Innovative approaches to developing scalable and sustainable adolescent maternal mental health interventions in Kenya and Mozambique

在肯尼亚和莫桑比克制定可扩展和可持续的青少年孕产妇心理健康干预措施的创新方法

基本信息

批准号：
MR/T019662/1
负责人：
Tatiana Taylor Salisbury
金额：
$ 155.84万
依托单位：
King's College London
依托单位国家：
英国
项目类别：
Fellowship
财政年份：
2020
资助国家：
英国
起止时间：
2020 至无数据
项目状态：
未结题

来源：
https://gtr.ukri.org/projects?ref=MR%2FT019662%2F1
关键词：
Innovative approaches developing scalable sustainable

项目摘要

The majority of the 20,000 babies born to adolescent mothers in low and middle-income countries live in sub-Saharan Africa. Efforts to achieve the UN Sustainable Development Goals have focused on preventing teenage pregnancy, leaving adolescent mothers with limited support to overcome the specific challenges they face. Adolescent girls are particularly vulnerable with 1 in 2 experiencing a mental disorder during pregnancy or the year after birth. The adverse effects on their physical health, social networks, educational achievements and employment opportunities and well as the developmental, emotional, behavioural and physical health outcomes of their children are significant. Despite this inequity, no interventions focused on adolescent maternal mental health have been evaluated in these low-resource settings. This is the challenge this Fellowship will address.To support adolescent mothers and their children to survive and thrive, it is necessary to engage stakeholders in the development of mental health interventions and identify how to leverage the surrounding structures and forces to optimise interventions for both front-line use and local and national implementation through the combination of human-centred design and systems thinking approaches. Through this fellowship I will use human-centred, systems-minded design to partner with adolescent girls, their families, and health providers to design, implement, and evaluate interventions to improve the mental health of adolescents during pregnancy and the year after birth in Mozambique and Kenya.A seven-year, three-phase, mixed-method design will be used to develop and evaluate a mental health prevention intervention for pregnant and new mothers aged 15-19 living in Mozambique and Kenya. In Phase 1 (months 2-18) a human-centred, system-minded design approach will be used to partner with adolescents, their families, local service providers and policymakers to identify, adapt and prototype an intervention to improve adolescent maternal mental health outcomes in each country. In Phase 2 (months 14-48), the intervention will be piloted within each country to assess feasibility, appropriateness, and acceptability and collect mental health, process and resource data to prepare for a trial. Lastly, in Phase 3 (months 49-84), a randomised controlled trial evaluating clinical effectiveness and delivery outcomes compared to usual care/basic mental health literacy intervention will be conducted. The research will result in the development of an intervention(s) that supports adolescent maternal wellbeing and gives adolescent mothers the hope and skills to build a better life for them and their children by packaging what we know are the risk and protective factors for maternal mental disorders in a way that is attractive to young mothers, their families and service providers. By using human-centred, systems-minded design to understand the needs and priorities of young mothers and the health and community systems in which they live, the resulting intervention(s) and approach to contextual adaptation has significant potential for international transferability and impact beyond Mozambique and Kenya, and beyond Africa. In addition, the work undertaken will provide a foundation for the development of approaches to adaptation and implementation of mental health interventions which can be used by providers of mental health interventions across the lifespan.

低收入和中等收入国家的青少年母亲所生的 20,000 名婴儿中，大多数生活在撒哈拉以南非洲地区。实现联合国可持续发展目标的努力重点是预防少女怀孕，这使得少女母亲在克服她们面临的具体挑战方面获得的支持有限。青春期女孩尤其容易受到伤害，其中有二分之一的人在怀孕期间或出生后一年内经历过精神障碍。对他们的身体健康、社交网络、教育成就和就业机会以及他们孩子的发育、情感、行为和身体健康结果的不利影响是显着的。尽管存在这种不平等，但在这些资源匮乏的环境中，尚未对针对青少年孕产妇心理健康的干预措施进行评估。这是该奖学金将要解决的挑战。为了支持青少年母亲及其孩子生存和成长，有必要让利益相关者参与心理健康干预措施的制定，并确定如何利用周围的结构和力量来优化两方面的干预措施- 通过以人为本的设计和系统思维方法相结合，进行线路使用以及地方和国家实施。通过这项研究金，我将采用以人为本、注重系统的设计，与青春期女孩、她们的家人和卫生服务提供者合作，设计、实施和评估干预措施，以改善莫桑比克青少年怀孕期间和出生后一年的心理健康将采用为期七年的三阶段混合方法设计，为居住在莫桑比克和肯尼亚的 15 至 19 岁孕妇和新妈妈制定和评估心理健康预防干预措施。在第一阶段（第 2-18 个月），将采用以人为本、注重系统的设计方法，与青少年、其家庭、当地服务提供者和政策制定者合作，确定、调整和原型化干预措施，以改善青少年孕产妇心理健康结果在每个国家。在第 2 阶段（第 14-48 个月），干预措施将在每个国家进行试点，以评估可行性、适当性和可接受性，并收集心理健康、过程和资源数据，为试验做准备。最后，在第 3 阶段（第 49-84 个月），将进行一项随机对照试验，评估与常规护理/基本心理健康素养干预相比的临床有效性和交付结果。该研究将开发出一种干预措施，支持青少年母亲的健康，并通过包装我们所知道的孕产妇心理风险和保护因素，为青少年母亲提供希望和技能，为她们及其孩子创造更好的生活。以对年轻母亲、她们的家人和服务提供者有吸引力的方式治疗疾病。通过使用以人为本、注重系统的设计来了解年轻母亲的需求和优先事项以及她们所居住的卫生和社区系统，由此产生的干预措施和适应环境的方法具有巨大的国际可移植性和影响力的潜力。莫桑比克和肯尼亚以及非洲以外的地区。此外，所开展的工作将为制定适应和实施心理健康干预措施的方法奠定基础，可供心理健康干预措施提供者在整个生命周期中使用。

项目成果

期刊论文数量（10）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Mutuality as a method: advancing a social paradigm for global mental health through mutual learning

DOI：
10.1007/s00127-023-02493-1
发表时间：
2023-07-01
期刊：
SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY
影响因子：
4.4
作者：
Bemme，Dorte;Roberts，Tessa;Burgess，Rochelle A.
通讯作者：
Burgess，Rochelle A.

Burden, impact, and needs of caregivers of children living with mental health or neurodevelopmental conditions in low-income and middle-income countries: a scoping review

DOI：
10.1016/s2215-0366(21)00207-8
发表时间：
2021-10-01
期刊：
LANCET PSYCHIATRY
影响因子：
64.3
作者：
Ademosu, Temitope;Ebuenyi, Ikenna;Salisbury, Tatiana
通讯作者：
Salisbury, Tatiana

Impact of mental health stigma on help-seeking in the Caribbean: Systematic review.

DOI：
10.1371/journal.pone.0291307
发表时间：
2023
期刊：
PloS one
影响因子：
3.7
作者：
通讯作者：

COVID-19 mental health impact and responses in low-income and middle-income countries: reimagining global mental health.

DOI：
10.1016/s2215-0366(21)00025-0
发表时间：
2021-06
期刊：
LANCET PSYCHIATRY
影响因子：
64.3
作者：
Kola, Lola;Kohrt, Brandon A.;Hanlon, Charlotte;Naslund, John A.;Sikander, Siham;Balaji, Madhumitha;Benjet, Corina;Cheung, Eliza Yee Lai;Eaton, Julian;Gonsalves, Pattie;Hailemariam, Maji;Luitel, Nagendra P.;Machado, Daiane B.;Misganaw, Eleni;Omigbodun, Olayinka;Roberts, Tessa;Salisbury, Tatiana Taylor;Shidhaye, Rahul;Sunkel, Charlene;Ugo, Victor;van Rensburg, Andre Janse;Gureje, Oye;Pathare, Soumitra;Saxena, Shekhar;Thornicroft, Graham;Patel, Vikram
通讯作者：
Patel, Vikram

Psychological and psychosocial interventions for maternal mental health delivered in sub-Saharan Africa: A systematic review

撒哈拉以南非洲地区孕产妇心理健康的心理和社会心理干预措施：系统评价