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ASHA Bangladesh--An Integrated Intervention to Address Depression in Low Income Rural Women

ASHA 孟加拉国——解决低收入农村妇女抑郁问题的综合干预措施

基本信息

批准号：
10299300
负责人：
ALISON KARASZ
金额：
$ 56.1万
依托单位：
ALBERT EINSTEIN COLLEGE OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-02 至 2026-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10299300
关键词：
Address Advocate Affect Agriculture Asia Bangladesh Caring Child Clinical Cluster randomized trial Collaborations Country Decision Making Depressed mood Development Disease remission Dose Economic Development Economics Effectiveness Evaluation Family Fellowship Generations Government Government Agencies Health Health Care Costs Health Personnel High Prevalence Individual International Interruption Intervention Intervention Studies Interview Investigation Link Low income Mediating Mediator of activation protein Medicine Mental Depression Mental Health Methods Modeling Outcome Participant Pathway interactions Patients Perception Personal Satisfaction Persons Pilot Projects Play Policies Policy Developments Policy Maker Poverty Process Productivity Randomized Relapse Research Research Personnel Research Training Resources Role Rural Scientist Social support Structure Testing Universities Well in self Woman Work arm career development college contextual factors cost depressive symptoms design disability doctoral student economic outcome empowerment evidence base experience fighting graduate student hands on research health economics implementation outcomes implementation process implementation research implementation study improved insight low and middle-income countries men novel pandemic disease policy implication poverty alleviation programs psychosocial recruit skills treatment arm treatment effect treatment trial university student uptake

项目摘要

A leading cause of global disability, depression is widespread among women in low and middle income countries (LMIC). Poverty plays a major role in depression via multiple pathways, while depression worsens poverty, compromising economic productivity. Efforts to increase access to depression treatment in LMIC have been hampered by low treatment uptake/engagement and weak treatment effects. Recently, researchers & policy makers have pointed to the importance of poverty alleviation in the fight again the global depression pandemic. We propose to implement an integrated poverty alleviation/depression treatment intervention for low income women in rural Bangladesh, designed to break the toxic cycle of poverty and depression. A capacity building component will build skills and support career development in qualitative implementation research for young scientists and establish a year-long research fellowship for graduate students at the University of Dhaka. Our project builds on an established partnership between Albert Einstein College of Medicine and the ICDDRB in Dhaka. Following our successful pilot study, we will implement a cluster randomized trial of an integrated intervention, recruiting 1200 low income women with depression from 80 villages. Villages will be randomized into one of four treatment arms: 1) evidence based depression treatment; 2) poverty alleviation through an agricultural asset transfer; 3) combined depression treatment/poverty alleviation, and 4) no-treatment control. Participants will be followed for 24 months. We hypothesize: improved depression outcomes at 6 and 24 months in the combined arm, compared to depression treatment or poverty alleviation alone. A detailed, mixed methods process evaluation, designed to generate new hypotheses regarding program and contextual factors influencing outcomes, will include in-depth qualitative interviews with program participants and staff, conducted by ASHA fellows. The proposed project will generate findings with significant implications for policy makers. To date, the work of depression researchers and economic development groups has included little collaboration. Programs that seek to reduce depression do not address the devastating impact of poverty; while, similarly poverty alleviation programs do not address the role of mental health in economic productivity. Results of this study, if promising, will generate evidence to guide collaborations among development agencies, researchers, policy-makers, and treatment providers. Our team’s dissemination efforts will bring government agencies, international and national health and economic development NGOS to consider the potential for a new generation of collaborative, integrated intervention approaches.

抑郁症是全球残疾的主要原因，在中低收入妇女中普遍存在收入国家（LMIC）。贫困通过多种途径在抑郁症中发挥着重要作用，而抑郁症加剧贫困，损害经济生产力。努力增加获得中低收入国家的抑郁症治疗因治疗采用率/参与度低和薄弱而受到阻碍治疗效果。最近，研究人员和政策制定者指出了贫困的重要性缓解全球抑郁症大流行的斗争。我们建议实施综合针对孟加拉国农村低收入妇女的减贫/抑郁症治疗干预措施，旨在打破贫困和抑郁的恶性循环。将建立能力建设部分技能并支持年轻科学家在定性实施研究中的职业发展为达卡大学研究生设立为期一年的研究奖学金。我们的项目建立在阿尔伯特·爱因斯坦医学院和达卡 ICDDRB。在我们成功的试点研究之后，我们将实施整群随机试验一项综合干预措施，从 80 个村庄招募了 1200 名患有抑郁症的低收入妇女。村庄将被随机分为四个治疗组之一：1）基于证据的抑郁症治疗； 2）农业资产流转扶贫； 3）抑郁症/贫困联合治疗缓解，4) 不治疗对照。参与者将被跟踪 24 个月。我们假设：与抑郁症相比，联合治疗组在 6 个月和 24 个月时的抑郁症结果有所改善单独治疗或扶贫。详细的混合方法过程评估，旨在产生关于影响结果的计划和背景因素的新假设，将包括由 ASHA 研究员对项目参与者和工作人员进行深入的定性访谈。拟议项目将产生对政策制定者具有重大影响的研究结果。迄今为止，抑郁症研究人员和经济发展团体的工作几乎没有包括合作。旨在减少抑郁症的计划并没有解决抑郁症的破坏性影响贫困;同时，同样，扶贫方案也没有考虑心理健康在贫困人口中的作用。经济生产力。这项研究的结果如果有希望的话，将产生证据来指导发展机构、研究人员、政策制定者和治疗提供者之间的合作。我们团队的传播努力将为政府机构、国际和国家健康带来影响和经济发展非政府组织考虑新一代协作的潜力，综合干预方法。