Mutamba Byamah Brian, Rai Sauharda, Semakula Lynn, Cappo David, Asher Laura, Gwaikolo Wilfred, Kohrt Brandon A
YouBelong Uganda, Kampala, Uganda.
Butabika National Referral Mental Hospital, Kampala, Uganda.
Pilot Feasibility Stud. 2025 Jul 21;11(1):103. doi: 10.1186/s40814-025-01684-8.
Mental health services are most effective and equitable when designed, delivered, and evaluated in collaboration with People With Lived Experience of mental health conditions (PWLE). However, PWLE are rarely involved in health systems strengthening, and when they are, it is limited to specific components (e.g., peer helpers) rather than multi-tiered collaboration in the full continuum of home to community to facility based services. Moreover, programs that do involve PWLE typically involve people with a history of substance use conditions or common mental disorders. The collaboration of People With Lived Experience of Psychosis (PWLP) is especially rare. Therefore, we aim to explore the feasibility of collaborating with PWLP for health systems strengthening in this feasibility trial.
This pilot cluster randomized controlled feasibility trial will randomize 36 health facilities to a standard implementation arm where primary care workers (PCW) will be trained by mental health specialists (control), or a collaborative care model with added co-facilitation of PCW trainings by PWLP as well as home visits by PWLP to service users (intervention). The intervention condition is referred to as "Strengthening CAre in collaboration with People with lived Experience of psychosis in Uganda" (SCAPE-U). The 36 health facilities will be distributed across six clusters with three clusters in each arm. PhotoVoice will be used to train PWLP to be co-facilitators of PCW training and provide home-based support to service users in the intervention arm. The primary outcomes of the feasibility trial will be the feasibility, acceptability, and safety of collaborating with PWLP. Data will also be collected on individual-level outcomes for PCWs, and service users to inform the feasibility of data collection and obtain effect size estimates.
Findings from this feasibility trial will inform a fully powered trial to evaluate the benefits of an implementation strategy characterized by collaboration with PWLP across the continuum of healthcare services.
ClinicalTrials.gov. number: NCT05863572. Date of registration: May 18, 2023. URL of trial registry record: https://clinicaltrials.gov/study/NCT05863572?term=NCT05863572&rank=1 .
当与有精神健康问题亲身经历的人（PWLE）合作设计、提供和评估精神健康服务时，这些服务最为有效且公平。然而，PWLE很少参与卫生系统的强化工作，即便参与，也仅限于特定组成部分（如同伴帮助者），而非在从家庭到社区再到机构服务的整个连续过程中的多层次合作。此外，确实让PWLE参与的项目通常涉及有物质使用问题或常见精神障碍病史的人。有精神病亲身经历的人（PWLP）的合作尤为罕见。因此，我们旨在通过这项可行性试验探索与PWLP合作以强化卫生系统的可行性。
这项试点整群随机对照可行性试验将把36个卫生机构随机分为一个标准实施组，在该组中，初级保健工作者（PCW）将由精神健康专家进行培训（对照组），或分为一个协作护理模式组，由PWLP共同协助PCW培训，并由PWLP对服务使用者进行家访（干预组）。干预条件被称为“在乌干达与有精神病亲身经历的人合作强化护理”（SCAPE-U）。这36个卫生机构将分布在六个整群中，每组三个整群。将使用照片声音法培训PWLP成为PCW培训的共同协助者，并为干预组的服务使用者提供居家支持。可行性试验的主要结果将是与PWLP合作的可行性、可接受性和安全性。还将收集关于PCW和服务使用者个体层面结果的数据，以了解数据收集的可行性并获得效应量估计值。
这项可行性试验的结果将为一项全面的试验提供信息，以评估一种以在整个医疗服务连续过程中与PWLP合作为特征的实施策略的益处。
ClinicalTrials.gov编号：NCT05863572。注册日期：2023年5月18日。试验注册记录的网址：https://clinicaltrials.gov/study/NCT05863572?term=NCT05863572&rank=1 。
