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

项目摘要 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是存在的，但部分 由于缺乏训练有素的精神卫生专业人员和与“精神疾病”有关的耻辱， 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是 问题是心理健康任务转移，心理健康服务从训练有素的心理健康 专业人员到非精神卫生专业人员或接受特定精神卫生专业培训的非专业人员 健康计划。基于正念（MB）的干预是一种抑郁症EBT，使用活动来帮助人们 变得更加意识到身体的感觉，感觉和想法，而不自动判断它们，减少 加速和加剧情感心理健康问题的负面情绪反应。R21 专注于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， 萧条MB干预措施来自佛教冥想实践，在一个 世俗的方式。利用佛教僧侣作为甲基溴干预措施的任务转移提供者可能是有利的， (1)冥想是佛教僧侣训练的核心部分，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 减少治疗的耻辱感。项目的具体目标是：#1。进行能力发展需求评估 与大约68个利益相关者，使用焦点小组和关键知情人访谈，为这一目标做准备。 项目和更全面的未来研究; #2：适应基于正念的减压（MBSR）， 僧侣们的任务转移。这一具体目标的目标是（a）为僧侣调整MBSR（MBSR）， （B）在MBSR-4 M中培训僧侣，以便在具体目标#3下实施;以及（c） 通过参与适应的协作分享过程，增加我们的了解更多 一般来说，我们的扩展团队如何才能最有效地合作; #3：进行类型2混合 实施MBSR-4 M的有效性评估。主要目标是：（a）获得合作经验 与越南佛教系统进行实施研究，以便（B）发展未来的能力 （c）确定可能影响信息系统的文化和其他因素 未来研究的目标领域;以及（d）获得初步RCT数据，以评估 和我们的节目改编的成功。MBSR-4 M评估将在河内和岘港进行 宝塔与160名参与者（一半在治疗条件下，一半在控制）与抑郁症，招募来自 塔和一般社区。#4：能力发展：这些具体目标的核心功能是 发展能力，以支持这项研究，通过提供我们的团队与相关的知识，物流 结构和专业关系，以朝着这些方向前进。此外，本发明还提供了一种方法， 还将举办针对具体目标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.