Improving mental health among Ugandan and Ghanaian adolescents through a school-based sleep health intervention: Better Sleep, Better Health

Insomnia can cause depression and anxiety in adolescents. Cognitive behavior therapy for insomnia (CBT-I) is an effective early intervention for depression and anxiety. Focusing on improving sleep can offer a non-stigmatising pathway to improve mental health, but CBT-I is not widely used due to lack of awareness of the importance of sleep for mental health, shortage of trained providers and non-existence of scalable resource-efficient delivery models. We will address the evidence gap of how to deliver CBT-I at scale to adolescents in Africa. In the Foundation Phase, we will build a partnership to design and evaluate scalable CBT-I-based interventions to improve the mental health of secondary school students in Africa. Objectives: 1) To establish a sustainable equitable partnership among researchers, implementation partners, lived-experience experts, WHO and the Ministries of Health and Education in Uganda and Ghana. 2) To adapt a CBT-I-based intervention to ensure scalability and sustainability in Uganda and Ghana, guided by May’s General Theory of Implementation and feasibility case-series. 3) To co-design a cluster-randomised controlled trial to evaluate the implementation, effectiveness, cost-effectiveness and sustainability of these CBT-I-based interventions to reduce depression and anxiety among secondary school students in Uganda and Ghana, using the RE-AIM evaluation framework.