Objective To report the interim results from the training of providers inevidence-based psychotherapies (EBPs) and use of mobile applications.
Design and Setting The Partnerships in Research to Implement and Disseminate Sustainable and Scalable Evidence (PRIDE) study is a cluster-randomised hybrid effectiveness-implementation trial comparing three delivery pathways for integrating comprehensive mental healthcare into primary care in Mozambique. Innovations include the use of EBPs and scaling-up of task-shifted mental health services using mobile applications.
Main outcome measures We examined EBP training attendance, certification, knowledge and intentions to deliver each component. We collected qualitative data through rapid ethnography and focus groups. We tracked the use of the mobile applications to investigate early reach of a valid screening tool (Electronic Mental Wellness Tool) and the roll out of the EBPs
Participants Psychiatric technicians and primary care providers trained in the EBPs.
Results PRIDE has trained 110 EBP providers, supervisors and trainers and will train 279 community health workers in upcoming months. The trainings improved knowledge about the EBPs and trainees indicated strong intentions to deliver the EBP core components. Trained providers began using the mobile applications and appear to identify cases and provide appropriate treatment.
Conclusions The future of EBPs requires implementation within existing systems of care with fidelity to their core evidence-based components. To sustainably address the vast mental health treatment gap globally, EBP implementation demands: expanding the mental health workforce by training existing human resources; sequential use of EBPs to comprehensively treat mental disorders and their comorbid presentations and leveraging digital screening and treatment applications.
- depression & mood disorders
- schizophrenia & psychotic disorders
- substance misuse
- anxiety disorders
- adult psychiatry
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MLW and MLG are joint first authors.
MAO and MMW are joint senior authors.
Correction notice This article has been corrected since it appeared Online First. Joint 'first' authorship has been replaced with joint 'senior' authorship.
Contributors MLW and MW conceptualised the paper, which was then discussed with MLG and MAO for further detail. MLW and MAS completed the initial draft and identified where coauthors could contribute their expertise. AOM, JdeJM, KLL, MM, CD, AFS, MLG, JdJM, JMA, SS, DSM, RM, ANA, DM, FM, FC, J-MA-B, TN, BK, WF contributed to writing the background sections. PF, AS, MM, CB, KLL, PFdS, PN, and MLW contributed to writing the methods and results. MLW, MLG, MAO, and MMW drafted the conclusions. All authors reviewed and contributed to each draft of the paper. MLW and MAS finalised the paper following coauthors’ review.
Funding This research was supported by NIMH grants U19 MH113203 and T32 MH096724 and a FIC/NIMH grant D4 3TW009675.
Competing interests MAO receives royalties from the Research Foundation for Mental Hygiene for the commercial use of the Columbia Suicide Severity Rating Scale and owns shares in Mantra, Inc. She serves as an advisor to Alkermes and Fundacion Jimenez Diaz (Madrid). Her family owns stock in Bristol Myers Squibb.MMW receives royalties from Multi-Health Systems Inc. for use of the Social Adjustment Scale-Self-Report (SAS-SR) as well as book royalties from Perseus Press, Oxford Press, and APA Publishing. Additionally, MMW has received research funding from the Brain and Behavior Foundation, Templeton Foundation and the Sackler Foundation.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request. Data collection is ongoing. Study data will be available once the study is completed upon reasonable request for de-identified data.
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