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Stanislawski ER, Saali A, Magill EB, Deshpande R, Kumar V, Chan C, Hurtado A, Charney DS, Ripp J, Katz CL. Longitudinal Mental Health Outcomes of Third-year Medical Students Rotating Through the Wards During COVID-19. Psychiatry Res 2023; 320:115030. [PMID: 36623426 PMCID: PMC9791716 DOI: 10.1016/j.psychres.2022.115030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/22/2022] [Accepted: 12/24/2022] [Indexed: 12/27/2022]
Abstract
This study investigated third year medical students' psychological well-being during clinical rotations at Mount Sinai hospitals in New York City during the COVID-19 pandemic. All students (n = 147) starting rotations (psychiatry, surgery, obstetrics-gynecology, neurology, pediatrics, and medicine) could participate in quarterly, online, anonymous surveys comprised of validated screeners for: psychological symptoms, risk, coping, and protective factors, demographics, COVID-19 worries, and stressful clerkship-related events. Associations between variables were examined with Chi-squared, Fisher's exact, t-, Wilcoxon Rank Sum, one-way ANOVA, and McNemar tests. Significant univariate predictors of psychological distress were included in stepwise multivariable linear regression models. The baseline survey was completed by 110 (74.8%) students; ninety-two (62.6%) completed at least one other survey. During the year, 68 (73.9%) students screened positive for depression, anxiety, or PTSD. The prevalence of psychiatric symptoms peaked in June 2020 without significant changes in average scores over time. COVID-19 worries decreased over time but did not influence psychological symptoms at year-end. Eighty-three students (90.2%) experienced stressful clerkship-related events, which were traumatic and/or COVID-19-related for 26 (28.3%) and 22 students (24.0%), respectively. Baseline psychological distress, childhood emotional abuse, and resilience predicted depression, anxiety, and/or PTSD by year-end. This study highlights the importance of recognizing psychological distress and implementing interventions to support students' well-being.
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Affiliation(s)
- Emma R. Stanislawski
- Department of Psychiatry, 22 Bramhall Street, Maine Medical Center, Portland, ME, United States of America,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, United States of America,Correspondence author
| | - Alexandra Saali
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, United States of America
| | - Elizabeth B. Magill
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, United States of America
| | - Richa Deshpande
- Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, United States of America
| | - Vedika Kumar
- Department of Psychiatry, Zucker Hillside Hospital, 75-59 263rd St, Glen Oaks, New York, United States of America
| | - Chi Chan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, United States of America,Mental Illness Research, Education, and Clinical Center, James J. Peters VA Medical Center, 130 W Kingsbridge Rd, Bronx, NY, United States of America
| | - Alicia Hurtado
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, United States of America
| | - Dennis S. Charney
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, United States of America
| | - Jonathan Ripp
- Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, United States of America
| | - Craig L. Katz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, United States of America
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Hermosilla S, Forthal S, Sadowska K, Magill EB, Watson P, Pike KM. We need to build the evidence: A systematic review of psychological first aid on mental health and well-being. J Trauma Stress 2023; 36:5-16. [PMID: 36300605 PMCID: PMC10624106 DOI: 10.1002/jts.22888] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 11/10/2022]
Abstract
Ensuring effective mental health and psychosocial support is crucial following exposure to a potentially traumatic event and can have long-term consequences for individuals, families, and communities. Psychological first aid (PFA) has become a widespread intervention of choice following exposure to conflict or disaster; however, its impact is unknown. This systematic review assessed PFA efficacy in improving the mental health and psychosocial well-being of individuals exposed to potentially traumatic events. We searched PubMed, PsycINFO, PTSDpubs, and EMBASE for peer reviewed studies evaluating programmatic outcomes of PFA, or an adapted intervention, published in English before March 9, 2021. Studies evaluating training outcomes or program feasibility were excluded. The primary outcomes were reported measures of participant mental health and psychosocial well-being, with narrative results presented for each. The Cochrane Risk of Bias tool was applied. Of 9,048 potentially eligible citations, 12 studies with a total of 1,437 participants met the inclusion criteria. Only one study was a randomized controlled trial. The findings from all studies suggest a positive impact of PFA, with most reporting reduced symptoms of anxiety, depression, posttraumatic stress, and distress, as well as improved ratings of mood, the experience of safety, connectedness, and a sense of control, among youth and adults. Risk of bias was generally high. Inconsistent intervention components, insufficient evaluation methodologies, and a high risk of bias within the reviewed studies present challenges in assessing PFA efficacy, and an imbalance between popular support for PFA and scant evidence of outcome data exists. Further research is needed to justify the proliferation of PFA.
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Affiliation(s)
- Sabrina Hermosilla
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
- Columbia University Irving Medical Center, New York, New York, USA
| | - Sarah Forthal
- Columbia University Irving Medical Center, New York, New York, USA
| | | | - Elizabeth B. Magill
- Columbia University Irving Medical Center, New York, New York, USA
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Patricia Watson
- National Center for Posttraumatic Stress Disorder, Washington, D.C., USA
| | - Kathleen M. Pike
- Columbia University Irving Medical Center, New York, New York, USA
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Magill EB, Nyandiko W, Baum A, Aluoch J, Chory A, Ashimoshi C, Lidweye J, Njoroge T, Sang F, Nyagaya J, Scanlon M, Hogan J, Vreeman R. Factors associated with caregiver compliance to an HIV disclosure intervention and its effect on HIV and mental health outcomes among children living with HIV: post-hoc instrumental variable-based analysis of a cluster randomized trial in Eldoret, Kenya. Front Public Health 2023; 11:1150744. [PMID: 37213654 PMCID: PMC10196043 DOI: 10.3389/fpubh.2023.1150744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/03/2023] [Indexed: 05/23/2023] Open
Abstract
Background The HADITHI study is a cluster-randomized trial of children living with HIV and their caregivers in Kenya that aimed to increase rates of caregiver disclosure of their child's HIV status, encourage earlier status disclosure, and improve pediatric mental health and HIV outcomes. This analysis identified characteristics predicting caregiver non-responsiveness and compared outcomes among children based on disclosure status. Methods A penalized logistic regression model with lasso regularization identified the most important predictors of disclosure. The two-stage least squares instrumental variable approach was used to assess outcomes accounting for non-compliance to disclosure. Results Caregiver non-isolation and shorter time on antiretroviral therapy were predictive of HIV status disclosure. There were no statistically significant differences found in CD4 percentage, depression status, or mental and emotional status based on disclosure status up to 24 months-post intervention. Conclusion These findings have implications for specialists seeking to tailor disclosure interventions to improve caregiver-child dyad responsiveness.
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Affiliation(s)
- Elizabeth B. Magill
- Department of Health Systems Design and Global Health, Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Elizabeth B. Magill
| | - Winstone Nyandiko
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
- Department of Child Health and Pediatrics, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya
| | - Aaron Baum
- Department of Health Systems Design and Global Health, Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Josephine Aluoch
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Ashley Chory
- Department of Health Systems Design and Global Health, Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | | | - Janet Lidweye
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Tabitha Njoroge
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Festus Sang
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Jack Nyagaya
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Michael Scanlon
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
- Center for Global Health, Indiana School of Medicine, Bloomington, IN, United States
| | - Joseph Hogan
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
- Department of Biostatistics, Brown University School of Public Health, Providence, RI, United States
| | - Rachel Vreeman
- Department of Health Systems Design and Global Health, Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
- *Correspondence: Rachel Vreeman
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Pike KM, Rebello TJ, Hanasaki S, Narita-Ohtaki R, Kaufman P, Akiyama T, Doerries B, Yang LH, Suzuki N, Magill EB, Yasumura S. The Tōhoku Theater Project in Postdisaster Japan: An Exemplar for Addressing Community Mental Health in the Context of Disaster. Psychiatr Serv 2022; 73:712-715. [PMID: 34666511 DOI: 10.1176/appi.ps.202000520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The Tōhoku Theater Project was completed 2 years after the natural and nuclear disasters in Tōhoku, Japan, on March 11, 2011. It employed the dramatic arts to support the healing process, promote resilience, and increase dialogue and understanding about mental health among individuals who were directly affected by the disasters. The four performances fostered important discussions regarding the psychological impact of the Tōhoku disasters. Participants (N=143) found the theater performance effective at facilitating discussion, increasing empathy, and enhancing mental health knowledge, coping, and resilience. The performances provided critical information about access to services; many participants reported that they had not known where to seek help for mental health prior to their involvement with the Tōhoku Theater Project. Lessons learned may inform community-based strategies that promote mental health and healing in the wake of the COVID-19 pandemic and other public health disasters.
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Affiliation(s)
- Kathleen M Pike
- Columbia-WHO Center for Global Mental Health, Department of Psychiatry, Columbia University Irving Medical Center, New York City (Pike, Rebello, Magill);Engeki Design Guild, Tokyo (Hanasaki);Tōhoku Project, Tōhoku, Japan (Narita-Ohtaki, Suzuki);Massachusetts General Hospital Psychiatry Academy, Massachusetts General Hospital, Boston (Kaufman);Clay Center for Young Healthy Minds, Massachusetts General Hospital and Harvard Medical School, Boston (Kaufman);Department of Psychiatry, Tokyo University, Tokyo (Akiyama);Theater of War Productions, New York City (Doerries);Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York City (Yang);Department of Public Health, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan (Yasumura). Dr. Pike, Matías Irarrázaval, M.D., M.P.H., and Lola Kola, Ph.D., are editors of this column
| | - Tahilia J Rebello
- Columbia-WHO Center for Global Mental Health, Department of Psychiatry, Columbia University Irving Medical Center, New York City (Pike, Rebello, Magill);Engeki Design Guild, Tokyo (Hanasaki);Tōhoku Project, Tōhoku, Japan (Narita-Ohtaki, Suzuki);Massachusetts General Hospital Psychiatry Academy, Massachusetts General Hospital, Boston (Kaufman);Clay Center for Young Healthy Minds, Massachusetts General Hospital and Harvard Medical School, Boston (Kaufman);Department of Psychiatry, Tokyo University, Tokyo (Akiyama);Theater of War Productions, New York City (Doerries);Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York City (Yang);Department of Public Health, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan (Yasumura). Dr. Pike, Matías Irarrázaval, M.D., M.P.H., and Lola Kola, Ph.D., are editors of this column
| | - Setsu Hanasaki
- Columbia-WHO Center for Global Mental Health, Department of Psychiatry, Columbia University Irving Medical Center, New York City (Pike, Rebello, Magill);Engeki Design Guild, Tokyo (Hanasaki);Tōhoku Project, Tōhoku, Japan (Narita-Ohtaki, Suzuki);Massachusetts General Hospital Psychiatry Academy, Massachusetts General Hospital, Boston (Kaufman);Clay Center for Young Healthy Minds, Massachusetts General Hospital and Harvard Medical School, Boston (Kaufman);Department of Psychiatry, Tokyo University, Tokyo (Akiyama);Theater of War Productions, New York City (Doerries);Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York City (Yang);Department of Public Health, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan (Yasumura). Dr. Pike, Matías Irarrázaval, M.D., M.P.H., and Lola Kola, Ph.D., are editors of this column
| | - Ryoko Narita-Ohtaki
- Columbia-WHO Center for Global Mental Health, Department of Psychiatry, Columbia University Irving Medical Center, New York City (Pike, Rebello, Magill);Engeki Design Guild, Tokyo (Hanasaki);Tōhoku Project, Tōhoku, Japan (Narita-Ohtaki, Suzuki);Massachusetts General Hospital Psychiatry Academy, Massachusetts General Hospital, Boston (Kaufman);Clay Center for Young Healthy Minds, Massachusetts General Hospital and Harvard Medical School, Boston (Kaufman);Department of Psychiatry, Tokyo University, Tokyo (Akiyama);Theater of War Productions, New York City (Doerries);Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York City (Yang);Department of Public Health, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan (Yasumura). Dr. Pike, Matías Irarrázaval, M.D., M.P.H., and Lola Kola, Ph.D., are editors of this column
| | - Phyllis Kaufman
- Columbia-WHO Center for Global Mental Health, Department of Psychiatry, Columbia University Irving Medical Center, New York City (Pike, Rebello, Magill);Engeki Design Guild, Tokyo (Hanasaki);Tōhoku Project, Tōhoku, Japan (Narita-Ohtaki, Suzuki);Massachusetts General Hospital Psychiatry Academy, Massachusetts General Hospital, Boston (Kaufman);Clay Center for Young Healthy Minds, Massachusetts General Hospital and Harvard Medical School, Boston (Kaufman);Department of Psychiatry, Tokyo University, Tokyo (Akiyama);Theater of War Productions, New York City (Doerries);Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York City (Yang);Department of Public Health, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan (Yasumura). Dr. Pike, Matías Irarrázaval, M.D., M.P.H., and Lola Kola, Ph.D., are editors of this column
| | - Tsuyoshi Akiyama
- Columbia-WHO Center for Global Mental Health, Department of Psychiatry, Columbia University Irving Medical Center, New York City (Pike, Rebello, Magill);Engeki Design Guild, Tokyo (Hanasaki);Tōhoku Project, Tōhoku, Japan (Narita-Ohtaki, Suzuki);Massachusetts General Hospital Psychiatry Academy, Massachusetts General Hospital, Boston (Kaufman);Clay Center for Young Healthy Minds, Massachusetts General Hospital and Harvard Medical School, Boston (Kaufman);Department of Psychiatry, Tokyo University, Tokyo (Akiyama);Theater of War Productions, New York City (Doerries);Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York City (Yang);Department of Public Health, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan (Yasumura). Dr. Pike, Matías Irarrázaval, M.D., M.P.H., and Lola Kola, Ph.D., are editors of this column
| | - Bryan Doerries
- Columbia-WHO Center for Global Mental Health, Department of Psychiatry, Columbia University Irving Medical Center, New York City (Pike, Rebello, Magill);Engeki Design Guild, Tokyo (Hanasaki);Tōhoku Project, Tōhoku, Japan (Narita-Ohtaki, Suzuki);Massachusetts General Hospital Psychiatry Academy, Massachusetts General Hospital, Boston (Kaufman);Clay Center for Young Healthy Minds, Massachusetts General Hospital and Harvard Medical School, Boston (Kaufman);Department of Psychiatry, Tokyo University, Tokyo (Akiyama);Theater of War Productions, New York City (Doerries);Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York City (Yang);Department of Public Health, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan (Yasumura). Dr. Pike, Matías Irarrázaval, M.D., M.P.H., and Lola Kola, Ph.D., are editors of this column
| | - Lawrence H Yang
- Columbia-WHO Center for Global Mental Health, Department of Psychiatry, Columbia University Irving Medical Center, New York City (Pike, Rebello, Magill);Engeki Design Guild, Tokyo (Hanasaki);Tōhoku Project, Tōhoku, Japan (Narita-Ohtaki, Suzuki);Massachusetts General Hospital Psychiatry Academy, Massachusetts General Hospital, Boston (Kaufman);Clay Center for Young Healthy Minds, Massachusetts General Hospital and Harvard Medical School, Boston (Kaufman);Department of Psychiatry, Tokyo University, Tokyo (Akiyama);Theater of War Productions, New York City (Doerries);Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York City (Yang);Department of Public Health, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan (Yasumura). Dr. Pike, Matías Irarrázaval, M.D., M.P.H., and Lola Kola, Ph.D., are editors of this column
| | - Nao Suzuki
- Columbia-WHO Center for Global Mental Health, Department of Psychiatry, Columbia University Irving Medical Center, New York City (Pike, Rebello, Magill);Engeki Design Guild, Tokyo (Hanasaki);Tōhoku Project, Tōhoku, Japan (Narita-Ohtaki, Suzuki);Massachusetts General Hospital Psychiatry Academy, Massachusetts General Hospital, Boston (Kaufman);Clay Center for Young Healthy Minds, Massachusetts General Hospital and Harvard Medical School, Boston (Kaufman);Department of Psychiatry, Tokyo University, Tokyo (Akiyama);Theater of War Productions, New York City (Doerries);Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York City (Yang);Department of Public Health, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan (Yasumura). Dr. Pike, Matías Irarrázaval, M.D., M.P.H., and Lola Kola, Ph.D., are editors of this column
| | - Elizabeth B Magill
- Columbia-WHO Center for Global Mental Health, Department of Psychiatry, Columbia University Irving Medical Center, New York City (Pike, Rebello, Magill);Engeki Design Guild, Tokyo (Hanasaki);Tōhoku Project, Tōhoku, Japan (Narita-Ohtaki, Suzuki);Massachusetts General Hospital Psychiatry Academy, Massachusetts General Hospital, Boston (Kaufman);Clay Center for Young Healthy Minds, Massachusetts General Hospital and Harvard Medical School, Boston (Kaufman);Department of Psychiatry, Tokyo University, Tokyo (Akiyama);Theater of War Productions, New York City (Doerries);Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York City (Yang);Department of Public Health, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan (Yasumura). Dr. Pike, Matías Irarrázaval, M.D., M.P.H., and Lola Kola, Ph.D., are editors of this column
| | - Seiji Yasumura
- Columbia-WHO Center for Global Mental Health, Department of Psychiatry, Columbia University Irving Medical Center, New York City (Pike, Rebello, Magill);Engeki Design Guild, Tokyo (Hanasaki);Tōhoku Project, Tōhoku, Japan (Narita-Ohtaki, Suzuki);Massachusetts General Hospital Psychiatry Academy, Massachusetts General Hospital, Boston (Kaufman);Clay Center for Young Healthy Minds, Massachusetts General Hospital and Harvard Medical School, Boston (Kaufman);Department of Psychiatry, Tokyo University, Tokyo (Akiyama);Theater of War Productions, New York City (Doerries);Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York City (Yang);Department of Public Health, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan (Yasumura). Dr. Pike, Matías Irarrázaval, M.D., M.P.H., and Lola Kola, Ph.D., are editors of this column
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Coleman SF, Mukasakindi H, Rose AL, Galea JT, Nyirandagijimana B, Hakizimana J, Bienvenue R, Kundu P, Uwimana E, Uwamwezi A, Contreras C, Rodriguez-Cuevas FG, Maza J, Ruderman T, Connolly E, Chalamanda M, Kayira W, Kazoole K, Kelly KK, Wilson JH, Houde AA, Magill EB, Raviola GJ, Smith SL. Adapting Problem Management Plus for Implementation: Lessons Learned from Public Sector Settings Across Rwanda, Peru, Mexico and Malawi. Intervention (Amstelveen) 2021; 19:58-66. [PMID: 34642580 PMCID: PMC8503941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Problem Management Plus (PM+) is a low-intensity psychological intervention developed by the World Health Organization that can be delivered by nonspecialists to address common mental health conditions in people affected by adversity. Emerging evidence demonstrates the efficacy of PM+ across a range of settings. However, the published literature rarely documents the adaptation processes for psychological interventions to context or culture, including curriculum or implementation adaptations. Practical guidance for adapting PM+ to context while maintaining fidelity to core psychological elements is essential for mental health implementers to enable replication and scale. This paper describes the process of contextually adapting PM+ for implementation in Rwanda, Peru, Mexico and Malawi undertaken by the international nongovernmental organization Partners In Health. To our knowledge, this initiative is among the first to adapt PM+ for routine delivery across multiple public sector primary care and community settings in partnership with Ministries of Health. Lessons learned contribute to a broader understanding of effective processes for adapting low-intensity psychological interventions to real-world contexts.
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Affiliation(s)
| | | | | | - Jerome T. Galea
- School of Social Work and College of Public Health, University of South Florida, Tampa, USA; Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA
| | | | | | | | - Priya Kundu
- Partners In Health/Inshuti Mu Buzima, Rwanda
| | | | | | - Carmen Contreras
- Partners In Health/Socios En Salud, Peru, Harvard Global Health Institute, Boston, USA
| | | | - Jimena Maza
- Partners In Health/Compañeros En Salud, Mexico
| | | | - Emilia Connolly
- Partners In Health/Abwenzi Pa Za Umoyo, Malawi; Division of Pediatrics and Division of Hospital Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | | | | | | | | | | | | | | | - Giuseppe J. Raviola
- Partners In Health, Boston, USA,Partners In Health, Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA; The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, USA
| | - Stephanie L. Smith
- Partners In Health, Boston, MA; Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA; Department of Psychiatry, Brigham and Women’s Hospital, Boston, USA
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