Prism Scale Up Study

棱镜放大研究

• 批准号: 10198666
• 负责人: Hongtu Chen
• 金额: $ 45.67万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-10 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10198666
• 关键词: Address; Asia; Basic Science; Behavioral Symptoms; Case Study; Clinical; Communities; Community Health Aides; Consensus; Country; Dementia; Development; Effectiveness; Elderly; Ensure; Evaluation Studies; Evidence based intervention; Exhibits; Government; Health; Health Professional; Health Services Needs; Health Services for the Aged; Healthcare; Hybrids; Instruction; Interdisciplinary Study; Intervention; Intervention Studies; Knowledge; Medical; Mental Health; Mental Health Services; Modeling; National Institute of Mental Health; Nurses; Organizational Culture; Outcome; Performance; Physical Exercise; Policies; Politics; Primary Care Physician; Procedures; Process; Province; Randomized Controlled Trials; Readiness; Recommendation; Research; Research Personnel; Resolution; Resources; Scientist; Site; Specialist; Standard Model; Supervision; Testing; Thailand; Training; United States; Work; arm; base; community organizations; comparison intervention; design; effectiveness testing; evidence base; exercise intervention; experience; formative assessment; geriatric mental health; implementation barriers; implementation evaluation; implementation fidelity; implementation framework; implementation research; implementation science; implementation strategy; implementation tool; improved; innovation; intervention program; low and middle-income countries; mental training; programs; psychological symptom; randomized trial; response; scale up; social; success; tool; treatment arm; trend

Abstract: The Scale-Up Component of the Partnership in Implementation Science for Geriatric Mental Health (PRISM) project proposes an evidence-based physical exercise intervention for older adults who exhibit behavioral and psychological symptoms of dementia (BPSD). The intervention will be delivered in Thai communities through an evidence-based implementation strategy of “task sharing” among community health workers (CHWs), nurses, primary care physicians, and mental health specialists. In response to the common problem of technical and cultural compatibility between evidence-based interventions and local implementation contexts as well as the uneven local political will for implementing mental health service initiatives, we propose to develop and test an innovative implementation support strategy (i.e., the GTO-ThAI model), based on the evidence-based Getting-to-Outcome model, which will be adapted to Thai settings, to ensure the success of implementation and scaling up of the mental health service for older adults in Thailand. To our knowledge, no previous study has examined the effectiveness of a GTO-ThAI implementation support strategy for delivering clinical interventions for older adults with BPSD in Asia. The proposed evaluation study will conduct a randomized controlled trial with a Hyprid Type 3 design to compare the intervention arm that implements the culturally-adapted GTO model (GTO-ThAI) to deliver implementation support, with a control arm, which receives usual top-down administrative instruction for implementing a policy initiative. Our specific scale-up study aims are to: 1) tailor an evidence-based physical exercise intervention (EBPEI) to fit with Thai local social, cultural, and policy context (Yr 1); 2) develop culturally-informed tools to assess readiness for implementing EBPEI to improve mental health of older adults in local provinces of Thailand (Yr 1); 3) develop the GTO-ThAI implementation support model through a pre- implementation case study and formative evaluation (Yr 2); 4) evaluate implementation strategies and clinical outcomes through a hybrid Type 3 randomized trial to test effectiveness of the GTO-ThAI implementation support strategy for the delivery of EBPEI, compared with the existing standard administrative procedures for delivering the same EBPEI (Yrs 3-4); 5) develop policy recommendations with tools and performance indicators (Yr 5). The proposed scale-up study is expected to generate knowledge and tools essential for further scale-up of mental health services in Thailand, and will contribute significantly to knowledge development within other NIMH program HUBs on going to scale with mental health innovations in LMICs.

翻译后摘要：在老年心理健康实施科学的伙伴关系的规模扩大的组成部分 （PRISM）项目提出了一个基于证据的体育锻炼干预老年人谁表现出 痴呆的行为和心理症状（BPSD）。干预措施将以泰国语进行 通过社区卫生部门之间“任务分担”的循证执行战略， 工人（CHW），护士，初级保健医生和心理健康专家。为了应对共同的 循证干预措施与地方执行之间的技术和文化兼容性问题 背景以及实施精神卫生服务倡议的不平衡的地方政治意愿，我们建议 制定和测试创新的执行支助战略（即，GTO-ThAI模型），基于 以证据为基础的取得成果模式，将适应泰国的环境，以确保成功的 在泰国实施和扩大老年人心理健康服务。据我们所知，没有 以前的研究已经审查了GTO泰国实施支持战略的有效性， 亚洲老年BPSD患者的临床干预。 拟定的评价研究将采用3型Hybrid设计进行随机对照试验， 比较实施适应文化的GTO模式（GTO-ThAI）的干预部门， 执行支助，有一个控制部门，接受通常自上而下的行政指示， 实施一项政策举措。我们具体的规模扩大研究的目的是：1）定制一个基于证据的物理 运动干预（EBPEI），以适应泰国当地的社会，文化和政策背景（一年级）; 2）发展 评估实施EBPEI以改善老年人心理健康的准备情况的文化信息工具 在泰国地方省份（第一年）; 3）通过一个预先的 实施案例研究和形成性评估（2年级）; 4）评估实施策略和临床 通过混合3型随机试验来测试GTO-ThAI实施的有效性 与现有的标准行政程序相比， 提供相同的EBPEI（第3-4年）; 5）使用工具和绩效制定政策建议 指标（第5年）。拟议的扩大研究预计将产生必要的知识和工具， 进一步扩大泰国的精神卫生服务，并将大大促进知识 在其他NIMH项目中心内的发展，将与LMIC的心理健康创新一起进行规模化。