Protocol for a multi-phase, mixed methods study to develop and evaluate culturally adapted CBT to improve community mental health services for Canadians of south Asian origin

Trials

Andrew Tuck¹  Aamna Ashraf¹  Helen-Maria Vasiliadis²  M. Omair Husain³  Sean A. Kidd³  Farooq Naeem³  M. Ishrat Husain³  Marcos Sanches³  Kwame McKenzie⁴  Tariq Munshi⁵  Nicholas Watters⁶  Maureen Abbott⁶  Gary Thandi⁷  Puneet Dhillon⁸  Baldev Mutta⁸  Muhammad Ayub⁹  Nimo Farah^1,10  Azaad Kassam^1,11 

[1] Centre for Addiction and Mental Health, 33 Ursula Franklin St., M5S 2S1, Toronto, Ontario, Canada;Department of Community Health Sciences, Faculty of Medicine and Health Science, Université de Sherbrooke, Research Center Charles-Le Moyne – Saguenay–Lac-Saint-Jean sur les innovations en santé, Montreal, Canada;Department of Psychiatry, University of Toronto, Toronto, Canada;Centre for Addiction and Mental Health, 33 Ursula Franklin St., M5S 2S1, Toronto, Ontario, Canada;Department of Psychiatry, University of Toronto, Toronto, Canada;Centre for Addiction and Mental Health, 33 Ursula Franklin St., M5S 2S1, Toronto, Ontario, Canada;Wellesley Institute, Toronto, Canada;Department of Psychiatry, University of Toronto, Toronto, Canada;St Michael’s Hospital, Toronto, Canada;Mental Health Commission of Canada, Ottawa, Canada;Moving Forward Family Services, Vancouver, Canada;Punjabi Community Health Services, Toronto, Canada;Queen’s University, Kingston, Canada;Somerset West Community Health Centre, Ottawa, Canada;University of Ottawa, Ottawa, Canada;

关键词: South Asian;    Culturally adapted cognitive Behavioural therapy;    Canada;    Depression;    Anxiety;   

DOI  :  10.1186/s13063-021-05547-4

来源: Springer

【 摘 要 】

BackgroundCanadians of South Asian (SA) origin comprise the largest racialized group in Canada, representing 25.6% of what Statistics Canada terms “visible minority populations”. South Asian Canadians are disproportionately impacted by the social determinants of health, and this can result in high rates of mood and anxiety disorders. These factors can negatively impact mental health and decrease access to care, thereby increasing mental health inequities. Cognitive Behavioural Therapy (CBT) in its current form is not suitable for persons from the non-western cultural backgrounds. Culturally adapted Cognitive Behavioural Therapy (CaCBT) is an evidence-based practice. CaCBT is more effective than standard CBT and can reduce dropouts from therapy compared with standard CBT. Thus, CaCBT can increase access to mental health services and improve outcomes for immigrant, refugee and ethno-cultural and racialized populations. Adapting CBT for growing SA populations in Canada will ensure equitable access to effective and culturally appropriate interventions.MethodsThe primary aim of the study is to develop and evaluate CaCBT for Canadian South Asian persons with depression and anxiety and to gather data from stakeholders to develop guidelines to culturally adapt CBT. This mixed methods study will use three phases: (1) cultural adaptation of CBT, (2) pilot feasibility of CaCBT and (3) implementation and evaluation of CaCBT. Phase 1 will use purposive sampling to recruit individuals from four different groups: (1) SA patients with depression and anxiety, (b) caregivers and family members of individuals affected by anxiety and depression, (c) mental health professionals and (d) SA community opinion leaders. Semi-structured interviews will be conducted virtually and analysis of interviews will be informed by an ethnographic approach. Phase 2 will pilot test the newly developed CaCBT for feasibility, acceptability and effectiveness via quantitative methodology and a randomized controlled trial, including an economic analysis. Phase 3 will recruit therapists to train and evaluate them in the new CaCBT.DiscussionThe outcome of this trial will benefit health services in Canada, in terms of helping to reduce the burden of depression and anxiety and provide better care for South Asians. We expect the results to help guide the development of better services and tailor existing services to the needs of other vulnerable groups.Trial registrationClinicalTrials.gov NCT04010890. Registered on July 8, 2019

【 授权许可】

CC BY