SAGE Mental Health

最近对包括肯尼亚在内的五个低收入和中等收入国家的孤儿的研究表明，更多的 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%。结果是相当可观的 创伤后应激负担及其长期后遗症。然而，非洲的精神卫生服务缺口 世界上人口密度最高的国家，儿童资源尤其稀缺。心理健康水平的提升 通过任务转移模式进行干预具有缩小精神卫生服务差距的巨大潜力。躺下 辅导员提供的循证治疗可以忠实地实施，并导致减少后 创伤应激。现在，迫切需要促进扩大干预措施可持续性的战略。 同样重要的是，有必要向领导人和政策制定者提供关于 对其他社区的干预。K01导师研究科学家职业发展的目标 获奖是为了将候选人的专业知识扩展到传播和实施科学。通过一个 严谨的计划，包括课程作业、定向阅读、应用研究体验和个性化 在全球公认的科学专家的指导下，候选人将获得4个领域的能力： (1)传播和实施心理健康循证治疗方面的内容专门知识； (2) 开展可持续发展研究的混合方法工具 确定战略，使继续 扩大干预措施；(3)推广试验结果和扩大循证政策影响的方法 治疗，以及(4)专业发展，成为NIH资助的独立调查员 在资源匮乏的环境中进行文化敏感的研究。 这位候选人有一支跨学科的资深团队 在各自领域成为思想领袖的科学家，由初级导师凯瑟琳·惠顿博士和联合 导师香农·多西博士和詹姆斯·穆迪博士。 与他们一起的还有三位科学顾问，奥古斯丁 瓦松加、基尔斯利·斯图尔特博士和丹尼尔·韦斯特里奇博士。他们的指导将指导一系列研究目标 这扩大了在肯尼亚西部正在进行的由NIMH资助的实施效果试验。这项研究 具体而言，在一项整群随机临床试验中的所有40个地点至少在实施一年后开始。 在维持阶段，将使用定性方法和社会网络分析来确定 非专业辅导员使用的批判性策略及其社交网络的结构要素 持续的维持。此外，还将对所有儿童的干预效果进行概括性评估 这项研究直接回应了当地人对了解潜力的兴趣 对于更广泛的扩大，应对NIMH战略目标4“加强NIH对公共卫生的影响-- 支持工作，“具体目标4.2”，以加强研究-实践伙伴关系，以加快… 持续实施……循证心理健康服务。结果将确定可测试的策略以 实现在低资源环境中实施的心理健康干预措施的连续性。 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.