Sustained mental health outcomes from the youth readiness intervention: A four‐year effectiveness follow‐up of a hybrid type II trial in Sierra Leone.

Background: Strategies to expand access to care and sustain evidence‐based mental health interventions (EBIs) must be tested within novel delivery platforms to extend the reach of services in fragile and conflict‐affected settings. Integration into broader development programs may help maintain long...

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Publicado en:Journal of Child Psychology & Psychiatry Vol. 67; no. 9; pp. 1537 - 1547
Autores principales: Van Den Boom, Wijnand, Noon, Kathryn, Yang, Shuangshuang, Menart, Renee, Momoh, Fatoma, Bah, Abdulai Jawo, Placencio‐Castro, Matias, Betancourt, Theresa S.
Formato: Artículo
Publicado: Wiley-Blackwell Sep2026
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Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2026
      vid: 67
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      pub: Wiley-Blackwell
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        196036105
        10.1111/jcpp.70158
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        atl: Sustained mental health outcomes from the youth readiness intervention: A four‐year effectiveness follow‐up of a hybrid type II trial in Sierra Leone.
      aug:
        au:
          Van Den Boom, Wijnand
          Noon, Kathryn
          Yang, Shuangshuang
          Menart, Renee
          Momoh, Fatoma
          Bah, Abdulai Jawo
          Placencio‐Castro, Matias
          Betancourt, Theresa S.
        affil:
          Research Program on Children and Adversity, School of Social Work, Boston College, Chestnut Hill MA,, USA
          Innovation for Poverty in Action, New Haven CT,, USA
      su:
        United States
        Sierra Leone
        Mental health
        Adolescent health
        Mindfulness
        Evaluation of human services programs
        Anxiety
        Cognitive therapy
        Mental depression
        Effect sizes (Statistics)
        Emotion regulation
        Interpersonal psychotherapy
        Research funding
        Cronbach's alpha
        Entrepreneurship
        Functional assessment
        Descriptive statistics
        Structural equation modeling
        Chi-squared test
        Intraclass correlation
        Factor analysis
        Data analysis software
        Confidence intervals
      sug:
        subj:
          Mental health
          Adolescent health
          Mindfulness
          Evaluation of human services programs
          Anxiety
          Cognitive therapy
          Mental depression
          United States
          Sierra Leone
          Offices of Mental Health Practitioners (except Physicians)
          Effect sizes (Statistics)
          Emotion regulation
          Interpersonal psychotherapy
          Research funding
          Cronbach's alpha
          Entrepreneurship
          Functional assessment
          Descriptive statistics
          Structural equation modeling
          Chi-squared test
          Intraclass correlation
          Factor analysis
          Data analysis software
          Confidence intervals
      keyword:
        cognitive‐behavioral therapy
        daily functioning
        emotion regulation
        entrepreneurship training
        hybrid type II cluster‐randomized trial
        implementation science
        mental health
        Youth Readiness Intervention
        cognitive‐behavioral therapy
        daily functioning
        emotion regulation
        entrepreneurship training
        hybrid type II cluster‐randomized trial
        implementation science
        mental health
        Youth Readiness Intervention
      ab: Background: Strategies to expand access to care and sustain evidence‐based mental health interventions (EBIs) must be tested within novel delivery platforms to extend the reach of services in fragile and conflict‐affected settings. Integration into broader development programs may help maintain long‐term effects. This study presents a four‐year follow‐up of a previously conducted Hybrid Type II implementation‐effectiveness cluster‐randomized trial (CRT) of the Youth Readiness Intervention (YRI)—an EBI drawing on cognitive‐behavioral, interpersonal, and mindfulness‐based approaches—delivered within a youth entrepreneurship program in Sierra Leone (2018–2019). Methods: Long‐term mental health outcomes (emotion regulation, psychological distress, and interpersonal functioning) were examined among a randomly selected subgroup of 584 participants across three study arms: a control group, a group that only received entrepreneurship training ('ENTR'), and a group that received both YRI and ENTR ('YRI + ENTR'). Linear mixed‐effect models accounted for the nested structure of the data. Impact of the COVID‐19 pandemic was also assessed through economic and relationship stressors using structural equation modeling. Results: Four years postintervention, YRI + ENTR‐youth maintained improvements in depression (β = −.057; 95% CI −0.09 to −0.02; [effect size] d = −.111) and combined depression/anxiety symptoms (β = −.047; 95% CI −0.08 to −0.01; [effect size] d = −.096) though no sustained effects were observed for daily functioning or emotion regulation. No differences were found for ENTR‐only participants versus controls and YRI + ENTR. COVID‐19‐related economic stressors mediated the relationship between study arm and mental health, revealing small but significant effects. Conclusions: In low‐income settings like Sierra Leone, where formal mental health services are scarce, sustainable community‐based interventions such as the combined YRI + ENTR intervention offer a critical approach to reducing psychological distress. Sustained long‐term benefits suggest that participants developed coping strategies that supported resilience during challenges like the COVID‐19 pandemic. These gains may also foster broader community resilience, enhancing both individual well‐being and collective capacity to withstand future adversity.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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