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

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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