Participatory research to support the development of culturally sensitive mental health and wellbeing services for the Kankuamo people of Colombia

参与性研究，支持为哥伦比亚坎库阿莫人开发文化敏感的心理健康和福祉服务

• 批准号: ES/V013416/1
• 负责人: Ross White
• 金额: $ 39.14万
• 依托单位: University of Liverpool
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2021
• 资助国家: 英国
• 起止时间: 2021 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FV013416%2F1
• 关键词: Participatory; research; support; development; culturally

Phase 1: Knowledge Dialogue (Months 1-8)A) Literature review - application of capability approach with indigenous populations; B) Five stakeholder engagement workshops aimed at enhancing understanding about the mental health and quality of life of the Kankuamo people will be held. Sixty individuals (including traditional healers, community elders, health workers) will be purposively sampled from across the twelve Kankuamo communities. Data will be collected using Module One the Design, Implementation, Monitoring and Evaluation (DIME) approach. Module 1 of DIME elicits relevant qualitative information about: 1) Problems that adults in the community face; 2) The key function/tasks that adults are required to frequently undertake for themselves, their families, and their communities; 3) The advice that is currently provided by recognised community experts (i.e. key informants) to address the problems. Building on our work in Uganda and Rwanda as part of the ESRC funded COSTAR project (ES/S000976/1), this work will include a focus on the Capability Approach (Sen, 1999) through the inclusion of an additional question that will ask community members to indicate: 'What does a good life mean to you?'. Phase II: Developing Assessment Instruments (Months 9-13)A) Development or adaptation of assessment instruments for: i) common mental disorders, ii) quality of life based on the qualitative findings from Phase I. This will be guided by Module two of the DIME approach and will utilise the data collected in Phase 1.B) Piloting of Assessment Instrument - the two assessment instruments developed in Phase IIA will be piloted according to Module Three of the DIME Approach. Data collection will take place via a survey of 380 households across the 12 Kankuamo and will be undertaken by the participants of phase I, accompanied by members from the research team. The survey will include the novel assessment instruments for common mental disorders and quality of life, as well as internationally recognised standardised measures of depressive symptoms (i.e. PHQ-9) and quality of life (WHOQoL-BREF). Following the completion of the survey, purposive sampling will be used to recruit a subsample of participants into focus groups discussions (1 FGD of 10 people for each of the 12 communities; total N = 120) to provide qualitative feedback about the assessment instruments (including the cultural acceptability). C) Validation of the assessment instruments - Correlational analyses will be conducted on the data collected in Phase IIB to determine the construct validity of the new assessment instruments compared to PHQ9 and WHOQoL-BREF.Phase III: Guideline development (Months 13-20)Members from all 12 Kankuamo communities (N=120) will be invited to a combination of focus groups, workshops and interactive activities over a 2-day period to co-produce guidelines for the development and delivery of culturally sensitive primary care community mental health support. This will include consideration of ethical and legal obligations of stakeholders. Phase IV: Development and evaluation of the training program (Months 20-30)This phase will involve the development, delivery and evaluation of a training program aimed at training Community Wellbeing Advocate (CWA) to identify people experiencing mental health difficulties within the Kankuamo community, and to signpost them to appropriate, locally available, forms of support. A) Develop a short 3-day CWA training program based on the findings from Phase I, Phase II and Phase III. B) Deliver a 3-day CWA training program to participants (N=60). C) Evaluate: i) the acceptability of the CWA training program (two FGD of up to 8 CWA trainees 1-month post-training, ii) feedback from community members who have interacted with the CWA (2 FGD of up to 8 community members).D) Adjust the CWA training programme according to feedback received from the CWA trainees and community members in Phase IVC.

第一阶段：知识对话(1-8个月)a)文献审查--在土著居民中应用能力办法；b)将举办5个利益攸关方参与讲习班，以加强对坎库阿莫人民心理健康和生活质量的了解。将有目的地从12个Kankuamo社区中抽取60人(包括传统治疗师、社区长老、卫生工作者)。将使用第一模块设计、实施、监测和评价(DIME)方法收集数据。DIME的模块1引出了关于以下方面的相关定性信息：1)社区成年人面临的问题；2)成年人被要求经常为自己、家人和社区承担的关键职能/任务；3)目前由公认的社区专家(即关键告密者)提供的解决问题的建议。作为ESRC资助的COSTAR项目(ES/S000976/1)的一部分，我们在乌干达和卢旺达所做工作的基础上，这项工作将包括侧重于能力办法(Sen，1999)，方法是增加一个问题，要求社区成员指出：‘美好生活对你意味着什么？’第二阶段：发展评估工具(9-13个月)A)发展或改编评估工具：i)常见的精神障碍，ii)根据第一阶段的定性研究结果而定的生活质素。这将由DIME方法的单元二指导，并将使用在阶段1中收集的数据。B)试行评估工具-在IIA阶段开发的两个评估工具将根据DIME方法的单元三进行试验。数据收集将通过对12个Kankuamo地区的380个家庭的调查进行，并将由第一阶段的参与者在研究小组成员的陪同下进行。调查将包括常见精神障碍和生活质量的新评估工具，以及国际公认的抑郁症状标准化测量(即PHQ-9)和生活质量(WHOQL-BREF)。在调查完成后，将采用有目的的抽样，招募一部分参与者参加重点小组讨论(12个社区每个社区1个10人的FGD；总N=120)，以提供关于评估工具(包括文化可接受性)的定性反馈。C)评估工具的验证-将对第二阶段收集的数据进行相关分析，以确定新评估工具与PHQ9和WHOQOL-BREF相比的结构有效性。第三阶段：指南制定(13-20个月)来自所有12个Kankuamo社区(N=120)的成员将被邀请参加为期两天的焦点小组、研讨会和互动活动，共同制定和提供对文化敏感的初级保健社区精神健康支持的指南。这将包括考虑利益攸关方的道德和法律义务。第四阶段：培训计划的制定和评估(20-30个月)这一阶段将包括制定、提供和评估一项旨在培训社区福利倡导者(CWA)的培训计划，以识别Kankuamo社区内遇到精神健康困难的人，并将他们标记为适当的、当地可用的支持形式。A)根据第一阶段、第二阶段和第三阶段的调查结果，制定为期3天的CWA培训计划。B)向参与者(N=60)提供为期3天的CWA培训计划。C)评估：i)CWA培训计划的可接受性(最多8名CWA受训人员在培训后1个月接受两次FGD；ii)与CWA互动的社区成员的反馈(最多8名社区成员中有2名FGD)。d)根据在IVC阶段从CWA受训人员和社区成员那里收到的反馈，调整CWA培训计划。

项目成果

Application of the capability approach to Indigenous People's health and well-being: protocol for a mixed-methods scoping review.

• DOI: 10.1136/bmjopen-2022-066738
• 发表时间: 2022-12-20
• 期刊: BMJ OPEN
• 影响因子: 2.9
• 作者: van der Boor, Catharina;Molina-Bulla, Carlos Ivan;Chiumento, Anna;White, Ross G.
• 通讯作者: White, Ross G.