ESSENCE (Enabling translation of Science to Service to ENhance Depression CarE)

ESSENCE（将科学转化为服务以增强抑郁症 CarE）

基本信息

批准号：
10630486
负责人：
John A Naslund
金额：
$ 19.48万
依托单位：
HARVARD MEDICAL SCHOOL
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-07-01 至 2024-05-31
项目状态：
已结题

项目摘要

PROJECT ABSTRACT (OVERALL COMPONENT) The overall goal of the ESSENCE (Enabling translation of Science to Service to ENhance Depression CarE) project is to generate knowledge on effective implementation approaches for scaling up of evidence based interventions for depression in primary care settings in rural India. The ESSENCE Implementation Trial represents the second of two major trials in the ESSENCE program, and will yield valuable research findings on the effectiveness and costs of remote strategies that can support the uptake and implementation of a depression care package based on the World Health Organization's mhGAP program in routine primary care settings in Sehore district in Madhya Pradesh, India. The ESSENCE Implementation Trial builds directly on the successful roll out and completion of the ESSENCE Training Trial, which demonstrated the effectiveness of leveraging digital technology for building workforce capacity by training community health workers to deliver an evidence- based brief psychological treatment for depression. The ESSENCE Implementation Trial represents the next critical step in supporting the implementation of depression care, by supporting the primary health care facility teams with the adoption and integration of depression care, and establishing the referral pathways for screening and identifying depression cases in the community and then ensuring access to treatment delivered by the newly trained community health workers. The ESSENCE Implementation Trial consists of a cluster-randomized controlled trial, enrolling 14 primary care facilities in Sehore district, with 7 facilities randomly assigned to receive the Enhanced Implementation Support strategy intervention condition, and the remaining 7 facilities randomly assigned to receive the Routine Implementation Support control condition. Our primary hypothesis is that the Enhanced Implementation Support, involving remotely delivered coaching and emphasis on quality improvement, will be superior to Routine Implementation Support in increasing the proportion of outpatients screened for depression (using the PHQ-9, a common screener for depression). Furthermore, we hypothesize that among outpatients screened positive with depression, those in facilities randomized to the Enhanced Implementation Support will show greater reduction in symptom severity at 3-month follow up compared to outpatients in the Routine Implementation Support control condition. All 14 facilities have been trained in the mhGAP depression care package, and the implementation support strategies have been tested in April and May, 2022. The official launch of patient recruitment for the Implementation Trial will begin on June 1st, 2022. This Administrative Supplement will ensure that the key activities for the ESSENCE Implementation Trial can be completed, and that the data analyses and interpretation of the findings can inform the scale up of depression care towards reducing the treatment gap for depression care in India and globally.

项目摘要（总体组成部分） ESSENCE 的总体目标（将科学转化为服务，以增强抑郁症 CarE）项目旨在产生有关有效实施方法的知识，以扩大基于证据的印度农村初级保健机构的抑郁症干预措施。 ESSENCE 实施试验代表 ESSENCE 计划两项主要试验中的第二项，并将产生有价值的研究成果支持采取和实施抑郁症的远程策略的有效性和成本根据世界卫生组织 mhGAP 计划在常规初级保健机构中提供的护理包印度中央邦 Sehore 区。 ESSENCE 实施试验直接建立在成功的基础上推出并完成 ESSENCE 培训试验，证明了利用通过培训社区卫生工作者提供证据来建设劳动力能力的数字技术基于抑郁症的简短心理治疗。 ESSENCE 实施试验代表了下一个通过支持初级卫生保健机构，支持实施抑郁症护理的关键一步团队采用和整合抑郁症护理，并建立筛查转诊途径识别社区中的抑郁症病例，然后确保获得新社区提供的治疗训练有素的社区卫生工作者。 ESSENCE 实施试验包括整群随机对照试验，招募了 Sehore 地区的 14 个初级保健机构，其中 7 个机构随机分配接收增强实施支持策略干预条件，其余7个设施随机分配接收例行实施支持控制条件。我们的主要假设是增强实施支持，包括远程指导和对质量的重视改善，在增加门诊患者比例方面将优于常规实施支持筛查抑郁症（使用 PHQ-9，一种常见的抑郁症筛查仪）。此外，我们假设在门诊筛查出抑郁症呈阳性的患者中，那些在设施中随机分配到增强型的患者与实施支持相比，在 3 个月的随访中，实施支持将显示症状严重程度有更大程度的减轻门诊患者处于常规实施支持控制状态。所有 14 个设施均已接受过相关培训 mhGAP抑郁症关怀计划，以及实施支持策略已于4月和5月进行了测试， 2022年。实施试验的患者招募将于2022年6月1日正式开始。行政补充文件将确保 ESSENCE 实施试验的关键活动能够已完成，数据分析和对结果的解释可以为抑郁症的扩大提供信息致力于缩小印度和全球抑郁症护理的治疗差距。

项目成果

期刊论文数量（33）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

The emergence of digital mental health in low-income and middle-income countries: A review of recent advances and implications for the treatment and prevention of mental disorders.

DOI：
10.1016/j.jpsychires.2020.12.016
发表时间：
2021-01
期刊：
Journal of psychiatric research
影响因子：
4.8
作者：
Carter H;Araya R;Anjur K;Deng D;Naslund JA
通讯作者：
Naslund JA

Psychological Impact of COVID-19 Pandemic on Frontline Health Workers in Low- and Middle-Income Countries.

DOI：
pii: http://harvardpublichealthreview.org/wp-content/uploads/2020/10/deng-and-naslund-2020-28.pdf
发表时间：
2020
期刊：
Harvard public health review (Cambridge, Mass.)
影响因子：
0
作者：
Deng D;Naslund JA
通讯作者：
Naslund JA

Development of a Digital Program for Training Community Health Workers in the Detection and Referral of Schizophrenia in Rural India.

DOI：
10.1007/s11126-023-10019-w
发表时间：
2023-06
期刊：
PSYCHIATRIC QUARTERLY
影响因子：
3.5
作者：
Tyagi, Vidhi;Khan, Azaz;Siddiqui, Saher;Kakra Abhilashi, Minal;Dhurve, Pooja;Tugnawat, Deepak;Bhan, Anant;Naslund, John A
通讯作者：
Naslund, John A

Schizophrenia Assessment, Referral and Awareness Training for Health Auxiliaries (SARATHA): Protocol for a Mixed-Methods Pilot Study in Rural India.

DOI：
10.3390/ijerph192214936
发表时间：
2022-11-13
期刊：
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
影响因子：
0
作者：
Naslund, John A.;Tyagi, Vidhi;Khan, Azaz;Siddiqui, Saher;Abhilashi, Minal Kakra;Dhurve, Pooja;Mehta, Urvakhsh Meherwan;Rozatkar, Abhijit;Bhatia, Urvita;Vartak, Anil;Torous, John;Tugnawat, Deepak;Bhan, Anant
通讯作者：
Bhan, Anant

Applying Human-Centered Design in Global Mental Health to Improve Reach Among Underserved Populations in the United States and India.

DOI：
10.9745/ghsp-d-22-00312
发表时间：
2023-02-28
期刊：
Global health, science and practice
影响因子：
0
作者：
Black CJ;Berent JM;Joshi U;Khan A;Chamlagai L;Shrivastava R;Gautam B;Negeye A;Iftin AN;Ali H;Desrosiers A;Bhan A;Bhattacharya S;Naslund JA;Betancourt TS
通讯作者：
Betancourt TS