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

• 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

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.

在撒哈拉以南非洲，大多数在低收入和中等收入国家中出生的20,000名婴儿中的大多数。实现联合国可持续发展目标的努力集中在防止青少年怀孕，使青少年母亲的支持有限，以克服他们面临的具体挑战。青春期的女孩特别容易受到伤害，其中1分之一在怀孕期间或出生后的一年患有精神障碍。对他们的身体健康，社交网络，教育成就和就业机会以及子女的发展，情感，行为和身体健康成果的不利影响非常重要。尽管存在这种不平等，但在这些低资源环境中，尚未评估任何针对青少年孕产妇心理健康的干预措施。这是该奖学金将要解决的挑战。为了支持青少年的母亲及其子女生存和繁荣，有必要让利益相关者参与心理健康干预措施的发展，并确定如何通过人物美分的设计和系统的设计和系统思维方式来利用周围的结构和力量来优化前线使用以及本地和国家实施的干预措施。通过这项团契，我将使用以人为本的，有系统的设计设计与青少年女孩，他们的家人和健康提供者合作，以设计，实施和评估干预措施，以改善莫桑比克和肯尼亚出生后的青少年的心理健康。 肯尼亚。在第1阶段（2-18个月）中，将采用以人为本的，有系统的设计方法与青少年，他们的家人，当地服务提供者和政策制定者合作，以识别，适应和原型一种干预措施，以改善每个国家 /地区的青少年孕产妇心理健康成果。在第2阶段（14-48个月）中，将在每个国家 /地区进行干预措施，以评估可行性，适当性和可接受性，并收集心理健康，过程和资源数据以准备进行试验。最后，在第3阶段（第49-84个月）中，将进行一项随机对照试验，评估临床有效性和分娩结果与常规护理/基本的心理健康素养干预相比。这项研究将导致一项干预措施的发展，该干预措施通过包装我们所知道的，以对年轻母亲，家庭和服务提供者有吸引力的方式，使青少年的母亲为他们和他们的孩子提供了希望和孩子的希望和保护因素，从而为青少年母亲提供了希望和技能。通过使用以人为本的，有系统的设计设计来了解年轻母亲的需求和优先事项以及他们所居住的健康和社区体系，由此产生的干预和上下文适应的方法具有巨大的潜力，它具有莫桑比克和肯尼亚以外以及非洲以外的国际转移性和影响。此外，开展的工作将为开发适应和实施心理健康干预措施的方法提供基础，在整个生命周期中，精神健康干预措施的提供者可以使用。

项目成果

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

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

• 发表时间: 2023
• 作者: Lamahewa K