Identifying pathways for large-scale implementation of a school-based mental health programme in the Eastern Mediterranean Region: a theory-driven approach.
Identifying pathways for large-scale implementation of a school-based mental health programme in the Eastern Mediterranean Region: a theory-driven approach.
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DOI：
10.1093/heapol/czaa124
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发表时间：
2020-11-01
影响因子：
3.2
通讯作者：
Rahman A
中科院分区：
文献类型：
--
作者：
Alonge O;Chiumento A;Hamoda HM;Gaber E;Huma ZE;Abbasinejad M;Hosny W;Shakiba A;Minhas A;Saeed K;Wissow L;Rahman A
在全球范围内，儿童和青少年的心理健康问题负担沉重。向非专业人员（如学校教师）提供任务转移/任务分担精神卫生服务，为中低收入国家大规模实施精神卫生干预措施提供了独特的机会。在中低收入国家，指导大规模实施校本心理健康方案的信息很少。本文描述了东地中海地区（EMR）大规模实施学校心理健康规划（SMHP）的途径。建立了一个协作学习小组（CLG），由参与实施SMHP的利益相关者组成，包括来自电子病历国家的决策者、项目管理人员和研究人员。本研究的参与者运用变化理论（ToC）方法，确定了通过实施SMHP改善公立学校学龄儿童心理健康结果的前提条件、假设和假设途径。随后，在2017年1月至2019年9月期间举行的多个区域和国家ToC研讨会上，拟议的途径得到了验证，同时在埃及、巴基斯坦和伊朗这三个EMR国家推出了SMHP。适用于这三个国家的先决条件、战略和方案/环境调整是从方案执行过程的定性叙述摘要中提取的，并促进了每两年一次的CLG会议上的讨论。在EMR中大规模实施SMHP的ToC表明，确定国家冠军，制定专门的跨部门（包括卫生和教育部门）实施团队，持续的政策宣传和利益相关者在多个层面的参与，以及教育和卫生系统之间的有效协调，特别是在地方一级，是大规模实施计划的关键因素之一。本文所描述的途径有助于有效地大规模实施SMHP，并为评估EMR和其他中低收入国家的SMHP和类似计划提供了一个基于理论的框架。
Globally there is a substantial burden of mental health problems among children and adolescents. Task-shifting/task-sharing mental health services to non-specialists, e.g. teachers in school settings, provide a unique opportunity for the implementation of mental health interventions at scale in low- and middle-income countries (LMICs). There is scant information to guide the large-scale implementation of school-based mental health programme in LMICs. This article describes pathways for large-scale implementation of a School Mental Health Program (SMHP) in the Eastern Mediterranean Region (EMR). A collaborative learning group (CLG) comprising stakeholders involved in implementing the SMHP including policymakers, programme managers and researchers from EMR countries was established. Participants in the CLG applied the theory of change (ToC) methodology to identify sets of preconditions, assumptions and hypothesized pathways for improving the mental health outcomes of school-aged children in public schools through implementation of the SMHP. The proposed pathways were then validated through multiple regional and national ToC workshops held between January 2017 and September 2019, as the SMHP was being rolled out in three EMR countries: Egypt, Pakistan and Iran. Preconditions, strategies and programmatic/contextual adaptations that apply across these three countries were drawn from qualitative narrative summaries of programme implementation processes and facilitated discussions during biannual CLG meetings. The ToC for large-scale implementation of the SMHP in the EMR suggests that identifying national champions, formulating dedicated cross-sectoral (including the health and education sector) implementation teams, sustained policy advocacy and stakeholders engagement across multiple levels, and effective co-ordination among education and health systems especially at the local level are among the critical factors for large-scale programme implementation. The pathways described in this paper are useful for facilitating effective implementation of the SMHP at scale and provide a theory-based framework for evaluating the SMHP and similar programmes in the EMR and other LMICs.
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DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
3.7
作者：
Charara R;Forouzanfar M;Naghavi M;Moradi-Lakeh M;Afshin A;Vos T;Daoud F;Wang H;El Bcheraoui C;Khalil I;Hamadeh RR;Khosravi A;Rahimi-Movaghar V;Khader Y;Al-Hamad N;Makhlouf Obermeyer C;Rafay A;Asghar R;Rana SM;Shaheen A;Abu-Rmeileh NM;Husseini A;Abu-Raddad LJ;Khoja T;Al Rayess ZA;AlBuhairan FS;Hsairi M;Alomari MA;Ali R;Roshandel G;Terkawi AS;Hamidi S;Refaat AH;Westerman R;Kiadaliri AA;Akanda AS;Ali SD;Bacha U;Badawi A;Bazargan-Hejazi S;Faghmous IA;Fereshtehnejad SM;Fischer F;Jonas JB;Kuate Defo B;Mehari A;Omer SB;Pourmalek F;Uthman OA;Mokdad AA;Maalouf FT;Abd-Allah F;Akseer N;Arya D;Borschmann R;Brazinova A;Brugha TS;Catalá-López F;Degenhardt L;Ferrari A;Haro JM;Horino M;Hornberger JC;Huang H;Kieling C;Kim D;Kim Y;Knudsen AK;Mitchell PB;Patton G;Sagar R;Satpathy M;Savuon K;Seedat S;Shiue I;Skogen JC;Stein DJ;Tabb KM;Whiteford HA;Yip P;Yonemoto N;Murray CJ;Mokdad AH
通讯作者：
Mokdad AH
影响因子：
64.8
作者：
Collins, Pamela Y.;Patel, Vikram;Joestl, Sarah S.;March, Dana;Insel, Thomas R.;Daar, Abdallah S.
通讯作者：
Daar, Abdallah S.
影响因子：
3.6
作者：
Chibanda D;Verhey R;Munetsi E;Cowan FM;Lund C
通讯作者：
Lund C
DOI：
10.1016/j.jaac.2015.07.005
发表时间：
2015-10-01
影响因子：
13.3
作者：
Guzman, Javier;Kessler, Ronald C.;Murphy, J. Michael
通讯作者：
Murphy, J. Michael