Sustaining and Scaling Online Support and Intervention (OSI) for child anxiety problems in diverse international settings

Online Support and Intervention (OSI) is a brief therapist-guided, parent-led online Cognitive Behaviour Therapy platform for treating anxiety problems in children aged 5-12 years. OSI was codesigned with children, parents/carers, and clinicians in England, has proven clinical and cost-effectiveness in the UK, and is now being implemented in English child mental health services by Koa Health. Using OSI reduces therapist time required which, coupled with excellent outcomes achieved by non-expert practitioners, underscores the potential to scale this approach in diverse settings. This collaboration between researchers, commercial partners, lived experience experts, and key stakeholders from the UK, Japan, Chile, Pakistan, the Philippines, and Thailand aims to work across countries to maximise the intervention's applicability to diverse contexts, ultimately increasing its global reach while ensuring cultural relevance, stakeholder engagement, and rigorous evaluation across settings. We will:1. Adapt OSI for new settings and populations.2. Refine identification and assessment procedures for varied contexts.3. Test the feasibility of adapted procedures.4. Evaluate real-world clinical and cost-effectiveness5. Conduct pooled data analyses to maximise insights. 6. Establish the conditions for rapid at-scale implementation.7. Promote collaboration and shared learning, lived experience and wider stakeholder involvement, and research capacity building throughout.