Implementation, sustainability, and impact of Common Elements Treatment Approach in Ugandan healthcare facilities

AI Summary

High acceptability and perceived need for CETA, offering advantages over existing behavioural health services in high HIV-prevalence Ugandan settings.
Scale CETA beyond facilities via task shifting to community health workers to reduce provider fatigue and transport barriers, improving patient retention.
Develop in-country capacity using a train-the-trainer apprenticeship model to ensure long-term sustainability; rigorous testing needed for implementation and effectiveness.

AI Summary

The present study explored the implementation of Common Elements Treatment Approach (CETA), a transdiagnostic intervention, in Western Uganda, from the perspectives of multilevel stakeholders.

One-on-one in-depth interviews with multilevel stakeholders involved in the rollout of CETA in Uganda were conducted (n = 20) including Ministry of Health officials (n = 2), CETA trainers (n = 2), clinic managers (n = 5), and frontline providers (n = 11) involved in the rollout of CETA.

Key themes that emerged, organized by CFIR 2.0 domain and construct, included the acceptability and perceived need for CETA (and its perceived advantages over existing behavioral health services), the importance of expanding CETA beyond healthcare facilities into communities (through a task-shifting approach that leverages community health workers) to reduce provider fatigue and eliminate transportation related barriers to patient retention, and the necessity of building in-country capacity to support long-term sustainability and the train-the-trainer apprenticeship model.

Basic summary

SSM Ment Health. 2025 Dec;8:100569. doi: 10.1016/j.ssmmh.2025.100569. Epub 2025 Dec 5.

ABSTRACT

The health and social consequences of untreated mental health disorders and heavy alcohol use are substantial, particularly in settings with high HIV-prevalence. Transdiagnostic approaches may offer a more efficient public health response, particularly where behavioral health services are limited. The present study explored the implementation of Common Elements Treatment Approach (CETA), a transdiagnostic intervention, in Western Uganda, from the perspectives of multilevel stakeholders. One-on-one in-depth interviews with multilevel stakeholders involved in the rollout of CETA in Uganda were conducted (n = 20) including Ministry of Health officials (n = 2), CETA trainers (n = 2), clinic managers (n = 5), and frontline providers (n = 11) involved in the rollout of CETA. Data were thematically analyzed and organized using the Consolidated Framework for Implementation Research (CFIR 2.0). Key themes that emerged, organized by CFIR 2.0 domain and construct, included the acceptability and perceived need for CETA (and its perceived advantages over existing behavioral health services), the importance of expanding CETA beyond healthcare facilities into communities (through a task-shifting approach that leverages community health workers) to reduce provider fatigue and eliminate transportation related barriers to patient retention, and the necessity of building in-country capacity to support long-term sustainability and the train-the-trainer apprenticeship model. This qualitative implementation assessment provides suggestions for optimization of CETA delivery for this context in future implementation. Rigorous testing of CETA is needed to examine both implementation and effectiveness outcomes in Uganda.

PMID:42344436 | PMC:PMC13289709 | DOI:10.1016/j.ssmmh.2025.100569

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