Responding to the challenges of Adolescent Perinatal Depression with patient-centered mobile health

项目摘要/摘要 围产期抑郁(PD)在青少年中比老年围产期妇女更普遍。在LMIC， 妇幼保健(MCHC)服务主要由初级保健的非专科临床医生提供 由于人力资源不足。然而，尽管初级保健提供了有效的治疗，但 自我耻辱和医护人员的耻辱加剧了人们对 对少女母亲的排斥，并限制她们使用现有的服务。 无处不在，可用作混合方法中的治疗工具 移动技术与面对面的护理相结合，增加了患者与护理的接触。在尼日利亚，手机的使用率很高，甚至在 青少年。考虑到普遍的观察结果，年轻人经常痴迷于他们的手机， 移动技术为向这一人群提供保健提供了一种实用的媒介。目标是 这项拟议的新兴全球卫生领袖K43奖是为了发展Lola Kola博士在 开发和使用移动健康工具，以扩大基于证据的心理社会干预 LMIC常规护理范围内的疾病。通过研究、课程作业和有组织的指导活动， 应聘者将在(1)心理健康研究的移动技术方法方面获得新的能力，(2) 实施研究方法，(3)高级分析和统计方法和(4) 专业发展，在LMIC环境下独立领导大型研究项目。DRS Dror Ben Zeev，Oye Gureje，David Atkins和Crick Lund将指导她。有指导的研究将建立在 尼日利亚过去的扩大努力，特别是最近结束的一项研究，扩大对围产期妇女的护理 初级保健中有抑郁症(EXPONAT)，结果显示青春期母亲较少 可能会参加治疗，尽管有有效的治疗方法，但他们的孩子的结果更差 治疗。使用mhGAP指南的EXPOATE研究的治疗指南将被修改 供mHealth使用。候选人将使用以用户为中心的方法来设计、开发和改进 在常规护理中建立治疗青少年围产期抑郁症的移动健康系统，以及 使用实施研究原则制定R01应用程序的可伸缩性路线图。这个 研究推进FIC的使命(目标2)，通过技术刺激创新，以应对全球 健康问题和对NIMH战略计划目标4的贡献加强对公共卫生的影响 支持的研究。它推动了全球精神卫生领域的重大挑战，以改善和增加 获得循证护理(目标C和F)。将心理健康纳入初级保健并加以改进 获得护理也是世卫组织2013-2020年行动计划的目标。来自指导研究的数据将 提供有关mHealth在治疗LMIC中的动作障碍方面的独特信息。在训练结束时， 应聘者将获得在心理健康研究中使用mHealth的强大基础技能

Project Summary/Abstract Perinatal depression (PD) is more prevalent among adolescents than older perinatal women. In LMIC, Maternal and Child Health (MCHC) services are provided mainly by non-specialist clinicians in primary care due to insufficient human resources. However, despite availability of effective treatment in primary care, a combination of self stigma and perceived stigma from health care workers exacerbate feelings of ostracization in adolescent mothers and limit their use of available services. ubiquitous and can be leveraged as therapeutic tools in a blended approach Mobile technologies are with face to face care to increase patients' contact with care. In Nigeria there is high usage of mobile phones even among adolescents. Given the common observation that young people are often attached to their mobile phones, mobile technologies provide a practical medium for the delivery of health care to this population. The goal of this proposed Emerging Global Health Leader K43 Award is to develop Dr Lola Kola's expertise in the development and use of mHealth tools to scale up evidence based psychosocial interventions for mental disorders within routine care in LMIC. Through research, coursework, and structured mentorship activities, the candidate will acquire new competency in (1) Mobile Technology Methods in Mental Heath research, (2) Implementation research methodologies, (3) Advanced Analytic and Statistical methods and (4) Professional development to lead Large-scale research projects independently in LMIC settings. Drs Dror Ben Zeev, Oye Gureje, David Atkins and Crick Lund will mentor her. The mentored research will build on past scale up efforts in Nigeria, specifically a recently concluded study, Expanding care for perinatal women with depression (EXPONATE) in primary care, where results showed that adolescent mothers were less likely to attend treatment sessions, and their children had poorer outcomes despite availability of effective treatment. The treatment guide for the EXPONATE study which utilises mhGAP guidelines, will be adapted for mHealth use. Candidate will utilise a User-Centered approach to design, develop, and refined the mHealth system for the treatment of Adolescent Perinatal Depression (APD) within routine care, and develop a roadmap to scaleability in an R01 application using implementation research principles. The research advances FIC's mission (GOAL 2) to stimulate innovation through technologies to address global health problems and contributes to NIMH Strategic Plan Objective 4 to strengthen Public Health Impact of supported Research. It advances Grand Challenges in Global Mental Health to improve and increase access to evidence based care (Goal C and F). Integration of mental health into primary care and improved access to care are also goals of the WHO Action Plan 2013-2020. Data from the mentored study will provide unique information on mHealth use in the treatment of APD in LMIC. At the end of the training, candidate will have acquired strong foundational skills for mHealth use in mental health research