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Technology and implementation science to forge the future of evidence-based psychotherapies: the PRIDE scale-up study

Wainberg, Milton L.; Gouveia, Maria Lídia; Stockton, Melissa; Feliciano, Paulino; Suleman, Antonio; Mootz, Jennifer J.; Mello, Milena; Salem, Andre Fiks; Greene, M. Claire; Bezuidenhout, Charl; Ngwepe, Phuti; Lovero, Kathryn L.; Fortunato dos Santos, Palmira; Schriger, Simone H.; Mulumba, Rogerio; Anube, Anibal Neves; Mabunda, Dirceu; Mandlate, Flavio; Cournos, Francine; Alves Bradford, Jean-Marie; Nicholson, Terriann; Kann, Bianca; Fumo, Wilza; Duarte, Cristiane S.; Mari, Jair de Jesus; Mello, Marcelo F.; Mocumbi, Ana O.; Oquendo, Maria A.; Weissman, Myrna M.

Objective: To report the interim results from the training of providers in evidence-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.

Keywords: adult psychiatry; anxiety disorders; depression & mood disorders; schizophrenia & psychotic disorders; substance misuse.

© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

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Also Published In

Title
Evidence-Based Mental Health
DOI
https://doi.org/10.1136/ebmental-2020-300199

More About This Work

Academic Units
Psychiatry
Published Here
May 20, 2021