1. Child Mental Health Awareness:
A Nine-Country Pilot Study, 2004-2005
Presented by:
Christina W. Hoven
For:
WPA-WHO Awareness Taskforce
Chairperson: Sam Tyano, Israel
Members:
Theresa Ange Agossou, WHO/AFRO
Myron Belfer, Switzerland
K. Michael Hong, Korea
Christina W. Hoven, USA
Du, Yasong, China
Danuta Wasserman, Sweden
WPA
WHO
IACAPAP
WPA Meetings; Cairo, Egypt
September 15, 2005
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

2. WPA Child Mental Health Steering Committee
• Chairperson: Ahmed Okasha, Egypt
• Vice Chairperson: Norman Sartorius, Switzerland
• Scientific Director: Helmut Remschmidt, Germany
• Scientific Vice Director: Sam Tyano, Israel
• Secretary: Tarek Okasha, Egypt
• Members: John H. Heiligenstein, USA
Peter Jensen, USA
Barry Nurcombe, Australia
• WHO Representative: Myron Belfer, Switzerland
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

3. Participating Countries
Armenia
Site Project Director: Maruke Yeghiyan
Project Coordinator: Anna Velitsyan
Other Contributors: ACPP members
Area:
One school in the Yerevan district
Azerbaijan (Funded by GIP)
Site Project Director: Fuad Ismayilov
Project Coordinator: Nadir Ismayilov
Co-Investigator:
Hadji Agabek Sultanov
Project Director:
Polad Azizov
Other Contributors: Indira Hadjiyeva, Viktoria Magerramova, Nazim
Babayev, Tamerlan Radjabov, Vugar Mehtiyev, Sevda
Katibli, Zemfira Ismayilova, Shaik Sultanov
Area:
Four schools: two urban schools in Baku; and,
two rural schools in Mardakan and Shuvelan
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

4. Participating Countries (continued)
Brazil
Project Coordinator:
Co-Principal Investigator:
Co-Investigator:
Other Contributors:
Area:
Luis Augusto Rohde
Júlia Obst Comassetto
Rosane Brusius de Moraes
Maycoln L. M. Teodoro, and Clarissa Paim
One public school in Porto Alegre, the capital of
Brazil’s southernmost state.
China
Project Director:
Project Manager:
Data Coordinator:
Other Contributors:
Area:
Du, Yasong
Zhao, Zhimin
Liu, Yi
Wu, Zengquiang
Six schools in Shanghai
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

5. Participating Countries (continued)
Egypt
Project Director:
Amira Seif El Dine
Other Contributors: Mohamed Ramadan, Nagla Fathi, Mohamed Osman,
Dalia El Said, Wafaa Saad
Area:
Four schools in Alexandria
Georgia (Funded by GIP)
Project Director:
Co-Investigator:
Tea Jaliashvili
Marine Gegelashvili
Project Manager:
Campaign:
Jan Vorisek
Four schools: three in Tbilisi and one in Rustavi
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

6. Participating Countries (continued)
Israel
Principal Investigator: Alan Apter
Site Project Manager: Gitit Peer candidate
Area:
Two high schools and one elementary school in a small town
in Northern Israel.
Russia
Principal Investigator: Tatjana Dmitrieva
Other Contributors: Andrey Zanozin, Andreyuk, Alexandra Drozdova
Area:
One school in Nizhny Novgorod.
Uganda
Principal Investigator:
Project Manager:
Other Contributors:
Area:
Emilio Ovuga
Juliet Nakku
Alexander Bombom
Four primary schools and five secondary schools
in Kampala City
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

7. International Coordinating Center at Columbia University
International Study Director: Christina W. Hoven
International Project Coordinator: Thao Doan
International Project Data Managers: Fan Bin, George J. Musa
Awareness Manual Writing Team: David Wilkin (Team Leader), Thao Doan,
Carol Herbig, Mohammad Karim, Chakravarthy Koonapareddy,
Donald J. Mandell, Katie Merrill, Awali Samara, Karen Sautter,
Cynthia Weinstein
Procedure Manual Writing Team: Fan Bin, Donald J. Mandell, George J. Musa,
Karen Sautter, Min Tang, Judith Wicks,
Data Entry Programming Team: Alex Resto, Bensheng Ouyang
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

8. Study Rationale
• Psychiatric disorders/symptoms are frequently
undetected/untreated.
• Awareness is a precondition for
symptoms/disorders to be recognized.
• To raise awareness while avoiding unrealistic
expectations about available services.
• Assumption that sound information will
contribute to advocacy, thus shorten the time
when services become available.
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

9. Institutional Review Board Approval
• Baseline and follow-up surveys to be anonymous.
• Institutional Review Board (IRB) approval
obtained at each site.
• International Coordinating Center IRB approval
obtained before data was submitted.
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

10. Study Design
• Pre and Post assessment of students, parents and
teachers.
• Assessment of awareness of signs and symptoms of
childhood psychopathology.
• Assessment of child psychopathology/ impairment
(SDQ), child only.
• Assessment of stigma and attribution of symptoms.
• Assessment of knowledge and desire for more
information about mental illness.
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

11. Study Methodology
• Countries selected to represent different regions,
cultures and languages.
• To systematically disseminate accurate information,
an Awareness Manual was developed.
• Awareness Manual describes signs and symptoms
and serves as a resource for educating healthcare
professionals, parents, teachers and students.
• To insure comparability in implementation and
execution, a Procedures Manual was developed,
describing all aspects of study, including sampling
methods
• Data Procedures Manual: Data collection, data
entry, etc.
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

12. Samples
• School children, their parents and their
teachers.
• Schools were to be randomly selected.
• Student ages: 10-11 and 16-17.
• Target at least 400 students (200 in each
age group) at each site.
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

13. Study Procedures
• Following Procedures Manual participants
completed a baseline questionnaire.
• Each site waged an Awareness Campaign, based
on the Awareness Manual.
• Approximately two weeks after the Awareness
Campaign, a follow-up questionnaire was
administered.
• Data Entry Manual to guide data collect, data
entry and data transmission procedures.
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

14. Manuals Developed for Study
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

15. Overview of Study Design
Approval
(Highest, Local, and Individual School Authorities)
Parent Support Organizations
Start Planning
Awareness Campaign
Randomly Select Schools and Classrooms
Obtain Parent Consent
Pilot Test Procedures
Pre-Campaign Survey
Conduct
Awareness Campaign
Post-Campaign Survey
Double Data Entry and Data Submission
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

16. Study Website
• Dissemination of information and materials
(e.g., the Awareness Manual, the Procedures
Manual, Site Activity Logs, Survey
Questionnaires, Data Entry Programs and
Data Entry Manual).
• Email link for asking questions about
procedures, which were responded to by the
International Coordinating Center.
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

17. Pre-Campaign
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

18. Questionnaires Administered
Pre-Campaign
Site
Post-Campaign
Students Parents Teachers
Students Parents Teachers
Armenia
100
100
100
0
0
0
Azerbaijan
400
51
50
381
49
45
Brazil
119
0
7
106
0
5
China
541
0
114
541
0
115
Egypt
174
94
39
0
0
0
Georgia
432
53
43
364
42
34
Israel
143
31
60
0
0
0
Russia
159
129
26
144
96
15
Uganda
403
149
56
418
73
22
2,472
607
495
1,954
260
236
Total
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

19. All Sites: Pre-Campaign Student Demographics
N
Age
(Mean + SD)
Female
(%)
Armenia
100
13.3 + 3.14
53.0
Azerbaijan
400
13.5 + 2.86
51.5
Brazil
119
14.0 + 2.81
53.8
China
541
15.8 + 1.99
48.6
Egypt
174
13.6 + 1.62
54.6
Georgia
432
13.9 + 2.35
55.0
Israel
143
15.1 + 2.60
60.6
Russia
159
13.9 + 2.88
57.6
Uganda
403
13.4 + 3.06
53.6
2,472
14.2 + 2.73
53.1
SITE
TOTAL
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

20. All Sites: Pre-Campaign Parent Demographics
N
Female
(%)
Has at least 1 child
w/ MH problem (%)
Armenia
100
65.0
11.0
Azerbaijan
47
76.5
6.4
Brazil
NA
China
NA
Egypt
88
51.1
12.6
Georgia
51
100.0
12.0
Israel
27
63.0
NA
Russia
86
83.7
17.1
Uganda
119
63.9
37.5
518
69.9
17.4
SITE
TOTAL
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

21. All Sites: Pre-Campaign Teacher Demographics
N
Female
(%)
Has at least 1 student
w/ MH problem (%)
Armenia
100
65.0
11.0
Azerbaijan
50
76.0
68.0
Brazil
7
100.0
100.0
China
114
64.4
57.0
Egypt
33
72.7
74.3
Georgia
42
97.6
41.0
Israel
54
75.9
94.0
Russia
21
100.0
90.9
Uganda
56
53.6
60.8
477
70.6
54.8
SITE
TOTAL
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

22. All Sites: Pre-Campaign Student Report: SDQ (N = 2,281)
Unlikely
Possible
Probable
88.8%
70.0%
73.9%
80.0%
83.2%
90.0%
93.1%
100.0%
60.0%
50.0%
9.0%
17.1%
3.3%
7.8%
3.7%
10.0%
4.9%
20.0%
3.3%
30.0%
13.6%
40.0%
0.0%
Hyperactivity
Conduct
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
Emotional
www.childepi.org/awareness
Any
awareness@childpsych.columbia.edu

23. All Sites: Pre-Campaign Mental Health Awareness
91.8%
99.6%
80.9%
74.1%
93.3%
Teacher
19.8%
28.4%
26.6%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Parent
90.6%
Student
Knows enough about
MH
Wants to know more MH Campaign is good
about MH
idea
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

24. Armenia: Pre-Campaign Mental Health Awareness
98.0%
98.0%
100.0%
100.0%
100.0%
37.0%
37.0%
Teacher
6.0%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Parent
91.0%
Student
Knows enough about
MH
Wants to know more MH Campaign is good
about MH
idea
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

25. Azerbaijan: Pre-Campaign Mental Health Awareness
77.5%
76.7%
72.2%
91.8%
80.9%
Teacher
21.7%
21.3%
30.7%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Parent
100.0%
Student
Knows enough about
MH
Wants to know more MH Campaign is good
about MH
idea
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

26. Brazil: Pre-Campaign Mental Health Awareness
100.0%
92.0%
100.0%
Teacher
Knows enough about
MH
N/A
N/A
68.1%
N/A
22.8%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Parent
100.0%
Student
Wants to know more MH Campaign is good
about MH
idea
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

27. China: Pre-Campaign Mental Health Awareness
Knows enough about
MH
79.4%
N/A
N/A
91.9%
Teacher
65.0%
20.7%
N/A
16.8%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Parent
91.9%
Student
Wants to know more MH Campaign is good
about MH
idea
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

28. Egypt: Pre-Campaign Mental Health Awareness
94.7%
93.2%
87.0%
75.9%
100.0%
Teacher
26.3%
23.1%
24.8%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Parent
91.2%
Student
Knows enough about
MH
Wants to know more MH Campaign is good
about MH
idea
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

29. Georgia: Pre-Campaign Mental Health Awareness
100.0%
98.0%
84.8%
80.4%
97.6%
Teacher
27.9%
42.0%
26.1%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Parent
98.0%
Student
Knows enough about
MH
Wants to know more MH Campaign is good
about MH
idea
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

30. Israel: Pre-Campaign Mental Health Awareness
90.7%
86.2%
57.7%
76.6%
91.4%
Teacher
1.8%
30.0%
26.6%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Parent
79.3%
Student
Knows enough about
MH
Wants to know more MH Campaign is good
about MH
idea
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

31. Russia: Pre-Campaign Mental Health Awareness
73.3%
67.3%
40.8%
67.2%
91.3%
Teacher
21.7%
28.6%
27.8%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Parent
80.4%
Student
Knows enough about
MH
Wants to know more MH Campaign is good
about MH
idea
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

32. Uganda: Pre-Campaign Mental Health Awareness
91.8%
93.1%
89.6%
93.3%
93.2%
Teacher
19.8%
25.7%
37.4%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Parent
87.8%
Student
Knows enough about
MH
Wants to know more MH Campaign is good
about MH
idea
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

33. Campaigns
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

34. 7
7
5
4
W
PA
3
3
1
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
1
1
th
er
3
O
3
Ra
di
o
Te
lev
isi
on
In
ter
ne
Ce
t
ll
ph
on
es
O
th
er
m
ed
ia
9
8
7
6
5
4
3
2
1
0
Po
ste
rs
O
th
br
er
oc
wr
hu
itt
re
Lo
s
en
ca
m
lm
at
ee
er
tin
ia
Ne
l
gs
ws
/ tr
pa
ai
ni
pe
ng
rs
/m
ag
az
in
es
Number of Sites
Awareness Campaign Methods
awareness@childpsych.columbia.edu

35. Post-Campaign
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

36. All Sites: Post-Campaign Mental Health Awareness
98.1%
90.1%
Teacher
40.7%
46.5%
14.1%
34.3%
24.8%
50.7%
72.0%
60.2%
70.1%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Parent
88.3%
Student
School campaign Knew enough
occurred in last about MH before
6 mo.
campaign
Now knows
enough about
MH
Campaign was
good idea*
*Only asked of those who knew of school MH campaign.
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

37. All Sites: Post-Campaign Student Report:
“Campaign Changed How Child Feels Talking To …”
Feels LESS comfortable
100.0%
Feels about the SAME
Feels MORE comfrotable
90.0%
80.0%
0.0%
Teachers/Counselors
Parents/Relatives
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
27.9%
16.2%
10.0%
15.9%
20.0%
25.6%
30.0%
29.2%
40.0%
13.4%
50.0%
54.6%
58.5%
60.0%
58.7%
70.0%
Friends
awareness@childpsych.columbia.edu

38. All Sites: Post-Campaign Parent Report:
“Campaign Changed How …”
Feels LESS comfortable
100.0%
Feels about the SAME
Feels MORE comfrotable
90.0%
80.0%
45.2%
50.0%
59.6%
60.2%
60.0%
0.0%
Parent Feels Talking to
Child
30.8%
8.7%
10.0%
10.7%
20.0%
9.6%
30.0%
29.1%
40.0%
Child Feels talking to
Someone
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
46.2%
70.0%
Parent Discussing Child's
Problems w/ Teachers
www.childepi.org/awareness
awareness@childpsych.columbia.edu

39. All Sites: Post-Campaign Teacher Report:
“Campaign Changed How …”
Feels LESS comfortable
100.0%
Feels about the SAME
Feels MORE comfrotable
90.0%
60.0%
68.2%
70.0%
75.2%
75.2%
80.0%
50.0%
0.0%
Teacher Fees Talking to Teacher Feels Talking to
Student
School Personnel
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
1.3%
20.9%
3.9%
10.0%
22.3%
20.0%
2.5%
30.0%
30.5%
40.0%
Teacher Discussing
Student's Problems w/
Child's Parent
awareness@childpsych.columbia.edu

40. All Sites: Post-Campaign Parent Report: “Campaign Increased
Understanding about MH Problems Among …”
No
Don't Know/No Opinion
Yes
100.0%
90.0%
80.0%
64.8%
70.0%
28.6%
6.7%
10.0%
34.1%
20.0%
8.8%
30.0%
11.0%
42.9%
40.0%
48.4%
50.0%
54.9%
60.0%
0.0%
Teachers
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
Students
www.childepi.org/awareness
Parents
awareness@childpsych.columbia.edu

41. All Sites: Post-Campaign Teacher Report: “Campaign
Increased Understanding about MH Problems Among …”
No
Don't Know/No Opinion
Yes
100.0%
90.0%
60.0%
59.9%
70.0%
70.0%
79.2%
80.0%
50.0%
40.0%
Teachers
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
Students
www.childepi.org/awareness
27.6%
12.5%
8.7%
0.0%
13.6%
10.0%
7.1%
20.0%
21.3%
30.0%
Parents
awareness@childpsych.columbia.edu

42. Azerbaijan: Post-Campaign Mental Health Awareness
100.0%
82.5%
53.3%
62.8%
17.1%
30.4%
31.9%
96.3%
Teacher
89.3%
Parent
100.0%
100.0%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
96.3%
Student
School campaign Knew enough
occurred in last about MH before
6 mo.
campaign
Now knows
enough about
MH
Campaign was
good idea*
*Only asked of those who knew of school MH campaign.
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

43. Azerbaijan: Post-Campaign Student Report:
“Campaign Changed How Child Feels Talking To …”
Feels LESS comfortable
100.0%
Feels about the SAME
Feels MORE comfortable
90.0%
80.0%
70.0%
Teachers/Counselors
Parents/Relatives
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
60.2%
10.0%
0.0%
13.1%
10.0%
13.3%
20.0%
30.0%
30.0%
28.8%
40.0%
29.7%
50.0%
56.9%
57.9%
60.0%
Friends
awareness@childpsych.columbia.edu

44. Azerbaijan: Post-Campaign Parent Report:
“Campaign Changed How …”
Feels LESS comfortable
100.0%
Feels about the SAME
Feels MORE comfrotable
90.0%
80.0%
50.0%
66.7%
60.0%
60.0%
70.4%
70.0%
Parent Feels Talking to
Child
Child Feels talking to
Someone
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
33.3%
0.0%
0.0%
22.2%
10.0%
12.0%
20.0%
7.4%
30.0%
28.0%
40.0%
Parent Discussing Child's
Problems w/ Teachers
www.childepi.org/awareness
awareness@childpsych.columbia.edu

45. Azerbaijan: Post-Campaign Teacher Report:
“Campaign Changed How …”
80.0%
97.1%
90.0%
Feels MORE comfrotable
100.0%
Feels about the SAME
94.4%
Feels LESS comfortable
100.0%
70.0%
60.0%
50.0%
40.0%
Teacher Fees Talking to Teacher Feels Talking to
Student
School Personnel
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
2.9%
0.0%
0.0%
0.0%
0.0%
10.0%
2.8%
20.0%
2.8%
30.0%
Teacher Discussing
Student's Problems w/
Child's Parent
awareness@childpsych.columbia.edu

46. Azerbaijan: Post-Campaign Parent Report: “Campaign
Increased Understanding about MH Problems Among …”
No
Don't Know/No Opinion
Yes
100.0%
90.0%
44.0%
50.0%
40.0%
0.0%
Teachers
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
0.0%
10.0%
0.0%
20.0%
8.0%
29.2%
30.0%
Students
www.childepi.org/awareness
20.0%
60.0%
48.0%
70.8%
70.0%
80.0%
80.0%
Parents
awareness@childpsych.columbia.edu

47. Azerbaijan: Post-Campaign Teacher Report: “Campaign
Increased Understanding about MH Problems Among …”
No
Don't Know/No Opinion
Yes
100.0%
80.0%
70.0%
75.7%
86.5%
89.2%
90.0%
60.0%
50.0%
40.0%
Teachers
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
Students
www.childepi.org/awareness
0.0%
10.8%
0.0%
0.0%
13.5%
10.0%
0.0%
20.0%
24.3%
30.0%
Parents
awareness@childpsych.columbia.edu

48. Brazil: Post-Campaign Mental Health Awareness
School campaign Knew enough
occurred in last about MH before
6 mo.
campaign
Now knows
enough about
MH
N/A
20.0%
N/A
N/A
N/A
18.8%
51.0%
91.9%
100.0%
Teacher
100.0%
Parent
100.0%
N/A
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
100.0%
Student
Campaign was
good idea*
*Only asked of those who knew of school MH campaign.
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

49. Brazil: Post-Campaign Student Report:
“Campaign Changed How Child Feels Talking To …”
Feels LESS comfortable
100.0%
Feels about the SAME
Feels MORE comfrotable
90.0%
80.0%
70.0%
10.0%
0.0%
9.0%
20.0%
Teachers/Counselors
Parents/Relatives
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
53.5%
38.4%
8.1%
30.0%
11.0%
34.0%
40.0%
49.0%
50.0%
40.0%
57.0%
60.0%
www.childepi.org/awareness
Friends
awareness@childpsych.columbia.edu

50. Brazil: Post-Campaign Teacher Report:
“Campaign Changed How …”
Feels LESS comfortable
100.0%
Feels about the SAME
Feels MORE comfrotable
90.0%
80.0%
80.0%
70.0%
60.0%
60.0%
50.0%
0.0%
Teacher Fees Talking to Teacher Feels Talking to
Student
School Personnel
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
40.0%
33.3%
33.3%
0.0%
10.0%
0.0%
20.0%
20.0%
30.0%
33.3%
40.0%
www.childepi.org/awareness
Teacher Discussing
Student's Problems w/
Child's Parent
awareness@childpsych.columbia.edu

51. Brazil: Post-Campaign Teacher Report: “Campaign Increased
Understanding about MH Problems Among …”
No
Don't Know/No Opinion
Yes
100.0%
90.0%
80.0%
80.0%
70.0%
50.0%
0.0%
Teachers
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
20.0%
20.0%
10.0%
0.0%
20.0%
20.0%
30.0%
20.0%
40.0%
40.0%
40.0%
60.0%
60.0%
Students
www.childepi.org/awareness
Parents
awareness@childpsych.columbia.edu

52. China: Post-Campaign Mental Health Awareness
95.5%
Teacher
School campaign Knew enough
occurred in last about MH before
6 mo.
campaign
Now knows
enough about
MH
N/A
24.3%
N/A
32.4%
12.2%
N/A
18.3%
57.4%
N/A
44.0%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Parent
83.6%
Student
Campaign was
good idea*
*Only asked of those who knew of school MH campaign.
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

53. China: Post-Campaign Student Report:
“Campaign Changed How Child Feels Talking To …”
Feels LESS comfortable
100.0%
Feels about the SAME
Feels MORE comfrotable
90.0%
80.0%
40.0%
Teachers/Counselors
33.2%
8.7%
0.0%
11.8%
10.0%
11.8%
20.0%
27.2%
30.0%
Parents/Relatives
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
27.5%
50.0%
55.0%
61.0%
60.0%
63.8%
70.0%
Friends
awareness@childpsych.columbia.edu

54. China: Post-Campaign Teacher Report:
“Campaign Changed How …”
Feels LESS comfortable
100.0%
Feels about the SAME
Feels MORE comfrotable
90.0%
80.0%
50.0%
61.5%
60.0%
67.7%
68.2%
70.0%
36.9%
1.5%
1.5%
10.0%
27.3%
20.0%
4.5%
30.0%
30.8%
40.0%
0.0%
Teacher Fees Talking to Teacher Feels Talking to
Student
School Personnel
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
Teacher Discussing
Student's Problems w/
Child's Parent
awareness@childpsych.columbia.edu

55. China: Post-Campaign Teacher Report: “Campaign Increased
Understanding about MH Problems Among …”
No
Don't Know/No Opinion
Yes
100.0%
90.0%
60.0%
50.0%
58.5%
70.0%
63.1%
76.9%
80.0%
40.0%
Teachers
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
Students
www.childepi.org/awareness
24.6%
16.9%
13.8%
0.0%
10.8%
10.0%
12.3%
20.0%
23.1%
30.0%
Parents
awareness@childpsych.columbia.edu

56. Egypt: Post-Campaign Mental Health Awareness
93.9%
35.1%
51.8%
48.1%
21.6%
31.3%
23.1%
46.7%
School campaign Knew enough
occurred in last about MH before
6 mo.
campaign
97.5%
Teacher
64.9%
75.2%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Parent
87.7%
Student
Now knows
enough about
MH
Campaign was
good idea*
*Only asked of those who knew of school MH campaign.
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

57. Egypt: Post-Campaign Student Report:
“Campaign Changed How Child Feels Talking To …”
Feels LESS comfortable
100.0%
Feels about the SAME
Feels MORE comfrotable
90.0%
80.0%
70.0%
0.0%
Parents/Relatives
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
43.9%
35.1%
20.9%
Teachers/Counselors
10.0%
16.9%
20.0%
14.8%
30.0%
35.6%
40.0%
37.2%
49.7%
50.0%
45.9%
60.0%
Friends
awareness@childpsych.columbia.edu

58. Egypt: Post-Campaign Parent Report:
“Campaign Changed How …”
Feels LESS comfortable
100.0%
Feels about the SAME
Feels MORE comfrotable
90.0%
80.0%
50.0%
61.7%
60.0%
57.0%
64.2%
70.0%
40.0%
Parent Feels Talking to
Child
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
23.5%
21.5%
Child Feels talking to
Someone
14.8%
0.0%
21.5%
10.0%
16.0%
20.0%
19.8%
30.0%
Parent Discussing Child's
Problems w/ Teachers
www.childepi.org/awareness
awareness@childpsych.columbia.edu

59. Egypt: Post-Campaign Teacher Report:
“Campaign Changed How …”
Feels LESS comfortable
100.0%
Feels about the SAME
Feels MORE comfrotable
90.0%
70.0%
58.1%
60.0%
64.5%
78.1%
80.0%
50.0%
40.0%
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
25.8%
25.8%
Teacher Fees Talking to Teacher Feels Talking to
Student
School Personnel
9.7%
0.0%
16.1%
10.0%
9.4%
20.0%
12.5%
30.0%
Teacher Discussing
Student's Problems w/
Child's Parent
awareness@childpsych.columbia.edu

60. Egypt: Post-Campaign Parent Report: “Campaign Increased
Understanding about MH Problems Among …”
No
Don't Know/No Opinion
Yes
100.0%
90.0%
80.0%
0.0%
9.9%
10.0%
3.7%
20.0%
Teachers
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
Students
www.childepi.org/awareness
25.0%
30.0%
11.3%
39.5%
40.0%
23.5%
50.0%
50.6%
60.0%
63.8%
72.8%
70.0%
Parents
awareness@childpsych.columbia.edu

61. Egypt: Post-Campaign Teacher Report: “Campaign Increased
Understanding about MH Problems Among …”
No
Don't Know/No Opinion
Yes
100.0%
90.0%
80.0%
67.7%
70.0%
0.0%
Teachers
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
Students
www.childepi.org/awareness
25.8%
16.1%
10.0%
16.1%
20.0%
19.4%
30.0%
32.3%
40.0%
45.2%
48.4%
50.0%
29.0%
60.0%
Parents
awareness@childpsych.columbia.edu

62. Georgia: Post-Campaign Mental Health Awareness
100.0%
48.5%
51.7%
47.9%
18.8%
32.3%
27.4%
93.1%
Teacher
89.7%
Parent
84.8%
85.7%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
79.6%
Student
School campaign Knew enough
occurred in last about MH before
6 mo.
campaign
Now knows
enough about
MH
Campaign was
good idea*
*Only asked of those who knew of school MH campaign.
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

63. Georgia: Post-Campaign Student Report:
“Campaign Changed How Child Feels Talking To …”
Feels LESS comfortable
100.0%
Feels about the SAME
Feels MORE comfrotable
90.0%
80.0%
0.0%
Teachers/Counselors
Parents/Relatives
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
26.8%
17.9%
10.0%
16.7%
20.0%
20.9%
30.0%
28.6%
40.0%
12.3%
50.0%
53.4%
62.4%
60.0%
60.9%
70.0%
Friends
awareness@childpsych.columbia.edu

64. Georgia: Post-Campaign Parent Report:
“Campaign Changed How …”
Feels about the SAME
85.7%
90.0%
80.0%
68.2%
70.0%
Feels MORE comfrotable
95.0%
Feels LESS comfortable
100.0%
60.0%
50.0%
0.0%
Parent Feels Talking to
Child
Child Feels talking to
Someone
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
22.7%
9.1%
5.0%
10.0%
0.0%
20.0%
0.0%
30.0%
14.3%
40.0%
Parent Discussing Child's
Problems w/ Teachers
www.childepi.org/awareness
awareness@childpsych.columbia.edu

65. Georgia: Post-Campaign Teacher Report:
“Campaign Changed How …”
Feels LESS comfortable
100.0%
Feels about the SAME
Feels MORE comfrotable
90.0%
80.0%
44.4%
50.0%
0.0%
Teacher Fees Talking to Teacher Feels Talking to
Student
School Personnel
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
3.7%
18.5%
10.0%
0.0%
20.0%
27.6%
30.0%
11.1%
40.0%
51.9%
60.0%
70.4%
72.4%
70.0%
Teacher Discussing
Student's Problems w/
Child's Parent
awareness@childpsych.columbia.edu

66. Georgia: Post-Campaign Parent Report: “Campaign Increased
Understanding about MH Problems Among …”
No
Don't Know/No Opinion
Yes
100.0%
70.0%
86.4%
80.0%
80.0%
85.0%
90.0%
60.0%
50.0%
40.0%
Teachers
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
Students
www.childepi.org/awareness
13.6%
0.0%
0.0%
0.0%
15.0%
10.0%
0.0%
20.0%
20.0%
30.0%
Parents
awareness@childpsych.columbia.edu

67. Georgia: Post-Campaign Teacher Report: “Campaign
Increased Understanding about MH Problems Among …”
No
Don't Know/No Opinion
Yes
100.0%
90.0%
80.0%
4.5%
10.0%
20.0%
20.0%
8.0%
30.0%
8.7%
40.9%
40.0%
43.5%
50.0%
47.8%
60.0%
54.5%
72.0%
70.0%
0.0%
Teachers
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
Students
www.childepi.org/awareness
Parents
awareness@childpsych.columbia.edu

68. Russia: Post-Campaign Mental Health Awareness
72.9%
86.7%
100.0%
Teacher
13.3%
39.7%
50.8%
13.3%
36.4%
25.6%
46.8%
70.4%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Parent
88.6%
Student
School campaign Knew enough
occurred in last about MH before
6 mo.
campaign
Now knows
enough about
MH
Campaign was
good idea*
*Only asked of those who knew of school MH campaign.
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

69. Russia: Post-Campaign Student Report:
“Campaign Changed How Child Feels Talking To …”
Feels LESS comfortable
100.0%
Feels about the SAME
Feels MORE comfrotable
90.0%
80.0%
70.0%
10.0%
47.6%
45.2%
43.0%
7.1%
20.0%
4.7%
30.0%
10.5%
40.0%
43.0%
52.3%
50.0%
46.5%
60.0%
0.0%
Teachers/Counselors
Parents/Relatives
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
Friends
awareness@childpsych.columbia.edu

70. Russia: Post-Campaign Parent Report:
“Campaign Changed How …”
Feels LESS comfortable
100.0%
Feels about the SAME
Feels MORE comfrotable
90.0%
78.4%
80.0%
70.0%
0.0%
Parent Feels Talking to
Child
Child Feels talking to
Someone
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
16.2%
5.4%
10.0%
37.8%
20.0%
5.4%
30.0%
8.1%
40.0%
43.2%
51.4%
50.0%
54.1%
60.0%
Parent Discussing Child's
Problems w/ Teachers
www.childepi.org/awareness
awareness@childpsych.columbia.edu

71. Russia: Post-Campaign Teacher Report:
“Campaign Changed How …”
Feels LESS comfortable
100.0%
Feels about the SAME
Feels MORE comfrotable
90.0%
80.0%
10.0%
0.0%
0.0%
Teacher Fees Talking to Teacher Feels Talking to
Student
School Personnel
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
33.3%
20.0%
0.0%
30.0%
8.3%
41.7%
40.0%
41.7%
50.0%
50.0%
58.3%
60.0%
66.7%
70.0%
www.childepi.org/awareness
Teacher Discussing
Student's Problems w/
Child's Parent
awareness@childpsych.columbia.edu

72. Russia: Post-Campaign Parent Report: “Campaign Increased
Understanding about MH Problems Among …”
No
Don't Know/No Opinion
Yes
100.0%
90.0%
80.0%
70.0%
0.0%
Teachers
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
41.0%
12.8%
19.4%
10.0%
26.7%
20.0%
20.0%
30.0%
45.2%
40.0%
35.5%
53.3%
50.0%
46.2%
60.0%
Students
www.childepi.org/awareness
Parents
awareness@childpsych.columbia.edu

73. Russia: Post-Campaign Teacher Report: “Campaign Increased
Understanding about MH Problems Among …”
No
Don't Know/No Opinion
Yes
100.0%
90.0%
80.0%
50.0%
50.0%
60.0%
58.3%
66.7%
70.0%
40.0%
0.0%
Teachers
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
Students
www.childepi.org/awareness
25.0%
25.0%
25.0%
16.7%
10.0%
8.3%
20.0%
25.0%
30.0%
Parents
awareness@childpsych.columbia.edu

74. Uganda: Post-Campaign Mental Health Awareness
80.0%
47.6%
66.7%
69.5%
100.0%
Teacher
15.8%
35.5%
26.6%
34.9%
55.0%
63.8%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Parent
94.4%
Student
School campaign Knew enough
occurred in last about MH before
6 mo.
campaign
Now knows
enough about
MH
Campaign was
good idea*
*Only asked of those who knew of school MH campaign.
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

75. Uganda: Post-Campaign Student Report:
“Campaign Changed How Child Feels Talking To …”
Feels LESS comfortable
100.0%
Feels about the SAME
Feels MORE comfrotable
90.0%
80.0%
50.0%
55.2%
58.8%
60.0%
59.8%
70.0%
Teachers/Counselors
Parents/Relatives
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
29.6%
15.3%
0.0%
12.4%
10.0%
27.8%
20.0%
8.6%
30.0%
32.6%
40.0%
Friends
awareness@childpsych.columbia.edu

76. Uganda: Post-Campaign Parent Report:
“Campaign Changed How …”
Feels LESS comfortable
100.0%
Feels about the SAME
Feels MORE comfrotable
90.0%
80.0%
50.0%
52.4%
60.0%
50.0%
65.0%
70.0%
40.0%
0.0%
Parent Feels Talking to
Child
Child Feels talking to
Someone
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
23.8%
23.8%
25.0%
25.0%
10.0%
15.0%
20.0%
20.0%
30.0%
Parent Discussing Child's
Problems w/ Teachers
www.childepi.org/awareness
awareness@childpsych.columbia.edu

77. Uganda: Post-Campaign Teacher Report:
“Campaign Changed How …”
80.0%
100.0%
90.0%
Feels MORE comfrotable
100.0%
Feels about the SAME
100.0%
Feels LESS comfortable
100.0%
70.0%
60.0%
50.0%
40.0%
30.0%
Teacher Fees Talking to Teacher Feels Talking to
Student
School Personnel
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
10.0%
0.0%
20.0%
Teacher Discussing
Student's Problems w/
Child's Parent
awareness@childpsych.columbia.edu

78. Uganda: Post-Campaign Parent Report: “Campaign Increased
Understanding about MH Problems Among …”
No
Don't Know/No Opinion
Yes
100.0%
90.0%
80.0%
60.0%
68.4%
70.6%
70.0%
40.0%
13.3%
0.0%
17.6%
10.0%
11.8%
20.0%
Teachers
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
10.5%
33.3%
30.0%
Students
www.childepi.org/awareness
21.1%
53.3%
50.0%
Parents
awareness@childpsych.columbia.edu

79. Uganda: Post-Campaign Teacher Report: “Campaign
Increased Understanding about MH Problems Among …”
Don't Know/No Opinion
100.0%
100.0%
90.0%
80.0%
80.0%
Yes
100.0%
No
70.0%
60.0%
50.0%
40.0%
30.0%
Teachers
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
Students
www.childepi.org/awareness
10.0%
10.0%
0.0%
0.0%
0.0%
0.0%
10.0%
0.0%
20.0%
Parents
awareness@childpsych.columbia.edu

80. Principle Investigator
Questionnaires
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

81. Campaign: Ease of Administration
Easy
Somewhat Easy
Somewhat Difficult
Difficult
7
6
6
Sites
5
4
5
4 4
4
3
3
2
1
0
3 3
2
1
0
Translations
2
0
IRB
3
2
0
Communication w/
Columbia
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
2
0
Procedures Manual
www.childepi.org/awareness
0 0
Awareness Manual
awareness@childpsych.columbia.edu

82. Website
Somewhat Useful
Yes
Not Useful
Easy to Use?
Useful
3
No
1
8
6
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
Informative?
Yes
www.childepi.org/awareness
No
0
7
awareness@childpsych.columbia.edu

83. Sufficient Funding?
Sufficient
Not Funded
Not Sufficient
2
5
2
Major Delays?
Adequacy of Funds and Reasons for Delays
Yes
No
2
7
Main Reason Given for
Delays:
• Funding (4 sites)
• IRB (2 sites)
• Translations/
Questionnaires (2 sites)
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

84. Data Entry: Ease and Clarity
Easy
Somewhat Easy
Somewhat Difficult
Difficult
4
Sites
3
2
Instructions Clear?
5
4
3
3
2
2
1
3
0
7
1
0
Data Entry
No
2
1
0
Yes
Data Submission
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
0
0
CSPro Application
www.childepi.org/awareness
awareness@childpsych.columbia.edu

85. Neutral
Mixed
1
1
7
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
Opinion Change?
Liked it
Yes
Opinion Improve?
Local Community Opinion
Yes
www.childepi.org/awareness
No
1
7
No
1
5
awareness@childpsych.columbia.edu

86. Intentions to Conduct More Campaigns
Yes
Depends on Funds
Local/National?
1
Local
National
8
7
6
Sites
5
7
4
7
5
3
2
1
0
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

87. Recommendations
• Revise Awareness Manual according to
feedback.
• Conduct large-scale, more rigorous
study, with controls.
• Generate paper and web-based final
Awareness Manual in multiple
languages.
• Make materials available worldwide.
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

88. Current Study’s Limitations
• Due to time constraints, this project may have been negatively
affected by not having sufficient time for adequate Awareness
Campaign.
• Although translations were requested to be done both forward
and backward, this did not always happen.
• Translations may not always have been done by individuals who
were equally conversant with mental health terminology and
English.
• For the SDQ, the original algorithm includes parent and teacher
questionnaire items in the criteria of hyperactivity disorder.
Since the parent and teacher questionnaires did not include the
SDQ, these items were excluded from the scoring algorithm and
only student items were used (allowed by the SDQ published
algorithm).
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu

89. Current Study’s Limitations (Continued)
• Due to time requirements for seeking and
obtaining a higher level of Institutional Review
Board (Ethics Committee) approval,
questionnaires were necessarily anonymous and
consequently the follow-up assessments were not
necessarily with all the same individuals who
participated at baseline.
• For a variety of reasons, including distance,
language differences, literacy, etc., not all parents
were able to participate.
• For a variety of reasons, some sites were not able
to recruit the proposed sample size.
Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI
www.childepi.org/awareness
awareness@childpsych.columbia.edu