From Innovation to Scale: Policy Engagement for Enhanced Community-Based Depression Care in Vietnam

Murphy, Jill; Nguyen, V.H.; Chau, Leena W.; O’Neil, John; Nguyen, VH; Minas, Harry

doi:10.1007/978-3-319-70134-9_83-1

Cited by 3 publications

(2 citation statements)

References 28 publications

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“…This successful RCT and collaboration with MOLISA laid the ground work for additional ongoing studies, funded by GCC and the Canadian Institutes of Health Research (CIHR), to support the adaptation of the intervention for app-based delivery and to support several aspects of mental health policy and system strengthening. The process and history of policy engagement is described in depth elsewhere (Murphy et al ., 2019 b ). In brief, the continued funding for this study, from pilot to RCT to adaptation and scale-up, in addition to the alignment with GoV priorities and the trust built over time between study team members and policy makers, has led to a collaboration that has been active for almost a decade.…”

Section: Recommendations To Support Meaningful Stakeholder Engagementmentioning

confidence: 99%

Considerations for supporting meaningful stakeholder engagement in global mental health research

Murphy

2022

Epidemiol Psychiatr Sci

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The need to ensure that research evidence is adopted by health systems and is informed by lived experience expertise has been increasingly recognised in mental health research. In the field of global mental health (GMH), though some progress has been made, the meaningful engagement of key stakeholders in research remains low. This editorial outlines recommendations to support the meaningful engagement of policy makers and people with lived or living experience of mental illness in GMH research. Recommendations include: increasing funding structures that are designed to support meaningful engagement; urging institutions to consider administrative structures that support engagement with lower resourced partners; promoting capacity development opportunities and resources to support researchers to promote meaningful engagement; developing research governance structures that include key stakeholders; and, taking steps to ensure the needs of diverse stakeholders are met through their engagement in research. Examples of good practice from these areas are provided. Though not an exhaustive list of recommendations, this editorial represents a call to the GMH research community to take a deliberate and proactive approach to prioritising meaningful stakeholder engagement in GMH research with the ultimate goal of improving accessible and appropriate mental health care.

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Section: Recommendations To Support Meaningful Stakeholder Engagementmentioning

confidence: 99%

Considerations for supporting meaningful stakeholder engagement in global mental health research

Murphy

2022

Epidemiol Psychiatr Sci

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“…Both have policy mandates to improve community-based depression care. The network of national and provincial psychiatric hospitals and primary care clinics are the responsibility of MOH, while MOLISA is responsible for social workers and overseeing the social protection system that provides rehabilitation and social support services to persons with mental illness (25,26). Unique, and relatively new, to Vietnam is a group of lay social workers known as social collaborators who are primarily the responsibility of MOLISA and are mobilized at the community level to provide social support to community members.…”

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confidence: 99%

Lay Social Workers implementing a task-sharing approach to managing depression in Vietnam

Chau

Murphy

Cong

et al. 2020

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Background While depression is a leading contributor to burden of disease in Vietnam, there is a critical gap in depression care due to the shortage of mental health specialists and extremely limited mental health services in general health care settings. We have previously reported the effectiveness of a supported self-management (SSM) task-sharing intervention for depression, delivered by social collaborators (lay social workers). The purpose of this study was to identify factors influencing the effectiveness of delivery of SSM by social collaborators and delineate areas for further attention that are relevant for scale-up. Methods A hundred and ten (110) key informant interviews were conducted with three stakeholder groups (patients, social collaborators, experts) from eight provinces in Vietnam. Participants were identified through records from a recently completed randomized trial that showed the effectiveness of SSM in community-based settings in Vietnam. Qualitative descriptive methods and thematic analysis were used to examine the interviews. A coding framework and corresponding themes were developed deductively, based on the findings from the randomized trial and the literature, and through inductive analysis, to describe the contextual factors that impacted the social collaborators’ role in successfully implementing the SSM intervention. Results Our analysis identified the following benefits of working with social collaborators: 1) increased awareness of mental health in the family and community; 2) reduced stigma; 3) a better understanding that depression is treatable; 4) increased help-seeking; and 5) improved access to care. There were also significant challenges, including social collaborator characteristics (age, education, pre-existing training and skills) and contextual factors influencing their work (roles and responsibilities, training, compensation, support from government). Conclusions Engaging social collaborators in the delivery of SSM in the community can help fill a critical gap in depression care in Vietnam. However, several contextual challenges that are an impediment to increased engagement and sustainable integration into health and social systems need to be resolved through policy change to regulate their practice, define their scope of work, and provide adequate remuneration.

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Challenges and mitigation strategies in the development, usability testing, and implementation of a digital mental health intervention for depression (VMood) in Vietnam: A feasibility study (Preprint)

Chau,

Murphy,

Nguyen

et al. 2024

Preprint

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BACKGROUND Worldwide, the COVID-19 pandemic has contributed to further gaps in mental health care, particularly in low- and middle-income countries such as Vietnam, where care is inaccessible for 83% of those who need it. In response, there has been an explosion of digital mental health interventions, such a s smartphone apps. Presently, the evidence for such interventions is limited, especially where they have been adapted from evidence-based in-person formats. Implementation science aims to promote the uptake of scientific findings into practice. A key determinant of implementation success is an intervention’s usability. Hurdles to usability include an intervention being too confusing or time-intensive to use. Facilitators include incorporating a greater number of engagement features and integrating human support. OBJECTIVE The aim of this implementation science feasibility study is to describe the challenges and mitigation strategies used in the development, usability testing, and implementation of a digital depression intervention (VMood smartphone app) developed in Vietnam. VMood was adapted from an evidence-based in-person intervention originally developed in Canada that is grounded in principles of Cognitive Behavioural Therapy, with supportive coaching by a nonspecialist provider. The research team is currently testing the effectiveness and cost-effectiveness of VMood in a randomized controlled trial (RCT) across eight provinces in Vietnam, informed by results from this feasibility study. METHODS This mixed methods feasibility study was informed by Proctor et al.,’s Implementation Outcomes Framework, focusing on acceptability, adoption, appropriateness, and feasibility. This study involved three data collection components: 1) usability testing (interviews and focus groups with app user and provider participants who tested VMood in one Vietnamese province; 2) app metrics (from the early phase of the RCT in the same province but from different municipalities); and 3) discourse data (notes from various team meetings, communications, and reports on VMood’s development and implementation). Qualitative data were analyzed using thematic content analysis. App usage data were analyzed using basis descriptive statistics. RESULTS Findings from the three data components showed there were seven main challenges that fell within Proctor et al.,’s Framework: 1) challenges with recruitment and uptake of the app; 2) challenges with utilization and engagement; 3) screening challenges; 4) digital divide; 5) limitations to digital applications for mental health; 6) technological challenges; and 7) funding and policy constraints. Various solutions to help mitigate the challenges were utilized by the team. CONCLUSIONS Adjustments based on recommendations critical to VMood’s usability and implementation were made to the VMood intervention that is currently being tested in the RCT. Findings from this study have applicability for others looking to develop and implement similar digital interventions. CLINICALTRIAL The larger RCT is registered at ClinicialTrials.gov, identifier [NCT05783531].

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From Innovation to Scale: Policy Engagement for Enhanced Community-Based Depression Care in Vietnam

Cited by 3 publications

References 28 publications

Considerations for supporting meaningful stakeholder engagement in global mental health research

Considerations for supporting meaningful stakeholder engagement in global mental health research

Lay Social Workers implementing a task-sharing approach to managing depression in Vietnam

Challenges and mitigation strategies in the development, usability testing, and implementation of a digital mental health intervention for depression (VMood) in Vietnam: A feasibility study (Preprint)

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