Annika C Sweetland, Claudio Gruber Mann, Maria Jose Fernandes, Camila Matsuzaka, Fatima Virginia de Silva, Jae Lee, Christopher McCarty, Afrânio Kritski, Sandra Fortes, Maria Cavalcanti, Marcelo Feijó Mello, Maria A Oquendo, Thomas Valente, Harold Pincus, Milton L Wainberg
{"title":"在巴西,利用社交网络将抑郁症治疗纳入初级保健和结核病治疗。","authors":"Annika C Sweetland, Claudio Gruber Mann, Maria Jose Fernandes, Camila Matsuzaka, Fatima Virginia de Silva, Jae Lee, Christopher McCarty, Afrânio Kritski, Sandra Fortes, Maria Cavalcanti, Marcelo Feijó Mello, Maria A Oquendo, Thomas Valente, Harold Pincus, Milton L Wainberg","doi":"10.2174/0126660822243332230921052022","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) and depression are highly comorbid and linked to higher rates of death and disability. Several evidence-based treatments for depression have been successfully implemented in low- and middle-income countries, but more knowledge is needed on how to bring these innovations to scale within complex 'real world' public health systems.</p><p><strong>Objective: </strong>To explore whether the principles of social network analysis could be used to enhance receptivity to integrating depression treatment into primary care for individuals with and without TB in Brazil.</p><p><strong>Methods: </strong>We used existing scales to identify settings and providers with high receptivity and connectivity within the primary care network. We trained and supervised existing staff in three primary care sites to deliver a brief evidence-based intervention over one year, coupled with active dissemination activities. Afterwards, we reassessed receptivity among individuals involved, and not involved, in the pilot.</p><p><strong>Results: </strong>Highly significant changes were observed in mental health literacy, attitudes towards evidence-based practices, work self-efficacy, and implementation leadership supporting our hypothesis. Limited social connections between primary care clinics precluded the examination of the hypothesis that targeting settings with high connectivity could capitalize on the information flow between and transcend the decentralized structure of the network, but leveraging the centralized nature of the TB program to integrate mental health services emerged as a promising alternative.</p><p><strong>Conclusions: </strong>The findings of this study strongly suggest that social networks may be leveraged to change individual providers' attitudes, thereby contributing to the enhanced dissemination of evidence-based interventions.</p>","PeriodicalId":36711,"journal":{"name":"Current Psychiatry Research and Reviews","volume":null,"pages":null},"PeriodicalIF":0.3000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11271758/pdf/","citationCount":"0","resultStr":"{\"title\":\"Leveraging Social Networks to Integrate Depression Treatment into Primary Health and Tuberculosis Care in Brazil.\",\"authors\":\"Annika C Sweetland, Claudio Gruber Mann, Maria Jose Fernandes, Camila Matsuzaka, Fatima Virginia de Silva, Jae Lee, Christopher McCarty, Afrânio Kritski, Sandra Fortes, Maria Cavalcanti, Marcelo Feijó Mello, Maria A Oquendo, Thomas Valente, Harold Pincus, Milton L Wainberg\",\"doi\":\"10.2174/0126660822243332230921052022\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Tuberculosis (TB) and depression are highly comorbid and linked to higher rates of death and disability. Several evidence-based treatments for depression have been successfully implemented in low- and middle-income countries, but more knowledge is needed on how to bring these innovations to scale within complex 'real world' public health systems.</p><p><strong>Objective: </strong>To explore whether the principles of social network analysis could be used to enhance receptivity to integrating depression treatment into primary care for individuals with and without TB in Brazil.</p><p><strong>Methods: </strong>We used existing scales to identify settings and providers with high receptivity and connectivity within the primary care network. We trained and supervised existing staff in three primary care sites to deliver a brief evidence-based intervention over one year, coupled with active dissemination activities. Afterwards, we reassessed receptivity among individuals involved, and not involved, in the pilot.</p><p><strong>Results: </strong>Highly significant changes were observed in mental health literacy, attitudes towards evidence-based practices, work self-efficacy, and implementation leadership supporting our hypothesis. Limited social connections between primary care clinics precluded the examination of the hypothesis that targeting settings with high connectivity could capitalize on the information flow between and transcend the decentralized structure of the network, but leveraging the centralized nature of the TB program to integrate mental health services emerged as a promising alternative.</p><p><strong>Conclusions: </strong>The findings of this study strongly suggest that social networks may be leveraged to change individual providers' attitudes, thereby contributing to the enhanced dissemination of evidence-based interventions.</p>\",\"PeriodicalId\":36711,\"journal\":{\"name\":\"Current Psychiatry Research and Reviews\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.3000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11271758/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current Psychiatry Research and Reviews\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2174/0126660822243332230921052022\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/10/17 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Psychiatry Research and Reviews","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2174/0126660822243332230921052022","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/10/17 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Leveraging Social Networks to Integrate Depression Treatment into Primary Health and Tuberculosis Care in Brazil.
Background: Tuberculosis (TB) and depression are highly comorbid and linked to higher rates of death and disability. Several evidence-based treatments for depression have been successfully implemented in low- and middle-income countries, but more knowledge is needed on how to bring these innovations to scale within complex 'real world' public health systems.
Objective: To explore whether the principles of social network analysis could be used to enhance receptivity to integrating depression treatment into primary care for individuals with and without TB in Brazil.
Methods: We used existing scales to identify settings and providers with high receptivity and connectivity within the primary care network. We trained and supervised existing staff in three primary care sites to deliver a brief evidence-based intervention over one year, coupled with active dissemination activities. Afterwards, we reassessed receptivity among individuals involved, and not involved, in the pilot.
Results: Highly significant changes were observed in mental health literacy, attitudes towards evidence-based practices, work self-efficacy, and implementation leadership supporting our hypothesis. Limited social connections between primary care clinics precluded the examination of the hypothesis that targeting settings with high connectivity could capitalize on the information flow between and transcend the decentralized structure of the network, but leveraging the centralized nature of the TB program to integrate mental health services emerged as a promising alternative.
Conclusions: The findings of this study strongly suggest that social networks may be leveraged to change individual providers' attitudes, thereby contributing to the enhanced dissemination of evidence-based interventions.