Addressing barriers to Scaling-up Perinatal Mental Health Intervention

项目总结/摘要 在中低收入国家，围产期抑郁症的负担非常高。它与儿童健康状况不佳有关。 作为任务分担的一部分，通过非精神卫生专业人员提供的心理社会干预措施， 对减少围产期抑郁症有效。最近，世卫组织mhGAP项目采用了证据， 基于心理社会干预的健康思维方案，在全球传播。人们日益 有证据表明，任务分担干预措施在改善LMIC的心理健康方面是有效的。也有越来越多 记录妨碍此类干预措施扩大规模的障碍。缺乏与现有卫生保健的融合 平台和大规模的质量培训和监督是扩大规模的一些障碍。的目标 这个国际研究职业发展奖K43是发展候选人的专业知识， 扩大基于证据的围产期心理健康干预措施。通过研究， 课程作业和结构化的导师活动，候选人将发展新的能力， 实施研究，包括i）以理论为基础的实施研究的概念知识 （二）在实施研究设计方面的方法学专业知识，以及（三）专业 成为一名独立的LIMIC研究员。Drs Lawrence Wissow，Atif Rahman，Assad Hafeez，Vikram Patel和Joanna Maselko将指导候选人实现这三个目标。这项研究将 在巴基斯坦进行，正在进行的NIMH U19 SHARE和NICHD/NIH提供的基础设施 巴基斯坦的RO1 SHARE CHILD项目。候选人将在随机对照试验中评估 政府雇用的社区卫生工作者的能力， 辅助版本的THP（简称为THP-TA），并详细说明了放大THP-TA的过程， 确定障碍和战略。在巴基斯坦利用社区卫生工作者提供妇幼保健服务， 技术创新具有扩大巴基斯坦THP规模的潜力。它也有可能被 世界卫生组织全球传播。在此指导职业发展结束时，候选人将拥有 实施研究的基本技能，以实施科学的原则为基础。 此外，候选人将有技术辅助版本的THP开发和评估， 获得非专业工人的能力和扩大知情的途径。这将通知R01， 实施"健康思维方案-技术辅助方案"。

Project Summary/Abstract The burden of perinatal depression is extremely high in LMICs. It is linked with poor child health outcomes. Psychosocial interventions delivered through non-mental health professionals as part of task sharing have shown to be effective in reducing perinatal depression. Recently, WHO mhGAP Program adopted the evidence based psychosocial intervention Thinking Healthy Program (THP) for global dissemination. There is increasing evidence that task sharing interventions are effective in improving mental health in LMIC. There is also growing documentation of barriers to the scalability of such interventions. Lack of integration into existing health care platforms and large scale quality training and supervision are some of the barriers to scaling up. The goal of this International Research Career Development Award K43 is to develop candidate’s expertise in implementing scale up of evidence based perinatal mental health interventions. Through research, coursework, and structured mentorship activities, the candidate will develop new competencies in implementation research including i) conceptual knowledge of implementation research grounded in theory and practice; ii) methodological expertise in implementation research designs, and iii) professional development towards becoming an independent LIMIC researcher. Drs Lawrence Wissow, Atif Rahman, Assad Hafeez, Vikram Patel and Joanna Maselko will mentor the candidate in these three objectives. The research will be conducted in Pakistan and the infrastructure provided by the ongoing NIMH U19 SHARE and NICHD/NIH RO1 SHARE CHILD projects in Pakistan. The candidate will evaluate, in a randomized controlled trial competencies of government employed community health workers trained and supervised on a technology assisted version of THP (called THP-TA for short) and elaborate the process of scaling-up THP-TA by identifying barriers and strategies. Using community health workers in Pakistan delivering MCH services and technology innovation has the potential of scaling-up THP in Pakistan. It also has the potential of take up by WHO for global dissemination. By the conclusion of this mentored career development, candidate will have the foundational skills for implementation research with grounding in the principles of implementation science. Furthermore the candidate will have the technology assisted version of THP developed and assessed for acquisition of competencies lay workers and the pathway to scale up informed. This will inform an R01 for an implementation program of Thinking Healthy Program – Technology Assisted (THP-TA).