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科技与实施科学铸就循证心理疗法的未来:PRIDE 扩展研究。

Technology and implementation science to forge the future of evidence-based psychotherapies: the PRIDE scale-up study.

机构信息

Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.

New York State Psychiatric Institute, New York, New York, USA.

出版信息

Evid Based Ment Health. 2021 Feb;24(1):19-24. doi: 10.1136/ebmental-2020-300199. Epub 2020 Nov 11.

Abstract

OBJECTIVE

To report the interim results from the training of providers inevidence-based psychotherapies (EBPs) and use of mobile applications.

DESIGN AND SETTING

The Partnerships in Research to Implement and Disseminate Sustainable and Scalable Evidence (PRIDE) study is a cluster-randomised hybrid effectiveness-implementation trial comparing three delivery pathways for integrating comprehensive mental healthcare into primary care in Mozambique. Innovations include the use of EBPs and scaling-up of task-shifted mental health services using mobile applications.

MAIN OUTCOME MEASURES

We examined EBP training attendance, certification, knowledge and intentions to deliver each component. We collected qualitative data through rapid ethnography and focus groups. We tracked the use of the mobile applications to investigate early reach of a valid screening tool (Electronic Mental Wellness Tool) and the roll out of the EBPs PARTICIPANTS: Psychiatric technicians and primary care providers trained in the EBPs.

RESULTS

PRIDE has trained 110 EBP providers, supervisors and trainers and will train 279 community health workers in upcoming months. The trainings improved knowledge about the EBPs and trainees indicated strong intentions to deliver the EBP core components. Trained providers began using the mobile applications and appear to identify cases and provide appropriate treatment.

CONCLUSIONS

The future of EBPs requires implementation within existing systems of care with fidelity to their core evidence-based components. To sustainably address the vast mental health treatment gap globally, EBP implementation demands: expanding the mental health workforce by training existing human resources; sequential use of EBPs to comprehensively treat mental disorders and their comorbid presentations and leveraging digital screening and treatment applications.

摘要

目的

报告基于证据的心理疗法(EBP)提供者培训和移动应用程序使用的中期结果。

设计和设置

“伙伴关系研究实施和传播可持续和可扩展的证据(PRIDE)”研究是一项集群随机混合有效性实施试验,比较了莫桑比克将综合心理健康护理纳入初级保健的三种综合方法。创新包括使用 EBP 和使用移动应用程序扩大任务转移的心理健康服务。

主要结果测量

我们检查了 EBP 培训的出勤率、认证、知识和提供每个组件的意图。我们通过快速民族志和焦点小组收集定性数据。我们跟踪了移动应用程序的使用情况,以调查有效的筛选工具(电子心理健康工具)的早期应用情况以及 EBP 的推出情况。

参与者

接受 EBP 培训的精神科技术人员和初级保健提供者、主管和培训师。

结果

PRIDE 已培训了 110 名 EBP 提供者、主管和培训师,并将在未来几个月培训 279 名社区卫生工作者。培训提高了对 EBP 的认识,并且受训者表示强烈的意愿提供 EBP 的核心组成部分。接受培训的提供者开始使用移动应用程序,并似乎能够识别病例并提供适当的治疗。

结论

EBP 的未来需要在现有护理系统内以其核心循证组件的保真度实施。为了可持续地解决全球范围内广泛的心理健康治疗差距,EBP 的实施需要:通过培训现有人力资源来扩大心理健康劳动力;序贯使用 EBP 来全面治疗精神障碍及其合并症,并利用数字筛查和治疗应用程序。

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