Randomized Control Trial On Implementation Strategies for Task-Shifting Depression Care in Vietnam
Randomized Control Trial On Implementation Strategies for Task-Shifting Depression Care in Vietnam
批准号:
9540281
负责人:
Victoria Khanh Ngo
金额:
$77.44万
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
项目状态:
已结题
起止时间:
2017-09-18 至 2019-06-19
关键词:
AddressAdoptedAdoptionCaringClinicCollaborationsCommunitiesCommunity HealthCompetenceCountryDepressed moodEducational workshopEffectivenessEffectiveness of InterventionsEvaluationEvidence based interventionEvidence based practiceFundingGovernmentHealthHealth PersonnelHealth ResourcesHealth systemHealthcareHuman ResourcesHybridsIncomeIndividualInterventionKnowledgeLeadLeadershipLearningMaintenanceMeasuresMental DepressionMental HealthMental Health ServicesMethodsMissionModelingNational Institute of Mental HealthOrganizational CultureOutcomeOwnershipPatient-Focused OutcomesPatientsPoliciesPopulationPrimary Health CareProblem SolvingProviderPsychiatristRandomized Controlled TrialsResearchResistanceResourcesRestSelf EfficacyServicesSupervisionSystemTestingTimeTrainingVietnamWorkWorkloadWorld Bankbasecare burdencollaborative carecompare effectivenesscostcost effectivenessdepression modeleconomic costhealth literacyimplementation scienceimprovedimproved outcomeincremental cost-effectivenessinnovationlow and middle-income countriespatient populationscale upvirtual
中文摘要
研究摘要
抑郁症是世界上最大的单一医疗负担;没有其他疾病占其一半。
负担最近,世界银行、世卫组织和NIMH强调,
抑郁症和需要在全球范围内扩大抑郁症护理。在越南,我们发现了合作护理,
是有效的,并进行了集群随机对照试验,显示了大的效应量,
抑郁症多因素协作护理模式(MCCD),其中抑郁症护理是任务转移的
在移动的精神科医生的支持下,而
协作护理对抑郁症的好处是公认的,最合适和有效的
尚未确定扩大这一模式的实施战略。为了弥补这一知识差距,
我们的R 01提案将建立在我们小组先前关于军事和民防的工作基础上,并利用当前的政策倡议
与越南抑郁症护理相关,以确定最有可能导致成功的实施模式
在资源匮乏的情况下提供和维持有效的服务。我们将与当地和
国家社区和政府组织进行随机对照试验(RCT),
三种实施模式的有效性:(a)通常实施(UI),通常包括一个
讲习班和工具包;(B)加强监督(ES;包括UI模型);(c)社区参与学习
协作(CELC;包括ES)。根据RE-AIM实施评估框架,
人口水平的影响,EBI必须由提供者采用,达到目标患者的大部分
人口,被忠实地实施,有效地改善结果,并在研究后保持
资金被撤回,因此我们将评估组织,提供者和患者的实施结果
在这个框架的基础上。此外,我们还将评估与以下因素相关的组织和供应商因素:
并衡量每项执行战略成本效益增量。
比较RE-AIM实施结果和成本效益的实施模型可以指导
关于支持扩大抑郁症和其他疾病合作护理模式的最佳战略的政策决定
EBI。这项全面和严格的执行效力研究将有助于我们
理解使用CELC战略的附加值超过培训的最佳实践(ES),
即使在高收入国家也没有这样做。及时评估抑郁症治疗任务-
转变将提供急需的知识,了解实施战略和因素将促进
在资源有限的环境中采用、提供和维持高质量的抑郁症护理
提供精神卫生人力资源,解决执行中的全球优先知识差距
科学和心理健康研究。
英文摘要
Research Abstract
Depression is the single largest health care burden in the world; no other illness accounts for even half its
burden. Recently, the World Bank, WHO, and NIMH highlighted the crippling economic costs of unaddressed
depression and the need to scale up depression care globally. In Vietnam, we have found collaborative care to
be effective and have conducted clustered randomized control trial that has shown large effect sizes for a
Multicomponent Collaborative Care Model for Depression (MCCD), in which depression care was task-shifted
to primary care providers in local community health clinics and supported by mobile psychiatrists. While the
benefits of collaborative care for depression are well-established, the most appropriate and effective
implementation strategies for scaling up this model have not been identified. To address this knowledge gap,
our R01 proposal will build on our team's previous work on the MCCD and leverage current policy initiatives
related to depression care in Vietnam to identify implementation models most likely to lead to successful
implementation and sustainment of effective services in low resource settings. We will partner with local and
national community and government organizations to conduct a randomized controlled trial (RCT) comparing
effectiveness of three implementation models: (a) usual implementation (UI), which typically includes one
workshop and toolkit; (b) enhanced supervision (ES; includes model UI); and (c) community-engaged learning
collaborative (CELC; includes ES). According to the RE-AIM Implementation Evaluation framework, to have a
population-level impact, an EBI must be adopted by providers, reach a large proportion of the targeted patient
population, be implemented with fidelity, effectively improve outcomes, and be maintained after research
funds are withdrawn, thus we will assess implementation outcomes at the organizational, provider, and patient
levels based on this framework. Additionally, we will assess organizational and provider factors associated with
successful implementation and measure incremental cost-effectiveness of each implementation strategy.
Comparing implementation models on RE-AIM implementation outcomes and cost-effectiveness can guide
policy decisions on best strategies to support scale-up of collaborative care models for depression and other
EBIs. This comprehensive and rigorous implementation effectiveness study will contribute to our
understanding of the added value of using a CELC strategy over and above the best practice in training (ES),
which has not been done even in high-income countries. This timely evaluation of an depression care task-
shifting will provide much needed knowledge about what implementation strategies and factors promote
adoption, delivery, and sustainment of high-quality depression care in low-resource settings where limited
mental health human resources are available, addressing global priority knowledge gaps in implementation
science and mental health research.
期刊论文(1)
专著(0)
科研奖励(0)
会议论文
DOI:
10.1186/s12889-023-16312-4
发表时间:
2023-07-28
期刊:
BMC public health
影响因子:
4.5
作者:
[]
通讯作者:
Harlem Strong Mental Health Coalition: A Multi-sector Community-Engaged Collaborative for System Transformation
-
批准号:10414696
-
项目类别:
-
资助金额:$197.76万
-
财政年份:2021
-
负责人:Victoria Khanh Ngo
-
依托单位:
Harlem Strong Mental Health Coalition: A Multi-sector Community-Engaged Collaborative for System Transformation
-
批准号:10831876
-
项目类别:
-
资助金额:$103.82万
-
财政年份:2021
-
负责人:Victoria Khanh Ngo
-
依托单位:
Randomized Control Trial on Implementation Strategies for Task-Shifting Depression Care in Vietnam
-
批准号:9531167
-
项目类别:
-
资助金额:$61.13万
-
财政年份:2019
-
负责人:Victoria Khanh Ngo
-
依托单位:
Randomized Control Trial on Implementation Strategies for Task-Shifting Depression Care in Vietnam
-
批准号:10244889
-
项目类别:
-
资助金额:$63.05万
-
财政年份:2019
-
负责人:Victoria Khanh Ngo
-
依托单位:
Randomized Control Trial on Implementation Strategies for Task-Shifting Depression Care in Vietnam
-
批准号:10470812
-
项目类别:
-
资助金额:$63.85万
-
财政年份:2019
-
负责人:Victoria Khanh Ngo
-
依托单位:
Development of an Integrated Microfinance and Depression Care Program for Women
-
批准号:8302170
-
项目类别:
-
资助金额:$25.43万
-
财政年份:2012
-
负责人:Victoria Khanh Ngo
-
依托单位:
Development of an Integrated Microfinance and Depression Care Program for Women
-
批准号:8463623
-
项目类别:
-
资助金额:$24.24万
-
财政年份:2012
-
负责人:Victoria Khanh Ngo
-
依托单位:
Sources of Bias in the CBCL for African Americans
-
批准号:7023819
-
项目类别:
-
资助金额:$3.13万
-
财政年份:2005
-
负责人:Victoria Khanh Ngo
-
依托单位:
Sources of Bias in the CBCL for African Americans
-
批准号:6943727
-
项目类别:
-
资助金额:$3.22万
-
财政年份:2005
-
负责人:Victoria Khanh Ngo
-
依托单位:
海外基金