Development of a remote implementation support strategy to enhance integration of depression treatment into primary care settings in rural India

IntroductionContextually responsive implementation support strategies are needed to enhance the integration of mental health services into primary health care. Technical assistance is widely used as a core “capacity building” strategy, primarily for increasing the motivation and capacity of individu...

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Main Authors: Gloria A. Pedersen, Juliana Restivo Haney, Abhishek Singh, Shivangi Choubey, Ameya Bondre, Vorapat Vorapanya, Anant Bhan, Deepak Tugnawat, Vikram Patel, John A. Naslund, Rohit Ramaswamy
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Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2024.1439997/full
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author Gloria A. Pedersen
Juliana Restivo Haney
Juliana Restivo Haney
Abhishek Singh
Shivangi Choubey
Ameya Bondre
Vorapat Vorapanya
Anant Bhan
Deepak Tugnawat
Vikram Patel
Vikram Patel
John A. Naslund
Rohit Ramaswamy
Rohit Ramaswamy
author_facet Gloria A. Pedersen
Juliana Restivo Haney
Juliana Restivo Haney
Abhishek Singh
Shivangi Choubey
Ameya Bondre
Vorapat Vorapanya
Anant Bhan
Deepak Tugnawat
Vikram Patel
Vikram Patel
John A. Naslund
Rohit Ramaswamy
Rohit Ramaswamy
author_sort Gloria A. Pedersen
collection DOAJ
description IntroductionContextually responsive implementation support strategies are needed to enhance the integration of mental health services into primary health care. Technical assistance is widely used as a core “capacity building” strategy, primarily for increasing the motivation and capacity of individuals (e.g., frontline workers) to adopt evidence-based interventions in healthcare settings. This article documents the systematic design of a technical assistance strategy for supporting primary care staff (e.g., nurses) in integrating depression care, from screening to treatment, aligned with a non-communicable disease program across seven health facilities in the Sehore District of Madhya Pradesh, India.MethodsWe conducted a mapping exercise of local health facilities with dedicated staff and a literature review to inform the development of the technical assistance strategy.ResultsReporting guidelines guided the structure of the strategy protocol. The evidence-supported strategy, called Remote Coaching Support, is tailored to the local setting. It uses quality improvement methods like the Plan-Do-Act-Study cycle and training materials to help coaches deliver support remotely via video/phone-based calls and WhatsApp messaging with the overall goal of increasing uptake and fidelity of depression screening and referral among primary care staff in alignment with an existing non-communicable diseases program.ConclusionThe development of Remote Coaching Support involved iterative improvements through team meetings and practice-training feedback, though limitations exist due to a lack of systematic implementation standards, especially in this setting. This strategy will be tested in increasing scales to refine its application, with effectiveness and acceptability results to be evaluated in a randomized control trial.
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spelling doaj-art-43a2fda3c78a4d7095d584a296c9f3a02025-08-20T02:31:08ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-12-011210.3389/fpubh.2024.14399971439997Development of a remote implementation support strategy to enhance integration of depression treatment into primary care settings in rural IndiaGloria A. Pedersen0Juliana Restivo Haney1Juliana Restivo Haney2Abhishek Singh3Shivangi Choubey4Ameya Bondre5Vorapat Vorapanya6Anant Bhan7Deepak Tugnawat8Vikram Patel9Vikram Patel10John A. Naslund11Rohit Ramaswamy12Rohit Ramaswamy13Mental Health for All Lab, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United StatesMental Health for All Lab, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United StatesDepartment of Psychology, West Virginia University, Morgantown, WV, United StatesBhopal Hub, Sangath, Bhopal, Madhya Pradesh, IndiaBhopal Hub, Sangath, Bhopal, Madhya Pradesh, IndiaBhopal Hub, Sangath, Bhopal, Madhya Pradesh, IndiaGillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesBhopal Hub, Sangath, Bhopal, Madhya Pradesh, IndiaBhopal Hub, Sangath, Bhopal, Madhya Pradesh, IndiaMental Health for All Lab, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United StatesDepartment of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United StatesMental Health for All Lab, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United StatesGillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesJames M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United StatesIntroductionContextually responsive implementation support strategies are needed to enhance the integration of mental health services into primary health care. Technical assistance is widely used as a core “capacity building” strategy, primarily for increasing the motivation and capacity of individuals (e.g., frontline workers) to adopt evidence-based interventions in healthcare settings. This article documents the systematic design of a technical assistance strategy for supporting primary care staff (e.g., nurses) in integrating depression care, from screening to treatment, aligned with a non-communicable disease program across seven health facilities in the Sehore District of Madhya Pradesh, India.MethodsWe conducted a mapping exercise of local health facilities with dedicated staff and a literature review to inform the development of the technical assistance strategy.ResultsReporting guidelines guided the structure of the strategy protocol. The evidence-supported strategy, called Remote Coaching Support, is tailored to the local setting. It uses quality improvement methods like the Plan-Do-Act-Study cycle and training materials to help coaches deliver support remotely via video/phone-based calls and WhatsApp messaging with the overall goal of increasing uptake and fidelity of depression screening and referral among primary care staff in alignment with an existing non-communicable diseases program.ConclusionThe development of Remote Coaching Support involved iterative improvements through team meetings and practice-training feedback, though limitations exist due to a lack of systematic implementation standards, especially in this setting. This strategy will be tested in increasing scales to refine its application, with effectiveness and acceptability results to be evaluated in a randomized control trial.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1439997/fulldepressionmental healthglobal healthimplementation scienceprimary care
spellingShingle Gloria A. Pedersen
Juliana Restivo Haney
Juliana Restivo Haney
Abhishek Singh
Shivangi Choubey
Ameya Bondre
Vorapat Vorapanya
Anant Bhan
Deepak Tugnawat
Vikram Patel
Vikram Patel
John A. Naslund
Rohit Ramaswamy
Rohit Ramaswamy
Development of a remote implementation support strategy to enhance integration of depression treatment into primary care settings in rural India
Frontiers in Public Health
depression
mental health
global health
implementation science
primary care
title Development of a remote implementation support strategy to enhance integration of depression treatment into primary care settings in rural India
title_full Development of a remote implementation support strategy to enhance integration of depression treatment into primary care settings in rural India
title_fullStr Development of a remote implementation support strategy to enhance integration of depression treatment into primary care settings in rural India
title_full_unstemmed Development of a remote implementation support strategy to enhance integration of depression treatment into primary care settings in rural India
title_short Development of a remote implementation support strategy to enhance integration of depression treatment into primary care settings in rural India
title_sort development of a remote implementation support strategy to enhance integration of depression treatment into primary care settings in rural india
topic depression
mental health
global health
implementation science
primary care
url https://www.frontiersin.org/articles/10.3389/fpubh.2024.1439997/full
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