Ryan Grace Kenneally

All Publications

• Multi-sector determinants of implementation and sustainment for non-specialist treatment of depression and post-traumatic stress disorder in Kenya: a concept mapping study. Implementation science communications Crable, E. L., Meffert, S. M., Kenneally, R. G., Ongeri, L., Bukusi, D., Burger, R. L., Rota, G., Otieno, A., Rotai, R., Mathai, M., Aarons, G. A. 2025; 6 (1): 55

  Abstract

  The global shortage of trained mental health workers disproportionately impacts mental health care access in low- and middle-income countries. In Kenya, effective strategies are needed to scale-up the workforce to meet the demand for depression and post-traumatic stress disorder treatment. Task-shifting - delegating specific tasks to non-specialist workers - is one workforce expansion approach. However, non-specialist workers remain underutilized in Kenya due to a paucity of research on how to scale-up and sustain such service models.Purposive sampling was used to recruit experts from policy, healthcare practice, research, and mental health advocacy roles in Kenya (N = 30). Participants completed concept mapping activities to explore factors likely to facilitate or hinder a collaborative Ministry of Health-researcher training of the mental health non-specialist workforce. Participants brainstormed 71 statements describing determinants and implementation strategies, sorted and rated the importance and changeability of each. Multidimensional scaling and hierarchical cluster analysis quantified relationships between statements. The Exploration, Preparation, Implementation, and Sustainment (EPIS) framework guided cluster interpretation activities.Twelve determinant clusters were identified: 1) Current workforce characteristics, 2) Exploration considerations, 3) Preparation considerations, 4) Sustainment considerations, 5) Inner context implementation processes and tools, 6) Local capacity and partnerships, 7) Financing for community health teams, 8) Outer context resource allocation/policy into action, 9) Workforce characteristics to enhance during implementation, 10) Workforce implementation strategies, 11) Cross-level workforce strategies, and 12) Training and education recommendations. Cluster 8 was rated the most important and changeable.Concept mapping offers a rapid, community-engaged approach for identifying determinants and implementation strategies to address workforce shortages. Organizing results by EPIS phases can help prioritize strategy deployment to achieve implementation goals. Scale-up and sustainment of the non-specialist workforce in Kenya requires formal partnerships between the Ministry of Health and community health worker teams to distribute financial resources and collaboratively standardize training curriculum.

  View details for DOI 10.1186/s43058-025-00744-7

  View details for PubMedID 40336135

  View details for PubMedCentralID PMC12056999

• Exploration, Preparation, Implementation, Sustainment (EPIS) framework: Utility for Implementation Science and Nursing Research. Kango kenkyu: The Japanese Journal of Nursing Research Aarons, G. A., Crable, E. L., Kenneally, R. G., Sklar, M., Moullin , J. C. 2024; 57 (3)

  View details for DOI 10.11477/mf.1681202207

• Applying the Exploration, Preparation, Implementation, Sustainment Framework Implementation Science Crable, E. L., Kenneally, R. G., Betancourt , T. S., Aarons, G. A. 2024: 14

  View details for DOI 10.4324/9781003318125-15

• Applying after-action reviews to child and family teams to improve mental health service linkage within child welfare services: a study protocol. Implementation science communications Sklar, M., Kenneally, R., Aarons, G. A., Fettes, D. L. 2023; 4 (1): 121

  Abstract

  Half of child-welfare-involved children and adolescents meet the criteria for at least one mental health diagnosis. This project proposes to improve successful mental health service linkage in child welfare services (CWS) by adapting and testing the after-action review (AAR) team effectiveness intervention to augment the child and family team (CFT) services' intervention. Despite being both required and a collaborative approach to service planning, CFT meetings are implemented with questionable fidelity and consistency, rarely including the voice of children and families as intended.Using a parallel group trial design, with non-equivalent comparison groups, and qualitative and quantitative methodology, this study will tailor and assess the impact of the AAR on enhancing CFT outcomes. The authors will conduct a qualitative needs assessment targeting the ongoing implementation of the CFT services intervention in a large, publicly funded, CWS system. A qualitative inquiry consisting of interviews and focus groups with key stakeholders will result in the preparation of an action plan to address identified gaps between the current and desired CFT services intervention outcomes. The AAR implementation strategy will be adapted and tailored to address the CFT services' intervention needs. To test the effectiveness of the AAR on improving outcomes associated with the CFT services intervention, we will utilize blocked randomization of four CWS caseworkers from two CWS system regions to either the intervention condition (CFT + AAR) or standard implementation (CFT as usual). The authors will collect data from the CWS caseworkers and additional CFT members via web-based surveys. Mechanisms of the AAR team effectiveness intervention for CFT implementation will be assessed.By inclusion of child and family voice, the AAR-enhanced CFT should lead to increased fidelity to the CFT intervention and greater levels of parental satisfaction with the service and shared decision-making, thus resulting in enhanced follow-through with service plans and linkage to mental health treatment services for children. The knowledge gained by this randomized clinical trial has the potential to benefit service delivery and integration for CWS leaders, caseworkers, formal and informal CFT member support persons, parents/caregivers, and children with open cases. Improving intervention effectiveness, both at the system and family levels, is crucial for practice efficiencies and improved child and family outcomes.NCT05629013. Approval date: November 28, 2022 (version 1).University of California, San Diego.Danielle Fettes.

  View details for DOI 10.1186/s43058-023-00479-3

  View details for PubMedID 37798808

  View details for PubMedCentralID PMC10552205

• Overcoming stigma as a barrier to children’s mental health care: The role of empowerment and mental health literacy. Stigma and Health Kosyluk, K., Kenneally, R. G., Tran, J. T., Cheong, Y., Bolton, C., Conner, K. 2022

  View details for DOI 10.1037/sah0000402