Integrating evidence-based MDD treatment in primary care: TB in Brazil as a model

将循证 MDD 治疗纳入初级保健：以巴西结核病为典范

基本信息

批准号：
9268083
负责人：
Annika Claire Sweetland
金额：
$ 18.13万
依托单位：
NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-06-01 至 2020-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9268083
关键词：
Address Adoption Affect Area Behavioral Brazil Caring Cause of Death Clinic Clinical Collaborations Communication Communities Comorbidity Country Data Development Diabetes Mellitus Diffusion Educational workshop Environment Epidemic Evidence based intervention Evidence based treatment Family health status Foundations Funding Future Goals HIV Health Health Policy Health Services Accessibility Health system Individual Intervention Knowledge Learning Low income Major Depressive Disorder Measures Medical Mental Depression Mental Health Mentored Research Scientist Development Award Mentors Mentorship Methodology Methods Modeling National Institute of Mental Health Outcome Pathway Analysis Patients Pilot Projects Policies Policy Maker Policy Research Poverty Primary Health Care Process Provider Public Health Reading Research Research Design Research Infrastructure Research Methodology Research Personnel Resources Science Scientist Services Site Social Network Social Sciences Social Work Specialist Sustainable Development System Target Populations Testing Training Tuberculosis Universities World Health base care systems career comorbid depression disability evidence base experience health care availability implementation science improved innovation low and middle-income countries novel programs prospective provider intervention public health relevance scale up skills success symposium tuberculosis treatment webinar

项目摘要

DESCRIPTION (provided by applicant): Integrating evidence-based MDD treatment in primary care: TB in Brazil as a model The WHO and NIMH recognizes the integration of depression treatment into primary as the most viable strategy for increasing access and closing the global mental health (GMH) treatment gap. Several evidence-based treatments for depression have been adapted and demonstrated efficacious in low-resource settings but systematic strategies are needed to bring these practices to scale in low-resource settings where there are few MH specialists. As a leading cause of death in LMIC that is driven, in part, by high comorbidity with depression, tuberculosis (TB) represents a strategic point-of-entry for building capacity for depression treatment in primary care systems in low resource settings. The overall aim of this proposal is to develop a targeted prospective scale-up strategy for integrating evidence-based depression treatment into primary care, using TB services in Brazil as a point-of-entry. My long term career goal is to become an independent GMH researcher specialized in scaling-up evidence-based MH interventions within diverse `real world' systems of care. This K01 award will enable me to build on my strong clinical, theoretical, and methodological foundations in clinical social work, public health, the social sciences, and sustainable development, to develop expertise in a new technical area (social network analysis), and to use research to inform policy around the scale-up of evidence-based interventions in `real world' systems of care. My training goals are to 1) expand my skills and expertise in dissemination and implementation science with a focus on systems-level scale-up of evidence based interventions in GMH; 2) learn and apply the principals of social network analysis to inform system-level scale- up in low resource settings, and 3) to bridge the gap between policy and research in implementation science to maximize public health impact. These goals will be achieved through a combination of direct mentorship, coursework and tutorials, webinars/seminars, directed readings, workshops, conferences and hands-on experience. In my proposed research, I will 1) operationalize the constructs of "receptivity" (likelihood of adoption) to integrating evidence-based depression treatment and "connectivity" (likelihood of diffusion) among TB providers to strategically identify and target the two most receptive and well connected pilot clinics from all the clinics in the Itaboraí public health system in which to implement evidence-based depression treatment, 2) pilot depression/TB treatment integration within these two pilot clinics, and 3) measure diffusion of influence (changes in receptivity) in individuals within the Itaboraí public health system (connected or not) not part of the two the pilot sites. The overall goal will be to develop an efficient and effective targeted strategy for future scale-up of evidence based interventions that can be applied in diverse settings and other health conditions, in the US and abroad, and gather feasibility data to inform a subsequent R01 proposal.

描述（由申请人提供）：基于循证的初级保健：TB在巴西作为将剥夺疗法的整合到主要的，作为增加访问权限和结束全球心理健康（GMH）治疗差距的最可行的策略。将这些做法在低资源环境中扩展，其中很少有MH的专家。在低资源环境中，原始护理系统的整体目的是将基于预期的降压疗程开发为基于级别的抑郁症。独立的GMH研究人员专门研究循证的MH，在各种各样的“现实世界”护理体系中，我可以继续使用Theoreti。和可持续发展，在“现实世界”护理系统中发展新技术领域（社交网络分析）的专业知识。 - 基于GMH的基于证据的干预措施；直接指导，课程和教程，网络研讨会/研讨会，定向阅读，研讨会，会议和动手经验。在结核病提供商中以识别战略并针对基于ITABORAíNCE抑郁症治疗中所有诊所的最受欢迎，连接良好的飞行员诊所，2）这两个试验诊所内的试验性抑郁症/结核病治疗整合，3） ITABORAí公共卫生系统（是否连接）中的个人总体目标将是制定有效的有针对性策略，用于将来以基于证据的基于基于证据的基于基于证据的基于基于证据的干预措施和其他健康状况1提案。