Task sharing of a psychological intervention for maternal depression in Khayelitsha, South Africa: study protocol for a randomized controlled trial

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dc.contributor.authorLund, Crick
dc.contributor.authorSchneider, Marguerite
dc.contributor.authorDavies, Thandi
dc.contributor.authorNyatsanza, Memory
dc.contributor.authorHonikman, Simone
dc.contributor.authorBhana, Arvin
dc.contributor.authorBass, Judith
dc.contributor.authorBolton, Paul
dc.contributor.authorDewey, Michael
dc.contributor.authorJoska, John
dc.contributor.authorKagee, Ashraf
dc.contributor.authorMyer, Landon
dc.contributor.authorPetersen, Inge
dc.contributor.authorPrince, Martin
dc.contributor.authorStein, Dan J
dc.contributor.authorThornicroft, Graham
dc.contributor.authorTomlinson, Mark
dc.contributor.authorAlem, Atalay
dc.contributor.authorSusser, Ezra
dc.date.accessioned2015-06-19T13:26:48Z
dc.date.available2015-06-19T13:26:48Z
dc.date.issued2014-11-21
dc.date.updated2015-05-05T18:01:27Z
dc.description.abstractBackground: Maternal depression carries a major public health burden for mothers and their infants, yet there is a substantial treatment gap for this condition in low-resourced regions such as sub-Saharan Africa. To address this treatment gap, the strategy of “task sharing” has been proposed, involving the delivery of interventions by non-specialist health workers trained and supervised by specialists in routine healthcare delivery systems. Several psychological interventions have shown benefit in treating maternal depression, but few have been rigorously evaluated using a task sharing approach. The proposed trial will be the first randomised controlled trial (RCT) evaluating a task sharing model of delivering care for women with maternal depression in sub-Saharan Africa. The objective of this RCT is to determine the effectiveness and cost-effectiveness of a task sharing counseling intervention for maternal depression in South Africa. Methods/Design: The study is an individual-level two-arm RCT. A total of 420 depressed pregnant women will be recruited from two ante-natal clinics in a low-income township area of Cape Town, using the Edinburgh Postnatal Depression Scale to screen for depression; 210 women will be randomly allocated to each of the intervention and control arms. The intervention group will be given six sessions of basic counseling over a period of 3 to 4 months, provided by trained community health workers (CHW)s. The control group will receive three monthly phone calls from a CHW trained to conduct phone calls but not basic counseling. The primary outcome measure is the 17-Item Hamilton Depression Rating Scale (HDRS-17). The outcome measures will be applied at the baseline assessment, and at three follow-up points: 1 month before delivery, and 3 and 12 months after delivery. The primary analysis will be by intention-to-treat and secondary analyses will be on a per protocol population. The primary outcome measure will be analyzed using linear regression adjusting for baseline symptom severity measured using the HDRS-17. Discussion: The findings of this trial can provide policy makers with evidence regarding the effectiveness and cost-effectiveness of structured psychological interventions for maternal depression delivered by appropriately trained and supervised non-specialist CHWs in sub-Saharan Africa. Trial registration Clinical Trials (ClinicalTrials.gov): NCT01977326 , registered on 24/10/2013; Pan African Clinical Trials Registry ( http://www.pactr.org ): PACTR201403000676264 , registered on 11/10/2013.en_ZA
dc.identifier.apacitationLund, C., Schneider, M., Davies, T., Nyatsanza, M., Honikman, S., Bhana, A., ... Susser, E. (2014). Task sharing of a psychological intervention for maternal depression in Khayelitsha, South Africa: study protocol for a randomized controlled trial. <i>Trials</i>, http://hdl.handle.net/11427/13093en_ZA
dc.identifier.chicagocitationLund, Crick, Marguerite Schneider, Thandi Davies, Memory Nyatsanza, Simone Honikman, Arvin Bhana, Judith Bass, et al "Task sharing of a psychological intervention for maternal depression in Khayelitsha, South Africa: study protocol for a randomized controlled trial." <i>Trials</i> (2014) http://hdl.handle.net/11427/13093en_ZA
dc.identifier.citationLund, C., et al. (2014). Task sharing of a psychological intervention for maternal depression in Khayelitsha, South Africa: study protocol for a randomized controlled trial. Trials, 15(1): 457en_ZA
dc.identifier.issn1745-6215en_ZA
dc.identifier.ris TY - Journal Article AU - Lund, Crick AU - Schneider, Marguerite AU - Davies, Thandi AU - Nyatsanza, Memory AU - Honikman, Simone AU - Bhana, Arvin AU - Bass, Judith AU - Bolton, Paul AU - Dewey, Michael AU - Joska, John AU - Kagee, Ashraf AU - Myer, Landon AU - Petersen, Inge AU - Prince, Martin AU - Stein, Dan J AU - Thornicroft, Graham AU - Tomlinson, Mark AU - Alem, Atalay AU - Susser, Ezra AB - Background: Maternal depression carries a major public health burden for mothers and their infants, yet there is a substantial treatment gap for this condition in low-resourced regions such as sub-Saharan Africa. To address this treatment gap, the strategy of “task sharing” has been proposed, involving the delivery of interventions by non-specialist health workers trained and supervised by specialists in routine healthcare delivery systems. Several psychological interventions have shown benefit in treating maternal depression, but few have been rigorously evaluated using a task sharing approach. The proposed trial will be the first randomised controlled trial (RCT) evaluating a task sharing model of delivering care for women with maternal depression in sub-Saharan Africa. The objective of this RCT is to determine the effectiveness and cost-effectiveness of a task sharing counseling intervention for maternal depression in South Africa. Methods/Design: The study is an individual-level two-arm RCT. A total of 420 depressed pregnant women will be recruited from two ante-natal clinics in a low-income township area of Cape Town, using the Edinburgh Postnatal Depression Scale to screen for depression; 210 women will be randomly allocated to each of the intervention and control arms. The intervention group will be given six sessions of basic counseling over a period of 3 to 4 months, provided by trained community health workers (CHW)s. The control group will receive three monthly phone calls from a CHW trained to conduct phone calls but not basic counseling. The primary outcome measure is the 17-Item Hamilton Depression Rating Scale (HDRS-17). The outcome measures will be applied at the baseline assessment, and at three follow-up points: 1 month before delivery, and 3 and 12 months after delivery. The primary analysis will be by intention-to-treat and secondary analyses will be on a per protocol population. The primary outcome measure will be analyzed using linear regression adjusting for baseline symptom severity measured using the HDRS-17. Discussion: The findings of this trial can provide policy makers with evidence regarding the effectiveness and cost-effectiveness of structured psychological interventions for maternal depression delivered by appropriately trained and supervised non-specialist CHWs in sub-Saharan Africa. Trial registration Clinical Trials (ClinicalTrials.gov): NCT01977326 , registered on 24/10/2013; Pan African Clinical Trials Registry ( http://www.pactr.org ): PACTR201403000676264 , registered on 11/10/2013. DA - 2014-11-21 DB - OpenUCT DO - 10.1186/1745-6215-15-457 DP - University of Cape Town J1 - Trials LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 SM - 1745-6215 T1 - Task sharing of a psychological intervention for maternal depression in Khayelitsha, South Africa: study protocol for a randomized controlled trial TI - Task sharing of a psychological intervention for maternal depression in Khayelitsha, South Africa: study protocol for a randomized controlled trial UR - http://hdl.handle.net/11427/13093 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1186/1745-6215-15-457
dc.identifier.urihttp://hdl.handle.net/11427/13093
dc.identifier.urihttp://hdl.handle.net/11427/13093
dc.identifier.urihttp://dx.doi.org/10.1186/1745-6215-15-457
dc.identifier.urihttp://hdl.handle.net/11427/13093
dc.identifier.urihttp://dx.doi.org/10.1186/1745-6215-15-457
dc.identifier.vancouvercitationLund C, Schneider M, Davies T, Nyatsanza M, Honikman S, Bhana A, et al. Task sharing of a psychological intervention for maternal depression in Khayelitsha, South Africa: study protocol for a randomized controlled trial. Trials. 2014; http://hdl.handle.net/11427/13093.en_ZA
dc.languageengen_ZA
dc.language.rfc3066en
dc.publisherBioMed Centralen_ZA
dc.publisher.departmentDepartment of Psychiatry and Mental Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsCreative Commons Attribution 4.0 International (CC BY 4.0)*
dc.rights.holderLund et al.; licensee BioMed Central Ltd.
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_ZA
dc.sourceTrialsen_ZA
dc.source.urihttp://www.trialsjournal.com/
dc.titleTask sharing of a psychological intervention for maternal depression in Khayelitsha, South Africa: study protocol for a randomized controlled trialen_ZA
dc.typeJournal Articleen_ZA
uct.subject.keywordsCommunity health workers
uct.subject.keywordsCost-effectiveness
uct.subject.keywordsCounseling
uct.subject.keywordsHamilton depression rating scale
uct.subject.keywordsMaternal depression
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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