting with families) (2 items, 1-5 point scale); and (vi) Teacher-Student Interaction (5 items, 1-5 point scale). The final score is a mean composite of these six measures and ranges from 1-5; where higher scores indicate greater use of EBI practices.
Month 18
Teacher Stress Score
Time Frame: Baseline
Teacher Stress was assessed using four measures: (i) Work Burnout (level of emotional and physical exhaustion from work) (9 items, 1-7 point scale), (ii) Family Stress (relationship stress) (5 items, 1-4 point scale); (iii) Kessler Psychological Distress Scale (K10) (anxiety and depressive symptoms) (10 items, 1-5 point scale); and (iv) Organization/ School Staff Stress (teachers' perception of level of stress in school) (5 items, 1-5 point scale). The total score is a mean composite of these four measures and ranges from 1-5; higher scores indicate higher stress levels.
Baseline
Teacher Stress Score
Time Frame: Month 6
Teacher Stress was assessed using four measures: (i) Work Burnout (level of emotional and physical exhaustion from work) (9 items, 1-7 point scale), (ii) Family Stress (relationship stress) (5 items, 1-4 point scale); (iii) Kessler Psychological Distress Scale (K10) (anxiety and depressive symptoms) (10 items, 1-5 point scale); and (iv) Organization/ School Staff Stress (teachers' perception of level of stress in school) (5 items, 1-5 point scale). The total score is a mean composite of these four measures and ranges from 1-5; higher scores indicate higher stress levels.
Month 6
Teacher Stress Score
Time Frame: Month 18
Teacher Stress was assessed using four measures: (i) Work Burnout (level of emotional and physical exhaustion from work) (9 items, 1-7 point scale), (ii) Family Stress (relationship stress) (5 items, 1-4 point scale); (iii) Kessler Psychological Distress Scale (K10) (anxiety and depressive symptoms) (10 items, 1-5 point scale); and (iv) Organization/ School Staff Stress (teachers' perception of level of stress in school) (5 items, 1-5 point scale). The total score is a mean composite of these four measures and ranges from 1-5; higher scores indicate higher stress levels.
Month 18
Teacher Stress Management
Time Frame: Baseline
Teacher Stress Management was assessed using four measures: (i) Cognitive regulation (ability to redirect negative thinking to positive thinking when distressed) (3 items, 1-5 point scale); (ii) Emotion Expression (ability to express emotion) (4 items, 1-5 point scale); (iii) Emotion Acceptance (ability to accept negative emotion) (3 items, 1-5 point scale); and (iv) Support from Work (getting support from school staff) (5 items, 1-5 point scale). The total score is a mean composite of these four measures and ranges from 1-5; higher scores indicate greater management of stress.
Baseline
Teacher Stress Management
Time Frame: Month 6
Teacher Stress Management was assessed using four measures: (i) Cognitive regulation (ability to redirect negative thinking to positive thinking when distressed) (3 items, 1-5 point scale); (ii) Emotion Expression (ability to express emotion) (4 items, 1-5 point scale); (iii) Emotion Acceptance (ability to accept negative emotion) (3 items, 1-5 point scale); and (iv) Support from Work (getting support from school staff) (5 items, 1-5 point scale). The total score is a mean composite of these four measures and ranges from 1-5; higher scores indicate greater management of stress.
Month 6
Teacher Stress Management
Time Frame: Month 18
Teacher Stress Management was assessed using four measures: (i) Cognitive regulation (ability to redirect negative thinking to positive thinking when distressed) (3 items, 1-5 point scale); (ii) Emotion Expression (ability to express emotion) (4 items, 1-5 point scale); (iii) Emotion Acceptance (ability to accept negative emotion) (3 items, 1-5 point scale); and (iv) Support from Work (getting support from school staff) (5 items, 1-5 point scale). The total score is a mean composite of these four measures and ranges from 1-5; higher scores indicate greater management of stress.
Month 18

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Child Mental Health- Conduct Problem
Time Frame: Baseline
Conduct problem items (5 items) from the Strengths and Difficulties Questionnaire (SDQ) are rated by parents, which assesses child's conduct and non-compliant behaviors over the last six months. Each item is rated on a Likert scale from 0 (not true) to 2 (certainly true). The total score is the sum of responses and ranges from 0-10; higher scores indicate greater difficulties.
Baseline
Child Mental Health- Conduct Problem
Time Frame: Month 6
Conduct problem items (5 items) from the Strengths and Difficulties Questionnaire (SDQ) are rated by parents, which assesses child's conduct and non-compliant behaviors over the last six months. Each item is rated on a Likert scale from 0 (not true) to 2 (certainly true). The total score is the sum of responses and ranges from 0-10; higher scores indicate greater difficulties.
Month 6
Child Mental Health- Conduct Problem
Time Frame: Month 18
Conduct problem items (5 items) from the Strengths and Difficulties Questionnaire (SDQ) are rated by parents, which assesses child's conduct and non-compliant behaviors over the last six months. Each item is rated on a Likert scale from 0 (not true) to 2 (certainly true). The total score is the sum of responses and ranges from 0-10; higher scores indicate greater difficulties.
Month 18

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Keng-Yen Huang, MD, MPH, NYU Langone Health

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

August 1, 2021

Primary Completion (Actual)

June 30, 2024

Study Completion (Actual)

February 28, 2025

Study Registration Dates

First Submitted

April 16, 2020

First Submitted That Met QC Criteria

May 7, 2020

First Posted (Actual)

May 12, 2020

Study Record Updates

Last Update Posted (Actual)

September 14, 2026

Last Update Submitted That Met QC Criteria

August 17, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • 20-00117

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

The de-identified participant data from the final research datasets (defined below) will be shared via the National Databased of Clinical Trials (NDCT) related to Mental Illness. The proposed cluster RCT study will be carried out in Uganda. It will collect data on 540 school staff (i.e., teachers), and 1,980 parent-child pairs from 36 schools. Child and teacher/school effectiveness outcome data and demographic data collected from teachers, schools, and families across all three assessment time points will be released for sharing. In addition, implementation context data will also be released. These data will be share via the NDCT related to Mental Illness. Implementation fidelity data will not be shared through NDCT, but can be requested from the PI Keng-Yen Huang directly beginning 9 months following article publication or at the end of the study.

IPD Sharing Time Frame

Analyzed data file and final trial data will be share at the end of the study via the National Databased of Clinical Trials (NDCT) related to Mental Illness (the NIMH recommended format). There will be no end date for data sharing.

IPD Sharing Access Criteria

Requests should be directed to PI Keng-Yen Huang at huangk01@nyulangone.org. To gain access, data requestors will need to sign a data access agreement.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.