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

佛教僧侣作为越南抑郁症治疗的任务转移提供者

• 批准号: 10297970
• 负责人: Bahr Weiss
• 金额: $ 19.85万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-20 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10297970
• 关键词: Address; Affective; Aftercare; Antidepressive Agents; Area; Awareness; Behavioral; Clinical; Cognitive Therapy; Collaborations; Communities; Data; Development; Disadvantaged; Educational workshop; Emotional; Evaluation; Feeling; Focus Groups; Future; Goals; Group Interviews; Group Practice; Health Professional; Health system; Human Resources; Intervention; Interview; Knowledge; Label; Logistics; Meditation; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mindfulness Training; Needs Assessment; Outcome; Outpatients; Participant; Patients; Pharmaceutical Preparations; Process; Program Acceptability; Provider; Psychologist; Public Health; Recurrence; Research; Research Activity; Research Support; Risk; Service provision; Services; Solid; Structure; System; Techniques; Therapeutic; Thinking; Training; Universities; Vietnam; acceptability and feasibility; base; behavioral health; bodily sensation; design; dissemination strategy; effective intervention; effective therapy; effectiveness evaluation; effectiveness implementation study; experience; implementation fidelity; implementation intervention; implementation research; informant; low and middle-income countries; medical schools; mental training; mindfulness; mindfulness intervention; mindfulness-based stress reduction; programs; psychologic; public health relevance; recruit; smoking cessation; social stigma; success

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.

项目概要 抑郁症是一个巨大的公共卫生负担。抑郁症的有效治疗方法存在，但还很有限 由于缺乏训练有素的心理健康专业人员以及与“精神疾病”相关的耻辱， 大多数抑郁症患者没有接受治疗，特别是在中低收入国家。解决这些问题的一种方法 问题是精神卫生任务转移，即从训练有素的精神卫生部门转移精神卫生服务 专业人员到非精神卫生专业人员或接受特定精神方面集中培训的非专业人士 健康计划。基于正念 (MB) 的干预措施是一种抑郁症 EBT，通过活动来帮助人们 更加意识到身体的感觉、感觉和想法，而不自动判断它们，从而减少 负面情绪反应会引发并加剧情感心理健康问题。这个R21 重点是利用越南佛教僧侣作为基于正念的干预的任务转移提供者 沮丧。 MB 干预源自佛教冥想实践，在 世俗的方式。利用佛教僧侣作为 MB 干预的任务转移提供者可能是有利的，因为 (1) 冥想是佛教僧侣训练的核心部分，虽然不是心理健康专业人士， 僧侣在任务转移的基础技术方面拥有扎实的背景； (2) 宝塔式治疗可 减少治疗耻辱。项目具体目标是：#1。进行能力发展需求评估 与约 68 个利益相关者合作，通过焦点小组和关键知情人访谈，为此做好准备 项目和更全面的未来研究； #2：采用基于正念的减压（MBSR） 僧侣的任务转移实施。这一具体目标的目标是 (a) 为僧侣调整 MBSR（MBSR- 4M）实施； (b) 对僧侣进行MBSR-4M培训，以实现具体目标#3；和（三） 通过参与改编的协作分享过程，增加我们的了解更多 一般而言，我们的扩展团队如何才能最有效地协作； #3：进行 2 型混合 MBSR-4M 的实施效果评估。主要目标是： (a) 获得合作经验 与越南佛教系统一起开展实施研究，以便 (b) 发展未来的能力 该领域及相关领域的合作研究； (c) 确定潜在影响信息系统的文化和其他因素 未来研究的目标领域； (d) 获取初步 RCT 数据以评估适当性 以及我们的计划改编的成功。 MBSR-4M评估将于16日在河内和岘港进行 宝塔有 160 名患有抑郁症的参与者（一半处于治疗状态，一半处于控制状态），招募自 宝塔和广大社会。 #4：能力发展：这些具体目标的核心功能是 通过为我们的团队提供相关知识、后勤保障来发展支持这项研究的能力 朝着这些方向前进所必需的结构和专业关系。此外， 还将举办针对具体目标#1 中确定的具体发展领域的研讨会。