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Predictors of Psychotherapy Impact Analysis of 6 RCTs in Non Western Countries

非西方国家 6 项随机对照试验的心理治疗影响分析的预测因素

基本信息

批准号：
8961005
负责人：
Judith Karen Bass
金额：
$ 32.4万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-09-01 至 2018-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8961005
关键词：
Accounting Adult Advocate Affect Age Anxiety Bass Caring Characteristics Code Cognitive Therapy Comorbidity Conflict (Psychology)Coping Skills Country Data Data Analyses Data Set Databases Demographic Factors Disasters Disease Education Effectiveness Evidence based treatment Exposure to Funding Future Grant Health Health Personnel Health Professional Impairment Income Individual Intervention Intervention Trial Jordan Knowledge Marital Status Mental Depression Mental Health Meta-Analysis Methods Modeling Movement National Institute of Mental Health Participant Population Post-Traumatic Stress Disorders Process Provider Psyche structure Psychotherapy Randomized Controlled Trials Reporting Research Respondent Risk Role Sampling Severities Sorting - Cell Movement Specialist Stream Stress and Coping Structure Substance Use Disorder Survivors Symptoms System Training Trauma Treatment Factor Treatment Protocols Violence Work arm burden of illness cognitive process contextual factors disability disability-adjusted life years evidence base improved improved functioning interpersonal therapy intervention effect meetings mental function public health relevance scale up sex skills training success

项目摘要

DESCRIPTION (provided by applicant): The burden of mental health problems in low- and middle-income countries (LMIC) is substantial. Although the burden associated with these problems is high, the gap between those who suffer from them and those who receive any sort of evidence-based treatment is large. Among the factors associated with this treatment gap in LMIC is the scarcity of trained mental health professionals, leading to the growing movement advocating use of non-specialists in task-sharing models to provide evidence-based treatments. Despite the growing number of rigorous studies showing promising effects of psychotherapeutic interventions provided through task-sharing strategies by non-specialist mental health providers, a gap exists in our knowledge as to modifying factors and demographic characteristics that influence the magnitude of these intervention impacts because the intervention trials have not been powered to examine effects by sub-groups providing little information about which treatments work best for which participants. Study Methods: The proposed study will evaluate the modifying effects of individual, symptom specific and contextual factors on the utilization and impacts of psychotherapy provided by non-specialist providers using data from six randomized controlled trials in LMIC across 4 continents. This synthesis will use integrative data analysis of pooled data (i.e., combining and analyzing individual-level data across numerous studies using coordinated coding and analysis methods that maximize precision of comparisons). The Specific Aims include Aim 1: building a consolidated database of respondents from the trials which have a combined baseline sample of n=1611. And the following aims which look at different factors that may predict differential utilization and impacts of psychotherapy provided by non-specialist providers: Aim 2: Identify individual factors such as sex, age, education, marital status, and trauma exposure; Aim 3: Identify factors related to symptoms, disorders, and impairment such as symptom severity, and increased impairment; Aim 4: Identify contextual and treatment factors such as degree of insecurity, provider training, provider sex and specific therapy used; and a Secondary Aim: Explore the role of symptom comorbidity. Furthering our understanding of predictors of treatment success, which includes treatment completion, reduced symptomatology, and improved functioning, will identify further adaptations of training and treatment protocols to meet the needs of a wider range of populations in LMIC than is currently able to be treated, an important step for disseminating and scaling up promising treatments, improving the mental health of the population in the LMICs, and reducing the Global Burden of Disease.