Scalable Transdiagnostic Early Assessment of Mental Health (STREAM): a study protocol

Article


Williams, E. H., Thompson, N. M., McCray, G., Crespo-Llado, M. M., Bhavnani, S., Gajria, D., Mukherjee, D., Del Bianco, T., Lockwood-Estrin, G., Mason, L., Ngoma, V., Namathanga, C., Nkhata, R., Bennie. A., Ranjan, A., Kawelama, U., Midha, N., Singh, A., Mpakiza, I., Gautam, A., Gulati, S., Johnson, M. H., Lancaster, G., Belmonte, M. K., Jones, E., Patel, V., Chandran, S., Mbale, E., Divan, G., Gladstone, M. and Chakrabarti, B. 2024. Scalable Transdiagnostic Early Assessment of Mental Health (STREAM): a study protocol. BMJ Open. 14 (Art. e088263). https://doi.org/10.1136/bmjopen-2024-088263
AuthorsWilliams, E. H., Thompson, N. M., McCray, G., Crespo-Llado, M. M., Bhavnani, S., Gajria, D., Mukherjee, D., Del Bianco, T., Lockwood-Estrin, G., Mason, L., Ngoma, V., Namathanga, C., Nkhata, R., Bennie. A., Ranjan, A., Kawelama, U., Midha, N., Singh, A., Mpakiza, I., Gautam, A., Gulati, S., Johnson, M. H., Lancaster, G., Belmonte, M. K., Jones, E., Patel, V., Chandran, S., Mbale, E., Divan, G., Gladstone, M. and Chakrabarti, B.
Abstract

Introduction
Early childhood development forms the foundations for functioning later in life. Thus, accurate monitoring of developmental trajectories is critical. However, such monitoring often relies on time-intensive assessments which necessitate administration by skilled professionals. This difficulty is exacerbated in low-resource settings where such professionals are predominantly concentrated in urban and often private clinics, making them inaccessible to many. This geographic and economic inaccessibility contributes to a significant ‘detection gap’ where many children who might benefit from support remain undetected. The Scalable Transdiagnostic Early Assessment of Mental Health (STREAM) project aims to bridge this gap by developing an open-source, scalable, tablet-based platform administered by non-specialist workers to assess motor, social and cognitive developmental status. The goal is to deploy STREAM through public health initiatives, maximising opportunities for effective early interventions.

Methods and analysis
The STREAM project will enrol and assess 4000 children aged 0–6 years from Malawi (n=2000) and India (n=2000). It integrates three established developmental assessment tools measuring motor, social and cognitive functioning using gamified tasks, observation checklists, parent-report and audio-video recordings. Domain scores for motor, social and cognitive functioning will be developed and assessed for their validity and reliability. These domain scores will then be used to construct age-adjusted developmental reference curves.

Ethics and dissemination
Ethical approval has been obtained from local review boards at each site (India: Sangath Institutional Review Board; All India Institute of Medical Science (AIIMS) Ethics Committee; Indian Council of Medical Research—Health Ministry Screening Committee; Malawi: College of Medicine Research and Ethics Committee; Malawi Ministry of Health—Blantyre District Health Office). The study adheres to Good Clinical Practice standards and the ethical guidelines of the 6th (2008) Declaration of Helsinki. Findings from STREAM will be disseminated to participating families, healthcare professionals, policymakers, educators and researchers, at local, national and international levels through meetings, academic journals and conferences.

JournalBMJ Open
Journal citation14 (Art. e088263)
ISSN2044-6055
Year2024
PublisherBMJ Publishing Group
Publisher's version
License
File Access Level
Anyone
Digital Object Identifier (DOI)https://doi.org/10.1136/bmjopen-2024-088263
Publication dates
Online13 Jun 2024
Publication process dates
Accepted30 May 2024
Deposited16 Jul 2024
FunderMedical Research Council (MRC)
Copyright holder© 2024, The Author(s)
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