SAGE Mental Health

最近对包括肯尼亚在内的五个中低收入国家的孤儿进行的一项研究表明， 超过90%的人在13岁之前经历过创伤;创伤事件的年发生率为25%。结果是可观的 创伤后压力负担及其长期后遗症。然而，非洲的精神卫生服务差距 这些国家的儿童死亡率是世界上最高的，用于儿童的资源特别稀缺。扩大心理健康 通过任务转移模式采取的干预措施在缩小心理健康服务差距方面具有巨大潜力。层 咨询师提供的循证治疗可以忠实地实施，并导致减少后， 创伤压力现在，迫切需要制定战略，促进扩大干预措施的可持续性 同样重要的是，需要让领导人和决策者了解 对其他社区的干预。这个K 01指导研究科学家职业发展的目标 奖是扩大候选人的专业知识，传播和实施的科学。通过 严格的计划，包括课程，指导阅读，应用研究经验，和个性化 来自全球公认的科学专家的指导，候选人将获得4个领域的能力： (1)传播和实施精神卫生循证治疗的内容专业知识， （二） 进行可持续性研究的混合方法工具 确定战略， 扩大干预措施，（3）推广试验结果和扩大循证医学政策范围的方法， 治疗，和（4）专业发展，成为一个NIH资助的独立调查员进行 在低资源环境下进行文化敏感的研究。 候选人拥有一支跨学科的高级团队 科学家谁是思想领袖在各自的领域，由主要导师博士领导凯瑟琳惠顿和合作， 导师香农多尔西博士和詹姆斯穆迪博士。 三位科学顾问奥古斯丁 瓦松加，凯斯利·斯图尔特博士，和丹尼尔·韦斯特赖希博士。他们的指导将指导一系列研究目标 这扩大了正在进行的NIMH资助的实施效果试验在肯尼亚西部。本研究 特别是在群集随机临床试验中的所有40个站点至少实施一年后开始。 在维持阶段将使用定性方法和社会网络分析，以确定 非专业咨询师采用的关键策略及其社交网络的结构要素， 继续维持。此外，还将对所有儿童的干预效果进行评估 这项研究是直接响应当地的兴趣，了解潜力 为了更广泛地扩大规模，解决NIMH战略目标4“加强NIH的公共卫生影响， 支持工作”，特别是目标4.2“加强研究实践伙伴关系，以加快. 持续执行…基于证据的心理健康服务。”结果将确定可测试的策略， 继续在资源匮乏的环境中实施心理健康干预措施。 肯尼亚的孤儿

A recent study of orphaned children in five low- and middle-income countries, including Kenya, showed that more than 90% experience trauma by age 13; annual incidence of a traumatic event is 25%. The result is substantial burden of post-traumatic stress and its long-term sequelae. Yet, the mental health services gap in African countries is the highest in the world, and resources for children are particularly scarce. Scale-up of mental health interventions through task-shifting models has great potential to narrow the mental health services gap. Lay counselor delivery of evidence-based treatments can be implemented with fidelity and result in reduced post- traumatic stress. Now, there is an urgent need for strategies that facilitate sustainability of scaled-up interventions and, equally important, a need to equip leaders and policy makers with information about the generalizability of the interventions to other communities. The goal of this K01 Mentored Research Scientist Career Development award is to expand the candidate’s expertise to the science of dissemination and implementation. Through a rigorous plan including coursework, directed reading, applied research experience, and individualized mentorship from globally-recognized scientific experts, the candidate will acquire competencies in 4 areas: (1) content expertise in dissemination and implementation of mental health evidence-based treatments, (2) mixed methods tools for conducting sustainment research to identify strategies enabling the continuation of scaled-up interventions, (3) approaches to generalize trial results and extend the policy reach of evidence-based treatments, and (4) professional development to become an NIH-funded independent investigator conducting culturally-sensitive research in low-resource settings. The candidate has a team of interdisciplinary senior scientists who are thought leaders in their respective fields, led by Primary Mentor Dr. Kathryn Whetten and co- Mentors Dr. Shannon Dorsey and Dr. James Moody. They are joined by three Scientific Advisors, Augustine Wasonga, Dr. Kearsley Stewart, and Dr. Daniel Westreich. Their mentorship will guide a set of research aims that expands an ongoing NIMH-funded implementation effectiveness trial in western Kenya. This research specifically begins after all 40 sites in a cluster-randomized clinical trial are at least one year post-implementation. Both qualitative methods and social network analysis will be used during the sustainment phase to identify the critical strategies employed by lay counselors and the structural elements of their social networks that facilitate continued sustainment. In addition, generalizability of the intervention effects in children will be estimated for all This research is directly responsive to local interest in understanding the potential for broader scale-up, addressing NIMH Strategic Objective 4 “Strengthening the Public Health Impact of NIH- Supported Work,” specifically Objective 4.2 to “Strengthen research-practice partnerships to expedite… sustained implementation...of evidence-based mental health service.” Results will identify testable strategies to achieve continuation of mental health interventions implemented in low-resource settings. orphaned children in Kenya.