Integrating Mental Health into Community-Based Maternal Health Services

项目总结目标：本研究的目标是收集成型数据，以便为 将心理健康预防和促进纳入孕产妇健康的地方和文化相关模块 西非马里农村地区围产期妇女获得的服务。具体地说，本研究旨在：1)定性地 确定当地的心理健康结构；2)检查当地的优先事项和心理健康护理的来源；以及3) 常见围产期精神障碍干预内容和传递机制的文献综述 低收入和中等收入国家(低收入和中等收入国家)。意义：围产期被定义为 产前至产后一年。CPMD在LMIC中非常普遍，并已被证明在 儿童身心健康状况较差的风险增加。有限的研究一直是 在产前护理的背景下，制定和评估对慢性阻塞性肺疾病的预防干预措施。在……里面 马里没有官方的精神卫生政策，精神卫生保健服务和提供者极其 有限的。这项研究解决了全球精神卫生目标B、C、D和E中的重大挑战，以及 通过开发创新的服务提供模式来改善精神健康，促进NIMH战略目标4。 方法：这项研究嵌入了目前由NIH-Fogarty国际中心(FIC)资助的R21项目 在马里塞林圭(09/14-08/16；将请求无费用延长12个月)。本研究由以下人员提供信息 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，特别是在没有措施的情况下，并将被用来深入了解 心理健康概念。目标1-2将采用定性方法，包括多次面谈 围产期妇女、非专科卫生工作者(NSHW)和精神卫生提供者之间的技术 确定当地建筑和护理的优先事项，以及对NSHW家访的观察。目标1将是 使用文化显著分析进行分析，这是衡量共同信念的标准分析技术 文化。来自AIM 2的数据将使用护理和护理优先级的排序逻辑回归进行分析 主题分析。目标3将通过对干预内容和实施的文献回顾来解决 CPMD的机制。资料来源将包括同行评议的文献以及在线手册和工具包 产妇心理健康领域。奖学金信息：这项研究是她的博士论文。 Lasater是约翰霍普金斯大学彭博社国际卫生系的现任博士生 公共卫生学院。Lasater女士选择了一个主赞助商和四个共同赞助商 在本项目的方法和主题方面的补充专业知识。培训计划是根据以下内容设计的 指导、研究和密集的课程工作，使Lasater女士能够发展定性方面的专业知识 研究方法和强大的量化能力，帮助她实现成为一名 撒哈拉以南非洲地区全球精神卫生领域的领先独立研究人员。

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.