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ASHA Bangladesh--An Integrated Intervention to Address Depression in Low Income Rural Women

ASHA 孟加拉国——解决低收入农村妇女抑郁问题的综合干预措施

基本信息

批准号：
10767666
负责人：
ALISON KARASZ
金额：
$ 51.37万
依托单位：
UNIV OF MASSACHUSETTS MED SCH WORCESTER
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：
2021-09-02 至 2026-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10767666
关键词：
Address Advocate Affect Agriculture Asia Bangladesh Caring Child Clinical Cluster randomized trial Collaborations Country Decision Making Depressed mood Development Disease remission Dose Economic Development Economics Effectiveness Evaluation Family Fellowship Generations Government Government Agencies Health Health Care Costs Health Personnel High Prevalence Individual International Interruption Intervention Intervention Studies Interview Investigation Link Low Income Population Low income Manuals Mediating Mediator Medicine Mental Depression Mental Health Methods Modeling Outcome Participant Pathway interactions Patients Perception Personal Satisfaction Persons Pilot Projects Play Policies Policy Developments Policy Maker Poverty Productivity Randomized Relapse Research Research Personnel Research Training Resource-limited setting Role Rural Scientist Social support Structure Testing Universities Woman Work arm career development college comparison control contextual factors cost depressive symptoms design disability doctoral student economic outcome empowerment evidence base experience fighting graduate student hands on research implementation outcomes implementation process implementation research implementation study improved insight low and middle-income countries men novel pandemic disease policy implication poverty alleviation process evaluation programs psychosocial wellbeing recruit skills syndemic treatment arm treatment effect treatment trial university student uptake

项目摘要

A leading cause of global disability, depression is widespread among women in low and middle income countries (LMIC). Poverty plays a major role in depression via multiple pathways, while depression worsens poverty, compromising economic productivity. Efforts to increase access to depression treatment in LMIC have been hampered by low treatment uptake/engagement and weak treatment effects. Recently, researchers & policy makers have pointed to the importance of poverty alleviation in the fight again the global depression pandemic. We propose to implement an integrated poverty alleviation/depression treatment intervention for low income women in rural Bangladesh, designed to break the toxic cycle of poverty and depression. A capacity building component will build skills and support career development in qualitative implementation research for young scientists and establish a year-long research fellowship for graduate students at the University of Dhaka. Our project builds on an established partnership between Albert Einstein College of Medicine and the ICDDRB in Dhaka. Following our successful pilot study, we will implement a cluster randomized trial of an integrated intervention, recruiting 1200 low income women with depression from 80 villages. Villages will be randomized into one of four treatment arms: 1) evidence based depression treatment; 2) poverty alleviation through an agricultural asset transfer; 3) combined depression treatment/poverty alleviation, and 4) no-treatment control. Participants will be followed for 24 months. We hypothesize: improved depression outcomes at 6 and 24 months in the combined arm, compared to depression treatment or poverty alleviation alone. A detailed, mixed methods process evaluation, designed to generate new hypotheses regarding program and contextual factors influencing outcomes, will include in-depth qualitative interviews with program participants and staff, conducted by ASHA fellows. The proposed project will generate findings with significant implications for policy makers. To date, the work of depression researchers and economic development groups has included little collaboration. Programs that seek to reduce depression do not address the devastating impact of poverty; while, similarly poverty alleviation programs do not address the role of mental health in economic productivity. Results of this study, if promising, will generate evidence to guide collaborations among development agencies, researchers, policy-makers, and treatment providers. Our team’s dissemination efforts will bring government agencies, international and national health and economic development NGOS to consider the potential for a new generation of collaborative, integrated intervention approaches.

抑郁症是全球致残的主要原因，在中低收入妇女中普遍存在