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.

全球精神卫生（MH）治疗和研究差距要求有效的治疗方法得到扩大， 利用现有平台。与此同时，政策必须在一段时间内维持它们。PRIDE 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 合作研究网络的新生研究“种子团队”。这种“种子队”， 能力建设部分，可在整个区域开展能力建设和执行工作 研究以可持续地扩大卫生保健服务。扩大研究（莫桑比克），在卫生保健和物质使用方面 疾病将评估扩大创新，综合，可持续，阶梯式护理的战略和成本， 社区方法。我们将利用：（1）莫桑比克培训精神病医生的任务转移战略 技术人员（PsyTs）提供MH护理，（2）WHO资助的癫痫社区护理计划成功 在5个省实施，目前卫生部已做好扩大规模的准备。我们的成本效益方法 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 计划对所有MH疾病实施预防和治疗，而不是单一疾病。模型 采用EBP（例如，精神药理学;人际治疗），已经被PsyTs使用：a）建立一个 由非MH专业人员提供和监督的可持续方案，由MH专家监督; B） 为所有精神卫生障碍提供社区筛查、护理和/或转诊;以及c）使用实施工具， 监测可持续性。这个合作网络将扩大一个具有成本效益的，可持续的计划，并告知 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;莫桑比克卫生研究所 教育和研究）和我们的莫桑比克福格蒂/NIMH MH实施计划（合作伙伴： 莫桑比克[卫生部; U Eduardo Mondlane];美国[哥伦比亚;宾夕法尼亚大学];和巴西[U 联邦圣保罗]）培训来自博茨瓦纳、马拉维、 莫桑比克、南非、赞比亚。每个国家都将提供致力于共同努力的“种子小组”， 包括开发、测试、实施和维持社区卫生保健服务所需的所有行动者， 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卫生保健政策和方案; 培训人员准备工作人员提供适应EBP，保持保真度;和4）高级教师发展 大学计划为下一代研究人员做准备。培训包括协同教学法， 在当地利益相关者的合作伙伴关系中设计的实践研究经验，以及来自当地或美国的指导 资深调查员在扩大研究中吸取的经验教训将用于伙伴国家的研究 其他LMIC