Strengthening the identification and treatment of depression in primary care in Mozambique
加强莫桑比克初级保健中抑郁症的识别和治疗
基本信息
- 批准号:9314123
- 负责人:
- 金额:$ 17.4万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2017
- 资助国家:美国
- 起止时间:2017-08-01 至 2021-07-31
- 项目状态:已结题
- 来源:
- 关键词:AccountingAffectAfricaAreaAwardCaringCensusesCharacteristicsClinicClinicalClinical ResearchCluster randomized trialCommunitiesComorbidityCompetenceComplexCountryDSM-IVDataDevelopmentEducational CurriculumEffectivenessEthicsEvaluationExerciseFeasibility StudiesFeeling suicidalFundingGoalsGoldGrantGuidelinesHIV/TBHealthHealth PersonnelHealth Services AccessibilityHealth StatusHealth financingHealth systemHealthcareHospitalsHuman DevelopmentHuman ResourcesIndividualInterventionInterviewK-Series Research Career ProgramsKnowledgeMental DepressionMental HealthMental Health ServicesMental disordersMentored Research Scientist Development AwardMentorsMentorshipMethodsModelingMozambiqueOutcomePathway interactionsPatient CarePatient-Focused OutcomesPatientsPeer ReviewPerceptionPilot ProjectsPopulationPovertyPredictive ValuePrevalencePrevalence StudyPrimary Health CareProcessProvincePsyche structurePsychiatric therapeutic procedurePsychiatristPublic HealthPublic SectorPublicationsQuestionnairesReceiver Operating CharacteristicsRecommendationResearchResearch PersonnelResearch Project GrantsSensitivity and SpecificityServicesSideSouth AfricaSpecialistStructureSuicideSystemTechniquesTestingTimeUnited StatesUnited States National Institutes of HealthVisitWorkWorld Health Organizationagedbasecare seekingcommunity settingdepressive symptomsdesigndisabilityevidence baseexperienceexperimental analysishealth care deliveryimplementation researchimplementation scienceimprovedindexinginformantinterestintervention effectlow and middle-income countriesprimary care settingprogramspublic health relevancerandomized trialscale upscreeningsuccesssuicide ratesupport toolssymposiumsystems researchtoolyears lived with disability
项目摘要
ABSTRACT
Mozambique was recently estimated to have the highest suicide rate in Africa.
Global modeling exercises
estimate that depression is one of the leading causes of disability nationally, yet our pilot studies suggest
depression is not often identified or treated.
Given limited specialist human resources and reach of the current
mental health system, the Ministry of Health has targeted mental health service integration with primary care as
a high priority. However, there is currently no primary care integration, with all mental healthcare occurring at
district-level specialized psychiatric services. The goal of this award is to broaden the candidate’s expertise to
conduct independent mental health systems research focused on the integration of mental health in global
primary care settings. Through research, coursework, structured mentorship, and conference attendance, the
candidate will develop new competencies in mental health systems research, including: (1) content knowledge
on the evidence-base for integrating mental healthcare in primary care; (2)
mixed-methods
techniques for
pragmatic randomized trials in low- and middle-income country (LMIC) health systems; (3) ethical conduct of
clinical research in LMICs; and (4) professional development to become an independent NIH-funded investigator.
Drs. Deepa Rao, Kenneth Sherr, Jürgen Unützer, Inge Petersen, Palmira dos Santos, and Vasco Cumbe will
mentor and advise the candidate in these four objectives. The research will be conducted in Sofala, Mozambique
in partnership with the Mozambican Ministry of Health. The candidate will determine the optimal screening cut-
off for the Patient Health Questionnaire-9 and conduct the first-ever study of prevalence, associated factors, and
care-seeking for depressive symptoms (including suicidal ideation) among primary care patients in Sofala,
Mozambique (Aim 1).
These data, combined with semi-structured key-informant interviews of existing practices
and perceptions of supply/demand side barriers (Aim 2), will be used to inform the design and implementation
of mental health integration guidelines and decision-support tools.
Last, the candidate will implement and pilot-
test the feasibility of depression care integration within public clinics in Sofala, Mozambique.
The candidate will
collect mixed-methods pilot data of input variables, implementation outcomes, and patient outcomes, paired with
the Consolidated Framework for Implementation Research (CFIR) to systematically assess intervention
characteristics, outer/inner setting, and processes (Aim 3). Pilot effectiveness data, along with analyses of CFIR
constructs affecting implementation, will help identify factors distinguishing between facilities achieving high and
low implementation success, and inform implementation strategies for a follow-on NIH grant testing impact and
implementation strategies in an adequately-powered cluster randomized trial. In Mozambique, this research will
contribute to scalable mental health integration models that promote integrated care for depressive symptoms.
More generally, we anticipate our mixed-methods data, including the CFIR constructs of implementation
success, will be of interest to the larger global community looking to close mental health treatment gaps in LMICs.
摘要
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Bradley Wagenaar其他文献
Bradley Wagenaar的其他文献
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{{ truncateString('Bradley Wagenaar', 18)}}的其他基金
Systems Analysis and Improvement Approach to Optimize the Task-Shared Mental Health Treatment Cascade (SAIA-MH): A ClusterRandomized Trial
优化任务共享心理健康治疗级联 (SAIA-MH) 的系统分析和改进方法:集群随机试验
- 批准号:
10208400 - 财政年份:2021
- 资助金额:
$ 17.4万 - 项目类别:
Systems Analysis and Improvement Approach to Optimize the Task-Shared Mental Health Treatment Cascade (SAIA-MH): A ClusterRandomized Trial
优化任务共享心理健康治疗级联 (SAIA-MH) 的系统分析和改进方法:集群随机试验
- 批准号:
10594587 - 财政年份:2021
- 资助金额:
$ 17.4万 - 项目类别:
Systems Analysis and Improvement Approach to Optimize the Task-Shared Mental Health Treatment Cascade (SAIA-MH): A ClusterRandomized Trial
优化任务共享心理健康治疗级联 (SAIA-MH) 的系统分析和改进方法:集群随机试验
- 批准号:
10403584 - 财政年份:2021
- 资助金额:
$ 17.4万 - 项目类别:
Systems analysis and improvement approach to optimize task-shifted mental health diagnosis and treatment cascades (SAIA-MH)
优化任务转移心理健康诊断和治疗级联的系统分析和改进方法(SAIA-MH)
- 批准号:
9371841 - 财政年份:2017
- 资助金额:
$ 17.4万 - 项目类别:
Strengthening the identification and treatment of depression in primary care in Mozambique
加强莫桑比克初级保健中抑郁症的识别和治疗
- 批准号:
9767282 - 财政年份:2017
- 资助金额:
$ 17.4万 - 项目类别:
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