Buddhist Monks as Task-Shifting Providers of Depression Treatment in Viet Nam

佛教僧侣作为越南抑郁症治疗的任务转移提供者

• 批准号: 10297970
• 负责人: Bahr Weiss
• 金额: $ 19.85万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-20 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10297970
• 关键词: Address; Affective; Aftercare; Antidepressive Agents; Area; Awareness; Behavioral; Clinical; Cognitive Therapy; Collaborations; Communities; Data; Development; Disadvantaged; Educational workshop; Emotional; Evaluation; Feeling; Focus Groups; Future; Goals; Group Interviews; Group Practice; Health Professional; Health system; Human Resources; Intervention; Interview; Knowledge; Label; Logistics; Meditation; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mindfulness Training; Needs Assessment; Outcome; Outpatients; Participant; Patients; Pharmaceutical Preparations; Process; Program Acceptability; Provider; Psychologist; Public Health; Recurrence; Research; Research Activity; Research Support; Risk; Service provision; Services; Solid; Structure; System; Techniques; Therapeutic; Thinking; Training; Universities; Vietnam; acceptability and feasibility; base; behavioral health; bodily sensation; design; dissemination strategy; effective intervention; effective therapy; effectiveness evaluation; effectiveness implementation study; experience; implementation fidelity; implementation intervention; implementation research; informant; low and middle-income countries; medical schools; mental training; mindfulness; mindfulness intervention; mindfulness-based stress reduction; programs; psychologic; public health relevance; recruit; smoking cessation; social stigma; success

PROJECT SUMMARY Depression represents a substantial public health burden. Effective treatments for depression exist but in part because of a scarcity of trained mental health professionals and stigma associated with “mental illness”, the majority of depression patients do not receive treatment, particularly in LMIC. One approach to address these issues is mental health task-shifting, the transfer of mental health services from highly trained mental health professionals to non-mental health professionals or lay people receiving focused training in a particular mental health program. Mindfulness-based (MB) interventions are a depression EBT, using activities to help people become more aware of bodily sensations, feelings, and thoughts without automatically judging them, reducing negative emotional reactivity that precipitates and exacerbates affective mental health problems. This R21 focuses on use of Vietnamese Buddhist monks as task-shifting providers of mindfulness-based intervention for depression. MB interventions are derived from Buddhist meditation practices, developed and applied in a secular manner. Use of Buddhist monks as task-shifting providers of MB interventions may be advantageous as (1) meditation is a central part of Buddhist monks' training and although not mental health professionals, monks have a solid background in underlying techniques being task-shifted; (2) pagoda-based treatment may reduce treatment stigma. Project Specific Aims are: #1. Conduct a capacity development needs assessment with approximately 68 stakeholders, using focus groups and Key Informant interviews, to prepare for this project and more comprehensive future research; #2: Adapt Mindfulness-Based Stress Reduction (MBSR) for task-shifting implementation by monks. Goals of this specific aim are (a) to adapt MBSR for monks (MBSR- 4M) to implement; (b) train the monks in MBSR-4M for implementation under Specific Aim #3; and (c) through the process of collaborative sharing involved in the adaptation, increase our understanding more generally of how our expanded team can most effectively collaborate together; #3: Conduct a Type 2 Hybrid Implementation-Effectiveness evaluation of MBSR-4M. Primary goals are: (a) to gain experience collaborating with the VN Buddhist system conducting implementation research, in order to (b) develop capacity for future collaborative research in this and related areas; (c) identify cultural and other factors potentially influencing IS domains for targeting in future research; and (d) obtain preliminary RCT data to assess the appropriateness and success of our program adaptation. The MBSR-4M evaluation will be conducted in 16 Hanoi and Danang pagoda with 160 participants (half in the treatment condition, half in control) with depression, recruited from pagoda and the general community. #4: Capacity Development: A central function of these specific aims is to develop capacity to support this research, by providing our team with the relevant knowledge, logistic structures, and professional relationships necessary to move forward in these directions. In addition, workshops targeting specific development areas identified in Specific Aim #1 also will be provided.

项目摘要 抑郁症代表了伯宁的实质性公共卫生。存在有效的抑郁症治疗 由于受过训练的心理健康专业人员和与“精神疾病”相关的污名的稀缺， 大多数抑郁症患者未接受治疗，尤其是在LMIC中。一种解决这些问题的方法 问题是心理健康任务转移，从训练有素的心理健康中转移心理健康服务 非心理卫生专业人员或外行人接受特定心理培训的专业人士 健康计划。基于正念的（MB）干预措施是一种抑郁症EBT，使用活动来帮助人们 在没有自动判断的情况下，更了解身体的感觉，感觉和思想，减少 负面情绪反应性会导致情感和加剧情感心理健康问题。这个R21 专注于将越南佛像作为基于正念干预的任务转移提供者的使用 沮丧。 MB干预措施源自佛教冥想实践，并在 世俗的方式。将佛教僧侣用作MB干预措施的任务转移提供者可能是有利的 （1）冥想是佛教僧侣培训的核心部分，尽管不是心理健康专业人士，但 僧侣在任务迁移的基本技术方面具有坚实的背景； （2）基于宝塔的治疗可能 减少治疗污名。项目特定目标是：＃1。进行能力开发需求评估 使用焦点小组和关键线人访谈，大约有68位利益相关者为此做准备 项目和更全面的未来研究； ＃2：适应基于正念的压力减轻（MBSR） 僧侣的任务移动实施。该特定目的的目标是（a）适应MBR的僧侣（MBSR- 4m）实施； （b）在MBSR-4M中训练僧侣在特定目标＃3下实施； （c） 通过参与适应的协作共享的过程，更多地提高了我们的理解 通常，我们扩展的团队如何最有效地合作； ＃3：进行2型混合动力车 MBSR-4M的实施效应评估。主要目标是：（a）获得合作的经验 通过VN佛教系统进行实施研究，以（b）未来的发展能力 在该领域和相关领域的协作研究； （c）确定文化和其他因素潜在影响是 用于未来研究的领域； （d）获取初步的RCT数据以评估适当性 和我们计划改编的成功。 MBSR-4M评估将在16个河内和Danang进行 有160名参与者的宝塔（治疗条件下一半，一半在对照中），抑郁症，从 宝塔和一般社区。 ＃4：能力发展：这些特定目的的核心功能是 通过为我们的团队提供相关知识，物流来发展支持这项研究的能力 结构以及在这些方向前进所必需的专业关系。此外， 还将提供针对特定目标1中确定的特定发展领域的研讨会。