Leveraging Stakeholder Engagement and Virtual Environments to Develop a Strategy for Implementation of Adolescent Depression Services Integrated Within Primary Care Clinics of Mozambique

Frontiers in Public Health

article

Kathryn L. Lovero¹  Palmira Fortunato dos Santos²  Salma Adam²  Carolina Bila²  Maria Eduarda Fernandes²  Bianca Kann³  Teresa Rodrigues²  Ana Maria Jumbe²  Cristiane S. Duarte³  Rinad S. Beidas⁴  Milton L. Wainberg³ 

[1] Department of Sociomedical Sciences, Columbia University Mailman School of Public Health;Department of Mental Health, Ministry of Health;Department of Psychiatry, New York State Psychiatric Institute, Columbia University Vagelos College of Physicians and Surgeons;Departments of Psychiatry, Medical Ethics and Health Policy, Medicine, University of Pennsylvania Perelman School of Medicine;Penn Medicine Nudge Unit, University of Pennsylvania Health System;Penn Implementation Science Center at the Leonard Davis Institute ,(PISCE@LDI), University of Pennsylvania;Center for Health Incentives and Behavioral Economics, University of Pennsylvania Perelman School of Medicine

关键词: LMIC;    mental health;    depression;    adolescent;    implementation determinants;    implementation strategies;    community engagement;   

DOI  :  10.3389/fpubh.2022.876062

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Psychiatric disorders are the number one cause of disability in adolescents worldwide. Yet, in low- and middle-income countries (LMIC), where 90% of adolescents reside, mental health services are extremely limited, and the majority do not have access to treatment. Integration of mental health services within primary care of LMICs has been proposed as an efficient and sustainable way to close the adolescent mental health treatment gap. However, there is limited research on how to effectively implement integrated mental health care in LMIC. In the present study, we employed Implementation Mapping to develop a multilevel strategy for integrating adolescent depression services within primary care clinics of Maputo, Mozambique. Both in-person and virtual approaches for Implementation Mapping activities were used to support an international implementation planning partnership and promote the engagement of multilevel stakeholders. We identified determinants to implementation of mental health services for adolescents in LMIC across all levels of the Consolidated Framework for Implementation Research, of which of 25% were unique to adolescent-specific services. Through a series of stakeholder workshops focused on implementation strategy selection, prioritization, and specification, we then developed an implementation plan comprising 33 unique strategies that target determinants at the intervention, patient, provider, policy, and community levels. The implementation plan developed in this study will be evaluated for delivering adolescent depression services in Mozambican primary care and may serve as a model for other low-resource settings.

【 授权许可】

CC BY