Prism Scale Up Study

棱镜放大研究

• 批准号: 9317026
• 负责人: Hongtu Chen
• 金额: $ 51.05万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-10 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9317026
• 关键词: Address; Asia; Basic Science; Behavioral Symptoms; Case Study; Clinical; Communities; Community Health Aides; Consensus; Country; Dementia; Development; Effectiveness; Elderly; Ensure; Evaluation; Evaluation Studies; Evidence based intervention; Exhibits; Government; Health; Health Professional; Healthcare; Hybrids; Instruction; Interdisciplinary Study; Intervention; Intervention Studies; Knowledge; Medical; Mental Health; Mental Health Services; Modeling; National Institute of Mental Health; Nurses; Organizational Culture; Outcome; Performance; Physical Exercise; Policies; Politics; Primary Care Physician; Procedures; Process; Province; Randomized Controlled Trials; Readiness; Recommendation; Research; Research Personnel; Resolution; Resources; Scientist; Site; Specialist; Supervision; Testing; Thailand; Training; United States; Work; arm; base; community organizations; design; evidence base; exercise intervention; experience; formative assessment; geriatric mental health; implementation research; implementation science; improved; innovation; intervention program; low and middle-income countries; mental training; programs; psychological symptom; randomized trial; response; scale up; social; success; tool; trend

Abstract: The Scale-Up Component of the Partnership in Implementation Science for Geriatric Mental Health (PRISM) project proposes an evidence-based physical exercise intervention for older adults who exhibit behavioral and psychological symptoms of dementia (BPSD). The intervention will be delivered in Thai communities through an evidence-based implementation strategy of “task sharing” among community health workers (CHWs), nurses, primary care physicians, and mental health specialists. In response to the common problem of technical and cultural compatibility between evidence-based interventions and local implementation contexts as well as the uneven local political will for implementing mental health service initiatives, we propose to develop and test an innovative implementation support strategy (i.e., the GTO-ThAI model), based on the evidence-based Getting-to-Outcome model, which will be adapted to Thai settings, to ensure the success of implementation and scaling up of the mental health service for older adults in Thailand. To our knowledge, no previous study has examined the effectiveness of a GTO-ThAI implementation support strategy for delivering clinical interventions for older adults with BPSD in Asia. The proposed evaluation study will conduct a randomized controlled trial with a Hyprid Type 3 design to compare the intervention arm that implements the culturally-adapted GTO model (GTO-ThAI) to deliver implementation support, with a control arm, which receives usual top-down administrative instruction for implementing a policy initiative. Our specific scale-up study aims are to: 1) tailor an evidence-based physical exercise intervention (EBPEI) to fit with Thai local social, cultural, and policy context (Yr 1); 2) develop culturally-informed tools to assess readiness for implementing EBPEI to improve mental health of older adults in local provinces of Thailand (Yr 1); 3) develop the GTO-ThAI implementation support model through a pre- implementation case study and formative evaluation (Yr 2); 4) evaluate implementation strategies and clinical outcomes through a hybrid Type 3 randomized trial to test effectiveness of the GTO-ThAI implementation support strategy for the delivery of EBPEI, compared with the existing standard administrative procedures for delivering the same EBPEI (Yrs 3-4); 5) develop policy recommendations with tools and performance indicators (Yr 5). The proposed scale-up study is expected to generate knowledge and tools essential for further scale-up of mental health services in Thailand, and will contribute significantly to knowledge development within other NIMH program HUBs on going to scale with mental health innovations in LMICs.

摘要：老年心理健康实施科学伙伴关系的扩大组成部分 （PRISM）项目为展示的老年人提出了基于证据的体育锻炼干预 痴呆症的行为和心理局部症状（BPSD）。 通过基于证据的实施社区的社区卫生中的“任务共享” 工人（CHW），护士，初级保健医生和心理健康专家。 基于证据的干预措施与本地植入之间的技术和文化兼容兼容问题 我们建议的 基于您制定和测试创新的实施支持策略（即GTO-Thai模型） 基于证据的康复模型，该模型将适应泰国设置 据我们所知 先前的研究检查了GTO-Thai实施支持策略的有效性 亚洲BPSD老年人的临床干预措施。 支撑的评估研究将进行一项随机对照试验，并使用Hurpid 3型设计进行 比较实现文化适应GTO模型（GTO-THAI）的干预组 启示支持，使用控制臂，该控制部门接收平常的自上而下的管理员 实施政策倡议。我们的特定规模研究的目的是：1） 锻炼干预（EBPEI）符合泰国的当地社会，文化和政策环境（YR 1）； 具有文化知名的工具，以评估读物，以暗示EBPEI改善老年人的心理健康 在泰国的地方省（YR 1）； 3） 实施案例研究和形成性评估（YR 2）； 4）评估实施策略和临床 通过混合3型随机试验的结果测试ESTO-THAI实施 与现有的标准行政程序提交相比 提供EBPEI（YRS 3-4）； 5） 指标（YR 5）。 进一步扩大泰国的心理健康服务，并将为知识做出重大贡献 NIMH计划中心内的开发随着LMIC的心理健康创新而扩展。