An effective online treatment for childhood anxiety co-developed by researchers at Oxford Population Health’s Health Economics Research Centre is to be adapted and tested in five countries in Asia and South America, with the aim of driving widespread implementation in the future.
The Online Support and Intervention (OSI) tool is a brief therapist-guided, parent-led online Cognitive Behaviour Therapy platform for treating anxiety problems in children aged 5-12 years.
Funded by Wellcome, the new £7 million project will see researchers and clinicians in seven countries working together with commercial partners and lived experience experts to adapt, test and deliver the tool in Japan, Chile, Pakistan, the Philippines, and Thailand. Reaching 1,600 children, the team aims to ensure that OSI works in a variety of different contexts and create the conditions for it to be rolled out quickly and sustainably at scale.
Trials in the UK have shown that OSI is both clinically and cost effective, reducing therapist time and also achieving excellent outcomes when delivered by non-expert practitioners. This makes it particularly suitable for delivery in places where mental health support is not easily accessible for children and young people.
OSI was recommended by the National Institute of Clinical Excellence (NICE) in an Early Value Assessment in the UK and is already being delivered in child mental health services.
Professor Mara Violato, the health economics lead for the project, said ‘A key prerequisite for broad, efficient, and sustainable rollout is demonstrating that the intervention represents good value for money. We have already shown that it is cost-effective in the UK context, and I now look forward to working with colleagues across other countries to ensure the delivery model is adapted to local needs and contexts in a smooth and cost-effective way. This will support timely access to the intervention globally, ultimately improving outcomes for children, their families, and society as a whole.’
Professor Cathy Creswell, Paul Foundation Professor of Developmental Clinical Psychology at the University of Oxford, who developed OSI and is leading the project, said ‘We are incredibly grateful for this funding from Wellcome, which will accelerate and amplify the global reach of our Online Support and Intervention tool. OSI is proven to be an efficient and effective treatment for anxiety disorders in children in the UK, so it is very exciting to be able to make it available to children and their families in other countries across the world.
‘Our collaborative and multidisciplinary team of experts will help us ensure we adapt and refine the tool so it can be implemented at scale in a variety of contexts, so that more children and their families can benefit as quickly as possible.’
Dr Miguel Cordero Vega, Associate Professor at the Universidad del Desarrollo, will lead the work in Chile. Dr Vega said ‘Chile has a relatively strong healthcare system, but access to mental health care for children and adolescents remains limited. This new funded research programme will involve schools in adapting and evaluating the impact of delivering digital mental health support through OSI. Within five years, we hope to have contributed to improving access to evidence-based digital mental health services in Chile, and will share these lessons more widely across Latin America.’
Dr John Jamir Benzon Aruta, from De La Salle University in the Philippines, said ‘The Philippines has a very young population but some of the world’s scarcest child mental health services. With so few specialist providers and many children living far from services, we need solutions that travel to families, not the other way around. OSI will let us test what works in real-world settings across the Philippines and generate the evidence local governments need to invest in child mental health at a sustainable, national scale.’
Tayla McCloud, Research Lead in Digital Mental Health at Wellcome, said ‘Digital interventions have the potential to transform access to mental health care globally. Since many mental health conditions begin in childhood and can persist throughout life, early intervention is critical. That’s why we’re so pleased to support the development of OSI – an evidence-based, scalable solution that empowers families and helps prevent anxiety from limiting young people’s futures. We look forward to seeing how this international collaboration advances the reach and impact of OSI worldwide.’
The project will be supported by The Global Health Network, based in the University of Oxford’s Nuffield Department of Medicine, and the University of Exeter. OSI was originally developed and evaluated with support from the National Institute for Health and Care Research (NIHR); the Medical Research Council, part of UK Research and Innovation; the NIHR Applied Research Collaboration Oxford and Thames Valley; and the NIHR Oxford Health NIHR Biomedical Research Centre. It is being implemented in the UK by Koa Health, supported by BitJam Ltd, who will be the commercial partners on this project.