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Leveraging Social Networks to Integrate Depression Treatment into Primary Health and Tuberculosis Care in Brazil.
Sweetland, Annika C; Mann, Claudio Gruber; Fernandes, Maria Jose; Matsuzaka, Camila; de Silva, Fatima Virginia; Lee, Jae; McCarty, Christopher; Kritski, Afrânio; Fortes, Sandra; Cavalcanti, Maria; Mello, Marcelo Feijó; Oquendo, Maria A; Valente, Thomas; Pincus, Harold; Wainberg, Milton L.
Afiliação
  • Sweetland AC; Department of Psychiatry, Columbia Vagelos College of Physicians & Surgeons/New York State Psychiatric Institute, New York, NY, USA.
  • Mann CG; Psychiatric Institute at Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
  • Fernandes MJ; TB Control Program, Itaborai, Rio de Janeiro, Brazil.
  • Matsuzaka C; Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil.
  • de Silva FV; Interdisciplinary Laboratory of Primary Health Research (LIPAPS), Department of Psychiatry, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
  • Lee J; Department of Psychiatry, Columbia Vagelos College of Physicians & Surgeons/New York State Psychiatric Institute, New York, NY, USA.
  • McCarty C; Department of Anthropology, University of Florida, Gainsville, FL, USA.
  • Kritski A; Department of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
  • Fortes S; Interdisciplinary Laboratory of Primary Health Research (LIPAPS), Department of Psychiatry, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
  • Cavalcanti M; Psychiatric Institute at Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
  • Mello MF; Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil.
  • Oquendo MA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
  • Valente T; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
  • Pincus H; Department of Psychiatry, Columbia Vagelos College of Physicians & Surgeons/New York State Psychiatric Institute, New York, NY, USA.
  • Wainberg ML; Department of Psychiatry, Columbia Vagelos College of Physicians & Surgeons/New York State Psychiatric Institute, New York, NY, USA.
Curr Psychiatry Res Rev ; 20(4): 350-365, 2024.
Article em En | MEDLINE | ID: mdl-39055277
ABSTRACT

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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE País/Região como assunto: America do sul / Brasil Idioma: En Revista: Curr Psychiatry Res Rev Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Emirados Árabes Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE País/Região como assunto: America do sul / Brasil Idioma: En Revista: Curr Psychiatry Res Rev Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Emirados Árabes Unidos