Integrating Mental Health into Community-Based Maternal Health Services

将心理健康纳入社区孕产妇保健服务

• 批准号: 9195272
• 负责人: Molly Elizabeth Lasater
• 金额: $ 4.36万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-16 至 2019-02-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9195272
• 关键词: Address; Africa; Africa South of the Sahara; Anxiety; Belief; Budgets; Caring; Child; Cognitive; Communities; Community Health Services; Consult; Country; DSM-V; Data; Depressed mood; Development; Disease; Doctor of Philosophy; Emotional; Evidence based practice; Exercise; Fellowship; First Pregnancy Trimester; Funding; Goals; Guidelines; Health; Health Personnel; Health Policy; Health Priorities; Health Services Accessibility; Health care facility; Health system; Healthcare; Home visitation; House Call; Income; International; Intervention; Interview; Logistic Regressions; Low income; Maintenance; Mali; Malnutrition; Manuals; Maternal Health Services; Measures; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mental health promotion; Mentorship; Meta-Analysis; Methods; Modeling; Mothers; National Institute of Mental Health; Outcome; Parents; Peer Review; Perinatal; Postnatal Care; Postpartum Period; Prevalence; Prevention; Prevention Research; Preventive; Preventive Intervention; Primary Health Care; Provider; Psyche structure; Public Health Schools; Qualitative Methods; Qualitative Research; Research; Research Methodology; Research Personnel; Research Priority; Research Training; Review Literature; Risk; Rural; Services; Sorting - Cell Movement; Source; Specialist; Students; Symptoms; Techniques; Testing; Training; United States National Institutes of Health; Woman; base; contextual factors; cost; design; evidence base; experience; health care service; improved; innovation; intergenerational; international center; low and middle-income countries; mental disorder prevention; novel; online community; peripartum depression; physical conditioning; postnatal; psychologic; social stigma; symptom cluster; theories

PROJECT SUMMARY Aims: The goal of this study is to collect formative data to inform the development of a locally, culturally relevant module to integrate mental health prevention and promotion into maternal health services accessed by perinatal women in rural Mali, West Africa. Specifically, the study aims to: 1) qualitatively identify local mental health constructs; 2) examine local priorities and sources of care for mental health; and 3) review the literature of intervention content and delivery mechanisms for common perinatal mental disorders (CPMDs) in low and middle-income countries (LMIC). Significance: The perinatal period is defined as the antenatal period to one year postpartum. CPMDs are highly prevalent in LMICs, and have been shown to place children at increased risk for poorer physical and mental health outcomes. Limited research has been conducted to develop and evaluate prevention interventions for CPMDs within the context of antenatal care. In Mali, there is no official mental health policy, and mental health care services and providers are extremely limited. This research addresses Grand Challenges in Global Mental Health Goals, B, C, D, and E, and advances NIMH Strategic Aim 4 by developing innovative service delivery models to improve mental health. Approach: This study is embedded within a current NIH-Fogarty International Center (FIC) funded R21 project in Selingué, Mali (09/14- 08/16; a 12-month no cost extension will be requested). This study is informed by Patel’s model of the credibility gap, and the ethnomedical theory. Qualitative research methods are systematic and rigorous, particularly when measures do not exist, and will be utilized to gain in-depth understanding of mental health concepts. Aims 1-2 will be addressed with qualitative methods, including multiple interview techniques among perinatal women, non-specialist health workers (NSHWs), and mental health providers to identify local constructs and priorities for care, as well as observations of NSHWs home visits. Aim 1 will be analyzed using cultural salience analysis, the standard analytic technique for measuring shared beliefs as culture. Data from Aim 2 will be analyzed using ranked ordered logistic regression of priorities for care and thematic analysis. Aim 3 will be addressed through a literature review of intervention content and delivery mechanisms for CPMDs. Sources will include peer-reviewed literature and online manuals and toolkits in the field of maternal mental health. Fellowship Information: This study is the doctoral dissertation for Ms. Lasater, a current PhD student in the Department of International Health at the Johns Hopkins Bloomberg School of Public Health. Ms. Lasater has chosen one primary sponsor, and four co-sponsors who have complementary expertise in the methods and topics of this project. The training plan is designed with mentorship, research, and intensive coursework to allow Ms. Lasater to develop expertise in qualitative research methods, and strong quantitative competencies to help her achieve her long-term goal of becoming a leading independent researcher in global mental health in sub-Saharan Africa.

项目摘要目标：本研究的目标是收集形成性数据，为开发提供信息 一个与当地文化相关的模块，将心理健康预防和促进纳入孕产妇保健 西非马里农村围产期妇女获得的服务。具体而言，该研究旨在：1）定性 确定当地精神卫生结构; 2）检查当地精神卫生护理的优先事项和来源;以及3） 对围产期常见精神障碍的干预内容和实施机制进行文献综述 低收入和中等收入国家（LMIC）。意义：围产期定义为 产前至产后一年。CPMD在中低收入国家中非常普遍， 儿童身心健康状况恶化的风险增加。有限的研究已经 在产前保健的背景下，制定和评估CPMD的预防干预措施。在 马里，没有正式的精神卫生政策，精神卫生保健服务和提供者极其缺乏。 有限公司这项研究解决了全球心理健康目标B、C、D和E的重大挑战， 通过开发创新的服务提供模式来改善心理健康，推进NIMH战略目标4。 方法：本研究嵌入在当前NIH Fogarty国际中心（FIC）资助的R21项目中 在马里塞林格（2014年9月至2016年8月;将要求无费用延长12个月）。这项研究是由 帕特尔的可信度差距模型和民族医学理论。质的研究方法是系统的 和严格的，特别是当措施不存在，并将用于深入了解 心理健康概念。目标1-2将采用定性方法，包括多次访谈 技术围产期妇女，非专业卫生工作者（NSHW），和精神卫生提供者， 确定当地的结构和护理优先事项，以及观察新社会福利工作者的家访情况。目标1将是 分析使用文化显着性分析，标准的分析技术，衡量共同的信念， 文化将使用护理优先级的排序逻辑回归分析目标2的数据， 专题分析。目标3将通过对干预内容和实施的文献综述来解决 CPMD的机制。资源将包括同行评审的文献和在线手册以及 产妇心理健康领域。奖学金信息：这项研究是博士论文的女士。 拉塞特目前是约翰霍普金斯彭博社国际卫生系的博士生 公共卫生学院。Lasater女士选择了一个主要赞助商和四个共同赞助商， 在该项目的方法和主题方面的补充专业知识。培训计划的设计 导师，研究和密集的课程，让女士Lasater发展定性的专业知识， 研究方法，和强大的定量能力，以帮助她实现她的长期目标，成为一个 他是撒哈拉以南非洲地区全球心理健康领域的领先独立研究员。