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（整体组件）本质的总体目标（使科学翻译以增强抑郁症护理的服务）项目是为了扩大证据的有效实施方法的知识印度农村地区初级保健环境中抑郁症的干预措施。本质实施审判代表本质计划中两个主要试验中的第二个，并将产生有价值的研究结果可以支持抑郁症的吸收和实施的远程策略的有效性和成本基于世界卫生组织在常规初级保健环境中的MHGAP计划的护理包印度中央邦的Sehore区。本质实施试验直接建立在成功的基础上推出并完成本质培训试验，该试验证明了利用的有效性通过培训社区卫生工作者提供证据的数字技术来建立劳动力能力 - 基于抑郁症的简短心理治疗。本质实施试验代表下一个通过支持初级卫生保健机构，支持抑郁症护理的实施至关重要通过采用和整合抑郁症护理的团队，并建立筛查的转诊途径并确定社区中的抑郁案病例，然后确保获得新的治疗训练有素的社区卫生工作者。本质实施试验由集群随机组成对照试验，在Sehore地区注册14个初级保健设施，并随机分配了7个设施增强的实施支持策略干预条件以及其余的7个设施随机分配以接收常规实施支持控制条件。我们的主要假设是加强实施支持，涉及远程交付的教练和对质量的重视改进，将优于常规实施支持，以增加门诊病人的比例筛选抑郁症（使用PHQ-9，是抑郁症的常见筛选器）。此外，我们假设在抑郁症的门诊病人中，设施中的那些随机分配给了增强与实施支持相比，在3个月的随访时，实施支持将显示出更大的症状严重程度日常实施支持控制条件中的门诊病人。所有14个设施均已在 MHGAP抑郁症护理包以及4月和5月的实施支持策略已进行了测试， 2022年。实施试验的正式启动患者招募将于2022年6月1日开始。行政补充剂将确保可以实质实施试验的关键活动是完成，数据分析和解释可以告知抑郁症的规模护理降低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

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

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

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