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Advancing successful implementation of task-shifted mental health care in low-resource settings (BASIC): protocol for a stepped wedge cluster randomized trial.

dc.contributor.author Turner, Elizabeth
dc.contributor.author Whetten, Kathryn
dc.contributor.author Gray, Christine
dc.contributor.author Dorsey, Shannon
dc.contributor.author Wasonga, Augustine I
dc.contributor.author Amanya, Cyrilla
dc.contributor.author Weiner, Bryan J
dc.contributor.author Belden, C Micha
dc.contributor.author Martin, Prerna
dc.contributor.author Meza, Rosemary D
dc.contributor.author Weinhold, Andrew K
dc.contributor.author Soi, Caroline
dc.contributor.author Murray, Laura K
dc.contributor.author Lucid, Leah
dc.contributor.author Mildon, Robyn
dc.date.accessioned 2020-02-13T16:07:49Z
dc.date.available 2020-02-13T16:07:49Z
dc.date.issued 2020-01-08
dc.identifier 10.1186/s12888-019-2364-4
dc.identifier.issn 1471-244X
dc.identifier.issn 1471-244X
dc.identifier.uri https://hdl.handle.net/10161/20156
dc.description.abstract BACKGROUND:The mental health treatment gap-the difference between those with mental health need and those who receive treatment-is high in low- and middle-income countries. Task-shifting has been used to address the shortage of mental health professionals, with a growing body of research demonstrating the effectiveness of mental health interventions delivered through task-shifting. However, very little research has focused on how to embed, support, and sustain task-shifting in government-funded systems with potential for scale up. The goal of the Building and Sustaining Interventions for Children (BASIC) study is to examine implementation policies and practices that predict adoption, fidelity, and sustainment of a mental health intervention in the education sector via teacher delivery and the health sector via community health volunteer delivery. METHODS:BASIC is a Hybrid Type II Implementation-Effectiveness trial. The study design is a stepped wedge, cluster randomized trial involving 7 sequences of 40 schools and 40 communities surrounding the schools. Enrollment consists of 120 teachers, 120 community health volunteers, up to 80 site leaders, and up to 1280 youth and one of their primary guardians. The evidence-based mental health intervention is a locally adapted version of Trauma-focused Cognitive Behavioral Therapy, called Pamoja Tunaweza. Lay counselors are trained and supervised in Pamoja Tunaweza by local trainers who are experienced in delivering the intervention and who participated in a Train-the-Trainer model of skills transfer. After the first sequence completes implementation, in-depth interviews are conducted with initial implementing sites' counselors and leaders. Findings are used to inform delivery of implementation facilitation for subsequent sequences' sites. We use a mixed methods approach including qualitative comparative analysis to identify necessary and sufficient implementation policies and practices that predict 3 implementation outcomes of interest: adoption, fidelity, and sustainment. We also examine child mental health outcomes and cost of the intervention in both the education and health sectors. DISCUSSION:The BASIC study will provide knowledge about how implementation of task-shifted mental health care can be supported in government systems that already serve children and adolescents. Knowledge about implementation policies and practices from BASIC can advance the science of implementation in low-resource contexts. TRIAL REGISTRATION:Trial Registration: ClinicalTrials.gov Identifier: NCT03243396. Registered 9th August 2017, https://clinicaltrials.gov/ct2/show/NCT03243396.
dc.language eng
dc.publisher Springer Science and Business Media LLC
dc.relation.ispartof BMC psychiatry
dc.relation.isversionof 10.1186/s12888-019-2364-4
dc.subject Adolescents
dc.subject Children
dc.subject Evidence-based treatment
dc.subject Global mental health
dc.subject Implementation climate
dc.subject Implementation science
dc.subject Organizational theory
dc.subject School-based mental health care
dc.subject Task-sharing
dc.subject Task-shifting
dc.title Advancing successful implementation of task-shifted mental health care in low-resource settings (BASIC): protocol for a stepped wedge cluster randomized trial.
dc.type Journal article
duke.contributor.id Turner, Elizabeth|0579577
duke.contributor.id Whetten, Kathryn|0097036
duke.contributor.id Gray, Christine|0640386
dc.date.updated 2020-02-13T16:07:47Z
pubs.begin-page 10
pubs.issue 1
pubs.organisational-group School of Medicine
pubs.organisational-group Biostatistics & Bioinformatics
pubs.organisational-group Duke Science & Society
pubs.organisational-group Duke Global Health Institute
pubs.organisational-group Duke
pubs.organisational-group Basic Science Departments
pubs.organisational-group Initiatives
pubs.organisational-group Institutes and Provost's Academic Units
pubs.organisational-group University Institutes and Centers
pubs.organisational-group Sanford School of Public Policy
pubs.organisational-group Nursing
pubs.organisational-group School of Nursing
pubs.publication-status Published
pubs.volume 20
duke.contributor.orcid Turner, Elizabeth|0000-0002-7638-5942
duke.contributor.orcid Gray, Christine|0000-0002-0751-1626


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