Mootz Jennifer J, Fortunato Dos Santos Palmira, Moridi Leyly, Dos Santos Katia, Weissman Myrna, Oliffe John L, Stith Sandra, Khan Saida, Feliciano Paulino, Suleman Antonio, Rolin Stephanie A, Giusto Ali, Wainberg Milton L
Department of Psychiatry, Columbia University, New York, NY, USA.
Division of Translational Epidemiology and Mental Health Equity, New York State Psychiatric Institute, New York, NY, USA.
Glob Ment Health (Camb). 2024 Oct 21;11:e84. doi: 10.1017/gmh.2024.92. eCollection 2024.
High rates of intimate partner violence (IPV) and mental disorders are present in Mozambique where there is a significant treatment gap. We aimed to report Mozambican community stakeholder perspectives of implementing couple-based interpersonal psychotherapy (IPT-C) in preparation for a pilot trial in Nampula City.
We conducted 11 focus group discussions (6-8 people per group) and seven in-depth interviews with key informants in mental health or gender-based violence ( = 85) using purposive sampling. We used grounded theory methods to conduct an inductive coding and then deductively applied the consolidated framework for implementation research (CFIR).
For the outer setting, local attitudes that stigmatize mental health conditions and norm IPV as well as an inefficient legal system were barriers. Stakeholders expressed high acceptability of IPT-C, although a lack of resources was a structural challenge for the inner setting. Adaptation of the approach to screen for and address potential mediators of IPV was important for adopting a multisectoral response to implementation and planning. Delivering IPT-C in the community and in collaboration with community stakeholders was preferable.
Stakeholders recommended multilevel involvement and inclusion of community-based programming. Task shifting and use of technology can help address these resource demands.
莫桑比克存在高比例的亲密伴侣暴力(IPV)和精神障碍,且存在显著的治疗缺口。我们旨在报告莫桑比克社区利益相关者对实施基于夫妻的人际心理治疗(IPT-C)的看法,为在楠普拉市开展试点试验做准备。
我们采用目的抽样法,进行了11次焦点小组讨论(每组6 - 8人),并对心理健康或基于性别的暴力方面的关键信息提供者进行了7次深入访谈(n = 85)。我们运用扎根理论方法进行归纳编码,然后演绎应用实施研究的整合框架(CFIR)。
在外部环境方面,当地对精神健康状况的污名化态度、将IPV视为常态的观念以及低效的法律体系构成了障碍。利益相关者对IPT-C表示高度认可,尽管资源匮乏是内部环境的一个结构性挑战。调整该方法以筛查和解决IPV的潜在调节因素,对于采取多部门应对实施和规划措施很重要。在社区中并与社区利益相关者合作提供IPT-C更为可取。
利益相关者建议进行多层次参与并纳入基于社区的项目规划。任务转移和技术应用有助于满足这些资源需求。