Integration of a collaborative care model for mental health services into HIV care for pregnant and postpartum women in Kenya (the Tunawiri Study)
将心理健康服务协作护理模式纳入肯尼亚孕妇和产后妇女的艾滋病毒护理(图纳维里研究)
基本信息
- 批准号:10676019
- 负责人:
- 金额:$ 59.69万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-08-01 至 2028-05-31
- 项目状态:未结题
- 来源:
- 关键词:AIDS preventionAddressAdoptedAfrica South of the SaharaAnxietyBehavioralCaringCase ManagerChronicClinicClinicalCommunitiesComplexComprehensive Health CareCost AnalysisCost Effectiveness AnalysisCost effectiveness researchCountyDataData CollectionEducational workshopEffectivenessElectronicsEnsureEvidence based interventionExploration, Preparation, Implementation, and SustainmentFailureFamilyFocus GroupsGoalsGovernmentHIVHIV diagnosisHealthHealth care facilityHealth systemHealthcareHealthcare SystemsHybridsIncomeInfantInterventionInterviewKenyaLeadLinkMaternal HealthMaternal and Child HealthMental DepressionMental HealthMental Health ServicesMental disordersMentorsMethodsModelingMothersOutcomePatientsPerinatalPerinatal CarePharmaceutical PreparationsPoliciesPolicy MakerPostpartum PeriodPostpartum WomenPregnancyPregnancy OutcomePregnant WomenPrimary CarePrimary Health CareProbabilityProcessProtocols documentationProviderPsychiatric NursingPsychiatristPsychosocial Assessment and CareRecoveryRequest for ApplicationsResearchResource-limited settingRiskSelf EfficacyServicesSocial EnvironmentSpecialistSymptomsSystemTechniquesTestingTrainingTranslatingUnited States National Institutes of HealthViralViral Load resultWomanWorkacceptability and feasibilityantenatalantenatal careantiretroviral therapyanxiety symptomscare burdencare outcomesclinic readycollaborative carecommon treatmentcostcost effectivecost effectivenessdesigndissemination researcheffectiveness/implementation trialefficacious interventionefficacious treatmentexperiencehealth goalshealth service useimplementation barriersimplementation outcomesimplementation strategyimplementation studyimprovedinformantinterdisciplinary approachintimate partner violencelow and middle-income countriesmeetingsmodel buildingpeer coachingperinatal mental healthpostpartum carepostpartum healthproblem solving therapyscale upsocial determinantssocial health determinantssocial stigmasupport tools
项目摘要
Common mental disorders (CMD) of depression and anxiety are prevalent and largely untreated among Kenyan
pregnant and postpartum women living with HIV (PPWH). CMD lead to poor maternal and child health outcomes
and contribute to lack of HIV care engagement and virologic failure in PPWH. While efficacious treatments for
CMD exist, scaling treatment within routine health care in low- and middle-income (LMIC) settings will require
stakeholder engagement and both effectiveness and implementation data to inform scale up and sustainability.
Our team has integrated other efficacious interventions into antenatal (ANC) and HIV care in Kenya. We now
propose to integrate proven mental health services using a collaborative care model, combined with a low
intensity evidence-based intervention (problem solving therapy), while targeting known social determinants of
HIV-related health for PPWH (stigma and IPV). Building on the current multidisciplinary approach for HIV care
in Kenya, our proposed Collaborative Care Model (CCM) will utilize existing peer mentor mothers, non-specialist
behavioral care managers, and psychiatric nurses; and will incorporate a consultant psychiatrist into the
ANC/HIV care team. Guided by the EPIS (Exploration-Preparation-Implementation-Sustainment) framework, the
overall study goal is to integrate collaborative care for perinatal CMD within routine ANC/HIV services in
Kenya, assess the costs and cost-effectiveness of this approach, and work with policy and decision makers to
determine key considerations for scale-up. Specifically, in Aim 1, we will identify contextual barriers and
facilitators to refine an optimal integration model for delivering collaborative care model using multi-
method data collection (focus groups with providers, in-depth interviews with key informants, and a clinic
readiness checklist). A workshop with our Advisory Board comprising both county and national level stakeholders,
will allow us to translate findings into a locally relevant CCM. In Aim 2 we will test CCM
PPWH
health
during
depression
retention Aim 3, we will
refine CCM implementation strategies through cost-effectiveness and dissemination research. We will
carry out costing and cost-effectiveness analysis and invite policy and decision-makers to participate in a nominal
group technique process to elucidate factors for further scale up and sustainment of the CCM approach. Findings
from this study will developing a scalable model adaptable to other LMIC settings, contributing to global HIV and
maternal health goals while and addressing the burden of untreated CMD.
in antenatal care for
in a hybrid type 2 implementation-effectiveness trial using a stepped wedge design at 15 primary
care facilities in southwestern Kenya . We will i ntroduce CCM care for PPWH diagnosed with CMD
antenatal care. The co-primary health outcomes at 12 months postpartum will be (1) recovery from
or anxiety symptoms in PPWH, and (2) proportion PPWH with sustained viral suppression and
in HIV care. Key implementation outcomes are feasibility and acceptability. Finally, in
抑郁和焦虑的常见精神障碍(CMD)在肯尼亚人中很普遍,而且基本上没有得到治疗
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Lisa Lynn Abuogi其他文献
Lisa Lynn Abuogi的其他文献
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{{ truncateString('Lisa Lynn Abuogi', 18)}}的其他基金
Achieving successful treatment outcomes among adolescents and pregnant/postpartum women living with HIV in Kenya
在肯尼亚感染艾滋病毒的青少年和孕妇/产后妇女中取得成功的治疗结果
- 批准号:
10760594 - 财政年份:2023
- 资助金额:
$ 59.69万 - 项目类别:
Piloting risk stratification and tailored interventions with pregnant and postpartum women with HIV in Kenya to prevent disengagement from care and viral failure
在肯尼亚对感染艾滋病毒的孕妇和产后妇女进行风险分层试点和量身定制的干预措施,以防止脱离护理和病毒失败
- 批准号:
10701698 - 财政年份:2022
- 资助金额:
$ 59.69万 - 项目类别:
Piloting risk stratification and tailored interventions with pregnant and postpartum women with HIV in Kenya to prevent disengagement from care and viral failure
在肯尼亚对感染艾滋病毒的孕妇和产后妇女进行风险分层和量身定制的干预措施试点,以防止脱离护理和病毒失败
- 批准号:
10408229 - 财政年份:2022
- 资助金额:
$ 59.69万 - 项目类别:
Adaptive Strategies to Prevent and Treat Lapses of Retention in HIV Care for Adolescents (A4A)
预防和治疗青少年艾滋病毒护理中的保留失误的适应性策略 (A4A)
- 批准号:
10205178 - 财政年份:2019
- 资助金额:
$ 59.69万 - 项目类别:
Adaptive Strategies to Prevent and Treat Lapses of Retention in HIV Care for Adolescents (A4A)
预防和治疗青少年艾滋病毒护理中的保留失误的适应性策略 (A4A)
- 批准号:
10457310 - 财政年份:2019
- 资助金额:
$ 59.69万 - 项目类别:
Adaptive Strategies to Prevent and Treat Lapses of Retention in HIV Care for Adolescents (A4A)
预防和治疗青少年艾滋病毒护理中的保留失误的适应性策略 (A4A)
- 批准号:
10668384 - 财政年份:2019
- 资助金额:
$ 59.69万 - 项目类别:
Adaptive Strategies to Prevent and Treat Lapses of Retention in HIV Care for Adolescents (A4A)
预防和治疗青少年艾滋病毒护理中的保留失误的适应性策略 (A4A)
- 批准号:
10024087 - 财政年份:2019
- 资助金额:
$ 59.69万 - 项目类别:
Adaptive Strategies to Prevent and Treat Lapses of Retention in HIV Care for Adolescents (A4A)
预防和治疗青少年艾滋病毒护理中的保留失误的适应性策略 (A4A)
- 批准号:
9926603 - 财政年份:2019
- 资助金额:
$ 59.69万 - 项目类别:
Maximizing adherence and retention for women and infants in the context of Option
在 Option 的背景下最大限度地提高妇女和婴儿的依从性和保留率
- 批准号:
8729238 - 财政年份:2014
- 资助金额:
$ 59.69万 - 项目类别:
Maximizing adherence /retention for women /infants in the context of Option B+, Kenya
在选项 B 的背景下,肯尼亚最大限度地提高妇女/婴儿的依从性/保留率
- 批准号:
9045675 - 财政年份:2014
- 资助金额:
$ 59.69万 - 项目类别:
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