Global mental health (Cambridge, England)最新文献

{"title":"Using technology to scale-up training and supervision of community health workers in the psychosocial management of perinatal depression: a non-inferiority, randomized controlled trial.","authors":"Atif Rahman,&nbsp;Parveen Akhtar,&nbsp;Syed Usman Hamdani,&nbsp;Najia Atif,&nbsp;Huma Nazir,&nbsp;Iftikhar Uddin,&nbsp;Anum Nisar,&nbsp;Zille Huma,&nbsp;Joanna Maselko,&nbsp;Siham Sikander,&nbsp;Shamsa Zafar","doi":"10.1017/gmh.2019.7","DOIUrl":"https://doi.org/10.1017/gmh.2019.7","url":null,"abstract":"<p><strong>Background: </strong>The Thinking Healthy Programme (THP) is an evidence-based psychological intervention endorsed by the World Health Organization, tailored for non-specialist health workers in low- and middle-income countries. However, training and supervision of large numbers of health workers is a major challenge for the scale-up of THP. We developed a 'Technology-Assisted Cascaded Training and Supervision system' (TACTS) for THP consisting of a training application and cascaded supervision delivered from a distance.</p><p><strong>Methods: </strong>A single-blind, non-inferiority, randomized controlled trial was conducted in District Swat, a post-conflict area of North Pakistan. Eighty community health workers (called Lady Health Workers or LHWs) were randomly assigned to either TACTS or conventional face-to-face training and supervision by a specialist. Competence of LHWs in delivering THP post-training was assessed by independent observers rating a therapeutic session using a standardized measure, the 'Enhancing Assessment of Common Therapeutic factors' (ENACT), immediately post-training and after 3 months. ENACT uses a Likert scale to score an observed interaction on 18 dimensions, with a total score of 54, and a higher score indicating greater competence.</p><p><strong>Results: </strong>Results indicated no significant differences between health workers trained using TACTS and supervised from distance <i>v.</i> those trained and supervised by a specialist face-to-face (<i>mean ENACT score M</i>  =  24.97, s.d.  =  5.95 <i>v</i>. <i>M</i> =  27.27, s.d.  =  5.60, <i>p</i>  =  0.079, 95% CI 4.87-0.27) and at 3 months follow-up assessment (<i>M</i>  =  44.48, s.d.  =  3.97 <i>v</i>. <i>M</i> =  43.63, s.d.  =  6.34, <i>p</i>  =  0.53, CI -1.88 to 3.59).</p><p><strong>Conclusions: </strong>TACTS can provide a promising tool for training and supervision of front-line workers in areas where there is a shortage of specialist trainers and supervisors.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e8"},"PeriodicalIF":3.9,"publicationDate":"2019-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2019.7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37297398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping global Muslim mental health research: analysis of trends in the English literature from 2000 to 2015.","authors":"H H Altalib,&nbsp;K Elzamzamy,&nbsp;M Fattah,&nbsp;S S Ali,&nbsp;R Awaad","doi":"10.1017/gmh.2019.3","DOIUrl":"https://doi.org/10.1017/gmh.2019.3","url":null,"abstract":"<p><strong>Background: </strong>By 2030, the global Muslim population is expected to reach 2.2 billion people. The representations of Islam and Muslims in the media and academic literature may unconsciously impact how clinicians perceive and approach their Muslim patients. Our study focuses on the emerging Muslim mental health (MMH) literature using bibliometric analysis, specifically social network analysis of word co-occurrence and co-authorship networks of academic publications, to describe how the content of MMH discourse is evolving.</p><p><strong>Methods: </strong>We conducted an Ovid search (including Medline and PsycInfo databases) to identify articles written in English from 2000 to 2015 that had the terms 'Islam' and/or 'Muslim' in the abstract as well as research conducted in Muslim-majority countries and among Muslim minorities in the rest of the world.</p><p><strong>Results: </strong>Of the 2652 articles on MMH, the majority (65.6%) focused on describing psychopathology; the minority (11.2%) focused on issues around stigma, religiosity, spirituality, identity, or acculturation. Among the top 15 most frequent terms in abstracts were 'post-traumatic stress disorder', 'violence', 'fear', 'trauma', and 'war'. Social network analysis showed there was little collaborative work across regions.</p><p><strong>Conclusions: </strong>The challenges of producing MMH research are similar to the challenges faced across global mental health research. Much of the MMH research reflects regional challenges such as the impact of conflict and violence on mental health. Continued efforts to develop global mental health researchers through cross-cultural exchanges, academic journals' dedicated sections and programs for global mental health recruitment, and online training are needed to address the gap in research and collaborations.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e6"},"PeriodicalIF":3.9,"publicationDate":"2019-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2019.3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37297397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scaling-up psychological interventions in resource-poor settings: training and supervising peer volunteers to deliver the 'Thinking Healthy Programme' for perinatal depression in rural Pakistan.","authors":"N Atif,&nbsp;A Nisar,&nbsp;A Bibi,&nbsp;S Khan,&nbsp;S Zulfiqar,&nbsp;I Ahmad,&nbsp;S Sikander,&nbsp;A Rahman","doi":"10.1017/gmh.2019.4","DOIUrl":"https://doi.org/10.1017/gmh.2019.4","url":null,"abstract":"<p><strong>Background: </strong>There is a scarcity of specialist trainers and supervisors for psychosocial interventions in low- and middle-income countries. A cascaded model of training and supervision was developed to sustain delivery of an evidence-based peer-delivered intervention for perinatal depression (the Thinking Healthy Programme) in rural Pakistan. The study aimed to evaluate the model.</p><p><strong>Methods: </strong>Mixed methods were employed as part of a randomised controlled trial of the intervention. Quantitative data consisted of the peers' competencies assessed during field training and over the implementation phase of the intervention, using a specially developed checklist. Qualitative data were collected from peers and their trainers through 11 focus groups during the second and third year of intervention rollout.</p><p><strong>Results: </strong>Following training, 43 peers out of 45 (95%) achieved at least a 'satisfactory' level of competency (scores of ⩾70% on the Quality and Competency Checklist). Of the cohort of 45 peers initially recruited 34 (75%) were retained over 3 years and showed sustained or improved competencies over time. Qualitatively, the key factors contributing to peers' competency were use of interactive training and supervision techniques, the trainer-peer relationship, and their cultural similarity. The partnership with community health workers and use of primary health care facilities for training and supervision gave credibility to the peers in the community.</p><p><strong>Conclusion: </strong>The study demonstrates that lay-workers such as peers can be trained and supervised to deliver a psychological intervention using a cascaded model, thus addressing the barrier of scarcity of specialist trainers and supervisors.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e4"},"PeriodicalIF":3.9,"publicationDate":"2019-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2019.4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37290251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital depression screening in HIV primary care in South Africa: mood in retroviral + application monitoring [MIR + IAM].","authors":"R V Passchier,&nbsp;S E Owens,&nbsp;M N Wickremsinhe,&nbsp;N Bismilla,&nbsp;I D Ebuenyi","doi":"10.1017/gmh.2018.35","DOIUrl":"https://doi.org/10.1017/gmh.2018.35","url":null,"abstract":"<p><strong>Background: </strong>Integrating mental health care into HIV services is critical to addressing the high unmet treatment needs for people living with HIV and comorbid major depressive disorder. Introducing routine mental health screening at the primary health care level is a much needed diagonal approach to enhancing HIV care. In low-resource settings with a shortage of mental health care providers, eMental Health may provide a novel opportunity to attenuate this treatment gap and strengthen the health system.</p><p><strong>Objective: </strong>To conduct formative health systems research on the implementation of routine depression screening using a digital tool - Mood in Retroviral Positive Individuals Application Monitoring (MIR  +  IAM) - in an HIV primary care setting in South Africa.</p><p><strong>Methods: </strong>A Theory of Change (ToC) approach was utilised through individual and group session interviews to design an intervention that is embedded in the local context. Ten experts and local stakeholders were selected from the UK and South Africa. Data were analysed thematically using Atlas.ti to identify interventions, assumptions, barriers and facilitators of implementation.</p><p><strong>Findings: </strong>The participants considered digital depression screening in HIV care services relevant for the improvement of mental health in this population. The six main themes identified from the ToC process were: (1) user experience including acceptability by patients, issues of patient privacy and digital literacy, and the need for a patient-centred tool; (2) benefits of the digital tool for data collection and health promotion; (3) availability of treatment after diagnosis; (4) human and physical resource capacity of primary health care; (5) training for lay health care workers; and (6) demonstration of the intervention's usefulness to generate interest from decision-makers.</p><p><strong>Conclusion: </strong>Digital depression screening coupled with routine mental health data collection and analysis in HIV care is an applicable service that could improve the mental and physical health outcomes of this population. Careful consideration of the local health system capacity, including both workers and patients, is required. Future research to refine this intervention should focus on service users, government stakeholders and funders.</p>","PeriodicalId":520633,"journal":{"name":"Global mental health (Cambridge, England)","volume":" ","pages":"e2"},"PeriodicalIF":3.9,"publicationDate":"2019-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gmh.2018.35","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37041537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}