Scaling up PRIDE Mozambique - Scaling up Partnerships in Research to Implement and Disseminate Sustainable and Scalable Evidence Based Practices in Mozambique

扩大 PRIDE 莫桑比克 - 扩大研究合作伙伴关系，在莫桑比克实施和传播可持续和可扩展的循证实践

• 批准号: 10158541
• 负责人: MILTON L WAINBERG
• 金额: $ 30.98万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10158541
• 关键词: Adoption; Africa South of the Sahara; Botswana; Brazil; Caring; Characteristics; Client satisfaction; Clinic; Communities; Community Health Aides; Complement; Country; Data; Development; Diagnostic; Disease; Educational workshop; Effectiveness; Epilepsy; Evaluation; Evidence based practice; Faculty; Foundations; Funding; Future; Geography; Government; Guidelines; Health; Health Policy; Health Professional; Health education; Healthcare; Human Resources; Individual; Institutes; Institution; Knowledge; Malawi; Mediator of activation protein; Medicine; Mental Health; Mental Health Services; Mental Tests; Mental disorders; Mentorship; Methods; Modeling; Monitor; Mozambique; National Institute of Mental Health; Nurses; Outcome; Pathway interactions; Patient-Focused Outcomes; Patients; Pennsylvania; Policies; Policy Maker; Population; Prevention; Process; Program Sustainability; Province; Psychopharmacology; Randomized; Research; Research Personnel; Role; Rural; Sampling; Seeds; Self Efficacy; Services; South Africa; Specialist; Substance Use Disorder; Supervision; System; Testing; Time; Training; Universities; Work; Zambia; arm; base; care providers; care systems; community clinic; cost; cost effective; cost effectiveness; design; disability; dissemination research; education research; effectiveness implementation study; efficacious treatment; experience; hands on research; health literacy; health plan; health service use; implementation framework; implementation outcomes; implementation research; implementation tool; improved; innovation; interpersonal therapy; low and middle-income countries; medical specialties; member; next generation; peri-urban; preservation; programs; rural area; scale up; screening; service providers; success; tool; treatment as usual; treatment research

Global mental health (MH) treatment and research gaps require that efficacious treatments be scaled-up, leveraging existing platforms. In tandem, policies must sustain them over time. PRIDE SSA may generate templates for other LMICs by conducting a state of the art scale up study in Mozambique and by establishing a collaborative research network of nascent research “Seed Teams.” Such “Seed Teams,” trained by the capacity building component, may work across the region to build capacity and conduct implementation research to sustainably scale-up MH services. Scale Up Research (Mozambique) in MH and substance use disorders will evaluate strategies and costs of scaling up an innovative, integrated, sustainable, stepped-care community approach. We will leverage: (1) Mozambique's task-shifting strategy of training psychiatric technicians (PsyTs) to provide MH care, (2) the WHO-funded epilepsy community care program successfully implemented in 5 Provinces, now primed for scale-up by the Health Ministry. Our cost-effective approach redefines work roles without requiring new human resources. Importantly, it comports with the Health Ministry's plan to implement prevention and treatment for all MH conditions, rather than single disorders. The model employs EBPs (e.g. Psychopharmacology; Interpersonal Therapy), already in use by PsyTs to: a) establish a sustainable program delivered and supervised by non-MH professionals, overseen by MH specialists; b) provide community screening, care and/or referrals for all MH disorders; and c) use implementation tools to monitor sustainability. This collaborative network will scale-up a cost-effective, sustainable program and inform policy. Capacity Building Regional Partnerships will leverage well-established capacity building institutions (Foundation for Professional Development; U of Cambridge; U of Pretoria; Mozambique's Institute of Health Education and Research) and our Mozambique Fogarty/NIMH MH Implementation Program (partnership: Mozambique [Ministry of Health; U Eduardo Mondlane]; US [Columbia; U of Pennsylvania]; and Brazil [U Federal do São Paulo]) to train service providers, investigators and policy-makers from Botswana, Malawi, Mozambique, South Africa, Zambia. Each country will contribute `seed teams' committed to working together, that include all actors needed to develop, test, implement and sustain community based MH services using EBPs: 1) new researchers to conduct MH implementation and dissemination research; 2) policy makers to leverage evidence generated by local research to improve and test MH policies and programs; 3) trainer-of- trainers to prepare staff to deliver adapted EBPs that preserve fidelity; and 4) senior-level faculty to develop university programs to prepare the next generation of investigators. Training comprises synergistic didactics, hands-on research experience designed in partnership local stakeholders, and mentorship from local or US senior investigators. Lessons learned in the scale up research will be adapted for research in partner countries and other LMICs.

全球心理健康（MH）治疗和研究差距要求扩大有效的治疗， 利用现有平台。与此同时，政策必须长期维持它们。骄傲 SSA 可能会产生 通过在莫桑比克进行最先进的扩大研究并建立一个 新兴研究“种子团队”的协作研究网络。这样的“种子队”，由 能力建设部分，可在整个地区开展能力建设和实施工作 研究可持续扩大 MH 服务。扩大 MH 和物质使用研究规模（莫桑比克） 疾病将评估扩大创新、综合、可持续、阶梯式护理的策略和成本 社区方法。我们将利用：(1) 莫桑比克的精神病学培训任务转移战略 技术人员 (PsyT) 提供 MH 护理，(2) 世卫组织成功资助的癫痫社区护理计划 已在 5 个省实施，目前卫生部正准备扩大规模。我们具有成本效益的方法 重新定义工作角色，而不需要新的人力资源。重要的是，它符合卫生部的规定 计划对所有 MH 疾病而非单一疾病实施预防和治疗。型号 采用已被 PsyT 使用的 EBP（例如精神药理学；人际关系治疗）来： 由非 MH 专业人员实施和监督的可持续计划，并由 MH 专家监督； b) 为所有 MH 疾病提供社区筛查、护理和/或转诊； c) 使用实施工具 监控可持续性。该合作网络将扩大一项具有成本效益、可持续的计划，并提供信息 政策。能力建设区域伙伴关系将利用完善的能力建设机构 （专业发展基金会；剑桥大学；比勒陀利亚大学；莫桑比克健康研究所 教育和研究）以及我们的莫桑比克 Fogarty/NIMH MH 实施计划（合作伙伴： 莫桑比克[卫生部； U·爱德华多·蒙德拉内]；美国[哥伦比亚；宾夕法尼亚大学]；和巴西[U 圣保罗联邦]）培训来自博茨瓦纳、马拉维、 莫桑比克、南非、赞比亚。每个国家都将派遣致力于共同努力的“种子团队”， 包括开发、测试、实施和维持基于社区的 MH 服务所需的所有参与者 EBP：1）新的研究人员进行 MH 实施和传播研究； 2）政策制定者 利用当地研究产生的证据来改进和测试 MH 政策和计划； 3) 培训师- 培训师帮助员工做好准备，提供经过调整的 EBP，以保持保真度； 4）培养高级教师 为下一代研究人员做好准备的大学计划。培训包括协同教学法， 与当地利益相关者合作设计的实践研究经验，以及来自当地或美国的指导 高级调查员。扩大研究中吸取的经验教训将适用于伙伴国家的研究 和其他中低收入国家。