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Ransing R, Hawk M, McDonald M, Jones J, Bhatia T, Verma V, Shah GD, Brar J, Egan JE, Konsale P, Kaur J, Singh R, Singh H, Dhaliwal RS, Wood J, Nimgaonkar V, Deshpande S, Swaminathan S. A mentored hands-on training model for scaling up implementation and intervention research in India: "connecting the dots". Health Res Policy Syst 2023; 21:33. [PMID: 37131159 PMCID: PMC10153774 DOI: 10.1186/s12961-023-00980-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 04/05/2023] [Indexed: 05/04/2023] Open
Abstract
Despite the high burden of mental disorders in low- and middle-income countries (LMICs), less than 25% of those in need have access to appropriate services, in part due to a scarcity of locally relevant, evidence-based interventions and models of care. To address this gap, researchers from India and the United States and the Indian Council of Medical Research (ICMR) collaboratively developed a "Grantathon" model to provide mentored research training to 24 new principal investigators (PIs). This included a week-long didactic training, a customized web-based data entry/analysis system and a National Coordination Unit (NCU) to support PIs and track process objectives. Outcome objectives were assessed via scholarly output including publications, awards received and subsequent grants that were leveraged. Multiple mentorship strategies including collaborative problem-solving approaches were used to foster single-centre and multicentre research. Flexible, approachable and engaged support from mentors helped PIs overcome research barriers, and the NCU addressed local policy and day-to-day challenges through informal monthly review meetings. Bi-annual formal review presentations by all PIs continued through the COVID-19 pandemic, enabling interim results reporting and scientific review, also serving to reinforce accountability. To date, more than 33 publications, 47 scientific presentations, 12 awards, two measurement tools, five intervention manuals and eight research grants have been generated in an open-access environment. The Grantathon is a successful model for building research capacity and improving mental health research in India that could be adopted for use in other LMICs.
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Affiliation(s)
- Ramdas Ransing
- Department of Psychiatry, BKL Walwalkar Rural Medical College, Sawarde, Ratnagiri, Maharashtra, 415606, India
| | - Mary Hawk
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, PA, 15261, United States of America.
| | - Margaret McDonald
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, United States of America
| | - Jacquelyn Jones
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, United States of America
| | - Triptish Bhatia
- National Coordinating Unit ICMR for NMHP Projects, Department of Psychiatry, Centre of Excellence in Mental Health, ABVIMS, Dr Ram Manohar Lohia Hospital, New Delhi, 110001, India
| | - Vijay Verma
- Indian Council of Medical Research, Ansari Nagar, New Delhi, 110029, India
| | - Gyan D Shah
- National Coordinating Unit ICMR for NMHP Projects, Department of Psychiatry, Centre of Excellence in Mental Health, ABVIMS, Dr Ram Manohar Lohia Hospital, New Delhi, 110001, India
| | - Jaspreet Brar
- Department of Psychiatry, Western Psychiatric Institute and Clinic, Community Care Behavioral Health Organization, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, United States of America
| | - James Erin Egan
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, PA, 15261, United States of America
| | - Prasad Konsale
- University of Pittsburgh School of Medicine, University of Pittsburgh Swanson School of Engineering, VA Pittsburgh Healthcare System, Pittsburgh, PA, 15213, United States of America
| | - Jasmine Kaur
- Indian Council of Medical Research, Ansari Nagar, New Delhi, 110029, India
| | - Ravinder Singh
- Indian Council of Medical Research, Ansari Nagar, New Delhi, 110029, India
| | - Harpreet Singh
- Indian Council of Medical Research, Ansari Nagar, New Delhi, 110029, India
| | - R S Dhaliwal
- Indian Council of Medical Research, Ansari Nagar, New Delhi, 110029, India
| | - Joel Wood
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, United States of America
| | - Vishwajit Nimgaonkar
- Psychiatry and Human Genetics, University of Pittsburgh School of Medicine and Graduate School of Public Health, Pittsburgh, PA, United States of America
| | - Smita Deshpande
- Department of Psychiatry, Centre of Excellence in Mental Health, ABVIMS - Dr. Ram Manohar Lohia Hospital, Bangabandhu Sheikh Mujib Road, New Delhi, 110001, India
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Chakraborty S, Bhatia T, Antony N, Roy A, Shriharsh V, Sahay A, Brar JS, Iyengar S, Singh R, Nimgaonkar VL, Deshpande SN. Comparing the Indian Autism Screening Questionnaire (IASQ) and the Indian Scale for Assessment of Autism (ISAA) with the Childhood Autism Rating Scale–Second Edition (CARS2) in Indian settings. PLoS One 2022; 17:e0273780. [PMID: 36121860 PMCID: PMC9484635 DOI: 10.1371/journal.pone.0273780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 08/16/2022] [Indexed: 11/30/2022] Open
Abstract
The Indian Autism Screening Questionnaire (IASQ), derived from the Indian Scale for Assessment of Autism ISAA (the mandated tool for autism in India), is an autism screening instrument for use in the general population by minimally trained workers. While ISAA has 40 items with four anchor points, the IASQ is a 10-item questionnaire with yes/no answers. It was initially validated using the ISAA. During its development the ISAA was itself compared to the Childhood Autism Rating Scale version 1 (ISAA Manual). In the present study, we evaluated both the ISAA and the IASQ in relation to the Childhood Autism Rating Scale version 2 (CARS-2). Methods: Participants were recruited from three settings: a referral clinic for neurodevelopmental conditions run by the Department of Paediatrics of a tertiary care teaching hospital (NDC OPD), the outpatient department of an institute for disability and rehabilitation (NIEPID), and from the community (CGOC). Persons between ages 3–18 were recruited following consent or assent (parent and child/adolescent). The IASQ was administered by a minimally trained administrator. It was followed by ISAA and the CARS-2 (in alternating order, by different evaluators blind to each other) (CARS2 SV (Standard Version) and CARS2 HF (High Functioning) as applicable). Sensitivity, specificity and area under the Receiver Operator Characteristics (ROC) curve were calculated for IASQ and CARS2, as well as for ISAA and CARS2. Concordance between CARS2 and ISAA was calculated using kappa coefficient. Results: A total of 285 participants (NIEPD n = 124; NDC OPD, n = 4; CGOC n = 157) (a total of 70 with autism and 215 controls) participated. IASQ and CARS2 were administered on 285 participants, while IASQ and ISAA were administered on 264 participants. When IASQ was compared to CARS2, sensitivity was 97%, specificity 81%, PPV 63%, NPV 99% at cut off 1 while these values were 97%, 92%, 79% and 99% respectively at cut off 2. There was high concordance between CARS2 and ISAA (Kappa 0.907, p<0.0001). Conclusions: IASQ has satisfactory sensitivity, specificity and concordance when compared with CARS2; it can be used for screening children with autism in community. The ISAA also showed a high concordance with CARS2, as it had with the older version of CARS.
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Affiliation(s)
- Satabdi Chakraborty
- Department of Psychiatric Social Work, Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Sciences-Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Triptish Bhatia
- Indo-US Projects, Department of Psychiatry and De-addiction, Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Sciences-Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Nitin Antony
- Development and Validation of the Screening Version of ISAA, ‘ICMR Project’, Dept. of Psychiatric Social Work, Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Sciences-Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Aratrika Roy
- Development and Validation of the Screening Version of ISAA, ‘ICMR Project’, Dept. of Psychiatric Social Work, Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Sciences-Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Vandana Shriharsh
- Department of Clinical Psychology, Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Sciences-Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Amrita Sahay
- National Institute for the Empowerment of Persons with Intellectual Disabilities (NIEPID), Noida, U.P., India
| | - Jaspreet S. Brar
- Department of Psychiatry and Consultant, Community Care Behavioral Health Organization, Western Psychiatric Hospital of UPMC, Pittsburgh, Pennsylvania, United States of America
| | - Satish Iyengar
- Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Ravinder Singh
- Division of Non Communicable Diseases, Indian Council for Medical Research, New Delhi, India
| | - Vishwajit L. Nimgaonkar
- Department of Psychiatry and Department of Human Genetics, University of Pittsburgh School of Medicine and Graduate School of Public Health, Pittsburgh, Pennsylvania, United States of America
| | - Smita Neelkanth Deshpande
- Department of Psychiatry, Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Sciences-Dr. Ram Manohar Lohia Hospital, New Delhi, India
- * E-mail:
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