权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Brief Transdiagnostic Treatment for Anxiety Disorders and PTSD in South Africa: A Hybrid-Effectiveness Trial

南非焦虑症和创伤后应激障碍的简短跨诊断治疗：混合有效性试验

基本信息

批准号：
10669226
负责人：
Kristina Jo Korte
金额：
$ 18.29万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-23 至 2026-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10669226
关键词：
3-Dimensional Accounting Address Anxiety Anxiety Disorders Area Behavior Clinic Clinical Clinical Trials Collaborations Complex Control Groups Data Development Diagnosis Diagnostic Disease Dissemination and Implementation Educational Status Evidence based treatment Goals HIV Health Services Accessibility Hybrids Impairment Individual Intervention Interview Literature Malaria Measures Medical Mental Health Mental disorders Mentorship Methods Minority Modeling Nurses Outcome Patient Participation Patients Perception Persons Phase Population Post-Traumatic Stress Disorders Primary Care Primary Nursing Care Protocols documentation Provider Public Health Publications Randomized Research Methodology Research Personnel Resources Safety Sampling Schizophrenia Severities South Africa South African Therapeutic Intervention Time Training Work acceptability and feasibility career comorbidity design diagnostic strategy disability dissemination science effective therapy effectiveness evaluation effectiveness trial effectiveness/implementation design effectiveness/implementation study effectiveness/implementation trial experience implementation barriers implementation evaluation implementation facilitators implementation outcomes implementation science implementation strategy implementation trial improved low and middle-income countries meetings patient retention primary care clinic primary outcome scale up secondary outcome skills standard care therapy design training opportunity treatment of anxiety disorders

项目摘要

Background: Posttraumatic stress disorder (PTSD) and anxiety disorders are highly prevalent and a leading cause of disability in low and middle-income countries (LMICs). My long-term career goal is to address the burden posed by these disorders by becoming a leading expert in the implementation and dissemination of evidence-based treatments (EBTs) for these disorders for use in LMICs. This goal is motivated by observations from the literature and my own work. Despite the development of EBTs, an overwhelming majority of those in need (i.e., 85%) in LMICs do not receive treatment and, when they do, it is not empirically based. Despite the clear need for EBTs in LMICs, there are three primary barriers associated with the implementation of EBTs in these areas. These barriers include: (1) EBTs tend to be single disorder focused only treating one disorder at a time, (2) they are long in duration (e.g., 12-16 treatment sessions to treat one disorder), and (3) they tend to be complex and require a high level of skill to administer. Given the low availability of highly trained providers in LMICs, using an approach that is brief, culturally congruent, and less complex than typical EBTs is ideal for reducing these barriers. Proposed Study. The current study aims to evaluate a brief transdiagnostic treatment for anxiety disorders and PTSD (False Safety Behavior Elimination Treatment; F-SET; Schmidt et al., 2012) for use in South African primary care clinics. The aims follow a well-established implementation and dissemination model (PRISM; Feldstein & Glasgow, 2008) for all study aims. First, we will conduct in-depth qualitative interviews with patients (n=24) and providers and staff (n=10) to assess key barriers and facilitators to the implementation and sustainability of the F-SET intervention in South African primary care clinics (Specific Aim 1). Second, the F-SET intervention and implementation strategy will be adapted based on the findings from the qualitative study (Specific Aim 2). Third, we will conduct a randomized hybrid effectiveness-implementation trial to assess the effectiveness of the adapted F-SET and explore facilitators and barriers to implementation (Specific Aim 3). We will use a mixed methods approach (qualitative and quantitative) to evaluate the F-SET intervention administered by primary care nurses compared to an enhanced standard care control group in a sample of individuals with anxiety disorders and PTSD (N=60). We will evaluate the feasibility and acceptability of implementation as measured by: (1) patient participation and retention and (2) provider’s perceptions of barriers and facilitators of F-SET. Provider fidelity and quality of treatment delivery will be used as moderators. These data will be used to submit an R01 for a fully powered trial with clinic randomization in Year 4. Training Aims: This K01 proposal is will provide me with training needed to achieve my long-term career goal through training in: (1) the conducting culturally informed clinical trials in global mental health, (2) mixed methods research for implementation trials, and (3) implementation and dissemination science. The K01 training includes expert mentorship, extensive field-based experience in South Africa, coursework at Harvard, and publications.

背景：创伤后应激障碍（PTSD）和焦虑症是非常普遍和主要的疾病