ASHA Bangladesh--An Integrated Intervention to Address Depression in Low Income Rural Women

ASHA 孟加拉国——解决低收入农村妇女抑郁问题的综合干预措施

基本信息

批准号：
10767666
负责人：
ALISON KARASZ
金额：
$ 51.37万
依托单位：
UNIV OF MASSACHUSETTS MED SCH WORCESTER
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-02 至 2026-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10767666
关键词：
Address Advocate Affect Agriculture Asia Bangladesh Caring Child Clinical Cluster randomized trial Collaborations Country Decision Making Depressed mood Development Disease remission Dose Economic Development Economics Effectiveness Evaluation Family Fellowship Generations Government Government Agencies Health Health Care Costs Health Personnel High Prevalence Individual International Interruption Intervention Intervention Studies Interview Investigation Link Low Income Population Low income Manuals Mediating Mediator Medicine Mental Depression Mental Health Methods Modeling Outcome Participant Pathway interactions Patients Perception Personal Satisfaction Persons Pilot Projects Play Policies Policy Developments Policy Maker Poverty Productivity Randomized Relapse Research Research Personnel Research Training Resource-limited setting Role Rural Scientist Social support Structure Testing Universities Woman Work arm career development college comparison control contextual factors cost depressive symptoms design disability doctoral student economic outcome empowerment evidence base experience fighting graduate student hands on research implementation outcomes implementation process implementation research implementation study improved insight low and middle-income countries men novel pandemic disease policy implication poverty alleviation process evaluation programs psychosocial wellbeing recruit skills syndemic treatment arm treatment effect treatment trial university student uptake

项目摘要

A leading cause of global disability, depression is widespread among women in low and middle income countries (LMIC). Poverty plays a major role in depression via multiple pathways, while depression worsens poverty, compromising economic productivity. Efforts to increase access to depression treatment in LMIC have been hampered by low treatment uptake/engagement and weak treatment effects. Recently, researchers & policy makers have pointed to the importance of poverty alleviation in the fight again the global depression pandemic. We propose to implement an integrated poverty alleviation/depression treatment intervention for low income women in rural Bangladesh, designed to break the toxic cycle of poverty and depression. A capacity building component will build skills and support career development in qualitative implementation research for young scientists and establish a year-long research fellowship for graduate students at the University of Dhaka. Our project builds on an established partnership between Albert Einstein College of Medicine and the ICDDRB in Dhaka. Following our successful pilot study, we will implement a cluster randomized trial of an integrated intervention, recruiting 1200 low income women with depression from 80 villages. Villages will be randomized into one of four treatment arms: 1) evidence based depression treatment; 2) poverty alleviation through an agricultural asset transfer; 3) combined depression treatment/poverty alleviation, and 4) no-treatment control. Participants will be followed for 24 months. We hypothesize: improved depression outcomes at 6 and 24 months in the combined arm, compared to depression treatment or poverty alleviation alone. A detailed, mixed methods process evaluation, designed to generate new hypotheses regarding program and contextual factors influencing outcomes, will include in-depth qualitative interviews with program participants and staff, conducted by ASHA fellows. The proposed project will generate findings with significant implications for policy makers. To date, the work of depression researchers and economic development groups has included little collaboration. Programs that seek to reduce depression do not address the devastating impact of poverty; while, similarly poverty alleviation programs do not address the role of mental health in economic productivity. Results of this study, if promising, will generate evidence to guide collaborations among development agencies, researchers, policy-makers, and treatment providers. Our team’s dissemination efforts will bring government agencies, international and national health and economic development NGOS to consider the potential for a new generation of collaborative, integrated intervention approaches.

全球残疾的主要原因，抑郁症在低和中间的女性中普遍存在收入国家（LMIC）。通过多种途径在抑郁症中起主要作用，而抑郁症恶化了贫困，损害经济生产力。努力增加进入的机会 LMIC的抑郁症治疗受到低治疗吸收/参与度和弱治疗效果。最近，研究人员和政策制定者指出了贫困的重要性再次减轻战斗的全球抑郁症大流行。我们建议实施一个集成的孟加拉国农村低收入妇女的贫困缓解/抑郁治疗干预措施，旨在打破贫困和抑郁症的有毒循环。能力建设组件将建立技能和支持职业发展的年轻科学家定性实施研究和在达卡大学为研究生建立长达一年的研究奖学金。我们的项目建立在阿尔伯特·爱因斯坦医学院与达卡的ICDDRB。经过成功的试点研究，我们将实施一个群集随机试验在一项综合干预措施中，招募了来自80个村庄的1200名低收入抑郁症的低收入妇女。村庄将被随机分为四个治疗组之一：1）基于证据的抑郁症治疗； 2）通过农业资产转移来减轻贫困； 3）抑郁症治疗/贫困组合缓解和4）无治疗控制。参与者将持续24个月。我们假设：与抑郁症相比仅治疗或减轻贫困。详细的混合方法过程评估，旨在关于计划和上下文因素影响结果的新假设将包括由Asha Fellows进行的对计划参与者和员工的深入定性访谈。拟议的项目将产生对政策制定者产生重大影响的发现。迄今为止，抑郁研究人员和经济发展小组的工作很少合作。试图减轻抑郁的计划并不能解决贫困;而同样的是，贫困缓解计划也不能解决心理健康的作用经济生产力。这项研究的结果，如果承诺，将产生证据来指导发展机构，研究人员，政策制定者和治疗提供者之间的合作。我们团队的传播工作将带来政府机构，国际和国家卫生和经济发展非政府组织要考虑新一代合作的潜力，综合干预方法。