Evidence map›Paper›PMID 35590348›Full record

ArticleTrials2022

Comparative effectiveness of in-person vs. remote delivery of the Common Elements Treatment Approach for addressing mental and behavioral health problems among adolescents and young adults in Zambia: protocol of a three-arm randomized controlled trial.

Caleb J Figge, Jeremy C Kane, Stephanie Skavenski, Emily Haroz, Mwamba Mwenge, Saphira Mulemba, Luke R Aldridge, Michael J Vinikoor, Anjali Sharma, Sachi Inoue and 8 more

2 registry-linked trialsOpen access · goldAbstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03458039 nacompletednot on this map

Evaluating Implementation Strategies to Scale-up Transdiagnostic Evidence-based Mental Health Care in Zambia

TypeinterventionalSponsorCentre for Infectious Disease Research in ZambiaRan2020 to 2024Enrolled456ConditionsDepression, Post-traumatic Stress Disorder, Anxiety, Substance AbuseArmsIn-person CETA, Telephone CETA, Treatment as Usual (TAU)
NCT05121064 nacompletednot on this mapstarted 2023, after this paper: background citation

Common Elements Treatment Approach HIV Alcohol Reduction Trial in Zambia

TypeinterventionalSponsorUniversity of Alabama at BirminghamRan2023 to 2025Enrolled680ConditionsHIV/AIDS, Alcohol-Related Disorders, Mental IllnessArmsAlcohol Brief Intervention, Common Elements Treatment Approach, Standard of Care
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Selection and reporting of usual care comparators when designing primary care trials of complex health interventions: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
    Pooled it
  2. Trial
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 7 institutions in 2 countries.

Caleb J FiggeJohns Hopkins Bloomberg School of Public Health, Department of Mental Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA. cfigge1@jh.edu.ORCID http://orcid.org/0000-0003-4953-6191
Jeremy C KaneDepartment of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St., New York City, NY, 10032, USA.
Stephanie SkavenskiJohns Hopkins Bloomberg School of Public Health, Department of Mental Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
Emily HarozJohns Hopkins Bloomberg School of Public Health, Department of Mental Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
Mwamba MwengeThe Centre for Infectious Disease Research (CIDRZ) Zambia, Plot 34620, Lusaka, Zambia.
Saphira MulembaThe Centre for Infectious Disease Research (CIDRZ) Zambia, Plot 34620, Lusaka, Zambia.
Luke R AldridgeJohns Hopkins Bloomberg School of Public Health, Department of Mental Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
Michael J VinikoorThe Centre for Infectious Disease Research (CIDRZ) Zambia, Plot 34620, Lusaka, Zambia.
Anjali SharmaThe Centre for Infectious Disease Research (CIDRZ) Zambia, Plot 34620, Lusaka, Zambia.
Sachi InoueDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA, 02115, USA.
Ravi PaulDepartment of Psychiatry, University of Zambia, PO Box 50110, Lusaka, Zambia.
Francis SimendaMinistry of Health Zambia, Haille Selassie Avenue, Ndeke House, P.O. Box 30205, Lusaka, Zambia.
Kristina MetzJohns Hopkins Bloomberg School of Public Health, Department of Mental Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
Carolyn BoltonThe Centre for Infectious Disease Research (CIDRZ) Zambia, Plot 34620, Lusaka, Zambia.
Christopher KempDepartment of Global Health, Hans Rosling Center, University of Washington School of Public Health, 3980 15th Ave. NE, Seattle, WA, 98105, USA.
Samuel BosomprahThe Centre for Infectious Disease Research (CIDRZ) Zambia, Plot 34620, Lusaka, Zambia.
Izukanji Sikazwe *The Centre for Infectious Disease Research (CIDRZ) Zambia, Plot 34620, Lusaka, Zambia.
Laura K Murray *Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
Centre for Infectious Disease Research in Zambia · ZMJohns Hopkins University · USColumbia University · USHarvard University · USMinistry of Health · ZMUniversity of Washington · USUniversity of Zambia · ZM

Funding

Global Mental Health Training ProgramT32MH103210 · NIMH · JOHNS HOPKINS UNIVERSITY · PI Judith Karen Bass, Sarah Sutherlin-McIvor Murray · 2015 to 2026
$4.0M
Evaluating Implementation Strategies to Scale-up Transdiagnostic Evidence-based Mental Health Care in ZambiaR01MH115495 · NIMH · CENTRE FOR INFECTIOUS DISEASE RESEARCH · PI MURRAY, LAURA KAY, SHARMA, ANJALI · 2019 to 2022
$2.5M
Mental Health Services and Systems Training ProgramT32MH109436 · NIMH · JOHNS HOPKINS UNIVERSITY · PI Matthew Eisenberg, Elizabeth A. Stuart · 2017 to 2026
$1.7M
NIMH NIH HHS R01 MH115495NIMH NIH HHS R01MH115495NIMH NIH HHS T32 MH103210NIMH NIH HHS T32 MH109436
6 · The paper itself

Abstract

backgroundIn low- and middle-income countries (LMIC), there is a substantial gap in the treatment of mental and behavioral health problems, which is particularly detrimental to adolescents and young adults (AYA). The Common Elements Treatment Approach (CETA) is an evidence-based, flexible, transdiagnostic intervention delivered by lay counselors to address comorbid mental and behavioral health conditions, though its effectiveness has not yet been tested among AYA. This paper describes the protocol for a randomized controlled trial that will test the effectiveness of traditional in-person delivered CETA and a telehealth-adapted version of CETA (T-CETA) in reducing mental and behavioral health problems among AYA in Zambia. Non-inferiority of T-CETA will also be assessed.

methodsThis study is a hybrid type 1 three-arm randomized trial to be conducted in Lusaka, Zambia. Following an apprenticeship model, experienced non-professional counselors in Zambia will be trained as CETA trainers using a remote, technology-delivered training method. The new CETA trainers will subsequently facilitate technology-delivered trainings for a new cohort of counselors recruited from community-based partner organizations throughout Lusaka. AYA with mental and behavioral health problems seeking services at these same organizations will then be identified and randomized to (1) in-person CETA delivery, (2) telehealth-delivered CETA (T-CETA), or (3) treatment as usual (TAU). In the superiority design, CETA and T-CETA will be compared to TAU, and using a non-inferiority design, T-CETA will be compared to CETA, which is already evidence-based in other populations. At baseline, post-treatment (approximately 3-4 months post-baseline), and 6 months post-treatment (approximately 9 months post-baseline), we will assess the primary outcomes such as client trauma symptoms, internalizing symptoms, and externalizing behaviors and secondary outcomes such as client substance use, aggression, violence, and health utility. CETA trainer and counselor competency and cost-effectiveness will also be measured as secondary outcomes. Mixed methods interviews will be conducted with trainers, counselors, and AYA participants to explore the feasibility, acceptability, and sustainability of technology-delivered training and T-CETA provision in the Zambian context. DISCUSSION: Adolescents and young adults in LMIC are a priority population for the treatment of mental and behavioral health problems. Technology-delivered approaches to training and intervention delivery can expand the reach of evidence-based interventions. If found effective, CETA and T-CETA would help address a major barrier to the scale-up and sustainability of mental and behavioral treatments among AYA in LMIC.

trial registrationClinicalTrials.gov NCT03458039 . Prospectively registered on May 10, 2021.

Indexed as

Problem BehaviorPsychiatryAdolescentEquivalence Trials as TopicHumansRandomized Controlled Trials as TopicTreatment OutcomeViolenceYoung AdultZambiaAdolescentsGlobal mental healthImplementation scienceRandomized controlled trialTelehealthZambia

Identifiers

PMID35590348
PMCPMC9117594
OpenAlexW4280499092

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.