Pilot evaluation of a telephone-based psychosocial intervention package for perinatal depression in Nigeria

尼日利亚基于电话的围产期抑郁症心理社会干预方案的试点评估

• 批准号: 9195883
• 负责人: Bibilola Damilola Oladeji
• 金额: $ 7.19万
• 依托单位: COLLEGE OF MEDICINE, UNIVERSITY OF IBADAN
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-22 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9195883
• 关键词: Adopted; Adverse effects; Africa; Anxiety; Award; Car Phone; Caring; Clinic; Clinical Trials; Community Workers; Counseling; Country; Data; Data Analyses; Discipline of obstetrics; Effectiveness; Ensure; Epidemiologic Studies; Evaluation; Female of child bearing age; Fostering; Funding; Goals; Grant; Growth; Health; Health care facility; Healthcare; Impairment; Income; Indium; Infant; International; Intervention; Interview; Investments; Journals; K-Series Research Career Programs; Manuscripts; Maternal and Child Health; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mentors; Mentorship; Methods; Midwife; Modeling; Mothers; Nigeria; Nurse Midwives; Outcome; Outcome Measure; Penetration; Perinatal; Persons; Policies; Population; Primary Health Care; Principal Investigator; Provider; Psyche structure; Psychotherapy; Public Health; Publications; Qualitative Methods; Qualitative Research; Randomized Controlled Trials; Research; Research Activity; Research Design; Research Infrastructure; Research Methodology; Research Personnel; Research Project Grants; Research Training; Resources; Role; Schedule; Scientist; Services; Socioeconomic Status; Specialist; Statistical Methods; Sustainable Development; Telemedicine; Telephone; Testing; Time; Training; Training Activity; Training Support; Translating; Transportation; Ursidae Family; Use Effectiveness; Vocational Guidance; Woman; Work; Writing; base; career; cognitive development; cost; critical period; design; effective intervention; evidence base; experience; flexibility; follow-up; health care delivery; implementation research; improved; informant; innovation; interest; intervention program; low and middle-income countries; mHealth; organizational structure; peripartum depression; psychosocial; response; scale up; skills; success; symposium; tool

Project Summary The goal of this proposed Emerging Global Leader (K43) Award is to provide intensive mentored research career support and protected time to a junior research scientist from a low- or middle income country (LMIC) to enable the awardee develop skills to become an independently funded researcher. The treatment gap for mental disorders in most LMICs is close to 90%. Bridging this treatment gap and improving coverage for mental health care will require building a critical mass of researchers who are able to develop and test interventions for mental health problems that are effective, culturally appropriate, and could be scaled up within this limited resource context; to generate evidence that could inform policy changes necessary for sustainable development. The candidate’s long term career goal is to become a leader in developing and evaluating effective models for the scaling up mental health care through its integration into routine health care in resource limited settings. The specific training objectives of this 4-year grant are to enable the candidate to develop expertise in (1) advanced research methodology especially the design and execution of clinical trials and implementation research, (2) advanced statistical methods and (3) qualitative research methods needed to adapt and contextualize mental health interventions. These objectives will be achieved with the mentorship of Drs Oye Gureje, an expert in psychiatric epidemiology and implementation research in LMICs, and Ian M. Bennett, a leader in the use of team based care, telemedicine, mHealth interventions for women in the perinatal period. I will utilize these skills and mentorship support to carry out a research project. The proposed project will adopt a mixed methods approach to pilot a telephone-based psychosocial intervention package for perinatal depression delivered by nurse/midwives in routine antenatal care. Women of child bearing age bear a disproportionate burden for common mental disorders such as depression. Perinatal depression is associated with poor obstetric outcomes and impairments in infant cognitive development and growth parameters. Even though evidence supports the efficacy of evidence based psychosocial interventions for perinatal depression delivered by non-specialist health and community workers to alleviate these negative outcomes, a major limitation is the low rate of attendance at follow up counseling sessions. The goal of this research is to adapt psychosocial interventions for perinatal depression for use over the mobile telephone and assess the acceptability, feasibility and the effectiveness of this approach. Qualitative methods, specifically key informant interviews will be used to explore the organizational structure of the maternal and child health facilities as well as barriers/facilitators for the successful implementation of mental health interventions. Following this, midwives in two maternal and child health (MCH) facilities will be trained to identify perinatal depression and deliver interventions based on treatment specifications of the WHO Mental Health Gap Action Program Intervention Guide (mhGAP-IG). Interventions will be delivered fortnightly over the phone in one MCH clinic and in-person at the other clinic. Depression outcome measures will be compared between the two groups to explore the effectiveness of the telephone-based interventions. The skills acquired through this K43 Award and data generated from this pilot will be used to pursue funding to conduct a larger randomized controlled trial of this strategy.

项目摘要 这个提议的新兴全球领导者（K43）奖的目标是提供密集的指导研究 为来自低收入或中等收入国家（LMIC）的初级研究科学家提供职业支持和保护时间， 使获奖者发展技能，成为一个独立资助的研究人员。治疗差距 大多数中低收入国家的精神障碍患者接近90%。弥合这一治疗差距并提高 精神卫生保健将需要建立一个临界质量的研究人员谁能够开发和测试， 针对心理健康问题的干预措施是有效的，文化上适当的，并且可以在 在资源有限的情况下，提供证据，为可持续发展所需的政策变化提供信息， 发展候选人的长期职业目标是成为开发和评估 通过将精神卫生保健纳入常规卫生保健来扩大精神卫生保健的有效模式 资源有限的设置。这项为期4年的资助的具体培训目标是使候选人能够 发展（1）先进的研究方法，特别是临床试验的设计和执行方面的专业知识 和实施研究，（2）先进的统计方法和（3）定性研究方法，需要 调整心理健康干预措施并将其纳入具体环境。这些目标将在以下人员的指导下实现： Oye Gureje博士是一位精神病学流行病学和在中低收入国家实施研究的专家。 班尼特，在使用团队为基础的护理，远程医疗，移动健康干预妇女的领导者， 围产期我将利用这些技能和指导支持来开展一个研究项目。拟议 该项目将采用混合方法，试行一套基于电话的心理社会干预方案， 在常规产前护理中由护士/助产士分娩的围产期抑郁症。育龄妇女生育a 对抑郁症等常见精神疾病造成不成比例的负担。围产期抑郁症与 产科预后不良，婴儿认知发育和生长参数受损。甚至 尽管有证据支持基于证据的心理社会干预对围产期抑郁症的有效性， 由非专业卫生和社区工作者提供以减轻这些负面结果，这是一个主要的 局限性是参加后续咨询会议的比率很低。这项研究的目的是适应 通过移动的电话对围产期抑郁症进行社会心理干预， 这种方法的可接受性、可行性和有效性。定性方法，特别是关键信息提供者 访谈将被用来探讨产妇和儿童保健设施的组织结构，以及 作为成功实施心理健康干预措施的障碍/促进因素。在此之后， 两个妇幼保健机构的助产士将接受培训，以确定围产期抑郁症， 根据世卫组织精神卫生差距行动计划的治疗规范提供干预措施 干预指南（mhGAP-IG）。将每两周在一个妇幼保健诊所通过电话提供干预措施 在另一家诊所接受治疗将比较两组之间的抑郁结局指标， 探讨电话干预的有效性。通过这个K43奖获得的技能， 该试验产生的数据将用于寻求资金，以进行更大规模的随机对照试验， 这个战略。