{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T14:15:23Z","timestamp":1781878523136,"version":"3.54.5"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Russia\u2019s full-scale invasion of Ukraine has deepened the strain on an already fragile mental health system, long shaped by Soviet institutionalized psychiatry. In response, Ukraine has started a national reform to modernize mental health services by shifting from an institutional to a community-based mental health care model. Implementation of his transition is supported by the international technical project Mental Health for Ukraine (MH4U).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To generate evidence-based evaluation of the community-based mental health centers as a basis for continued improvement and to guide national scale-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We will conduct a mixed-methods evaluation guided by the RE-AIM framework. First, quantitative data will be collected through (a) questionnaires administered to patient\u2019s prospective longitudinal cohort at baseline, three, and six months, (b) questionnaires from providers at the baseline and in the follow-up, and (c) administrative records. Second, qualitative data will be gathered through (a) interviews with subsample of participating patients and all the providers, and (b) focus groups with community stakeholders for each oblast (administrative region). Analyses will follow the RE-AIM framework. Adhering to a learning health systems (LHS) framework, we established continuous feedback loops and workshops to communicate study findings to MH4U implementers and stakeholders in Ukraine and Switzerland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Evaluation will provide unique evidence on not only whether the community-based Mental Health Center model works, but also how and why it works in real-world conditions. Findings will also inform national policy on mental health reform and offer lessons for global mental health systems operating under crisis conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.isrctn.com\/ISRCTN61471084<\/jats:ext-link>\n                      , ISRCTN61471084.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1740963","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T15:47:57Z","timestamp":1775058477000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Community-based mental health centers in Ukraine \u2014 protocol for a mixed methods evaluation study using the RE-AIM framework"],"prefix":"10.3389","volume":"14","author":[{"given":"Maha Eid","family":"Madkour","sequence":"first","affiliation":[{"name":"Epidemiology, Biostatistics and Prevention Institute, University of Zurich","place":["Zurich, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann-Kathrin","family":"Schwientek","sequence":"additional","affiliation":[{"name":"Epidemiology, Biostatistics and Prevention Institute, University of Zurich","place":["Zurich, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktoriia","family":"Yasenok","sequence":"additional","affiliation":[{"name":"Epidemiology, Biostatistics and Prevention Institute, University of Zurich","place":["Zurich, Switzerland"]},{"name":"Population Research Center, University of Zurich","place":["Zurich, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Frei","sequence":"additional","affiliation":[{"name":"Epidemiology, Biostatistics and Prevention Institute, University of Zurich","place":["Zurich, Switzerland"]},{"name":"Population Research Center, University of Zurich","place":["Zurich, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Kaufmann","sequence":"additional","affiliation":[{"name":"Epidemiology, Biostatistics and Prevention Institute, University of Zurich","place":["Zurich, Switzerland"]},{"name":"Population Research Center, University of Zurich","place":["Zurich, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktoriia","family":"Petrashenko","sequence":"additional","affiliation":[{"name":"Sumy State University","place":["Sumy, Ukraine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miquel","family":"Serra Burriel","sequence":"additional","affiliation":[{"name":"Epidemiology, Biostatistics and Prevention Institute, University of Zurich","place":["Zurich, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svitlana","family":"Piven","sequence":"additional","affiliation":[{"name":"Sumy State University","place":["Sumy, Ukraine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Kolyada","sequence":"additional","affiliation":[{"name":"Sumy State University","place":["Sumy, Ukraine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erich","family":"Seifritz","sequence":"additional","affiliation":[{"name":"Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich","place":["Zurich, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariya","family":"Bachmaha","sequence":"additional","affiliation":[{"name":"Mental Health for Ukraine Project (MH4U)","place":["Lviv, Ukraine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orest","family":"Suvalo","sequence":"additional","affiliation":[{"name":"Institute of Mental Health, Ukrainian Catholic University","place":["Lviv, Ukraine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktor Von","family":"Wyl","sequence":"additional","affiliation":[{"name":"Epidemiology, Biostatistics and Prevention Institute, University of Zurich","place":["Zurich, Switzerland"]},{"name":"Population Research Center, University of Zurich","place":["Zurich, Switzerland"]},{"name":"Institute for Implementation Science in Health Care, University of Zurich","place":["Zurich, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milo A.","family":"Puhan","sequence":"additional","affiliation":[{"name":"Epidemiology, Biostatistics and Prevention Institute, University of Zurich","place":["Zurich, Switzerland"]},{"name":"Population Research Center, University of 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study protocol of the MAP research program in Ukraine (MAP-U) and in Zurich (MAP-Z)","volume":"69","author":"Yasenok","year":"2024","journal-title":"Int J Public Health"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"e019557","DOI":"10.1136\/bmjgh-2025-019557","article-title":"Mental health burden of persons living in Ukraine and Ukrainians displaced to Switzerland: the mental health assessment of the Ukrainian population (MAP) studies","volume":"10","author":"Yasenok","year":"2025","journal-title":"BMJ Glob Health"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed 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Method","author":"Gubrium","year":"2002"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"e49","DOI":"10.1017\/gmh.2025.40","article-title":"Mental health stigma in Ukraine over time: a cross-sectional study","volume":"12","author":"Gaschet","year":"2025","journal-title":"Cambridge Prisms: Global Mental Health"},{"key":"ref32","first-page":"1164","article-title":"Barriers to improvement of mental health services in low-income and middle-income countries","volume-title":"Lancet","author":"Saraceno","year":"2007"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1016\/S0140-6736(07)61263-X","article-title":"Mental health care utilisation among internally displaced persons in Ukraine: results from a nation-wide survey","volume":"28","author":"Roberts","year":"2017","journal-title":"Epidemiol Psychiatr Sci"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"25","DOI":"10.24869\/psyd.2024.25","article-title":"Trauma reenactment and war-associated factors in war-affected population in Bosnia and Herzegovina: cross-sectional study on the impact of war in Ukraine on mental health","volume":"36","author":"Begagi\u0107","year":"2024","journal-title":"Psychiatr Danub"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1037\/cps0000111","article-title":"The posttraumatic stress disorder (PTSD) checklist for DSM\u20135: a systematic review of existing psychometric evidence","volume":"30","author":"Forkus","year":"2023","journal-title":"Clin Psychol Sci Pract"},{"key":"ref36","article-title":"The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms","year":"2002"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch Intern Med"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1111\/j.1360-0443.1993.tb02093.x","article-title":"Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption--II","volume":"88","author":"Saunders","year":"1993","journal-title":"Addiction"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"1727","DOI":"10.1007\/s11136-011-9903-x","article-title":"Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)","volume":"20","author":"Herdman","year":"2011","journal-title":"Qual Life Res"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1186\/1471-2458-11-487","article-title":"Warwick-Edinburgh mental well-being scale (WEMWBS): validated for teenage school students in England and Scotland. A mixed methods assessment","volume":"11","author":"Clarke","year":"2011","journal-title":"BMC Public Health"},{"key":"ref41","article-title":"Working Alliance Inventory-Short Revised (WAI-SR): Psychometric Properties in Outpatients and Inpatients","year":"2009"},{"key":"ref42","article-title":"Team Development Measure (TDM)","year":"2016"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.psychres.2012.09.028","article-title":"Mental illness: clinicians\u2019 attitudes (MICA) scale-psychometric properties of a version for healthcare students and professionals","volume":"206","author":"Gabbidon","year":"2013","journal-title":"Psychiatry Res"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1016\/j.shaw.2019.10.002","article-title":"The third version of the Copenhagen psychosocial questionnaire","volume":"10","author":"Burr","year":"2019","journal-title":"Saf Health Work"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"9495","DOI":"10.3390\/ijerph17249495","article-title":"Burnout assessment tool (BAT)\u2014development, validity, and reliability","volume":"17","author":"Schaufeli","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1186\/s13033-020-00397-0","article-title":"Using the GHQ-12 to screen for mental health problems among primary care patients: psychometrics and practical considerations","volume":"14","author":"Anjara","year":"2020","journal-title":"Int J Ment Health Syst"},{"key":"ref47","first-page":"31","volume-title":"The Social Psychology of Health Claremont Symposium on Applied Social Psychology","author":"Cohen","year":"1988"},{"key":"ref48","article-title":"Perceived Stress Scale","year":""},{"key":"ref49","article-title":"Organizational Readiness for Implementing Change (ORIC) \u2013 Dissemination Implementation","year":""}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1740963\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T15:47:58Z","timestamp":1775058478000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1740963\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,27]]},"references-count":49,"alternative-id":["10.3389\/fpubh.2026.1740963"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1740963","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,27]]},"article-number":"1740963"}}