The contextual adaptation and educational impacts of the mhGAP-IG to address child mental and behavioral disorder treatment gap in China: A mixed-method study
The Mental Health Gap Action Program Intervention Guide (mhGAP-IG) is an international evidence-based intervention to enhance the scalability of non-specialized workforce to address mental, neurological, and substance use disorders, including child mental and behavioral disorders (CMBDs). Implementa...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-06-01
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| Series: | SSM - Mental Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666560325000015 |
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| author | Meng Zheng Yi Zhang Feng Chen Ang Chen Di Kong Kun Xie Jie Li Brian James Hall Andre M.N. Renzaho Jian-hui Gao Dao-meng Cheng Qing Zou Xin-yuan Zhong Qi-mei Yu Wen Chen |
| author_facet | Meng Zheng Yi Zhang Feng Chen Ang Chen Di Kong Kun Xie Jie Li Brian James Hall Andre M.N. Renzaho Jian-hui Gao Dao-meng Cheng Qing Zou Xin-yuan Zhong Qi-mei Yu Wen Chen |
| author_sort | Meng Zheng |
| collection | DOAJ |
| description | The Mental Health Gap Action Program Intervention Guide (mhGAP-IG) is an international evidence-based intervention to enhance the scalability of non-specialized workforce to address mental, neurological, and substance use disorders, including child mental and behavioral disorders (CMBDs). Implementation in China remains limited. This study sought to adapt the CMBDs-related components of the mhGAP-IG to the local context and assess the educational impacts of the adapted CMBDs-mhGAP-IG in non-specialized settings in Guangdong Province, China. Contextual adaptation was conducted through a four-step process guided by the Consolidated Framework for Implementation Research (CFIR) and the Ecological Validity Model (EVM). Qualitative data were collected via key informant interviews with six mental health experts and two focus group discussions involving seven kindergarten teachers or doctors and six general practitioners (GPs) from primary care centers. A qualitative analysis utilizing deductive and inductive thematic coding was applied. The educational impacts of a two-day training based on the adapted CMBDs-mhGAP-IG were assessed using a pre-post design among 89 participants, including kindergarten teachers or doctors and GPs. Changes in knowledge and stigma toward CMBDs were analyzed using paired t-tests. Qualitative findings identified barriers and facilitators to implementation across four CFIR domains: intervention characteristics, outer setting, inner setting, and characteristic of individuals. Barriers were concentrated in intervention characteristics (e.g., complexity, time and labor costs) and outer setting (e.g., stigma, high treatment cost). Contextual adaptation based on EVM addressed many of these barriers. Quantitative results indicated that the adapted CMBDs-mhGAP-IG training was associated with increased knowledge and reduced stigma toward CMBDs, demonstrating its educational effectiveness. This study identified barriers and facilitators to mhGAP implementation and documented a contextual adaptation process, offering insights into integrating contextual adaptation methods with implementation science. Trainings based on the adapted mhGAP-IG for non-specialists improved knowledge and stigma toward CMBDs, laying the foundation for future effectiveness evaluations. |
| format | Article |
| id | doaj-art-040616da50094159bf300aacaf7ac6a1 |
| institution | Kabale University |
| issn | 2666-5603 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM - Mental Health |
| spelling | doaj-art-040616da50094159bf300aacaf7ac6a12025-01-09T06:14:48ZengElsevierSSM - Mental Health2666-56032025-06-017100389The contextual adaptation and educational impacts of the mhGAP-IG to address child mental and behavioral disorder treatment gap in China: A mixed-method studyMeng Zheng0Yi Zhang1Feng Chen2Ang Chen3Di Kong4Kun Xie5Jie Li6Brian James Hall7Andre M.N. Renzaho8Jian-hui Gao9Dao-meng Cheng10Qing Zou11Xin-yuan Zhong12Qi-mei Yu13Wen Chen14Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Zhongshan Road 2, Guangzhou, 510080, ChinaDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Zhongshan Road 2, Guangzhou, 510080, ChinaDepartment of Clinical Research, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, ChinaDepartment of Science and Education, Zhongshan Boai Hospital, Zhongshan, 528405, ChinaDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Zhongshan Road 2, Guangzhou, 510080, ChinaDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Zhongshan Road 2, Guangzhou, 510080, ChinaThe Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, ChinaCenter for Global Healthy Equity, NYU Shanghai, Shanghai, 200122, ChinaTranslational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, AustraliaDepartment of Child Health Care, Zhongshan Boai Hospital, Zhongshan, 528405, ChinaThe Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, ChinaDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Zhongshan Road 2, Guangzhou, 510080, ChinaDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Zhongshan Road 2, Guangzhou, 510080, ChinaDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Zhongshan Road 2, Guangzhou, 510080, China; Department of Science and Education, Zhongshan Boai Hospital, Zhongshan, 528405, ChinaDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Zhongshan Road 2, Guangzhou, 510080, China; Corresponding author.The Mental Health Gap Action Program Intervention Guide (mhGAP-IG) is an international evidence-based intervention to enhance the scalability of non-specialized workforce to address mental, neurological, and substance use disorders, including child mental and behavioral disorders (CMBDs). Implementation in China remains limited. This study sought to adapt the CMBDs-related components of the mhGAP-IG to the local context and assess the educational impacts of the adapted CMBDs-mhGAP-IG in non-specialized settings in Guangdong Province, China. Contextual adaptation was conducted through a four-step process guided by the Consolidated Framework for Implementation Research (CFIR) and the Ecological Validity Model (EVM). Qualitative data were collected via key informant interviews with six mental health experts and two focus group discussions involving seven kindergarten teachers or doctors and six general practitioners (GPs) from primary care centers. A qualitative analysis utilizing deductive and inductive thematic coding was applied. The educational impacts of a two-day training based on the adapted CMBDs-mhGAP-IG were assessed using a pre-post design among 89 participants, including kindergarten teachers or doctors and GPs. Changes in knowledge and stigma toward CMBDs were analyzed using paired t-tests. Qualitative findings identified barriers and facilitators to implementation across four CFIR domains: intervention characteristics, outer setting, inner setting, and characteristic of individuals. Barriers were concentrated in intervention characteristics (e.g., complexity, time and labor costs) and outer setting (e.g., stigma, high treatment cost). Contextual adaptation based on EVM addressed many of these barriers. Quantitative results indicated that the adapted CMBDs-mhGAP-IG training was associated with increased knowledge and reduced stigma toward CMBDs, demonstrating its educational effectiveness. This study identified barriers and facilitators to mhGAP implementation and documented a contextual adaptation process, offering insights into integrating contextual adaptation methods with implementation science. Trainings based on the adapted mhGAP-IG for non-specialists improved knowledge and stigma toward CMBDs, laying the foundation for future effectiveness evaluations.http://www.sciencedirect.com/science/article/pii/S2666560325000015Child mental and behavioral disordersThe mhGAP-IGContextual adaptationThe consolidated framework for implementation researchEcological validity modelPilot study |
| spellingShingle | Meng Zheng Yi Zhang Feng Chen Ang Chen Di Kong Kun Xie Jie Li Brian James Hall Andre M.N. Renzaho Jian-hui Gao Dao-meng Cheng Qing Zou Xin-yuan Zhong Qi-mei Yu Wen Chen The contextual adaptation and educational impacts of the mhGAP-IG to address child mental and behavioral disorder treatment gap in China: A mixed-method study SSM - Mental Health Child mental and behavioral disorders The mhGAP-IG Contextual adaptation The consolidated framework for implementation research Ecological validity model Pilot study |
| title | The contextual adaptation and educational impacts of the mhGAP-IG to address child mental and behavioral disorder treatment gap in China: A mixed-method study |
| title_full | The contextual adaptation and educational impacts of the mhGAP-IG to address child mental and behavioral disorder treatment gap in China: A mixed-method study |
| title_fullStr | The contextual adaptation and educational impacts of the mhGAP-IG to address child mental and behavioral disorder treatment gap in China: A mixed-method study |
| title_full_unstemmed | The contextual adaptation and educational impacts of the mhGAP-IG to address child mental and behavioral disorder treatment gap in China: A mixed-method study |
| title_short | The contextual adaptation and educational impacts of the mhGAP-IG to address child mental and behavioral disorder treatment gap in China: A mixed-method study |
| title_sort | contextual adaptation and educational impacts of the mhgap ig to address child mental and behavioral disorder treatment gap in china a mixed method study |
| topic | Child mental and behavioral disorders The mhGAP-IG Contextual adaptation The consolidated framework for implementation research Ecological validity model Pilot study |
| url | http://www.sciencedirect.com/science/article/pii/S2666560325000015 |
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