Reducing stigma among healthcare providers to improve mental health services (RESHAPE): protocol for a pilot cluster randomized controlled trial of a stigma reduction intervention for training primary healthcare workers in Nepal

 

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dc.contributor.author Kohrt, Brandon A
dc.contributor.author Jordans, Mark J D
dc.contributor.author Turner, Elizabeth L
dc.contributor.author Sikkema, Kathleen J
dc.contributor.author Luitel, Nagendra P
dc.contributor.author Rai, Sauharda
dc.contributor.author Singla, Daisy R.
dc.contributor.author Lamichhane, Jagannath
dc.contributor.author Lund, Crick
dc.contributor.author Patel, Vikram
dc.date.accessioned 2018-04-17T08:16:27Z
dc.date.available 2018-04-17T08:16:27Z
dc.date.issued 2018-01-24
dc.identifier.citation Pilot and Feasibility Studies. 2018 Jan 24;4(1):36
dc.identifier.uri http://dx.doi.org/10.1186/s40814-018-0234-3
dc.identifier.uri http://hdl.handle.net/11427/27797
dc.description.abstract Abstract Background Non-specialist healthcare providers, including primary and community healthcare workers, in low- and middle-income countries can effectively treat mental illness. However, scaling-up mental health services within existing health systems has been limited by barriers such as stigma against people with mental illness. Therefore, interventions are needed to address attitudes and behaviors among non-specialists. Aimed at addressing this gap, REducing Stigma among HealthcAre Providers to ImprovE mental health services (RESHAPE) is an intervention in which social contact with mental health service users is added to training for non-specialist healthcare workers integrating mental health services into primary healthcare. Methods This protocol describes a mixed methods pilot and feasibility study in primary care centers in Chitwan, Nepal. The qualitative component will include key informant interviews and focus group discussions. The quantitative component consists of a pilot cluster randomized controlled trial (c-RCT), which will establish parameters for a future effectiveness study of RESHAPE compared to training as usual (TAU). Primary healthcare facilities (the cluster unit, k = 34) will be randomized to TAU or RESHAPE. The direct beneficiaries of the intervention are the primary healthcare workers in the facilities (n = 150); indirect beneficiaries are their patients (n = 100). The TAU condition is existing mental health training and supervision for primary healthcare workers delivered through the Programme for Improving Mental healthcarE (PRIME) implementing the mental health Gap Action Programme (mhGAP). The primary objective is to evaluate acceptability and feasibility through qualitative interviews with primary healthcare workers, trainers, and mental health service users. The secondary objective is to collect quantitative information on health worker outcomes including mental health stigma (Social Distance Scale), clinical knowledge (mhGAP), clinical competency (ENhancing Assessment of Common Therapeutic factors, ENACT), and implicit attitudes (Implicit Association Test, IAT), and patient outcomes including stigma-related barriers to care, daily functioning, and symptoms. Discussion The pilot and feasibility study will contribute to refining recommendations for implementation of mhGAP and other mental health services in primary healthcare settings in low-resource health systems. The pilot c-RCT findings will inform an effectiveness trial of RESHAPE to advance the evidence-base for optimal approaches to training and supervision for non-specialist providers. Trial registration ClinicalTrials.gov identifier, NCT02793271
dc.language.iso en
dc.publisher BioMed Central
dc.source Pilot and Feasibility Studies
dc.source.uri https://pilotfeasibilitystudies.biomedcentral.com/
dc.subject.other Attitudes
dc.subject.other Competence
dc.subject.other Low- and middle-income countries
dc.subject.other Mental health
dc.subject.other Non-specialists
dc.subject.other Primary care
dc.subject.other Service users
dc.subject.other Task-shifting
dc.subject.other Training
dc.subject.other Stigma
dc.title Reducing stigma among healthcare providers to improve mental health services (RESHAPE): protocol for a pilot cluster randomized controlled trial of a stigma reduction intervention for training primary healthcare workers in Nepal
dc.type Journal Article
dc.date.updated 2018-04-09T15:05:29Z
dc.rights.holder The Author(s).
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Department of Public Health and Family Medicine en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Kohrt, B. A., Jordans, M. J. D., Turner, E. L., Sikkema, K. J., Luitel, N. P., Rai, S., ... Patel, V. (2018). Reducing stigma among healthcare providers to improve mental health services (RESHAPE): protocol for a pilot cluster randomized controlled trial of a stigma reduction intervention for training primary healthcare workers in Nepal. <i>Pilot and Feasibility Studies</i>, http://hdl.handle.net/11427/27797 en_ZA
dc.identifier.chicagocitation Kohrt, Brandon A, Mark J D Jordans, Elizabeth L Turner, Kathleen J Sikkema, Nagendra P Luitel, Sauharda Rai, Daisy R. Singla, Jagannath Lamichhane, Crick Lund, and Vikram Patel "Reducing stigma among healthcare providers to improve mental health services (RESHAPE): protocol for a pilot cluster randomized controlled trial of a stigma reduction intervention for training primary healthcare workers in Nepal." <i>Pilot and Feasibility Studies</i> (2018) http://hdl.handle.net/11427/27797 en_ZA
dc.identifier.vancouvercitation Kohrt BA, Jordans MJD, Turner EL, Sikkema KJ, Luitel NP, Rai S, et al. Reducing stigma among healthcare providers to improve mental health services (RESHAPE): protocol for a pilot cluster randomized controlled trial of a stigma reduction intervention for training primary healthcare workers in Nepal. Pilot and Feasibility Studies. 2018; http://hdl.handle.net/11427/27797. en_ZA
dc.identifier.ris TY - Journal Article AU - Kohrt, Brandon A AU - Jordans, Mark J D AU - Turner, Elizabeth L AU - Sikkema, Kathleen J AU - Luitel, Nagendra P AU - Rai, Sauharda AU - Singla, Daisy R. AU - Lamichhane, Jagannath AU - Lund, Crick AU - Patel, Vikram AB - Abstract Background Non-specialist healthcare providers, including primary and community healthcare workers, in low- and middle-income countries can effectively treat mental illness. However, scaling-up mental health services within existing health systems has been limited by barriers such as stigma against people with mental illness. Therefore, interventions are needed to address attitudes and behaviors among non-specialists. Aimed at addressing this gap, REducing Stigma among HealthcAre Providers to ImprovE mental health services (RESHAPE) is an intervention in which social contact with mental health service users is added to training for non-specialist healthcare workers integrating mental health services into primary healthcare. Methods This protocol describes a mixed methods pilot and feasibility study in primary care centers in Chitwan, Nepal. The qualitative component will include key informant interviews and focus group discussions. The quantitative component consists of a pilot cluster randomized controlled trial (c-RCT), which will establish parameters for a future effectiveness study of RESHAPE compared to training as usual (TAU). Primary healthcare facilities (the cluster unit, k = 34) will be randomized to TAU or RESHAPE. The direct beneficiaries of the intervention are the primary healthcare workers in the facilities (n = 150); indirect beneficiaries are their patients (n = 100). The TAU condition is existing mental health training and supervision for primary healthcare workers delivered through the Programme for Improving Mental healthcarE (PRIME) implementing the mental health Gap Action Programme (mhGAP). The primary objective is to evaluate acceptability and feasibility through qualitative interviews with primary healthcare workers, trainers, and mental health service users. The secondary objective is to collect quantitative information on health worker outcomes including mental health stigma (Social Distance Scale), clinical knowledge (mhGAP), clinical competency (ENhancing Assessment of Common Therapeutic factors, ENACT), and implicit attitudes (Implicit Association Test, IAT), and patient outcomes including stigma-related barriers to care, daily functioning, and symptoms. Discussion The pilot and feasibility study will contribute to refining recommendations for implementation of mhGAP and other mental health services in primary healthcare settings in low-resource health systems. The pilot c-RCT findings will inform an effectiveness trial of RESHAPE to advance the evidence-base for optimal approaches to training and supervision for non-specialist providers. Trial registration ClinicalTrials.gov identifier, NCT02793271 DA - 2018-01-24 DB - OpenUCT DO - 10.1186/s40814-018-0234-3 DP - University of Cape Town J1 - Pilot and Feasibility Studies LK - https://open.uct.ac.za PB - University of Cape Town PY - 2018 T1 - Reducing stigma among healthcare providers to improve mental health services (RESHAPE): protocol for a pilot cluster randomized controlled trial of a stigma reduction intervention for training primary healthcare workers in Nepal TI - Reducing stigma among healthcare providers to improve mental health services (RESHAPE): protocol for a pilot cluster randomized controlled trial of a stigma reduction intervention for training primary healthcare workers in Nepal UR - http://hdl.handle.net/11427/27797 ER - en_ZA


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