Fidelity Sub-Study - Sub-Saharan Africa Regional Partnership (SHARP) for Mental Health Capacity Building trial
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https://cdr.lib.unc.edu/concern/data_sets/8p58pv482
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<p><strong><span data-contrast="auto">ABSTRACT</span></strong><span data-ccp-props="{"201341983":0,"335559740":480}"> </span></p>
<p><strong><span data-contrast="auto">Background</span></strong><span data-contrast="auto">: Depression is a leading cause of disability worldwide that disproportionately impacts low- and middle-income countries (LMICs). Evidence-based depression care options are often limited in LMICs and poorly integrated into existing healthcare systems. Improving such integration is crucial to improving patient outcomes and reducing disability. </span><span data-ccp-props="{"201341983":0,"335559740":480}"> </span></p>
<p><strong><span data-contrast="auto">Methods</span></strong><span data-contrast="auto">: In Malawi, a cluster-randomized trial of implementation strategies to integrate depression care into non-communicable disease clinics was conducted at 10 healthcare facilities from 2019 to 2021. Some clinics were highly successful in integrating depression care while others were less successful in both arms. This post-hoc mixed-methods analysis combined quantitative clinic performance indicators with qualitative endline key informant interview data to identify factors other than the tested implementation strategies that differentiated clinics that effectively integrated depression treatment from those that did not. </span><span data-ccp-props="{"201341983":0,"335559740":480}"> </span></p>
<p><strong><span data-contrast="auto">Results</span></strong><span data-contrast="auto">: Most participants reported several implementation barriers that were present across nearly all clinics. These pervasive barriers included access to resources, provider attitudes, and provider turnover. </span><span data-contrast="none">Differentiating factors, which when present allowed successful clinics to overcome pervasive barriers and when absent made the barriers difficult to overcome, included</span><span data-contrast="auto"> clinic coordinator engagement, management engagement, clinic ownership, and adequate training. </span><span data-ccp-props="{"201341983":0,"335559740":480}"> </span></p>
<p><strong><span data-contrast="auto">Discussion</span></strong><span data-contrast="auto">: Differentiating factors that facilitated implementation of depression care integration, even in the presence of commonly identified barriers, should be prioritized as targets for future implementation efforts. </span><span data-ccp-props="{"201341983":0,"335559740":480}"> </span></p>
提供机构：
The University of North Carolina at Chapel Hill University Libraries
创建时间：
2025-07-08
