Peer-reviewed article
From “4Rs and 2Ss” to “Amaka Amasanyufu” (Happy Families): Adapting a U.S.‐based Evidence‐Based Intervention to the Uganda Context
Ozge Sensoy Bahar, William Byansi, Apollo Kivumbi, Phionah Namatovu, Joshua Kiyingi et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This paper describes how a U.S. mental health intervention for children with disruptive behavior disorders was adapted for use in Uganda. The adaptation process involved meetings with school staff, manual review by local teams, consultation with community stakeholders, and cultural illustrations. The work was part of a randomized trial with 30 schools involving children with behavioral challenges and their caregivers. The paper emphasizes the importance of community participation in making evidence-based interventions fit local contexts.
Key points
- One in five children in Uganda presents mental health challenges, including disruptive behavior disorders
- The intervention was adapted through a structured process including stakeholder engagement and community feedback
- The adaptation involved balancing fidelity to the original intervention with cultural relevance to the Ugandan context
- Community stakeholders provided critical feedback on content and cultural appropriateness
- Children's drawings were used to illustrate the adapted manual
Limitations
The paper describes the adaptation process but does not present outcome data or effectiveness findings from the randomized trial. Therefore, it cannot tell us whether the adapted intervention actually improves children's mental health or reduces behavioral challenges.
Abstract
In Uganda, one in five children presents mental health challenges, including disruptive behavior disorders (DBDs). DBDs can persist through adulthood and result in negative outcomes. Effective interventions for DBDs have been developed and tested in high-poverty communities in developed countries. Yet, most African countries, such as Uganda, lack such interventions. This paper describes the adaptation process of an evidence-based intervention of U.S. origin to optimize fit to context with intervention fidelity, as part of a randomized trial conducted with youth that exhibit behavioral challenges and their caregivers in 30 schools in Uganda. The process involved: initial meetings with headteachers and teachers to introduce the study and the main concepts of the intervention; initial manual review focusing on 4Rs and 2Ss content by the Uganda team; engagement of community stakeholders for additional feedback on content and cultural relevance; final revision of the manual; and collection of children's drawings for the illustration of the manual. This paper describes both similarities and differences between the original and adapted intervention content and methods of delivery. The findings also highlight the importance of involving community stakeholders in the adaptation process.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Adaptation of a U.S.-based evidence-based intervention (4Rs and 2Ss) renamed 'Amaka Amasanyufu' (Happy Families) for delivery to youth with behavioral challenges and their caregivers
- Population
- Youth exhibiting behavioral challenges and their caregivers in 30 schools across Uganda
Key finding
The adaptation process successfully involved initial meetings with school staff, manual review, community stakeholder engagement, and cultural adaptation through illustrations
Bahar et al. · Prof. Fred M. Ssewamala (OpenAlex works) · 6 Feb 2020