Addressing barriers to Scaling-up Perinatal Mental Health Intervention

项目摘要/摘要 在LMICs中，围产期抑郁的负担非常高。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 证明对减少围产期抑郁是有效的。最近，世卫组织mhGAP计划采纳了证据 基于心理社会干预的思维健康计划(THP)，用于全球传播。有越来越多的 任务分担干预在改善LMIC患者心理健康方面有效的证据。也有越来越多的 记录阻碍这类干预措施可伸缩性的障碍。缺乏与现有医疗保健的整合 平台和大规模的质量培训和监督是扩大规模的一些障碍。的目标是 这一国际研究职业发展奖K43是为了发展候选人的专业知识 实施循证围产期心理健康干预措施。通过研究， 课程作业和结构化的指导活动，候选人将发展新的能力 实施研究，包括一)以理论为基础的实施研究概念性知识 和实践；二)实施研究设计方面的方法专长；三)专业知识 朝着成为独立的LIMIC研究人员的方向发展。劳伦斯·维索，阿蒂夫·拉赫曼，阿萨德 哈菲兹、维克拉姆·帕特尔和乔安娜·马塞尔科将在这三个目标上指导候选人。这项研究将 将在巴基斯坦进行，以及正在进行的NIMH U19 Share和NICHD/NIH提供的基础设施 RO1在巴基斯坦分享儿童项目。候选人将在随机对照试验中进行评估 政府雇用的社区卫生工作者在技术方面的培训和监督能力 THP的辅助版本(简称THP-TA)，并详细阐述了THP-TA的扩容过程 确定障碍和战略。使用巴基斯坦的社区卫生工作者提供妇幼保健服务和 技术创新有可能在巴基斯坦扩大热电联产的规模。它还有可能被 世卫组织对全球传播的支持。在此指导职业发展结束时，应聘者将拥有 以实施科学原理为基础的实施研究的基本技能。 此外，应聘者将获得技术辅助版本的THP开发和评估 获得员工的能力，并在知情的情况下扩大规模。这将通知R01用于 思维健康计划-技术辅助(THP-TA)实施方案。

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).