Research Component

项目总结(见说明)： SHARE-THPP的目标是开发一种创新、有效和可持续的方法来提供既定的心理治疗，以减轻南亚母亲的抑郁症负担。我们的目标是解决提高心理健康水平的一个关键障碍 在LMIC中采取干预措施，解决缺乏训练有素的人力资源的问题，方法是调整现有的循证干预措施，以便由同行辅导员--生活在同一社区的有经验的妇女--与现有的社区卫生工作者合作提供。SHARE-THPP干预将通过广泛的形成性研究和与同伴辅导员一起试点进行开发 评价实施干预措施的可行性和可接受性。随后将在南亚的三个不同环境中通过随机对照试验评估由此产生的干预措施的有效性： A)通过在巴基斯坦拉瓦尔品第(农村环境)进行的一项整群随机试验，涉及40个CHW监督区和444名母亲，并由训练有素的同伴辅导员在20个干预区以小组形式提供干预 B)通过在印度果阿(城市环境)进行的个人随机试验，将328名妇女随机分为干预组和对照组，由同伴辅导员以个人形式向被随机分配到干预组的母亲进行干预。 C)通过在巴基斯坦斯瓦特(受灾环境)进行的一项探索性随机试验，将60名妇女随机分为干预组和对照组，由同伴辅导员以个人形式向被随机分配到干预组的母亲进行干预。 主要结果是6个月后评估的产妇抑郁，次要结果包括产妇残疾和儿童健康。所有的分析都将是意向治疗。该方案将包括详细的进程评价和对部分参与者的定性访谈。

PROJECT SUMMARY (See instructions): The goal of SHARE-THPP, Thinking Health Programme-Peer delivery, is to develop an innovative, effective and sustainable approach for the delivery of an established psychological treatment that reduces the burden of depression in mothers in South Asia. We aim to address a key barrier to the scaling up of mental health interventions in LMIC, the lack of trained human resources, by adapting an existing evidence-based intervention so that it can be delivered by peer counsellors - experienced women living in the same community - in partnership with established community health workers (CHWs). The SHARE-THPP intervention will be developed through extensive formative research and piloting the intervention with peer counselors to evaluate the feasibility and acceptability of the the implementation of the intervention. The effectiveness of the resulting intervention will then be evaluated through randomised controlled trials in three diverse settings in South Asia: a) Through a cluster randomised trial in Rawalpindi, Pakistan (rural setting) involving 40 CHW supervisory zones and 444 mothers, with trained peer-counsellors delivering the intervention in group format in the 20 intervention zones b) Through an individual randomised trial in Goa, India (urban setting), involving 328 women randomised into intervention and control arms, with peer-counsellors delivering the intervention in individual format to the mothers randomised to the intervention arm. c) Through an exploratory randomised trial in Swat, Pakistan (disaster-affected setting) involving 60 women randomised into intervention and control arms, with peer-counsellors delivering the intervention in individual format to the mothers randomised to the intervention arm. The primary outcome is maternal depression evaluated at six months, and secondary outcomes include maternal disability and child health. All analyses will be intention to treat. The programme will include detailed process evaluation and qualitative interviews with a sub-sample of participants.