PALOP Mental Health Implementation Research Training

描述(由申请人提供)：PALOP(配对非洲语言和葡萄牙语)精神卫生(MH)实施研究培训计划。在全球范围内，在15岁以上的人中，精神障碍仍然是导致残疾多年的十大因素之一。在莫桑比克等低收入和中等收入国家，情况更是如此；在低收入和中等收入国家，超过75%的精神障碍患者在严重残疾的情况下得不到治疗，而且在提供治疗的地方，很少基于循证做法，侵犯人权的情况经常发生。《柳叶刀》全球卫生保健丛书(2007)总结说，“应为研究提供资金，以开发和评估非卫生保健专业人员可提供的干预措施(任务转移)，并评估卫生系统如何在所有常规护理环境中扩大此类干预措施。”遗憾的是，在LMIC中专注于MH的国际研究合作是有限的，任何LMIC中还没有MH实施研究方面的Fogarty或NIH培训计划。我们与UEM大学合作，并与圣保罗联邦大学和范德比尔特全球卫生研究所(VIGH)合作，提议在莫桑比克开展一个南北和南南合作的项目，培训下一代PALOP MH实施科学家，为期两年。该方案将有两个重点：A)以部署为重点的干预研究：通过社区合作，研究员将学习适应和实地测试针对获取、有效评估、有效预防和治疗的成熟和真实的干预措施；以及B)干预传播、实施和服务研究：研究如何在莫桑比克新扩大的卫生保健系统中扩大护理。莫桑比克是一个理想的环境，因为它是由我们的合作伙伴UEM与卫生部(也是合作者)共同制定的MH护理新战略计划，而且最近实施了一项针对精神病技术人员的创新培训计划，以提供非专科护理。该计划的组成部分将是：1)指导；2)研究设计、统计和拨款撰写方面的教学；3)干预研究培训；4) 参与设计、执行和分析研究以及提交科学论文/提案；5)通过设计/实施试点项目，在任务转移、分级护理和促进机会战略方面有实际研究经验；6)指导负责任的研究行为；7)在科学会议上发表演讲；8)与纽约州立精神病学(NYSPI)/哥伦比亚大学和联合国教育、科学及科学基金会的教职员工和该领域的杰出研究人员进行交流。莫桑比克可以成为其他PALOP和撒哈拉以南非洲国家以及包括美国在内的其他资源匮乏地区的榜样。该计划将利用NYSPI现有的8个奖学金，包括T32全球MH实施奖学金，以及联合国教科文组织提供的奖学金，以培养丰富的学习环境，使研究员沉浸在专注于培养本地、地区和全球MH的环境中。

DESCRIPTION (provided by applicant): PALOP (Paises Africanos de Lingua Oficial Portuguesa) Mental Health (MH) Implementation Research Training Program. Globally, mental disorders remain 3 of the top 10 contributors to years lived with disability among those over age 15. This is even more so in low- and middle-income countries (LMICs) such as Mozambique; over 75% of those with mental disorders in LMICs receive no care despite substantial disability, and where treatment is provided, it is rarely based on evidence-based practices and human rights violations occur frequently. The Lancet Global MH Series (2007) concluded that "funding should be given to research that develops and assesses interventions that can be delivered by people who are not MH professionals (task- shifting), and... assesses how health systems can scale up such interventions across all routine-care settings." Sadly, international research collaborations focused on MH in LMICs are limited and no Fogarty or NIH training programs in MH implementation research are yet available in any LMICs. Partnering with Universidade Eduardo Mondlane (UEM) and in alliance with Universidade Federal de Sao Paulo (UNIFESP) and the Vanderbilt Institute for Global Health (VIGH), we propose a program in Mozambique with a North-South and South-South collaboration that will train the next generation of PALOP MH implementation scientists in a 2- year fellowship. The program will have two foci: A) Deployment-focused interventions research: With community collaboration, fellows will learn adaptation and field-testing of tried and true interventions that address access, valid assessment, effective prevention and treatment; and B) Intervention dissemination, implementation and services research: Examining how care can be scaled-up within Mozambique's newly expanding system of MH care. Mozambique is an ideal setting given its new strategic plan for MH care developed by our partner UEM with the Ministry of Health (also collaborators) and the recent implementation of an innovative training program for psychiatric technicians to deliver non-specialist care. The program's components will be: 1) mentorship; 2) didactics in research design, statistics, and grant writing; 3) interventions research training; 4) participation in design, execution and analysis of research and submission of scientific papers/proposals; 5) hands-on research experience in task-shifting, stepped-care and access-enhancing strategies through design/implementation of pilot projects; 6) instruction in responsible conduct of research; 7) presentation at scientific meetings; and 8) interchange with New York State Psychiatric (NYSPI)/Columbia University and UNIFESP faculty and distinguished researchers in the field. Mozambique can be a model to other PALOP and sub-Saharan African countries as well as other low-resource settings, including the US. This program will leverage 8 existing fellowships at NYSPI, including a T32 Global MH implementation fellowship, and scholarships from UNIFESP to cultivate a rich learning environment that will immerse fellows in a milieu focused on fostering MH locally, regionally, and globally.