Leveraging Stakeholder Engagement and Virtual Environments to Develop a Strategy for Implementation of Adolescent Depression Services Integrated Within Primary Care Clinics of Mozambique

Lovero, Kathryn L.; Santos, Palmira Fortunato dos; Adam, Salma Ebrahim; Bila, Carolina; Fernandes, Maria Eduarda; Kann, Bianca; Rodrigues, Teresa I. Baltazar; Jumbe, Ana Maria; Duarte, Cristiane S.; Beidas, Rinad S.; Wainberg, Milton L.

doi:10.3389/fpubh.2022.876062

Cited by 3 publications

(1 citation statement)

References 38 publications

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“…Efforts to promote depression prevention and treatment policies involve committed individuals passionate about depression prevention and treatment even in the face of significant disincentives [ 15 ]. Health professionals join forces with other stakeholders in government, civil society and communities, including people who experience depression and their families, clinical and public health practitioners, researchers and policymakers, to work together to support such policies and actively participate in the design and implementation of services, procedures and research to reduce the burden caused by depression [ 16 ].…”

Section: Stakeholder Enthusiasm and Commitmentmentioning

confidence: 99%

Facilitators and barriers in the development and implementation of depression prevention and treatment policies in China: a qualitative study

Zhou²,

Fu³

et al. 2023

BMC Public Health

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Background Depression is one of the leading causes of avoidable suffering and premature death worldwide, leading to the disease burden among mental disorders. Depression-related deaths can be prevented by developing and implementing good depression prevention and treatment policies. The goal of this study is to provide theoretical direction and useful references for examining the outstanding service work of depression prevention and treatment. It also aims to describe how depression prevention and treatment policies were developed and put into practice in China, along with the associated facilitators and barriers. Methods We integrated two data sources using a case study approach: a document review of relevant policy documents, published articles and reports between 2004 and 2022 (N = 12 papers) and in-depth interviews (N = 41). Participants were drawn from pertinent sectors to managing depression: research and academia, relevant government departments, health care providers, people with depression and their families, and community organisations. Thematic analysis was used to analyse all data. Results A comprehensive programme of work exploring specific services for depression prevention and treatment was developed in China in 2020. Facilitators of policy development and implementation include (1) political commitment and strong leadership, (2) coordination mechanisms, (3) stakeholder enthusiasm and commitment, (4) resources, and (5) the use of digital technologies. The main barriers leading to delays in policy development and implementation include (1) insufficient awareness and lack of depression literacy, (2) lack of resources and (3) stigma and social discrimination (4) lack of united action. Conclusion Although the process of implementing a distinctive service programme for depression prevention and treatment in China has been long, the current policy is in line with current global efforts. Strategies to reduce Stigma and increase knowledge about depression are part of a national and international approach to reducing the burden of depression. Political commitment and the involvement of all stakeholders remain necessary. An adequate response to depression will require the involvement of society as a whole, with joint action to reduce the risk of exposure to adversity and enhance protective factors.

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Section: Stakeholder Enthusiasm and Commitmentmentioning

confidence: 99%

Facilitators and barriers in the development and implementation of depression prevention and treatment policies in China: a qualitative study

Zhou²,

Fu³

et al. 2023

BMC Public Health

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Application of the Expert Recommendations for Implementing Change (ERIC) compilation of strategies to health intervention implementation in low- and middle-income countries: a systematic review

Lovero,

Kemp,

Wagenaar

et al. 2023

Implementation Sci

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Background The Expert Recommendations for Implementing Change (ERIC) project developed a compilation of implementation strategies that are intended to standardize reporting and evaluation. Little is known about the application of ERIC in low- and middle-income countries (LMICs). We systematically reviewed the literature on the use and specification of ERIC strategies for health intervention implementation in LMICs to identify gaps and inform future research. Methods We searched peer-reviewed articles published through March 2023 in any language that (1) were conducted in an LMIC and (2) cited seminal ERIC articles or (3) mentioned ERIC in the title or abstract. Two co-authors independently screened all titles, abstracts, and full-text articles, then abstracted study, intervention, and implementation strategy characteristics of included studies. Results The final sample included 60 studies describing research from all world regions, with over 30% published in the final year of our review period. Most studies took place in healthcare settings (n = 52, 86.7%), while 11 (18.2%) took place in community settings and four (6.7%) at the policy level. Across studies, 548 distinct implementation strategies were identified with a median of six strategies (range 1–46 strategies) included in each study. Most studies (n = 32, 53.3%) explicitly matched implementation strategies used for the ERIC compilation. Among those that did, 64 (87.3%) of the 73 ERIC strategies were represented. Many of the strategies not cited included those that target systems- or policy-level barriers. Nearly 85% of strategies included some component of strategy specification, though most only included specification of their action (75.2%), actor (57.3%), and action target (60.8%). A minority of studies employed randomized trials or high-quality quasi-experimental designs; only one study evaluated implementation strategy effectiveness. Conclusions While ERIC use in LMICs is rapidly growing, its application has not been consistent nor commonly used to test strategy effectiveness. Research in LMICs must better specify strategies and evaluate their impact on outcomes. Moreover, strategies that are tested need to be better specified, so they may be compared across contexts. Finally, strategies targeting policy-, systems-, and community-level determinants should be further explored. Trial registration PROSPERO, CRD42021268374.

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Factors influencing implementation of a care coordination intervention for cancer survivors with multiple comorbidities in a safety-net system: an application of the Implementation Research Logic Model

Rodriguez,

Lee,

Higashi

et al. 2023

Implementation Sci

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Background Under- and uninsured cancer survivors have significant medical, social, and economic complexity. For these survivors, effective care coordination between oncology and primary care teams is critical for high-quality, comprehensive care. While evidence-based interventions exist to improve coordination between healthcare teams, testing implementation of these interventions for cancer survivors seen in real-world safety-net settings has been limited. This study aimed to (1) identify factors influencing implementation of a multicomponent care coordination intervention (nurse coordinator plus patient registry) focused on cancer survivors with multiple comorbidities in an integrated safety-net system and (2) identify mechanisms through which the factors impacted implementation outcomes. Methods We conducted semi-structured interviews (patients, providers, and system leaders), structured observations of primary care and oncology operations, and document analysis during intervention implementation between 2016 and 2020. The practice change model (PCM) guided data collection to identify barriers and facilitators of implementation; the PCM, Consolidated Framework for Implementation Research, and Implementation Research Logic Model guided four immersion/crystallization data analysis and synthesis cycles to identify mechanisms and assess outcomes. Implementation outcomes included appropriateness, acceptability, adoption, and penetration. Results The intervention was appropriate and acceptable to primary care and oncology teams based on reported patient needs and resources and the strength of the evidence supporting intervention components. Active and sustained partnership with system leaders facilitated these outcomes. There was limited adoption and penetration early in implementation because the study was narrowly focused on just breast and colorectal cancer patients. This created barriers to real-world practice where patients with all cancer types receive care. Over time, flexibility intentionally designed into intervention implementation facilitated adoption and penetration. Regular feedback from system partners and rapid cycles of implementation and evaluation led to real-time adaptations increasing adoption and penetration. Discussion Evidence-based interventions to coordinate care for underserved cancer survivors across oncology and primary care teams can be implemented successfully when system leaders are actively engaged and with flexibility in implementation embedded intentionally to continuously facilitate adoption and penetration across the health system.

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Leveraging Stakeholder Engagement and Virtual Environments to Develop a Strategy for Implementation of Adolescent Depression Services Integrated Within Primary Care Clinics of Mozambique

Cited by 3 publications

References 38 publications

Facilitators and barriers in the development and implementation of depression prevention and treatment policies in China: a qualitative study

Facilitators and barriers in the development and implementation of depression prevention and treatment policies in China: a qualitative study

Application of the Expert Recommendations for Implementing Change (ERIC) compilation of strategies to health intervention implementation in low- and middle-income countries: a systematic review

Factors influencing implementation of a care coordination intervention for cancer survivors with multiple comorbidities in a safety-net system: an application of the Implementation Research Logic Model

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