Buddhist Monks as Task-Shifting Providers of Depression Treatment in Viet Nam

项目总结 抑郁症是一个巨大的公共卫生负担。治疗抑郁症的有效方法是存在的，但部分是 由于缺乏训练有素的精神卫生专业人员，以及与“精神疾病”相关的耻辱， 大多数抑郁症患者没有接受治疗，特别是在LMIC。解决这些问题的一种方法 问题是精神健康任务的转移，将精神健康服务从训练有素的精神健康转移 从专业人员到非心理健康专业人员或非专业人员，在特定的心理领域接受集中培训 健康计划。基于正念的干预(MB)是一种抑郁症EBT，使用活动来帮助人们 更多地意识到身体的感觉、感觉和想法，而不是自动地评判它们，减少 消极的情绪反应会加速和加剧情绪性心理健康问题。这款R21 重点是使用越南佛教僧侣作为基于正念的干预的任务转移提供者 抑郁症。MB干预源自佛教冥想实践，开发并应用于 世俗的态度。使用佛教僧侣作为甲基溴干预的任务转移提供者可能有以下优势 (1)冥想是佛教僧侣培训的核心部分，尽管不是心理健康专业人员， 僧侣在任务转移的基础技术方面有坚实的背景；(2)基于宝塔的治疗可能 减少治疗污名。项目的具体目标是：#1.进行能力发展需求评估 利用焦点小组和关键线人访谈，与大约68个利益攸关方一起为此做好准备 项目和更全面的未来研究；#2：适应基于正念的压力减轻(MBSR) 和尚的任务转移执行。这一具体目标的目标是：(A)使MBSR适用于僧侣(MBSR- 4m)实施；(B)对僧侣进行MBSR-4m培训，以便在具体目标3下实施；和(C) 通过参与协作分享的过程中的适应，加深我们的理解 我们扩展后的团队如何才能最有效地协作；#3：实施类型2混合 MBSR-4M的实施效果评估。主要目标是：(A)获得协作经验 与VN佛教系统进行实施研究，以便(B)发展未来的能力 在这一领域和相关领域开展合作研究；(C)查明可能影响信息和通信技术的文化和其他因素 未来研究的目标领域；和(D)获得初步的随机对照试验数据，以评估其适当性 以及我们节目改编的成功。MBSR-4M评估将在16个河内和岘港进行 宝塔，160名抑郁症患者(一半在治疗中，一半在对照组)，招募自 宝塔和普通社区。#4：能力发展：这些具体目标的核心作用是 发展支持这项研究的能力，为我们的团队提供相关知识、后勤支持 结构，以及在这些方向上前进所必需的专业关系。此外, 还将提供针对具体目标1中确定的具体发展领域的讲习班。

PROJECT SUMMARY Depression represents a substantial public health burden. Effective treatments for depression exist but in part because of a scarcity of trained mental health professionals and stigma associated with “mental illness”, the majority of depression patients do not receive treatment, particularly in LMIC. One approach to address these issues is mental health task-shifting, the transfer of mental health services from highly trained mental health professionals to non-mental health professionals or lay people receiving focused training in a particular mental health program. Mindfulness-based (MB) interventions are a depression EBT, using activities to help people become more aware of bodily sensations, feelings, and thoughts without automatically judging them, reducing negative emotional reactivity that precipitates and exacerbates affective mental health problems. This R21 focuses on use of Vietnamese Buddhist monks as task-shifting providers of mindfulness-based intervention for depression. MB interventions are derived from Buddhist meditation practices, developed and applied in a secular manner. Use of Buddhist monks as task-shifting providers of MB interventions may be advantageous as (1) meditation is a central part of Buddhist monks' training and although not mental health professionals, monks have a solid background in underlying techniques being task-shifted; (2) pagoda-based treatment may reduce treatment stigma. Project Specific Aims are: #1. Conduct a capacity development needs assessment with approximately 68 stakeholders, using focus groups and Key Informant interviews, to prepare for this project and more comprehensive future research; #2: Adapt Mindfulness-Based Stress Reduction (MBSR) for task-shifting implementation by monks. Goals of this specific aim are (a) to adapt MBSR for monks (MBSR- 4M) to implement; (b) train the monks in MBSR-4M for implementation under Specific Aim #3; and (c) through the process of collaborative sharing involved in the adaptation, increase our understanding more generally of how our expanded team can most effectively collaborate together; #3: Conduct a Type 2 Hybrid Implementation-Effectiveness evaluation of MBSR-4M. Primary goals are: (a) to gain experience collaborating with the VN Buddhist system conducting implementation research, in order to (b) develop capacity for future collaborative research in this and related areas; (c) identify cultural and other factors potentially influencing IS domains for targeting in future research; and (d) obtain preliminary RCT data to assess the appropriateness and success of our program adaptation. The MBSR-4M evaluation will be conducted in 16 Hanoi and Danang pagoda with 160 participants (half in the treatment condition, half in control) with depression, recruited from pagoda and the general community. #4: Capacity Development: A central function of these specific aims is to develop capacity to support this research, by providing our team with the relevant knowledge, logistic structures, and professional relationships necessary to move forward in these directions. In addition, workshops targeting specific development areas identified in Specific Aim #1 also will be provided.