Leveraging Stakeholder Engagement and Virtual Environments to Develop a Strategy for Implementation of Adolescent Depression Services Integrated Within Primary Care Clinics of Mozambique.

Journal: Frontiers in public health

Volume: 10

Issue: 

Year of Publication: 2022

Affiliated Institutions:  Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, United States. Department of Mental Health, Ministry of Health, Maputo, Mozambique. Department of Psychiatry, New York State Psychiatric Institute, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States. Departments of Psychiatry, Medical Ethics and Health Policy, Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PN, United States.

Abstract summary 

Psychiatric disorders are the number one cause of disability in adolescents worldwide. Yet, in low- and middle-income countries (LMIC), where 90% of adolescents reside, mental health services are extremely limited, and the majority do not have access to treatment. Integration of mental health services within primary care of LMICs has been proposed as an efficient and sustainable way to close the adolescent mental health treatment gap. However, there is limited research on how to effectively implement integrated mental health care in LMIC. In the present study, we employed Implementation Mapping to develop a multilevel strategy for integrating adolescent depression services within primary care clinics of Maputo, Mozambique. Both in-person and virtual approaches for Implementation Mapping activities were used to support an international implementation planning partnership and promote the engagement of multilevel stakeholders. We identified determinants to implementation of mental health services for adolescents in LMIC across all levels of the Consolidated Framework for Implementation Research, of which of 25% were unique to adolescent-specific services. Through a series of stakeholder workshops focused on implementation strategy selection, prioritization, and specification, we then developed an implementation plan comprising 33 unique strategies that target determinants at the intervention, patient, provider, policy, and community levels. The implementation plan developed in this study will be evaluated for delivering adolescent depression services in Mozambican primary care and may serve as a model for other low-resource settings.

Authors & Co-authors:  Lovero Kathryn L KL Dos Santos Palmira Fortunato PF Adam Salma S Bila Carolina C Fernandes Maria Eduarda ME Kann Bianca B Rodrigues Teresa T Jumbe Ana Maria AM Duarte Cristiane S CS Beidas Rinad S RS Wainberg Milton L ML

Study Outcome 

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Statistics
Citations :  Gore FM, Bloem PJ, Patton GC, Ferguson J, Joseph V, Coffey C, et al. . Global burden of disease in young people aged 10-24 years: a systematic analysis. Lancet. (2011) 377:2093–102. 10.1016/S0140-6736(11)60512-6
Authors :  11
Identifiers
Doi : 876062
SSN : 2296-2565
Study Population
Male,Female
Mesh Terms
Adolescent
Other Terms
LMIC;adolescent;community engagement;depression;implementation determinants;implementation strategies;mental health
Study Design
Study Approach
Country of Study
Mozambique
Publication Country
Switzerland